Polio update for August 23, 2018

Greetings Rotarians:

 

A quick report this week:  no new polio cases!  Two new cVDPV cases, one each in Syria and in Nigeria. 

 

There is a bit of bright news in Nigeria…August 20 marks the two year anniversary of the last case of wild polio in Nigeria!  One more year and Nigeria will be eligible for consideration of a declaration of being polio free.  Note that this is not an automatic “three years and you’re free” declaration.  The Global Polio Eradication Initiative will carefully consider all of the evidence in any country before making a declaration that the country is polio free.  The last thing we want to do is certify a country polio-free and then see cases return.  While we hope for the absolute best, and continued success in Nigeria, we will follow the evidence in reaching that conclusion. 

 

Here’s to one more week of no new polio cases ... we all look forward to the time when the world will be polio free forever.  You are making this happen!

 

 

--Ken

 

Ken Howell

cell 208.371.3483

direct 208.388.4823

fax 208.954.5226

email khowell@hawleytroxell.com

mailing address:

 

·      Summary of new viruses this week: Afghanistan – two new wild poliovirus type 1 (WPV1) positive environmental samples. Democratic Republic of the Congo – circulating vaccine-derived poliovirus type 2 detected in the stool samples of two healthy contacts of two different negative AFP cases. Nigeria – one new case of cVDPV2, and two new cVDPV2 positive environmental samples. Somalia – one new case of cVDPV2. See country sections below for more details.   

 

·         No new cases of wild poliovirus type 1 (WPV1) were reported this week.

·         The total number of cases reported in Afghanistan in 2018 is 11. 

·         The latest case, from Arghandab district, Kandahar province, had onset of paralysis on 17 July 2018.

·         Two new WPV1-positive environmental samples were reported in the past week, one from Jalalabad province, and one from Kandahar province. 

·         During the August immunization campaign, almost ten million children were visited by vaccinators to protect them from the virus.

·         Read the latest polio update from Afghanistan to see information on cases, surveillance and vaccination campaigns.

 

·         No new cases of wild poliovirus type 1 (WPV1) were reported this week.

·         The total number of WPV1 cases reported in Pakistan in 2018 is three.

·         The latest case, from Dukki district, Balochistan province, had onset of paralysis on 18 May.

·         Read the latest polio update from Pakistan to see information on cases, surveillance and vaccination campaigns.  

 

·      No new cases of wild poliovirus type 1 (WPV1) were reported in the past week.  The most recently-detected WPV1 case, from Borno state, had onset of paralysis on 21 August 2016.  

·      One new circulating vaccine-derived poliovirus type 2 (cVDPV2) has been reported in the past week, from Nganzai Local Government Area, Borno state, with onset of paralysis on 13 July.

·      Two new cVDPV2-positive environmental samples were reported in the past week, one from Yobe state, and one from Sokoto state. 

·      In response to cVDPV2 detection, the country continues to conduct acute flaccid paralysis surveillance strengthening activities including enhanced active surveillance visits and community sampling. The programme has also carried out an extensive search for type 2 containing vaccines (tOPV/mOPV2) in the areas surrounding where the virus was detected.

·      The GPEI is working with regional and country counterparts and partners to support an outbreak response and plan the October sub-national immunization activity.

·      At the same time, outbreak response to WPV1 continues, including efforts to address surveillance and immunity gaps in parts of Borno state.

·      Read our Nigeria country page to see information on surveillance and vaccination campaigns. 

 

·      The detection of wild poliovirus type 1 (WPV1) and circulating vaccine-derived poliovirus type 2 (cVDPV2) in Nigeria continue to pose a risk to the neighbouring countries of the Lake Chad basin.

·      Emergency outbreak response efforts continue across the Lake Chad basin, together with activities to fill subnational surveillance gaps in the region. 

·      These include efforts to vaccinate children at markets, in internally displaced persons and refugee camps, and at international borders.

·      Preparations continue for a cross-border synchronized immunization activity in October.

 

·      No new cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) were reported in the past week in the Democratic Republic of the Congo. The total number of cases detected in the country in 2018 remains 11.

·      The country is affected by three separate strains of cVDPV2, in the provinces of Mongola, Maniema and Haut Lomami/Tanganika/Haut Katanga/Ituri.

