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Polio this week as of  17 August 2016

       
  • After advance notification of WPV1 in Borno state, Nigeria last week, two cases of WPV1 have now been officially reported, the first since July 2014. Virus was isolated in two local government areas (LGA) of Borno; in Gwoza, in a child with acute flaccid paralysis, onset of paralysis on 13 July and close healthy contacts of that child; and in Jere from a close healthy contact of a child who had developed AFP symptoms on 4 July.

  • An outbreak response plan has begun, focusing on both Nigeria and the Lake Chad sub-region more broadly (specifically parts of Chad, northern Cameroon, southern Niger and Central African Republic). See ‘Nigeria’ and ‘Lake Chad sub-region’ sections for more. 

  • Coming soon: the Global Polio Eradication Initiative web site is getting a makeover. Keep a lookout for the new design of the site, which will allow visitors to see the latest information on the programme, interactive data visualizations and media content including photo essays and videos. Existing resources from our current website will be available on the new site as well.

  • The GPEI seeks nominations for members of the new Independent Monitoring Board (IMB) that will monitor and guide polio transition (‘legacy’) planning. The closing date for nominations is Friday 9 September 2016. This new Transition IMB is separate from the current IMB, which monitors and guides progress towards interruption of transmission. Further information here.



  

Wild poliovirus type 1 and Circulating vaccine-derived poliovirus cases



Total cases

Year-to-date 2016

Year-to-date 2015

Total in 2015

WPV

 cVDPV

 WPV

 cVDPV

 WPV

 cVDPV

Globally

21

3

36

12

74

32

- in endemic countries

19

0

36

3

74

 3

- in non-endemic countries

2

3

0

9

0

 29

 

 

Case breakdown by country



Countries

Year-to-date 2016

Year-to-date 2015

Total in 2015

Onset of paralysis of  most  recent case

WPV

cVDPV 

WPV 

cVDPV

 WPV

cVDPV 

 WPV

 cVDPV

Afghanistan 6 0 7 0 20 0 29-May-16 NA
Pakistan  13 0 29 2 54 2 18-Jun-16 09-Feb-15
Guinea 0 0 0 0 0 7 NA 01-Dec-15
Lao PDR  0 3 0 0 0 8 NA 11-Jan-16
Madagascar 0 0 0 9 0 10 NA 22-Aug-15
Myanmar 0 0 0 0 0 2 NA 05-Oct-15
Nigeria 2 0 0 1 0 1 13-Jul-16 16-May-15
Ukraine 0 0 0 0 0 2 NA 07-Jul-15



NA: onset of paralysis in most recent case is prior to 2015. Figures exclude non-AFP sources. Madagascar, Ukraine and Lao PDR cVDPV1, all others cVDPV2. cVDPV definition: see document "Reporting and classification of vaccine-derived polioviruses" at http://www.polioeradication.org/Portals/0/Document/Resources/VDPV_ReportingClassification.pdf. Implementation as of 15 August 2015.



Afghanistan

  • No new case of wild poliovirus type one (WPV1) was reported in the past week. The most recent case had onset of paralysis in Shigal Wa Sheltan district of Kunar province on 29 May. The total number of WPV1 cases for 2016 remains six compared to seven at this time last year.

 

  • No WPV1 environmental positive samples have been reported in 2016. The most recent environmental positive samples were collected on 27 December 2015 - one in Jalalabad district of Nangarhar province and the second in the city of Kabul.

 

  • National Immunization Days (NIDs) are planned for 22-26 August and the 3-7 October with a Subnational Immunization Day (SNID) scheduled for the 7-11 November using bivalent oral polio vaccine (bOPV).

Pakistan

  • No new cases of wild poliovirus type one (WPV1) were reported in the past week. The most recent case was reported in South Waziristan district of Federally Administered Tribal Areas (FATA), with onset of paralysis on 18 June. The total number of WPV1 cases for 2016 remains 13 compared to 29 at this time in 2015.  

 

  • One new WPV1 environmental positive sample was reported in the past week in Khyber Pakhtunkhwa province in Dera Ismail Khan district, collected on the 16 July.

 

  • Efforts continue to further strengthen immunization and surveillance activities in all provinces of the country.

