This Week

Polio this week as of 13 February 2019

  • The 2019 Annual Letter by Bill & Melinda Gates makes a case for investment in global health. Progress by Global Polio Eradication Initiative is a good reminder of how investment in global health funds benefits people around the world. Read the letter here.
  • In Indonesia, a circulating vaccine-derived poliovirus type 1 (cVDPV1) outbreak is confirmed. See Indonesia section below for more details.
  • Summary of new viruses this week: Pakistan – once case of wild poliovirus type 1 (WPV1) and four wild polioviruses type 1 (WPV1) positive environmental samples; Nigeria – two circulating vaccine derived poliovirus type 2 (VDPV2) positive environmental samples; Indonesia- one case of circulating vaccine derived poliovirus type 1 (cVDPV1). See country sections below for more details.

NA: Onset of paralysis in most recent case is prior to 2017. Figures exclude non-AFP sources. In 2018, cVDPV includes all three serotypes 1, 2 and 3.

For Somalia: 1 cVDPV2 and cVDPV3 isolated from one AFP case.

cVDPV definition: see document “Reporting and classification of vaccine-derived polioviruses” at [pdf].

Weekly country updates as of 13 February 2019

  • No wild poliovirus type 1 (WPV1) case was reported in the past week.  There is only one WPV1 case reported in 2019 so far.
  • No WPV1-positive environmental samples were reported this week.
  • Afghanistan recently concluded a targeted national campaign. Read more here.
  • The Technical Advisory Group for polio eradication (TAG) met on 15-16 January to assess the progress made towards polio eradication in Afghanistan 2018 and made recommendations for the way forward in 2019.
  • Read the latest polio update from Afghanistan to see information on cases, surveillance and vaccination campaigns.
  • Once case of wild poliovirus type 1 (WPV1) was reported this week in Bannu district, Khyber Pakhtunkhwa province, with onset of paralysis on 15 January 2019.  This the second WPV1 case in 2019 in Pakistan.  Four WPV1-positive environmental samples were reported in the past week: one from Peshawar in Khyber Pakhtunkhwa district, one from South Waziristan district in Khyber Pakhtunkhwa Tribal Districts, one from Quetta district in Balochistan province, and one from Sukkur in Sindh province. Samples were collected from 22 January to 24 January 2019.
  • Read the latest polio update from Pakistan to see information on cases, surveillance and vaccination campaigns.
  • No cases of circulating vaccine-derived poliovirus type 2 this week. The total number of cVDPV2 cases in 2018 was 34. The most recent cVDPV2 case was reported from Baruten LGA in Kwara state, with onset of paralysis on 5 December 2018.
  • Two cVDPV2-positive environmental samples were reported in the past week from Maiduguri in Borno state both collected on 15 January 2019.
  • No cases of wild poliovirus type 1 (WPV1) were reported. The most recently-detected WPV1 case, from Borno state, had onset of paralysis on 21 August 2016.
  • The country continues to be affected by two separate cVDPV2 outbreaks, the first centered in Jigawa state with subsequent spread to other states as well as to neighbouring Republic of Niger, and the second in Sokoto state.
  • Recent confirmation of spread of one of the cVDPV2 outbreaks, both within Nigeria and internationally, underscores the urgent need to fill remaining vaccination gaps in the ongoing outbreak response, and to optimize the geographic extent and operational quality of mOPV2 response.
  • At the same time, outbreak response to WPV1 continues, including efforts to address surveillance and immunity gaps in parts of Borno state.
  • Read our Nigeria country page to see information on surveillance and vaccination campaigns.
  • No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) has been reported in the past week. The most recent cVDPV2 isolated in the country was in Magaria district, Zinder province with an onset of paralysis on 5 December 2018.
  • The total number of cVDPV2 cases in 2018 reported in Niger in 2018 is ten.  The outbreak is genetically-linked to the cVDPV2 outbreak originating in Jigawa, Nigeria. Virus was isolated from children with acute flaccid paralysis (AFP) from Zinder region, located in the south of Niger and on the border with Nigeria, with dates of onset of paralysis ranging from 18 July through 5 December 2018.
  • Acute flaccid paralysis surveillance and routine immunization across the country with focus on the infected provinces and the provinces at the international borders with Nigeria are being reinforced.
  • Active case finding for additional AFP cases is continuing, and additional surveillance measures such as increasing the frequency and extent of environmental surveillance and community sampling of healthy individuals is being expanded.
  • No cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) were reported this week in the Democratic Republic of the Congo (DRC). The total number of cVDPV2 cases reported in 2018 is 20.
  • The most recent cVDPV2 AFP case was reported from Mufunga-Sampwe district in Haut Katanga province with onset of paralysis on 7 October 2018.
  • DRC is affected by four separate cVDPV2 outbreaks, in the provinces of Haut Katanga; Mongala, Maniema and Haut Lomami/Tanganika/Haut Katanga/Ituri.
