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Polio this week as of 19 November 2014
 

  • On 13 November, the Director-General of WHO accepted the recommendation of an International Health Regulations (IHR) Emergency Committee of Experts on polio that the international spread of polio continues to constitute a Public Health Emergency of International Concern (PHEIC) under the IHR, and extended the existing Temporary Recommendations to prevent the international spread of polio for countries affected by the disease for another 3 months. Recognizing the escalating wild poliovirus (WPV) transmission in Pakistan, additional Temporary Recommendations were provided to further reduce the risk of international spread from Pakistan. Read more.
  • In response to the recent outbreak of circulating vaccine-derived poliovirus (cVDPV) in Madagascar, supplementary immunization activities are scheduled in December in high risk areas and across the entire country in January to stop transmission of the virus.
  • This week, the Centers for Disease Control and Prevention (CDC), USA, released a report marking 2 years during which type 3 wild poliovirus has not been detected anywhere in the world. While the CDC report concludes that WPV3 transmission has possibly been interrupted, continued sensitive surveillance is needed before a final conclusion on WPV3 eradication can be made.

  

 

  


Wild Poliovirus (WPV) cases

Total cases

Year-to-date 2014

Year-to-date 2013

Total in 2013 

Globally

291

341

416

- in endemic countries

272

123

160

- in non-endemic countries

19

218

256

  


Case breakdown by country


Countries

Year-to-date 2014

Year-to-date 2013


Total in
 2013

Date of most 
 recent case

 WPV1  WPV3   W1W3  Total   WPV1  WPV3  W1W3  Total 
Pakistan 246     246 63  
63 93 01-Nov-14
Afghanistan 20     20 9     9 14 20-Oct-14
Nigeria 6     6 51
  51 53 24-Jul-14
Somalia 5     5 183
  183 194 11-Aug-14
Equatorial Guinea 5     5       0  0 03-May-14
Iraq 2     2       0 0 07-Apr-14
Cameroon 5     5  2     2 4 09-Jul-14
Syria 1     1  13     13 35 21-Jan-14
Ethiopia      1     1 6     6 9 05-Jan-14
Kenya
    0 14     14 14 14-Jul-13
Total 291 0 0 291 341 0   341 416
Total in endemic countries      272 0 0 272 123 0
123 160   
 Total outbreak 19    0   0 19 218 0 0 218 256  

Data in WHO as of 19 November 2013 for 2013 data and 18 November 2014 for 2014 data.

Afghanistan

  • Two new wild poliovirus type 1 (WPV1) cases were reported in the past week in Afghanistan. One was found in Nahr-E-Saraj district of Hilmand province, and the second was reported from Zheray district of Kandahar province. Both areas had not reported WPV1 previously during 2014. The total number of WPV1 cases for 2014 in Afghanistan is now 20. The most recent WPV1 case had onset of paralysis on 20 October, from Kandahar province.
  • No new cases of type 2 circulating vaccine-derived poliovirus (cVDPV2) were reported in the past week. No cases of cVDPV2 have been reported in Afghanistan in 2014.
  • Given the growing outbreak in neighbouring Pakistan, Afghanistan continues to conduct supplementary immunization activities (SIAs) to limit the spread of imported polioviruses. Subnational Immunization Days (SNIDs) took place on 16 – 18 November across the south, using bivalent oral polio vaccine (OPV). From 23 - 25 November, SNIDs will take place in high risk areas of the south and east using monovalent OPV.

Nigeria

  • No new wild poliovirus type 1 (WPV1) cases were reported in the past week. Nigeria’s total WPV1 case count for 2014 remains six. The most recent case had onset of paralysis on 24 July in Sumaila Local Government Area (LGA), southern Kano state.
  • Five new type 2 circulating vaccine-derived poliovirus (cVDPV2) cases were reported in the past week, all in districts or states that had not reported cVDPV2 during 2014 to date. One case was in Guzamala district, Borno; 1 in Kura district, Kano; 1 in Barde district, Yobe; and 1 in each Dutse and Kiyawa districts, Jigawa. The total number of cVDPV2 cases for 2014 in Nigeria is now 26. The most recent cVDPV2 case had onset of paralysis on 16 October, in Barde district, Yobe state.
  • In selected high risk areas of Kano state, supplementary immunization activities (SIAs) using both inactivated polio vaccine (IPV) and oral polio vaccine (OPV) are taking place from 15 – 20 November. Large-scale Subnational Immunization Days (SNIDs) are planned for 13 – 16 December across northern Nigeria. The aim is to boost immunity to all strains of poliovirus, to rapidly interrupt circulation of both WPV1 and cVDPV2. 

