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Polio this week as of 21 January 2015
 

  • Ministers of Health from around the world will convene next week at WHO’s Executive Board meeting, to set global public health policies. Among other topics, representatives are expected to review the current polio epidemiology and global preparedness plans for the phased removal of oral polio vaccines. A report has been prepared, to facilitate discussions, available here.

 

  • In Nigeria, the Expert Review Committee on Polio Eradication and Routine Immunization (ERC) is meeting this week to discuss aggressive strategies to urgently eradicated both wild- and vaccine-derived polioviruses in the country as rapidly as possible. See ‘Nigeria’ section for more.

 

  • The first wild poliovirus type 1 (WPV1) case of 2015 is reported this week, from Pakistan. The case had onset of paralysis on 3 January, from Khyber Pakhtunkhwa. See ‘Pakistan’ section for more.

 

  • Bill and Melinda Gates, co-chairs of the Bill & Melinda Gates Foundation, this week published their annual letter, outlining how they believe the world will look like in 15 years. In the letter, they highlight the urgent need to eradicate polio. “Destroying a disease utterly is a very difficult thing to do – so difficult in fact, that it’s happened only once in history, when smallpox was eradicated in 1980. But if we keep working hard... we can get polio out of Africa this year and out of every country in the world in the next several years.” 

 
  

 

  


Wild poliovirus type 1 cases

Total cases

Year-to-date 2015

Year-to-date 2014

Total in 2014 

Globally

1

4

356

- in endemic countries

1

4

337

- in non-endemic countries

0

0

19

  


Case breakdown by country


Countries

Year-to-date 2015

Year-to-date 2014

Total in
 2014

Onset of paralysis of  most 
 recent case

Pakistan 1 4 303 03-Jan-15
Afghanistan 0 0 28 04-Dec-14
Nigeria 0 0 6 24-Jul-14
Somalia 0 0 5 11-Aug-14
Equatorial Guinea 0 0 5 03-May-14
Iraq 0 0 2 07-Apr-14
Cameroon 0 0 5 09-Jul-14
Syrian Arab Republic 0 0 1 21-Jan-14
Ethiopia 0 0 1 05-Jan-14
 

Afghanistan

  • No new wild poliovirus type 1 (WPV1) cases have been reported in the past week in Afghanistan. The most recent case had onset of paralysis on 4 December 2014. The total number of WPV1 cases for 2014 remains 28 compared to 14 in 2013. The bulk of these cases are linked to cross-border transmission with neighbouring Pakistan.
  • Subnational Immunization Days (SNIDs) are planned for 25 – 27 January in high risk areas of the south and east using bivalent oral polio vaccine (OPV). On 15 – 17 February, SNIDs will take place across the entire south of the country, also using bivalent OPV. The next National Immunization Days (NIDs) are planned for March using trivalent OPV, combined with inactivated polio vaccine (IPV) in some areas of Hilmand, Kandahar and Nangarhar.

Nigeria

  • No new wild poliovirus type 1 (WPV1) cases were reported in the past week. Nigeria’s total WPV1 case count for 2014 remains 6, compared to 53 in 2013. The most recent case had onset of paralysis on 24 July in Sumaila Local Government Area (LGA), southern Kano state.
  • Over 5 months has passed since the last case of WPV1 had onset of paralysis in Nigeria.
  • No new type 2 circulating vaccine-derived poliovirus (cVDPV2) case was reported this week. The most recent case had onset of paralysis on 16 November in Barde district of Yobe state. The total number of cVDPV2 cases for 2014 in Nigeria remains 29.
  • Subnational Immunization Days (SNIDs) are planned for 24 - 28 January in the north using bivalent oral polio vaccine and nationwide on 14 - 18 March using trivalent oral polio vaccine.
  • The Expert Review Committee on Polio Eradication and Routine Immunization (ERC) is this week meeting to review the epidemiological situation of both WPV1 and cVDPV2 transmission; put forward key recommendations to fill remaining coverage and surveillance gaps; and, optimise vaccine mix to address both WPV1 and cVDPV2 transmission. 

