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22
April
Most
recent polio cases in Sudan and Angola demonstrate ongoing risk of importations
Geneva,
22 April 2008 - A case of polio due to wild poliovirus type 1 (WPV1), with onset
of paralysis on 2 March 2008, has been reported in the southern part of Sudan
(Jonglei province) in an area bordering Ethiopia. It is the first polio detected
east of Chad since September 2007, the most recent cases in the Horn of Africa
being in Sudan in September 2007, Somalia in March 2007 and Ethiopia in November
2006.
This
most recent WPV1 is genetically-related to virus originating in northern Nigeria
that spread across the region, and which caused outbreaks across the Horn of
Africa. A combined Sudan/Ethiopia outbreak response is currently being planned.
Two large-scale supplementary immunization activities (SIAs) covering the whole
of southern Sudan (target population: approximately 2.5 million children) and 52
woredas (districts) of south-western Ethiopia bordering southern Sudan (target
population: approximately 400 000 children) will be held in early May and again
in early June, using monovalent oral polio vaccine type 1 (mOPV1).
Key
to success will be to reach every child, especially those living in remote,
difficult-to-access areas, as well as those living in zones of conflict.
Although current population immunity levels across the Horn of Africa are higher
than in 2004-2005 when large outbreaks occurred in this region, the risk of
further polio spread remains, compounded by frequent population movements. Plans
for further SIAs in the second half of 2008, and longer-term plans for
strengthening subnational surveillance across several countries in central
Africa, are currently being developed.
Angola
In
Angola, confirmation has been received of a polio case due to wild poliovirus
type 3 (WPV3), with onset of paralysis on 19 March (from Luanda province).
Angola is already fighting an outbreak of WPV1, and this is the first WPV3
reported from the country since 2000.
Preliminary
genetic data indicates this virus is of south Asian origin, and represents the
third separate importation from south Asia into Angola since 2005 (at least two
WPV1s and one WPV3). The situation in Angola poses a significant risk of onward
spread of polio, as efforts had concentrated on stopping WPV1 transmission;
population immunity levels to WPV3 must now be rapidly raised.
Two
National Immunization Days (NIDs) had already been planned with mOPV1 (on 16-18
May and on 20-22 June), and discussions are currently ongoing to ensure these
NIDs are used also as a platform to raise immunity to WPV3.
Risk
everywhere until endemic polio stopped
These
most recent polio cases in Angola and Sudan underscore the risk polio continues
to poses to populations everywhere, as long as endemic transmission of the virus
continues anywhere in the world. Four countries remain which have never
interrupted endemic transmission: Afghanistan, India, Nigeria and Pakistan.
Since the launch of the intensified eradication effort in February 2007, efforts
are continuing in all four countries to rapidly finish the disease once and for
all, through the wide-scale application of tailored tools and eradication
tactics.
9
April
Keeping
Sudan polio-free
Sudan’s
drive to eradicate polio has been one of the most successful health stories in
Africa in recent years. The country has remained
polio-free despite re-importation of wild poliovirus in September 2007 (of which
the sole case, in South Darfur, was genetically linked to virus of Nigerian
origin circulating in Chad). No other case was reported in the period up to the
end of December 2007. Effective vaccination campaigns, engaging both the media
and parties in conflict to ensure that children are reached, have prevented
spread within Sudan and protected neighbouring countries from further
spread. More
4
April
Polio
Eradication in India - April Communication Update
With
less than 100 days to go before the onset of rains, detailed plans are being
laid out by polio eradication partners in India for accessing families not
regularly reached because of geographic isolation, flooding and mobile
settlements along Bihar’s many riverbanks. One of the fundamentals of the
strategy is getting microplans updated, especially where districts intersect –
such as riverine areas. It is not uncommon for certain areas to get cut off from
the rest of the district during monsoon months and have to be approached from a
neighbouring district. When flood water recedes, leaving a rich topsoil,
communities also spring up overnight. Therefore, a grid approach is now being
used to plan, implement and monitor the programme in this sensitive area. This
premise will also guide the communication and social mobilization component of
the programme within this area. More
on this and other communications activities in India in the latest regular
update (pdf).
Previous
issues can be downloaded from here.
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