·      In the past week, circulating vaccine-derived poliovirus type 2 was detected in the stool samples of two healthy contacts of two different negative AFP cases. Based on the positive contacts, AFP cases will be classified as cVDPV2.

·      In response to recent geographic spread of one of the strains, including to Ituri province close to the border with Uganda, provincial governors on 26 July convened an urgent meeting and signed the ‘Kinshasa Declaration for Polio Eradication’. 

·      The high-level meeting was convened by HE the Minister of Health, as well as the WHO Director-General and the Regional Director for Africa.  Provincial governors committed to providing the necessary oversight, accountability and resources needed to urgently improve the quality of the outbreak response being implemented across the country.  Outbreak response since cVDPV was first confirmed in 2017 has been marred by operational challenges, as too many children continue to remain un- or under-vaccinated. This level of oversight can help ensure that operational deficits are rapidly identified and addressed. 

·      The polio outbreak response is being conducted simultaneously to an ongoing Ebola outbreak affecting North Kivu province, in the east of the country (close to provinces affected by cVDPV2).  As in the past, the polio teams are coordinating closely with the broader humanitarian emergency network, to ensure both outbreaks are addressed in a coordinated manner (as was the case during the recent Ebola outbreak in Equateur province, which was successfully stopped).

·      Partners of the Global Polio Eradication Initiative will continue to support authorities across the country, to ensure that this new level of commitment rapidly translates into operational improvements on the ground.

·      Read our Democratic Republic of the Congo country page to see information on surveillance and vaccination campaigns. 

·      Learn more about vaccine-derived polioviruses through this short animation or this ‘Coffee with Polio Experts’ video.

 

·      The Horn of Africa is currently affected by separate outbreaks of cVDPV2 and cVDPV3, reporting both cases and environmental positives.

·      One new circulating vaccine-derived poliovirus type 2 (cVDPV2) was reported in Somalia in the past week, from Daynile district, Banadir province, with onset of paralysis on 10 July.

·      Somalia has reported a total of five cases in 2018: Two cVDPV2, two cVDPV3 and one cVDPV2&3.

·      cVDPV2 has also been detected during 2018 in one environmental sample in Kenya.

·      Outbreak response to both virus types is currently being implemented in line with internationally-agreed guidelines. Large-scale supplementary immunization activities (SIAs) have been implemented in Banadir, Lower Shabelle and Middle Shabelle regions, Somalia, with additional SIAs planned or carried out in the affected zones of the Horn of Africa. Special surveillance activities are being undertaken to determine the origin of the viral circulation.

·      WHO and partners continue to support local public health authorities across the Horn of Africa in conducting field investigations and risk assessments.

·      Read our Somalia country page and Kenya country page to see information on surveillance and vaccination campaigns. 

·      Learn more about vaccine-derived polioviruses through this short animation or this ‘Coffee with Polio Experts’ video.

 

·      No new cases of circulating vaccine-derived poliovirus type 1 (cVDPV1) were reported this week.

·      The total number of cases in the country in 2018 is four (one from Eastern Highland, one from Enga and two from Morobe province). 

·      The latest case, from Eastern Highland province, had onset of paralysis on 8 July.

·      Papua New Guinea officially launched the outbreak response campaign on 16 July in Morobe, Madang and Eastern Highlands provinces. Three more campaigns are planned for late August, September and October.

·      With confirmation of recent cases in Eastern Highland and Enga province, the geographic extent of the outbreak response is currently being reviewed and will be expanded as necessary. 

·      Intensified surveillance measures to improve detection of acute flaccid paralysis and poliovirus are being implemented across the country, with on-the-ground training for provincial and district staff being provided by NDOH and WHO.

·      Read our Papua New Guinea country page to see information on surveillance and vaccination campaigns.

 

·      No new cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) were reported in the past week in Syria. The total number of officially reported cVDPV2 cases in Syria in 2017 remains 74. There are no cases reported in 2018. The most recent case (by date of onset) was reported in Boukamal district, with onset on 21 September 2017.

·      Read the latest polio update from Syria to see information on cases, surveillance and vaccination campaigns.