GPEI: Update: Polio this week – As of 26 June 2013

Update: Polio this week – As of 26 June 2013
Global Polio Eradication Initiative
http://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx
[Editor’s extract and bolded text]

:: In Pakistan, the WPV1 outbreak in Bara in Khyber Agency (Federally Administered Tribal Areas – FATA), is continuing. Seven cases have now been reported since end-April. This outbreak is the major WPV reservoir in all of Asia, and is threatening progress achieved elsewhere in the country and in neighbouring Afghanistan. See ‘Pakistan’ section below for more.

:: In Chad and Cameroon, new circulating vaccine-derived poliovirus type 2 (cVDPV2) cases were reported this week. Genetic sequencing is ongoing to determine the origin of these latest cases, though it is likely they are linked to the ongoing cVDPV2 outbreak affecting Chad. See ‘Chad and Cameroon’ sections below for more.

:: In the Horn of Africa, outbreak response is continuing. In Somalia, three campaigns have now been conducted and in Kenya, two large-scale activities have been implemented. Although newly-reported cases are increasing, it is important to note that none of these of these cases represent breakthrough transmission since outbreak response activities began.

Afghanistan
:: One new WPV case was reported in the past week (WPV1 from Nangarhar), bringing the total number of WPV cases for 2013 to three. It is the most recent WPV case in the country and had onset of paralysis on 6 June.

Pakistan
:: One new WPV case was reported in the past week (WPV1 from Bara in Khyber Agency, FATA), bringing the total number of WPV cases for 2013 to 17. It is the most recent WPV case in the country and had onset of paralysis on 6 June.

:: Bara is affected by an outbreak of WPV1, with seven cases now confirmed since end-April. This outbreak is the major WPV reservoir in all of Asia, and is threatening progress achieved elsewhere in the country and in neighbouring Afghanistan. It is an area where limited vaccination activities have been conducted since 2009, due to hampered access and insecurity.

:: In 2011 and 2012, Bara was the epicentre of a major outbreak which also spread to other areas.

Central Africa: Chad and Cameroon
:: In Chad, no new WPV cases were reported in the past week. The most recent WPV case had onset of paralysis on 14 June 2012 (WPV1 from Lac).

:: One new cVDPV2 case was reported in the past week in Chad, bringing the total number of cVDPV2 cases for 2013 to two. It is the most recent cVDPV2 case in the country and had onset of paralysis on 10 April (from N’Djamena).

:: In Cameroon, a cVDPV2 case was also reported from Extreme-Nord (onset of paralysis on 9 May).

:: Genetic sequencing is ongoing to determine the origin of these latest cases, but it is likely that they are linked to the ongoing cVDPV2 outbreak affecting Chad.

:: Emergency outbreak response plans are currently being finalized in both countries. In Chad, nationwide campaigns were held this week (23-26 June) with trivalent OPV. Cameroon will conduct its first round in the north of the country on 15-18 July with trivalent OPV.

Horn of Africa
:: Six new WPV cases were reported in the past week (WPV1s from Somalia), bringing the total number of WPV1 cases in the region to 31 (25 WPV1s from Somalia and six WPV1s from Kenya). The most recent WPV case in the region had onset of paralysis on 23 May (from Banadir, Somalia).

:: The bulk of the newly-reported cases are from Banadir, which remains the epicentre of the outbreak.

:: Although newly-reported cases are increasing, it is important to note that none of these cases represent breakthrough transmission since outbreak response activities began.

:: However, of concern is that two cases have now been reported from districts in Lower Shabelle region in south-central Somalia where access for supplementary immunization activities (SIAs) has been compromised for the past three years. Surveillance in this area, however, remains functional. As many as 500,000 children in this area are at particular risk of polio at the moment. Efforts are ongoing to operate in this area, and vaccinations are continuing at entry and exit points to build up immunity levels.

:: In Somalia, the third round of outbreak response campaigns was conducted last week, including in Banadir (which includes Mogadishu), targeting all age groups.

:: Anecdotal feedback from the field indicates overall good coverage is being achieved, with strong community participation. The fourth round will start on 1 July, again aiming to reach all age groups in Banadir.

:: The security situation continues to be evaluated, especially following the deadly attack on the UN compound in Mogadishu last week.

:: In Kenya, the second round of outbreak response campaigns was conducted last week. In the Dadaab area, all age groups were targeted. The third round will start on 1 July.

:: Immunization campaigns are also planned and being conducted in other countries of the Horn of Africa, notably Ethiopia and Yemen, to urgently boost population immunity levels and minimize the risk of spread of the outbreak.