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Polio this week as of 1 July 2015
 

       
  • In June, the wild poliovirus outbreaks in Equatorial Guinea, Ethiopia and Kenya were assessed to be over by independent teams, having successfully interrupted transmission of the virus. While this is a sign that supplementary immunization activities and acute flaccid paralysis have been strengthened since all of the outbreaks began in 2013, it is essential for these gains to be maintained and built upon in order to protect children within these countries from the return of the virus. Read more on Equatorial Guinea, Ethiopia and Kenya.

  • Five cases of circulating vaccine derived poliovirus type 1 (cVDPV1) have been reported in Madagascar, with dates of onset of paralysis in April and May 2015. These cases are genetically linked to that from September 2014, indicating prolonged and widespread circulation of the virus. The emergency outbreak response is now being intensified to build immunity against the virus in the country, as 25 % of children across Madagascar remain un- or under- immunized. Learn more about vaccine derived polioviruses here.
       


   

  


Wild poliovirus type 1 and Circulating vaccine-derived poliovirus cases

Total cases

Year-to-date 2015

Year-to-date 2014

Total in 2014 

WPV

 cVDPV

 WPV

 cVDPV

 WPV

 cVDPV

Globally

29

6

111

26

359

55

- in endemic countries

29

1

99

26

340

 52

- in non-endemic countries

0

5

12

 0

19

 3

  


Case breakdown by country


Countries

Year-to-date 2015

Year-to-date 2014

Total in
 2014

Onset of paralysis of  most 
 recent case

WPV

cVDPV 

WPV 

cVDPV

 WPV

cVDPV 

 WPV

 cVDPV

Pakistan 25 0 88 16 306 22 24-May-15 13-Dec-14 
Afghanistan 4 7 28 5-May-15 N/A 
Nigeria 0 1 4 10  6 30  24-Jul-14 16-Nov-14 
Somalia 0 1  0 5 11-Aug-14 N/A 
Equatorial Guinea 0  0 4  0 5 0 03-May-14 N/A 
Iraq 0 2  0 2 0 07-Apr-14 N/A 
Cameroon 0 3  0 5 09-Jul-14 N/A 
Syrian Arab Republic 0 1 1 0 21-Jan-14 N/A 
Ethiopia 0 1 1 0 05-Jan-14 N/A 
South Sudan  0  0  0  0 N/A  12-Sep-14 
Madagascar  5  0 N/A  3-May-15 

 
Circulating vaccine-derived poliovirus cVDPV: Madagascar is cVDPV1, all others cVDPV2. NA: onset of paralysis in most recent case is prior to 2014. cVDPV is associated with ≥ 2 AFP cases or non-household contacts. VDPV2 cases with ≥ 6 (≥ 10 for type1) nucleotides difference from Sabin in VP1 are reported here.

Afghanistan

  • No new polio cases were reported in the past week. The most recent case had onset of paralysis on 05 May 2015 in Gulestan district, Farah. The total number of WPV1 cases for 2015 remains four.
  • The Technical Advisory Group met in early June and identified that southern and eastern Afghanistan remains at particular risk of polio. The group identified reasons for missed children, which to a great extent are due to remaining operational challenges during campaign implementation. The meeting put forward key recommendations to urgently address these remaining gaps.
  • National Immunization Days are scheduled on 16 to 18 August using bivalent oral polio vaccine. Since the most recent case on the 05 May, Farah has seen two supplementary immunization activities.

Nigeria

  • No new wild poliovirus type 1 (WPV1) cases were reported in the past week. No cases have been reported in 2015. Nigeria’s total WPV1 case count for 2014 remains 6. The most recent case had onset of paralysis on 24 July 2014 in Sumaila Local Government Area (LGA), southern Kano state.
  • One new type 2 circulating vaccine-derived poliovirus (cVDPV2) case was reported in the past week, with onset of paralysis in Kwali district, FCT, Abuja, on the 16 May. This case is genetically linked to previous VDPVs found in the environment in Kaduna from August 2014 to January 2015. The total number of cases is now one for 2015. The total number of cVDPV2 cases for 2014 in Nigeria remains 30. Learn more about VDPVs here.
  • In line with national emergency action plans, there is an aggressive and rapid response to any detected virus, including to these recent environmental samples, with large-scale mop-ups using trivalent oral polio vaccine (tOPV) and inactivated polio vaccine (IPV).
  • Subnational Immunization Days (SNIDs) are planned across most of northern Nigeria from 25 – 28 July using tOPV, alongside mop-up activities in high-risk areas with dates to be confirmed.