Pakistan

  • Ten new wild poliovirus type 1 (WPV1) cases were reported in the past week. Six were from the Federally Administered Tribal Areas (FATA), with 1 in South Waziristan, and 5 in Khyber Agency; 1 from Killa Abdullah district in Balochistan province; 1 from Mardin district in Khyber Pakhtunkhwa province; and 2 from Sindh province (1 in Bin Qasim town of Karachi city and 1 in Badin district, southern Sindh province). The total number of WPV1 cases in Pakistan in 2014 is now 246, compared to 63 at this time last year. The most recent WPV1 case had onset of paralysis on 1 November, from Khyber Agency, FATA.
  • No cases of type 2 circulating vaccine-derived poliovirus (cVDPV2 were reported in the past week. This most recent cVDPV2 case had onset of paralysis in Khyber Agency, FATA, on 16 September. The country has reported 20 cases of cVDPV2 in 2014.
  • Immunization activities are continuing with particular focus on known high-risk areas, in particular newly opened previously inaccessible areas of FATA. At exit and entry points of conflict-affected areas that are still inaccessible during polio campaigns, 100 permanent vaccination points are being used to reach internally displaced families as they move in and out of the inaccessible area. Over 1 million people have been vaccinated in the past few months at transit points and in host communities, including over 850,000 children under 10 years old.

Central Africa

  • No new wild poliovirus type 1 (WPV1) cases were reported this week. In 2014, 10 cases have been reported in central Africa: 5 in Cameroon and 5 in Equatorial Guinea.
  • Throughout November, supplementary immunization activities (SIAs) are being implemented across central Africa, with campaigns taking place in Angola, Chad, Democratic Republic of Congo (DRC), the Republic of Congo and possibly in Gabon.
  • National Immunization Days (NIDs) in Cameroon and the Subnational Immunization Days (SNIDs) in Central African Republic and DRC are planned for December. From 17-21 December, campaigns in refugee camps in eastern Cameroon will reach children with inactivated polio vaccine (IPV).

Horn of Africa

  • No new wild poliovirus type 1 (WPV1) cases have been reported in the past week in countries of the Horn of Africa. The most recent case, which had onset of paralysis on 11 August, was from Hobyo district of Mudug province, central Somalia. The total number of cases that have been reported in the Horn of Africa in 2014 is six: 1 WPV1 in Ethiopia (date of onset of paralysis on 5 January) and 5 WPV1s in Somalia.
  • Following confirmation of two cases of circulating vaccine derived poliovirus type 2 (cVDPV2) in a refugee camp area of Unity state, South Sudan, two weeks ago, preparations for outbreak response immunization activities are being finalized in the country. National Immunization Days (NIDs) were implemented on 4–7 November, with further campaigns planned for December and January. The objective is to rapidly stop the cVDPV2 in the infected area, while further boosting immunity to type 1 polio and to minimize the risk of renewed outbreaks following virus re-introduction from infected countries and areas.
  • In November, supplementary immunization activities (SIAs) are being held in Djibouti, Ethiopia, Kenya, Somalia, and Sudan, and Child Health Days (CHDs) including polio vaccines in Yemen.
  

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 in recent months. The most recent positive sample was collected in southern Israel on 30 March. Environmental samples collected since April have been negative.
  • The Regional Certification Commission (RCC) reported that they strongly believe that WPV transmission has been interrupted in Israel. A comprehensive end-of-outbreak report has been requested from the Israel National Certification Commission in order for the RCC to reach a conclusion.

Middle East

  • No new wild poliovirus type 1 (WPV1) cases were reported in the past week. Three cases of WPV1 have been reported in the Middle East in 2014 - two in Iraq and one in Syria.
  • It has been more than seven months since the last reported cases of WPV1 in the Middle East. The most recent case reported from Syria had onset of paralysis on 21 January, while the most recent case in Iraq occurred in Mada'in district, Baghdad-Resafa province, with onset of paralysis on 7 April.
  • Phase 2 of the Middle East Outbreak response continues to be implemented across the region, with focus on further improving the quality of supplementary immunization activities and to increase the reach of campaigns. 
     

West Africa

  • No wild poliovirus type 1 (WPV1) cases have been reported in West Africa in 2014. The most recent WPV1 case in the region occurred in Tahoua province, Niger, with onset of paralysis on 15 November 2012.
  • No new cases of type 2 circulating vaccine-derived poliovirus (cVDPV2) were reported this week. The last case of cVDPV2 was reported in Niger on 11 July 2013.
  • 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.
  • National Immunization Days (NIDs) took place in Benin, Burkina Faso, Cape Verde, Côte d’Ivoire, Gambia, Ghana, Guinea Bissau, Mauritania, Senegal and Togo and Subnational Immunization Days (SNIDs) in Niger at the beginning of November. Further SNIDs are planned in Mali and Niger in December.