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Polio this week as of 13 August 2014

 

  • The Horn of Africa Technical Advisory Group (TAG) is meeting this week to review the current epidemiological situation and the impact of the outbreak response and to determine additional strategies needed to close the outbreak. See ‘Horn of Africa’ section below, for more.

 

  • In West Africa, polio staff are supporting efforts to curb the Ebola outbreak affecting the region. Staff are actively engaged in helping preparedness planning, social mobilization, surveillance of suspected cases, contact tracing and assisting with outbreak logistics. 

  

 

  


Wild Poliovirus (WPV) cases

Total cases

Year-to-date 2014

Year-to-date 2013

Total in 2013 

Globally

139

181

416

- in endemic countries

121

71

160

- in non-endemic countries

18

110

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 108     108 24  
24 93 16-Jul-14
Afghanistan 8     8 4     4 14 17-Jun-14
Nigeria 5     5 43
  43 53 27-May-14
Somalia 4     4 100
  100 194 03-Jun-14
Equatorial Guinea 5     5       0  0 03-May-14
Iraq 2     2       0 0 07-Apr-14
Cameroon 5     5       0 4 09-Jul-14
Syria 1     1       0 35 21-Jan-14
Ethiopia      1     1
    0 9 05-Jan-14
Kenya
    0 10     10 14 14-Jul-13
Total 139 0 0 139 181 0   181 416
Total in endemic countries      121 0 0 121 71 0
71 160   
 Total outbreak 18    0   0 18 110 0 0 110 256  

Data in WHO as of 13 August 2013 for 2013 data and 12 August 2014 for 2014 data.

Afghanistan

  • No new WPV1 cases were reported in the past week. The total number of WPV1 cases in 2014 remains eight. The most recent WPV1 case had onset of paralysis on 17 June, from Khost province (linked to virus in North Waziristan, Pakistan).
  • Khost province borders Pakistan, where communities displaced by military action have been leaving North Waziristan. Health authorities in surrounding districts of Pakistan and across the border in Afghanistan have been vaccinating displaced children: more than 35,000 displaced children under the age of 10 are reported to have received a dose of bivalent oral polio vaccine (bivalent OPV) as they entered the Afghan provinces of Paktika and Khost.
  • The next nationwide supplementary immunization activities (SIAs) are scheduled for 17-19 August with trivalent OPV, followed by a bivalent OPV subnational campaign in September.

Nigeria

  • No new WPV1 cases were reported in the past week. The most recent case had onset of paralysis on 27 May in Kano state; Nigeria’s total case count for 2014 is five.
  • No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2014 remains 18. The most recent cVDPV2 case had onset of paralysis on 22 June, from Kano.
  • A vaccination campaign in parts of Borno and Yobe took place from 9 August, using inactivated polio vaccine (IPV), as part of efforts to more rapidly boost immunity levels, particularly in hard-to-reach and inaccessible areas.
  • In other parts of the country, trivalent OPV was administered, as part of urgent efforts to address the spread of cVDPV2. 

Pakistan

  • Four new WPV1 cases were reported in the past week, from Federally Administered Tribal Areas (FATA), Khyber Pakhtunkhwa (KP), Punjab and Sindh, bringing the total number of WPV1 cases for 2014 to 108. The newly-reported case from FATA (North Waziristan) is the most recent in the country, and had onset of paralysis on 16 July.
  • No new cVDPV2 cases were reported in the past week. The country has reported 16 cases of cVDPV2 to date in 2014 and the most recent case had onset of paralysis on 27 May in FR Bannu, FATA.
  • Immunization activities are continuing with particular focus on known high-risk areas.

Central Africa

  • No new WPV1 cases were reported this week. In 2014, ten cases were reported in central Africa: five in Cameroon and five in Equatorial Guinea.
  • Following last week’s confirmation of two cases in Cameroon (from Est province) among refugees from Central African Republic (CAR), coordination with NGOs and organizations such as UNHCR is being strengthened.
  • Efforts are also ongoing to improve immunity levels and surveillance sensitivity in neighbouring CAR. Campaigns in border areas in the west of the country are planned for 23-25 August, and active searches for acute flaccid paralysis (AFP) cases will be conducted as part of the activity.
  • In Equatorial Guinea, the fourth National Immunization Days (NIDs) has just been completed. The activity targeted all children aged <15 years. OPV had been made available on demand for adults. Further SIAs are planned for 28-31 August, and later in September.

Horn of Africa

  • No new WPV1 cases were reported in the past week. Five cases have been reported in the Horn of Africa to date in 2014: one WPV1 in Ethiopia (14 January) and four WPV1s in Somalia (the most recent on 3 June in Mudug, Puntland).
  • New innovations had been implemented in Mudug and surrounding districts, in response to detection of recent cases there. The innovations focused on implementing three SIAD rounds in July and early August (including reaching out to older age groups); rolling out independent monitoring; ensuring recruitment of locally-appropriate vaccinators; and, increased and strengthened social mobilization activities, including sensitizing clan leaders and elders on the importance of vaccination.
  • A high-level visit to the activities was made by the State Minister of Health of Puntland.
  • To strengthen surveillance, all polio workers (including vaccinators) were sensitized to actively search for AFP cases. Village polio volunteers were recruited to conduct active community-based AFP surveillance. Contact sampling of AFP cases is being expanded, and a new initiative will focus on collecting and investigating stool samples from healthy children, as part of efforts to get a clearer understanding of transmission.
  • The Horn of Africa TAG is meeting this week, to review the current epidemiological situation, impact of outbreak response and determine additional strategies needed to rapidly interrupt residual transmission in the region. Focus of discussions will be on: reasons for transmission in Puntland, impact of response and additional strategies; further sensitizing subnational surveillance, including in inaccessible areas; expanding contact sampling of AFP cases; and, reaching the chronically-unreached children. 
  • The experiences of the recent operational innovations in Mudug and surrounding areas will help inform discussions.
  

Israel and West Bank and Gaza

  • WPV1 is not being detected in environmental samples in Israel, the West Bank and Gaza Strip in recent months; the most recent positive sample was collected in southern Israel on 30 March. Samples collected from April to July have been negative. Fourteen positive samples were collected from January to July 2014 in Israel, following 136 positive samples in 2013.

Middle East

  • No new cases were reported in the past week. There have been three cases of WPV1 reported in the Middle East in 2014 - two in Iraq and one in Syria. The most recent case reported from Iraq occurred in Mada'in district, Baghdad-Resafa province, with onset of paralysis on 7 April. Syria’s most recent case had onset of paralysis on 21 January 2014.
  • In the Middle East, the second phase of the comprehensive outbreak response is being implemented across the region.
  • WHO and UNICEF are committed to working with all organizations and agencies providing humanitarian assistance to Syrians affected by the conflict. This includes vaccination of all children no matter where they are, whether in government or contested areas of the country, or outside Syria.

West Africa

  • No cases have been reported in West Africa in 2014. The most recent case in the region was due to WPV1 and occurred in Tahoua province, Niger, with onset of paralysis on 15 November 2012. In addition, a single case of cVDPV2 was reported in Niger on 11 July, 2013.
  • Polio staff across West Africa are supporting efforts to control the Ebola outbreak affecting the region. The Ebola outbreak may impact the planned multi-country polio campaigns in September – contingency plans are being currently drawn up.