Pakistan

  • Seven new wild poliovirus type 1 (WPV1) cases were reported in the past week, including the first case with onset of paralysis in 2015. The total number of WPV1 cases in 2014 is 303, and one for 2015 (onset of paralysis on 3 January, from Khyber Pakhtunkhwa – KP).
  • No cases of type 2 circulating vaccine-derived poliovirus (cVDPV2) have been reported this week. The most recent cVDPV2 case had onset of paralysis in Khyber Agency, FATA, on 16 September 2014. The country reported 20 cases of cVDPV2 in 2014.
  • Pakistan accounts for more than 85% of all WPV1 cases worldwide in 2014.
  • To urgently address the intense transmission affecting the country, the government has put in place emergency measures to take advantage of the upcoming ‘low season’ for poliovirus transmission (in the early part of 2015). A ‘low season plan’ has been established, based on lessons learned on accessing populations in insecure areas, engaging communities and fixing remaining operational challenges. Implementation is overseen by Emergency Operations Centres at federal and provincial levels to ensure accountability for the quality of polio eradication operations. More

Central Africa

  • No new wild poliovirus type 1 (WPV1) cases were reported in the last week. In 2014, 10 cases were reported in central Africa: 5 in Cameroon and 5 in Equatorial Guinea. It is now more than six months since the last WPV1 case had onset of paralysis in central Africa (in Cameroon, onset of paralysis on 9 July 2014).
  • National Immunization Days (NIDs) are planned in Cameroon in January using trivalent oral polio vaccine (OPV) and in Cameroon and Chad in February using bivalent OPV. Subnational Immunization Days (SNIDs) are planned in the Central African Republic in February. NIDs are also planned in Chad and Gabon and SNIDs in Angola, Cameroon, the Central African Republic and the Democratic Republic of the Congo in March.
  • No confirmed campaigns are currently planned in Equatorial Guinea. The next activities are tentatively planned for April, though final dates are yet to be confirmed.

Horn of Africa

  • No wild poliovirus type 1 (WPV1) cases have been reported in the last week. The most recent case, which had onset of paralysis on 11 August 2014, was from Hobyo district of Mudug province, central Somalia. The total number of cases that were reported in the Horn of Africa in 2014 was 6: 1 WPV1 in Ethiopia (date of onset of paralysis on 5 January) and 5 WPV1s in Somalia.
  • No cases of type 2 circulating vaccine derived poliovirus (cVDPV2) have been reported in the last week. The most recent case of cVDPV2 had onset of paralysis in South Sudan on 12 September 2014.
  • The Horn of Africa Technical Advisory Group (TAG) will meet in February, to review current epidemiology, surveillance sensitivity and population immunity levels across the region.
  • NIDs are scheduled in January in Somalia and Uganda and in February in South Sudan, Somalia and Yemen. SNIDs are also scheduled in Ethiopia, Kenya, Somalia and Uganda in February.
  

Israel and West Bank and Gaza

  • Wild poliovirus type 1 (WPV1) has not been detected in environmental samples in Israel or the West Bank and Gaza Strip for more than 9 months. The most recent WPV positive sample was collected in southern Israel on 30 March 2014. All environmental samples collected since April have been negative for WPV.

Middle East

  • No new wild poliovirus type 1 (WPV1) cases have been reported in the last week. Three cases of WPV1 were reported in the Middle East in 2014 - 2 in Iraq and 1 in Syria.
  • The most recent case reported from Syria had onset of paralysis on 21 January 2014, while the most recent case in Iraq had onset of paralysis in Mada'in district, Baghdad-Resafa province, on 7 April.
  • Confirmation of the Middle East outbreak in October 2013 prompted an unprecedented regional outbreak response, to immunize more than 25 million children multiple times, across seven countries.
  • The response continues to be implemented through humanitarian and public health actors, across all lines of the conflict, to ensure all children can be reached with polio vaccine.
  • A review meeting of experts is scheduled this month in Beirut, Lebanon, to review the impact of current outbreak response activities and agree on strategies for moving forward.
  • The review meeting is anticipated to discuss steps to fill residual subnational surveillance and immunity gaps in some areas, as well as to address the risk of renewed spread of virus from Pakistan into the region, given the intense virus transmission in that country and large-scale population movements to the Middle East.

West Africa

  • No wild poliovirus type 1 (WPV1) cases have been reported in West Africa in the past week. The most recent WPV1 case in the region occurred in Tahoua province, Niger, with onset of paralysis on 15 November 2012.
  • Even as polio programme staff across West Africa support efforts to control the Ebola outbreak affecting the region, efforts are being made in those countries not affected by Ebola to vaccinate children against polio to create a buffer zone surrounding the Ebola-affected countries. The Ebola crisis in western Africa continues to have an impact on the implementation of polio eradication activities in Liberia, Guinea and Sierra Leone. Supplementary immunization activities (SIAs) in these countries have been postponed and the quality of acute flaccid paralysis surveillance has markedly decreased throughout 2014.
  • NIDs are planned using bivalent oral polio vaccine (OPV) in Niger and Benin on 27 February to 2 March, and Subnational Immunization Days (SNIDs) tentatively in Mali in February with dates to be confirmed. From 27 to 31 March, NIDs will take place in Benin, Burkina Faso, Côte d’Ivoire, Mali, Niger and Senegal using trivalent OPV. NIDs are also scheduled on those dates for the three Ebola-affected countries Guinea, Liberia and Sierra Leone.