Status: has never stopped indigenous wild poliovirus (WPV) circulation

Pakistan is one of only three countries in the world with ongoing wild poliovirus transmission, alongside Afghanistan and Nigeria. 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.

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.

Polio this week in Pakistan

  • 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.

Stopping Polio in Pakistan

Pakistan made important progress in 2015, with the lowest number of cases in its history. However, in high-risk areas of the country, unvaccinated children remain vulnerable.

An array of new approaches and tools are being used to bring Pakistan to the finishing line, including the Emergency Operations Centres to coordinate the program effectively and a National Emergency Action Plan with a strong accountability framework, improved surveillance, fewer unvaccinated children and fewer strains of the virus.

The virus is cornered in a few remaining sanctuaries Karachi, Quetta block and Khyber-Peshawar corridor. Stopping transmission in these core reservoirs will be critical to success. However, virus is regularly detected in every province through environmental surveillance in the sewage, indicating that pockets of under-immunised children are allowing the virus to survive and spread.

Pakistan has a real opportunity to end transmission this year, but it must remain focused on reaching children in high-risk areas of the country, increase and enhance surveillance quality in core reservoirs, conduct high-quality campaigns and ensure the safety and security of health workers.

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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


IHR Classification

Pakistan is classified by the International Health Regulations (IHR) as a state currently exporting wild poliovirus or circulating vaccine-derived poliovirus and hence it is subject to temporary recommendations as of November 2016.

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