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June 2006
Data as at 21 June 2006 English PDF
Version française en PDF
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Outbreak of polio in adults in Namibia:
government prepares nationwide immunization for all ages in response to an
outbreak of polio in Namibia, primarily among adults, due to importation of
poliovirus of Indian origin via Angola.
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World Health Assembly (WHA) resolves to support final stages of polio
eradication:
policy-setting
body passes resolution calling for increased focus on interrupting
transmission in polio endemic areas, adherence to rapid response standards
in case of importation of poliovirus and technical advice on planning for a
post-eradication world.
Nigeria
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In
2006, 467 cases have been reported to date, compared to 168 cases for the
same period in 2005.
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Five
states – Bauchi, Jigawa, Kaduna, Kano and Katsina – account for 86% of the
national caseload.
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The
first round of Immunization Plus Days (IPDs) took place starting 25 May, in
11 northern states. A 6 June review concluded that although coverage was
marginally higher than the most recent Supplementary Immunization Activities
(SIAs), 25% - 35% of children were still missed. Although vaccination teams
were composed of older women and trained health workers, social mobilization
and vaccinator training both require improvement. The review group
recommended formal engagement of traditional and religious leaders in order
to increase awareness of the campaigns.
India
Pakistan and Afghanistan
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In
Pakistan, 6 cases have been reported this year, compared with 10 for the
same period last year.
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In
Afghanistan, 13 cases have been reported this year, compared with 3 for the
same period last year. Two of the cases are in the Provinces of Uruzgan and
Zabul, previously unaffected by polio.
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On 4
and 6 June, synchronized activities were carried out in both countries,
except for the southern region of Afghanistan, which postponed its
immunization activities to 18 June for security reasons. Initial reports
indicate good coverage in North West Frontier Province but some missed
pockets in Karachi and in Quetta City. Polio teams in both countries faced
increasing difficulties in accessing children and implementing high-quality
SIAs in a number of insecure areas.
Namibia
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Four
cases of an outbreak of acute flaccid paralysis in Namibia were
virologically confirmed to be wild poliovirus type-1. Genetic sequencing has
determined that the virus is of Indian origin and was imported from Angola,
which reported 10 cases in 2005 (most recent case November 2005).
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An
international and regional rapid response team is assisting the government
and a response activity using mOPV1 started on 21 June, the first of three
nationwide rounds.
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The
majority of the more than 100 suspected cases are adults, and 15 have died.
Namibia began routine immunization for polio in 1990; the cause of the
largely adult outbreak is yet to be determined. The paralysis-to-infection
rate of poliovirus is higher among adults than in children, as is the
fatality rate. The first two of the three vaccination campaigns will target
the entire population across all ages.
Nepal
Bangladesh
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An
additional two cases were reported in Bangladesh (onset of paralysis on 23
January and 14 April, i.e. prior to the NIDs), bringing the total since the
initial importation of polio to three. The new cases are in the centre of
the country and on the western border with India.
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Bangladesh carried out a third NID on 8 June, in a rapid response to the
initial importation, to reach 22 million children under the age of five
years.
Myanmar
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A polio
case originally reported as wild poliovirus has been genetically found to be
a vaccine-derived poliovirus (VDPV). No further cases have been reported,
despite strengthened disease surveillance.
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The
Government of Myanmar is currently planning an immunization response of two
National Immunization Days (NIDs). The primary reason for this response is
to strengthen immunization levels against polio throughout Myanmar; routine
coverage for polio vaccination is reported to be 70%.
Somalia and Ethiopia
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In
Somalia, 25 cases have been reported in 2006. Polio appears to be on the
decline in Mogadishu, formerly the epicentre of the outbreak. The risk of
further spread across the Horn of Africa remains high.
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In
Ethiopia, 3 cases have been reported this year, in Somali and Amhara
regions. A cross-border meeting took place in order to improve coverage and
coordinate with Somalia and Kenya. Strategies were agreed for accessing
areas on both sides of the borders between the countries and for
coordinating national and sub-national immunization activities.
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The
first such synchronized campaign between Somalia and Ethiopia took place
starting 11 June.
The state of
polio eradication
In 2005, the world moved several critical milestones closer to polio
eradication, including the successful introduction of the monovalent oral polio
vaccines, visible progress in the hardest endemic areas and an end to west and
central Africa's epidemic (outside Nigeria).
Only 4 countries are still polio-endemic - an all-time low: Nigeria, India,
Pakistan and Afghanistan.
In addition to the endemic countries, nine countries have reported polio cases
in 2006 due to importations (Somalia, Yemen, Indonesia, Bangladesh, Ethiopia,
Namibia, Niger, Nepal and DRC).
The necessary tools to eradicate polio are in place. Stopping polio transmission
can be completed rapidly, except in Nigeria, where at least an additional 12
months will be required to finish the job, due to intense transmission in key
states.
The remaining challenges to a polio-free world are:
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Curbing the
intense transmission in the high-priority states in northern Nigeria
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Sustaining
campaigns to break the final polio chains in the other three endemic
countries.
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Rapidly stopping
polio outbreaks in previously polio-free countries.
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Addressing low
routine immunization rates and surveillance gaps in polio-free areas
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Maintaining
funding and political commitment
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