Poliovirus Weekly Update July 11, 2018

·         A Disease Outbreak News (DON) notification was issued on 10 July on the Democratic Republic of the Congo’s three concurrent circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreaks.

·         Papua New Guinea prepares for the launch of large-scale immunization campaigns in Morobe, Madang and Eastern Highlands provinces, set to commence next week.

·         Summary of new cases this week: Last week’s advance notifications of one wild poliovirus type 1 (WPV1) case in Afghanistan and one cVDPV2 case in Somalia with a cVDPV2 positive community contact have been confirmed. Two new WPV1 positive environmental samples have been reported in Afghanistan, and four new WPV1 positive environmental samples have been reported in Pakistan. See country sections below for more details. 

·         A new GPEI ‘Coffee With Polio Experts’ video interview featuring World Health Organization’s Honorine Mollard Billard looks at the importance of country support to vaccination campaigns, why polio-free countries need to maintain high immunity levels, and additional health interventions offered to communities during polio campaigns.

 

·         Last week’s advance notification of one wild poliovirus type 1 (WPV1) case in Nad-e-Ali district, Helmand province, has been confirmed. The case had onset of paralysis on 1 June. This brings the total number of WPV1 cases in 2018 (in Afghanistan) to nine. 

·         A sub-national immunization days campaign aiming to reach 6.4 million children under five years of age in 225 high risk districts of 27 provinces, primarily in the southern and eastern parts of the country including Kabul city, has concluded.

·         Two new WPV1 positive environmental samples have been reported: one in Kandahar City, Kandahar province, and one in Jalalabad, Nangarhar province.

·         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 officially reported WPV1 cases in Pakistan in 2018 is three.

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

·         Four new WPV1 positive environmental samples have been reported this week: one in Peshawar and one in Kohat, Khyber Pakhtunkhwa province (both 26 June), one in Karachi, Sindh province (23 June), and one in Islamabad, Punjab province (24 June).

·         A door-to-door polio vaccination round to reach approximately 11 million children in high-risk districts of Pakistan has concluded.

·         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. 

·         Four WPV1 cases were reported in Nigeria in 2016 and no cases have been reported in 2017 or 2018. The most recent WPV1 case (by date of onset) was reported in Monguno Local Government Area, Borno State, with onset on 21 August 2016.

·         One circulating vaccine-derived poliovirus type 2 (cVDPV2) positive environmental sample was reported in Jigawa state, collected on 2 May.

·         Since confirmation of cVDPV2 in Nigeria, virus has been isolated from environmental samples and one case with onset of paralysis on 15 April. 

·         In response to cVDPV2 detection, the country has conducted additional 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. A round of mOPV2 vaccination covering part of Jigawa, Gombe, Bauchi and Sokoto was carried out in May and early June. 

·         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 across the region. 

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

·         In June, one polio vaccination campaign targeting vulnerable island populations in Chad took place. This special vaccination activity concerned the eight health districts of Bagasola, Bol, Isseirom, Karal, Kouloudia, Liwa, Mani and Ngouri. 124 833 children were targeted for vaccination in the island villages in the Lake District and Hadjer Lamis.

·         In a recent meeting in N’Djamena, Chad, the Technical Advisory Group (TAG) reviewed the status of the recommendations from the previous TAG meeting and assessed progress towards closure of the outbreak.

 

·         No new cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) were reported in the past week in the Democratic Republic of the Congo (DRC).

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

·         The total number of cVDPV2 cases reported in the DRC in 2018 is seven.

·         The geographic extent of the outbreak response to all three strains is being re-evaluated, given the confirmed spread of one of the strains to Ituri and confirmation of the third strain in Mongola. The risk of further spread is magnified given the proximity of Ituri to Uganda, and known population movements between affected areas.

·         The Ministry of Health, supported by WHO and partners of the Global Polio Eradication Initiative, remains fully committed to outbreak response in the affected provinces, including use of monovalent oral polio vaccine type 2 (mOPV2) across the country, in line with internationally-agreed outbreak response protocols.

·         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.

·         Last week’s advance notification of one new case of circulating vaccine-derived poliovirus type 2 (cVDPV2) case in Somalia has been confirmed. The case was reported from Dolo district, Gedo region, with onset on 26 May. This is the first detection of cVDPV2 in Gedo region in this outbreak.

·         The Horn of Africa is currently affected by separate outbreaks of cVDPV2 and cVDPV3.

·         Outbreak response to both strains 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 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.

·         In an effort to heighten population immunity against type-2 among high risk populations, more than
5 000 children aged 2-23 months have received inactivated polio vaccine (IPV) in newly accessible areas of eastern Ghouta. In addition, a total of 33 836 children under 5 years of age have received bivalent oral polio vaccine (bOPV). 23 vaccination teams were deployed between March and May 2018 through fixed centres and mobile clinics that also provided other routine immunization.

·         WHO has supported further upgrades to the Syrian National Polio Laboratory, to improve poliovirus diagnostic capacity. Seven national technical staff were trained on intratypic differentiation of poliovirus samples, which will allow for more comprehensive testing and faster identification of results.

·         All empty and expired unopened vials of monovalent oral polio vaccine type-2 (mOPV2) have been destroyed according to global guidelines, under the direct supervision of WHO staff in country.

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

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

·         On 26 June, the Papua New Guinea Government declared the circulating vaccine-derived poliovirus type 1 (cVDPV1) outbreak in Morobe province a National Public Health Emergency.

·         One case of cVDPV1 and two cVDPV1 community contacts were reported in Lae, Morobe province. The case had onset of paralysis on 24 April 2018.

·         The National Department of Health (NDOH) is closely working with GPEI partners in launching a comprehensive response.

·         Preparations are underway for the implementation of large-scale supplementary immunization activities (SIAs), set to take place next week in Morobe, Madang and Eastern Highlands provinces. Four immunization campaigns are planned for July, August, September and October.

·         Mop-up vaccination has taken place in Morobe and Eastern Highlands provinces with bivalent oral polio vaccine (bOPV).

·         Intensified surveillance measures to improve detection of acute flaccid paralysis and poliovirus are being implemented in six provinces and the National Capital District, 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.