Pakistan

  • No new wild poliovirus type 1 (WPV1) cases were reported in the past week. The most recent case had onset of paralysis in South Waziristan in the Federally Administered Tribal Areas (FATA) on the 24 May. The total number of WPV1 cases for 2015 is now 25, compared to 83 at this time last year.
  • No new type 2 circulating vaccine-derived poliovirus (cVDPV2) cases were reported in the past week. No cases have been reported in 2015. The number of cVDPV cases reported in 2014 remains 22. The most recent case had onset of paralysis on 13 December.
  • No new environmental samples positive for WPV1 were reported in the past week. The most recent positive sample was collected on 1 June in Killa Abdullah, Balochistan province.
  • Environmental surveillance indicates widespread circulation of polioviruses, not just in known infected areas but also in areas without cases. Environmental surveillance is proving to be an instrumental supplemental surveillance tool enabling a clearer epidemiological picture.
  • The Technical Advisory Group convened earlier in the month to examine the impact of the low season emergency action plan currently being implemented in the country. Greater Karachi, North Waziristan and parts of Khyber Agency in FATA remain the highest-risk areas, where too many children remain under- and un-immunized. With the start of the ‘high season’ for polio transmission, the group concluded that there is a need to clearly identify reasons why children are missed in these areas, and to put in place corrective measures to rectify these gaps.

Central Africa

  • No new wild poliovirus type 1 (WPV1) cases were reported in the past week. No cases have been reported in 2015. In 2014, 10 cases were reported in central Africa: 5 in Cameroon and 5 in Equatorial Guinea. Over eleven months have passed since the last WPV1 case had onset of paralysis in central Africa (in Cameroon, onset of paralysis on 9 July).
  • The outbreak in Equatorial Guinea was closed last month. Equatorial Guinea must now use gains against polio to build more sustainable protection for the future health of its children. Read more.
  • National Immunization Days (NIDs) are underway in the Central African Republic (CAR) that are being staggered between end-May and August. NIDs will take place in Cameroon on 3 – 5 July, and in Angola and Congo in the second half of this month. Subnational Immunization Days (SNIDs) are scheduled in CAR from 24 to 26 July.  

Horn of Africa

  • No wild poliovirus type 1 (WPV1) cases have been reported in the past week. No cases have been reported in 2015. The total number of WPV1 cases that were reported in the Horn of Africa in 2014 was 6: 1 in Ethiopia (date of onset of paralysis on 5 January) and 5 in Somalia. The most recent case, which had onset of paralysis on 11 August 2014, was from Hobyo district of Mudug province, central Somalia.
  • No cases of type 2 circulating vaccine derived poliovirus (cVDPV2) have been reported in the past week. No cases have been reported in 2015. In 2014, 2 cases were reported in South Sudan. The most recent case of cVDPV2 had onset of paralysis in South Sudan on 12 September.
  • The outbreaks in Ethiopia and Kenya were closed last month, with an assessment team determining that transmission has stopped. Strong surveillance is central to close any outbreak, enabling confidence that the virus is truly absent. Read more.
  • Subnational Immunization Days (SNIDs) are planned in Somalia for August, with dates to be confirmed. In September, National Immunization Days are planned in Djibouti, Eritrea, Somalia and Yemen, and SNIDs in Ethiopia, Kenya and Uganda.

Middle East

  • No new wild poliovirus type 1 (WPV1) cases have been reported in the past week. No cases have been reported in 2015. 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 2014.
  • Phase III of the Middle East outbreak response is continuing to further strengthen vaccination services for vulnerable populations and to strengthen surveillance for polioviruses across the region.

West Africa

  • No wild poliovirus type 1 (WPV1) cases have been reported 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.
  • National Immunization Days (NIDs) are planned in Sierra Leone for 10 - 13 July, and in September in Benin, Burkina Faso, Guinea, Guinea Bissau, Liberia, Mauritania, Niger and Sierra Leone, and Subnational Immunization Days (SNIDs) in Cote d’Ivoire, Ghana and Mali.