17 March 2022 — On Monday 7 March 2022, a case of circulating vaccine-derived poliovirus type 3 (cVDPV3) was confirmed in an unvaccinated girl aged three years and nine months in Israel. The girl had developed acute flaccid paralysis and upon testing of her stool, poliovirus was confirmed.
Further testing of the virus isolated from the girl revealed genetic links to VDPV3-strains detected in environmental samples collected between September 2021 and January 2022 from sites in Jerusalem and Bethlehem.
Circulating VDPV3 has also been confirmed in a sample taken from a contact in Jerusalem. This child does not display any symptoms of paralysis.
A previous statement published on 10 March 2022 had indicated circulation of this VDPV3 also in occupied Palestinian territory; further field investigations concluded that at this time, circulation can only be confirmed in Israel. This classification does not however change the risk this cVDPV3 presents to children in Israel and in the occupied Palestinian territory, nor the planned response activities.
Although there is currently no evidence of circulation of this cVDPV3 in occupied Palestinian territory, the proximity and interconnectedness of communities on both sides of the border and the volume and frequency of cross-border population movement underscore the risk to unvaccinated children in both places.
Local health authorities in both Israel and occupied Palestinian territory are conducting field, epidemiological and virological investigations, to determine more clearly the source and origin of the isolated virus and potential risk of further spread associated with it. Discussions are ongoing to plan an immunization response as appropriate (extent and scale to be determined, potentially to include a series of immunization outreaches with both inactivated polio vaccine and bivalent oral polio vaccine, both in high-risk areas of Israel and occupied Palestinian territory). At the same time, efforts are continuing to strengthen surveillance comprehensively in both Israel and occupied Palestinian territory.
Experts from headquarters, regional and country offices of the Global Polio Eradication Initiative (GPEI) partnership, which includes WHO, Rotary International (RI), the US Centers for Disease Control and Prevention (CDC), the United Nations Children’s Fund (UNICEF), Bill & Melinda Gates Foundation (BMGF) and Gavi, the Vaccine Alliance, are working together to help ensure an appropriate response and cessation of this outbreak.
Detection of this cVDPV3 underscores the importance of strong disease surveillance and high population immunity levels, in order to minimize the risk and consequences of any poliovirus introduction or emergence.
The GPEI partnership urges all health authorities to enhance surveillance for poliovirus and implement enhanced vaccination response to prevent further transmission, so that no child is at risk of lifelong paralysis from a disease that can so easily be prevented. GPEI is committed to assisting the health authorities in their efforts to stop the cVDPV3 outbreak.
