Democratic Republic of the Congo
Status: affected by circulating vaccine-derived poliovirus
Status: affected by circulating vaccine-derived poliovirus
The Democratic Republic of the Congo (DR Congo) is affected by three separate strains of circulating vaccine-derived poliovirus type 2 (cVDPV2).
Circulating vaccine-derived poliovirus type 2 – Democratic Republic of the Congo – WHO disease outbreak news
Haut Lomami/Tanganika/Haut Katanga/Ituri provinces: this cVDPV2 strain was initially detected and reported in June 2017 from Haut Lomami province, which spread in 2017 and early 2018 to Tanganika and Haut Katanga provinces. The same virus has now been confirmed in Ituri province, from an AFP case with onset of paralysis on 5 May 2018. Ituri province is close to the border with Uganda.
Maniema province: affected by a separate cVDPV2 strain, with two cases confirmed in 2017 (date of onset of paralysis of the most recent case: 18 April 2017). So far, no new cases have been detected in 2018, and there is no evidence that this virus has spread further geographically.
Mongola province: a separate cVDPV2 was isolated from an acute flaccid paralysis (AFP) case with onset of paralysis on 26 April from Yamongili Health Zone, and genetically-related viruses from stool specimens from two healthy community contact confirming circulation of the strain.
Outbreak response to all three outbreaks is taking place, including use of monovalent OPV type 2 (mOPV2) in line with internationally-agreed outbreak response protocols. However, operational gaps in quality continue to hamper implementation, as high-risk populations remain under-immunized, and the response implemented thus far has not stopped the outbreak or prevented its further spread.
The geographic extent of the outbreak response to all three strains is being re-evaluated, given the confirmed spread of one of the strains to Ituri and confirmation of the new strain in Mongola.
In February 2018, the government declared cVDPV2 to be a national public health emergency. The remaining operational gaps in quality of the outbreak response must be urgently filled.
The risk of further spread of cVDPV from DR Congo is magnified by known population movements between the affected area of DR Congo and Uganda, Central African Republic and South Sudan, and the upcoming rainy season (which is associated with increased intensity of virus transmission).
International Health Regulations
The Democratic Republic of the Congo is classified by the International Health Regulations (IHR) as a state infected with cVDPV2, with potential risk of international spread. It is therefore subject to temporary recommendations as of August 2018.
Key at-risk: no longer poliovirus-infected, but at high risk of outbreaks
Outbreak: has stopped indigenous WPV circulation but affected by outbreak of imported WPV or circulating vaccine-derived poliovirus
Endemic: has never stopped indigenous wild poliovirus (WPV) circulation
Travel advice
WHO’s International Travel and Health recommends that all travellers to polio-affected areas be fully vaccinated against polio. Residents (and visitors for more than 4 weeks) from infected areas should receive an additional dose of OPV or inactivated polio vaccine (IPV) within 4 weeks to 12 months of travel.
