This Week

Polio this week as of  17 January 2017

  • Independent Monitoring Board (IMB) – changes to its membership: The IMB, established in 2010 to independently monitor progress towards a polio-free world, is undertaking changes to its membership. Under the guidance of the IMB and its chair, Sir Liam Donaldson, polio has been restricted to areas of just three countries: Pakistan, Afghanistan and Nigeria. To help achieve a polio-free world, the structure and composition of the IMB is now being revisited, in particular to strengthen its remit to focus solely on Objective 1 of the Polio Endgame Plan – detection and interruption of poliovirus transmission. At the request of the Polio Oversight Board (POB), Sir Liam will continue to chair the IMB and will form a selection committee to identify a new set of members. A call for nomination will be issued over the coming weeks. The GPEI owe a great debt of gratitude for the invaluable contribution that the current members of the IMB have made to this historic endeavour, and we look forward to working with the new, re-structured IMB to lead us over the finish line
  • Summary of newly-reported viruses this week (see country-specific sections below for further details): Afghanistan – one wild poliovirus type 1 (WPV1) case and one environmental WPV1 positive sample; Pakistan – one WPV1 case and one circulating vaccine-derived poliovirus type 2 (cVDPV2) positive sample; and Nigeria – one cVDPV2 case.

NA: onset of paralysis in most recent case is prior to 2015. Figures exclude non-AFP sources. Lao PDR cVDPV1, all others cVDPV2. cVDPV definition: see document “Reporting and classification of vaccine-derived polioviruses” at [pdf]

Weekly country updates as of 17 January 2017

  • One new wild poliovirus type 1 (WPV1) case was reported in the past week from Bermal district, Paktika province, with onset of paralysis on 16 December 2016.  This brings the total number of WPV1 cases for 2016 to 13.  More than half of the country’s cases in 2016 are from Bermal district.
  • One new environmental WPV1 positive sample was reported in the past week from Jalalabad, Nangarhar, collected on 26 December 2016.
  • Paktika province is close to the border with Pakistan, and constitutes a common WPV transmission corridor posing a major risk to both national programmes.  This corridor of transmission ranges from southern Khyber Pakhtunkhwa (KP)/Federally Administered Tribal Areas (FATA) in Pakistan to south-eastern Afghanistan in Paktika, Paktya and Khost provinces.
  • Nangarhar is part of the common cross-border WPV transmission corridor running from greater Peshawar/Khyber in Pakistan through to Nangarhar, Kunar and Laghman in Afghanistan.
  • Efforts are ongoing to urgently strengthen operations both for immunization and surveillance activities, in particular in the provinces affected by cross-border WPV transmission corridors.
  • One new wild poliovirus type 1 (WPV1) case was reported in the past week, from Killa Abdullah, Balochistan, with onset of paralysis on 22 December 2016. This brings the total number of WPV1 cases for 2016 to 20.
  • One new circulating vaccine-derived poliovirus type 2 (cVDPV2) positive environmental sample was reported in the past week, from Quetta, Balochistan, collected on 28 December 2016. This isolate is linked to an ongoing, confirmed cVDPV2 outbreak currently affecting Quetta.
  • Pakistan continues to implement the National Emergency Action Plan for polio eradication. The focus is to continue to build immunity against both type 1 and 2 poliovirus, to address ongoing circulation of both the WPV1 and the cVDPV2 strains.
  • No new cases of wild poliovirus type 1 (WPV1) were reported in the past week. The total number of WPV1 cases for 2016 remains four. The most recent case had onset of paralysis on 21 August in Monguno Local Government Area (LGA), Borno.
  • A circulating vaccine-derived poliovirus type 2 (cVDPV2) has been detected from Bodinga Local Government Area (LGA), Sokoto state. Two genetically-related viruses were isolated from an acute flaccid paralysis (AFP) case with onset of paralysis on 28 October 2016, and from a healthy community contact, collected on 24 November.
  • Following detection of the initial index case in October, a local immunization campaign conducted in the affected LGA and two wards of neighbouring LGAs with monovalent oral polio vaccine type 2 (mOPV2) were implemented on 3-6 December 2016, followed by a broader response on 16-19 December with other countries in the Lake Chad subregion. A third round synchronized mOPV2 vaccination campaign with neighbouring countries is planned for 28-31 January 2017.
  • These immunization activities are in response to both the cVDPV2 outbreak in Sokoto and an unrelated cVDPV2 detected in Borno state earlier this year, as well as to the WPV1 transmission affecting Borno.
  • The detection of wild poliovirus type 1 (WPV1) and vaccine-derived poliovirus type 2 (VDPV2) in Nigeria poses a risk to the neighbouring countries of the Lake Chad basin and hence an outbreak response plan is being implemented as part of the response to the Nigeria outbreak.
  • Emergency outbreak response efforts continue across the Lake Chad basin, together with activities to fill subnational surveillance gaps across the region.
  • No circulating vaccine-derived poliovirus type two (cVDPV2) cases have been reported from Guinea in 2016. The most recent case was reported from Kankan district with onset of paralysis on 14 December 2015. The total number of cVDPV2 cases for 2015 is seven.
  • While signs are positive in Guinea, and it has been more than a year since the last case had onset of paralysis, gaps remain sub-nationally both in population immunity and surveillance sensitivity. Undetected circulation cannot be ruled out. Efforts are continuing to rapidly fill these gaps and ensure the outbreak has been stopped.
  • No new cases of circulating vaccine-derived poliovirus type one (cVDPV1) were reported in the past week. The most recent case was reported in Fuang district of Vientiane province, with onset of paralysis on 11 January 2016. The total number of cVDPV1 cases remains three in 2016 and eight in 2015.
  • While no new cases have been detected for nearly one year, subnational surveillance gaps persist and efforts to strengthen surveillance are therefore ongoing.
  • Outbreaks of cVDPVs can arise in areas with low population immunity, emphasizing the importance of maintaining strong vaccination coverage.
  • No cases of circulating vaccine-derived poliovirus type 1 (cVDPV1) have been reported in 2016. The most recent case had onset of paralysis on 22 August 2015, from Sud-Ouest region. The total number of cVDPV1 cases for 2015 is 10.