  • Read our Democratic Republic of the Congo country page to see information on surveillance and vaccination campaigns.
  • Learn more about vaccine-derived polioviruses through this short animation or this ‘Coffee with Polio Experts’ video.
  • No circulating vaccine-derived poliovirus type 2 (cVDPV2) cases were reported in the past week.
  • The Horn of Africa is currently affected by separate outbreaks of circulating vaccine-derived poliovirus type 2 (cVDPV2) and type 3 (cVDPV3), reporting both cases and environmental positives.
  • Somalia has reported a total of 12 cVDPV cases (five type 2, six type 3 and one, coinfection of both type 2 and type 3) in 2018.
  • The most recent cVDPV2 virus was isolated from an environmental sample collected on 11 October 2018 from Waberi district in Banadir province.  The most recent cVDPV3 virus was isolated from an environmental sample also from Waberi district, Banadir province collected on 23 August 2018.
  • Circulating VDPV2 has also been detected during 2018 in one environmental sample in Kenya collected on 21 March 2018.
  • Outbreak response to both virus types is currently being implemented in line with internationally-agreed guidelines. Large-scale supplementary immunization activities (SIAs) have been implemented in Banadir, Lower Shabelle and Middle Shabelle regions, Somalia. Another vaccination round is planned during end-November as part of the ongoing outbreak response, to further enhance the population immunity in the highest risk areas.   Special surveillance activities continue to be undertaken to determine the origin of the viral circulation.
  • WHO and partners continue to support local public health authorities across the Horn of Africa in conducting field investigations and risk assessments.
  • Read our Somalia country page and Kenya country page to see information on surveillance and vaccination campaigns.
  • Learn more about vaccine-derived polioviruses through this short animation or this ‘Coffee with Polio Experts’ video.
  • No new cases of circulating vaccine-derived poliovirus type 1 (cVDPV1) were reported this week.  The total number of cases in 2018 was 26.
  • The most recent cVDPV1 virus was isolated from an environmental sample collected in the National Capital district on 6 November 2018.
  • Emergency Operation Centres are established and operational at the national level and in all affected provinces; environmental surveillance is functional in five sites in two major cities.
  • Three Supplementary Immunization Activities (SIAs) of expanding scope have taken place since late July, from three provinces to nine, to nation-wide. The most recent was aimed at children under the age of 15, due to large numbers of poorly-immunized older children.
  • Planning is underway for the next steps of the outbreak response, focusing on both vaccination and surveillance for polioviruses.
  • Detection and reporting of new viruses or cases at this point in the outbreak response is not unusual or unexpected, as surveillance is being strengthened and most reported and confirmed cases had onset of paralysis prior to the start of comprehensive outbreak response.
  • Read our Papua New Guinea country page to see information on surveillance and vaccination campaigns.
  • No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreak has been reported this week.
  • Two genetically-linked circulating vaccine-derived poliovirus type 2 (cVDPV2) isolates were detected, from an acute flaccid paralysis (AFP) case (with onset of paralysis on 21 October 2018, in a six-year old girl with no history of vaccination, from Molumbo district, Zambézia province), and one isolated from a community contact of the case reported on 10 December 2018.
  • The GPEI and partners are working with country counterparts to support the local public health authorities in conducting a field investigation (clinical, epidemiological and immunological) and thorough risk assessment to discuss planning and implementation of immunization and outbreak response.
  • In January 2017, a single VDPV2 virus had been isolated from a 5-year old boy with AFP, also from Zambézia province (Mopeia district).  Outbreak response was conducted in the first half of 2017 with monovalent oral polio vaccine type 2 (mOPV2).
  • Read our Mozambique country page to see information on cases, surveillance and response to the developing outbreak.
  • A new circulating vaccine-derived poliovirus type 1 (cVDPV1) outbreak has been confirmed in Indonesia.
  • Two genetically-linked circulating vaccine-derived poliovirus type 1 (cVDPV1) isolates were detected, from an acute flaccid paralysis (AFP) case, with onset of paralysis on 27 November 2018, and from a sample of a healthy community contact, in Papua province collected on 24 January 2019. This outbreak is not linked to the cVDPV1 currently affecting neighbouring Papua New Guinea.
  • The GPEI and partners are working with country counterparts to support the local public health authorities in conducting a field investigation (clinical, epidemiological and immunological) and thorough risk assessment to discuss planning and implementation of immunization and outbreak response.
  • Read our Indonesia country page to see information on cases, surveillance and response to the developing outbreak.