Kenya
4
November: Sub-national mop-up rounds with monovalent type-1 oral poliovirus vaccine
(mOPV1) are planned to start in northeastern Kenya today, covering 250,000
children in Kenya and coordinated with Somalia and Ethiopia.
A case of wild poliovirus type-1, due to an importation of virus from
neighboring Somalia, was confirmed in October from a refugee camp in North Eastern
Province of Kenya. The 3-year old girl, who has not traveled to Somalia, was
born and lives in the refugee camp in the District of Garissa bordering Somalia,
where an outbreak has led to over 200 cases since July 2005. She was
paralyzed by polio on 17 September 2006.
Genetic
sequencing indicates a virus of Nigerian origin, imported from Kismayo, Somalia;
it is not possible to determine how long the virus has been circulating in
Kenya.
Because
of the polio outbreak in neighboring Somalia, 4 rounds of sub-national
immunization days were already conducted in Kenya between April and September
2006, in an effort to limit the consequences of any importations. Each of these
sub-national immunization campaigns included the North Eastern Province of Kenya
(target population of 250,000 children aged less than 5 years). Although high
coverage (100%) was reported, accurate estimations are very difficult to make:
the area's sparse population moves frequently within the area and across the
borders of Somalia and Ethiopia. Moreover, monitoring of the campaigns and
retrospective reviews suggest children may have been missed in some areas.
The next round in
December has been expanded to include high-risk districts in the provinces of Coast,
Rift Valley and Eastern and the whole of North Eastern and
Nairobi
provinces.
Routine
immunization coverage with 3 doses of oral poliovirus vaccine (OPV3) is reported
to be between 50 and 60% in the northern districts of the Northeastern Province,
but above 80% in the southern districts, of which Garissa is one. However, in
the North Eastern Province in 2006, 50% of children with acute flaccid paralysis
(a symptom of polio) had three or fewer doses of OPV.
Note
Surveillance
indicators in North Eastern Province of Kenya: Non-polio acute flaccid paralysis
rate of 1-1.9 , below the recommended rate for areas contiguous to
polio-affected countries. Adequacy of stool collection is below 50%.
Report
in Weekly Epidemiological Record, WER
27 October 2006.
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