Status: affected by wild poliovirus type 1 and circulating vaccine-derived poliovirus type 2

Pakistan is affected by ongoing endemic wild poliovirus transmission and circulating vaccine-derived poliovirus type 2 (cVDPV2).

The Global Polio Eradication Initiative is focusing on reaching every last child in Pakistan with vaccines, strengthening surveillance and maintaining political commitment, financial resources and technical support at all levels.

Polio this week in Pakistan

  • Three wild poliovirus type 1 (WPV1) cases were reported: One from Sujawal in Sindh province and one each from Lakki Marwat and Tank in Khyber Pakhtunkhwa province. The onsets of paralysis were between 25 September and 11 October 2019. There are now 80 WPV1 cases reported in 2019. There were 12 WPV1 cases in 2018.
  • 19 WPV1-positive environmental samples were reported: one from Rawalpindi and four from Lahore in Punjab province, one from Peshawar in Khyber Pakhtunkhwa province, two each from Quetta and Killa Abdullah, one each from Zhob, Khuzdar and Nsirabad, all in Balochistan province. In Sindh province, two samples were reported from Karachi Gadap and one each from Karachi Giqbal, Karachi Orangi ,Karachi Landhi and Jacobabad. The samples were collected between 11 and 21 October 2019.
  • As of 5 November, seven children have been paralysed from cVDPV2 in Pakistan – four in Diamer, one in Torghar, one in Kohistan and one in MCI Islamabad.  The virus was also found in samples from contacts experiencing acute flaccid paralysis, as well as in healthy children and in environmental samples.  Data will be officially reflected week of 11 November.
  • In response, the Pakistan government is mounting a response, including included vaccinating 180,000 children in the immediate area at risk. In the coming days, a large immunisation campaign will aim to reach 2 million children under the age of five in affected districts with type 2 oral polio vaccine.

International Health Regulations

Pakistan is classified by the International Health Regulations (IHR) as a state infected with WPV1, cVDPV1 or cVDPV3 with potential risk of international spread, with potential risk of international spread.  It is therefore subject to temporary recommendations as of September 2019.

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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 Recommendations

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.

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