Polio and prevention
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Monthly situation reports
Newsletter - Polio News
Data as of 16 October 2007
Countries on track to meet milestones, but funding gap not met
: an interim progress report on the new milestones shows strong epidemiological progress but gaps in funding. The Initiative is on track to meet three of the four agreed milestones by the end of the year: a 50% reduction in infected districts in endemic countries; an increase in vaccination coverage in infected areas; and an end to outbreaks in re-infected countries. The fourth milestone, however, measuring the international community's ability to meet the programme's necessary financial resources, remains unmet: the Initiative continues to face a global funding gap of US$60 million for 2007. More.
An extra 80,000 children reached during immunization campaigns in Afghanistan
: Thanks to a pause in hostilities for International Peace Day, vaccinators were able to reach areas previously inaccessible due to insecurity in the southern region of Afghanistan .
Global update on circulating vaccine-derived polioviruses (cVDPVs) published
: the Weekly Epidemiological Record (WER) has published an annual update on VDPVs detected in 2006 and 2007. The update covers cVDPVs detected in a number of countries, including Cambodia , Myanmar and Nigeria . The update contributes to a more thorough understanding of VDPVs, which can cause polio outbreaks in areas with low rates of coverage with oral polio vaccine (OPV). Understanding VDPVs is essential in reducing and managing the risk of polio cases by these viruses. For further information, please click here.
Polio infects new province in DR Congo:
in the Democratic Republic of the Congo (DR Congo), the outbreak from a fourth importation is continuing in Equateur Province , and has spread into neighbouring Orientale Province . See 'Re-infected countries' below for more.
Polio confirmed in Sudan
: a polio case in southern Darfur, from a virus genetically linked to a known transmission zone in neighbouring Chad , has been reported, the first polio identified in Sudan since June 2005. See 'Re-infected countries' below for more.
In 2007, 209 cases have been reported (71 type 1 and 138 type 3), a 77% decline in cases compared to the same period in 2006.
Immunization Plus Days (IPDs) were held on 1-4 September using trivalent oral polio vaccine (OPV). Independent monitoring of the activity indicated the highest achieved coverage of all IPDs in 2007, despite extensive flooding in a number of key endemic areas (with the start of the rainy season).
Despite improvements, substantial coverage gaps remain in particular in the highest-risk states.
In Kano state, two type 1 polio cases have been reported. They are the first type 1 cases in Kano in 2007. Since systematic administration of monovalent OPV type 1 (mOPV1) during IPDs, type 1 polio transmission is on the decline. In 2007, 64 cases of type 1 have been reported, compared with 843 type 1 cases in 2006. The successful suppression of type 1 is particularly evident in Kano state, the original epicentre of the type 1 outbreak which spread to 20 polio-free countries in 2003-2006.
Four rounds of SIAs with trivalent OPV have been conducted in northern Nigeria , in response to the identified cVDPVs, consistent with global recommendations.
The next Expert Review Committee on Polio Eradication (ERC) is scheduled to convene in Abuja on 8-9 November.
In 2007, 304 cases have been reported (64 type 1 and 240 type 3). India has the highest number of cases of any single country in 2007.
17 cases of type 3 polio were reported in Bihar state, the first type 3 cases there since January 2004. Genetic sequencing has confirmed that they are related to type 3 circulating in western Uttar Pradesh. In response, a monovalent OPV type 3 (mOPV3) campaign was held in both states at the end of September/early October. Although the eradication of type 1 is the strategic priority, contingency plans for potential re-infection with type 3 have been made, and a sufficient supply of mOPV3 was already available in Bihar .
Polio campaigns proceeded in August despite extensive flooding in Bihar . In particularly hard-hit areas of central and north-western Bihar , campaigns were held after a delay of several days. Flood-prone areas were identified ahead of time, WHO technical staff were re-deployed to these areas and extra vaccination teams were put in place. Monovalent OPV1 was systematically administered during relief activities. Partnerships are being strengthened at local level to offer additional health support, including de-worming tablets and Vitamin A supplements.
Pakistan and Afghanistan
In 2007, 16 cases have been reported in Pakistan (8 type 1 and 8 type 3) and 12 cases in Afghanistan (4 type 1 and 8 type 3). Cases are primarily restricted to the southern and eastern transmission zones in Afghanistan , and the northern and southern transmission zones in Pakistan .
Vaccinators were able to reach children in previously inaccessible areas during the 19-21 September campaigns in Afghanistan following agreements reached in the southern region to honour International Peace Day.
Efforts are focused on engaging communities at the local level and fostering support among local and provincial civil and religious leadership to ensure safe access for vaccinators.
On 1-2 October, a technical consultation on polio eradication in Afghanistan and Pakistan convened in Oman .
Chad & Sudan
: in Sudan , the first polio identified in Sudan since June 2005 was confirmed, in southern Darfur, in an area close to a known transmission zone in Chad . The case is a 30-month old child, from a nomadic group travelling across southern Darfur . The detection of 6 cases in Chad this year underlines the ongoing threat of re-infection from endemic areas. The risk of further spread to the east remains high, and is further compounded by large population movements across the region for the upcoming Hajj season. Sudan has been conducting preventive polio campaigns since confirmation of polio in Chad earlier this year. An emergency outbreak response campaign will now be held on 23 October, in synchronization with Chad .
: in 2007, the polio outbreak following a fourth importation is continuing in Equateur Province , and has spread into neighbouring Orientale Province . 32 cases have been reported this year, the highest number of cases of all the re-infected countries. Although a number of SIAs have been conducted throughout the year in the affected areas, several operational challenges affect the quality of the campaigns, including availability of petrol for transport and adequate microplanning to reach all populations along the Congo River. Emphasis on upcoming campaigns is to urgently address these operational issues.
: in Angola , where 9 cases have been reported this year, discussions are underway to determine an appropriate SIA schedule for the rest of 2007. Efforts to fill subnational surveillance gaps are ongoing in the country.
: A total of 11 wild poliovirus cases have been reported in 2007, along with 3 cVDPV cases. There is a risk of further spread within Myanmar . Sub-national surveillance gaps in Myanmar indicate that potential undetected circulation cannot be ruled out. The next NIDs will be held in November.
The state of polio eradication
The world now has its best chance to eradicate polio
: Only four parts of four countries have never interrupted indigenous wild poliovirus transmission: Nigeria , India , Pakistan and Afghanistan .
Global polio eradication depends on the engagement of the leaders of these four countries.
The tools to eradicate polio are better than ever
. The programme now has vaccines which are twice as effective and diagnostic tools that detect and track poliovirus twice as fast. New tactics have been formulated to reach all children in endemic areas.
New policies and tactics are in place to minimize the risks and consequences of international spread of poliovirus
: travellers to and from polio-endemic countries are advised to be fully vaccinated before travel.
The remaining steps to a polio-free world include:
Rapidly overcoming the remaining operational challenges to reaching every child in the four endemic areas of Nigeria , India , Pakistan and Afghanistan .
Rapidly mobilizing the necessary financial resources to fully implement polio eradication strategies.
Continuing outbreak response activities in the remaining re-infected countries, and minimise the risk and consequences of further international spread of polio.
Maintaining high quality AFP surveillance in all countries.
Polio eradication will only succeed if the necessary funds are made available, and with strong political commitment in polio-affected countries
. More than 10 million children will be paralysed in the next 40 years if the world fails to capitalize on its >US$5 billion global investment in eradication.
The Global Polio Eradication Initiative
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