Lao People's Democratic Republic

  • No new cases of circulating vaccine-derived poliovirus type one (cVDPV1) were reported in the past week. The most recent case was reported in Fuang district of Vientiane province, with onset of paralysis on 11 January 2016. The total number of cVDPV1 cases remains three in 2016 and eight in 2015. 

 

  • Outbreaks of cVDPVs can arise in areas with low population immunity, emphasizing the importance of maintaining strong vaccination coverage. 

 

  • An Outbreak Response Assessment (OBRA) is currently taking place from 15-19 August

Madagascar

  • No cases of circulating vaccine-derived poliovirus type one (cVDPV1) have been reported in 2016. The most recent case had onset of paralysis on 22 August 2015 from Sud-Ouest region. The total number of cVDPV1 cases for 2015 was 10. 

 

  • The 2015 cases are genetically linked to a case with onset of paralysis in September 2014, indicating prolonged and widespread circulation of the virus. 

 

  • The third Outbreak Response Assessment (OBRA) in Madagascar found that the surveillance system is not yet strong enough to conclude that polio transmission has been interrupted. Thirty-nine high-risk districts have been identified to receive focused attention.

 

  • Madagascar’s next Outbreak Response Assessment (OBRA) is scheduled for 19-30 August. 

 

  • National Immunization Days (NIDs) are planned for 9-11 November using bivalent oral polio vaccine (bOPV).

Myanmar

  • No cases of circulating vaccine-derived poliovirus type two (cVDPV2) have been reported in 2016. The most recent case was isolated from a 16-month old child in Maungdaw district of Rakhine state, with onset of paralysis on 05 October 2015. The total number of cVDPV2 cases in 2015 is two.   

Nigeria

  • In Nigeria, wild poliovirus type one (WPV1) has been detected from Borno state. Virus was isolated in two local government areas (LGA) of Borno; in Gwoza, in a child with acute flaccid paralysis (AFP), onset of paralysis on 13 July and close healthy contacts of that child; and in Jere from a close healthy contact of a child who had developed AFP symptoms on 6 July.

 

  • These are the first WPV1 detected in Nigeria since July 2014. Genetic sequencing of the isolated viruses suggest they are most closely linked to WPV1 last detected in Borno in 2011, indicating the strain has been circulating without detection since that time. 

 

  • An outbreak response plan has begun under the guidance of the Emergency Operations Committee, led by the Government of Nigeria and with support from WHO and GPEI partners. Detailed field investigations are underway with two investigation teams constituted by the Borno State EOC and deployed to Jere and Gwoza LGAs respectively.

 

  • Surveillance is being strengthened. A community case search ongoing, targeting a minimum of 50,000 households around each case. An external surveillance review has begun and will continue until 26 August in five states: Borno, Kano, Kaduna, Sokoto and Federal Capital Territory (FCT).

 

  • An emergency vaccination response is underway from 15-18 August. Five subsequent large-scale supplementary immunization activities (SIAs) with bivalent oral polio vaccine (bOPV) are planned, the first one scheduled for 27-30 August, and subsequent rounds planned at short intervals of two to three weeks, with the SIAs due to be completed by 22 November.

Lake Chad sub-region

  • The detection of WPV1 in Borno state, Nigeria poses a risk to the neighbouring countries of the Lake Chad sub-region and hence an outbreak response plan is being implemented as part of the response to the Nigeria outbreak. 

 

  • A WHO Lake Chad Task Force has been established to coordinate the response to the cVDPV2 positive environmental sample detected in March in Maiduguri LGA, Borno.

West Africa

  • No circulating vaccine-derived poliovirus type two (cVDPV2) cases have been reported from Guinea in 2016. The most recent case was reported from Kankan district, with onset of paralysis on 14 December. The total number of cVDPV2 cases for 2015 is seven. The 2015 cases are genetically linked to the case with onset in August 2014.

 

  • An Outbreak Response Assessment (OBRA) is underway in Guinea to assess progress towards stopping the transmission of VDPV2.

 

  • National Immunization Days (NIDs) are planned in Guinea, Liberia and Sierra Leone from 30 September-3 October. NIDs are also planned in Benin, Guinea, Liberia, Mali and Sierra Leone from 28-31 October. SNIDs are planned in Mauritania and Niger from 28-31 October.