GPEI Update: Polio this week – As of 17 July 2013

Update: Polio this week – As of 17 July 2013
Global Polio Eradication Initiative
http://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx
[Editor’s extract and bolded text]

:: The outbreak in the Horn of Africa is expanding, with 21 newly-reported cases (one from Kenya, 20 from Somalia). In Somalia, two immunization campaigns have been conducted since the most recent case occurred. Outbreak response activities are continuing, and planning and approaches continue to be strengthened. See ‘Horn of Africa’ section for more.

:: Update on WPV in environmental samples in Israel: WPV1 has now been isolated in 30 sewage samples from 10 sampling sites in Israel. The samples were collected between February and June 2013. All viruses have been detected in sewage only – no cases of paralytic polio have been reported. Health authorities in Israel are continuing to conduct a full epidemiological and public health investigation. The Government of Israel is planning supplementary immunization activities (SIAs) with OPV, to boost mucosal immunity levels to rapidly interrupt virus circulation. More.

Pakistan
:: Three new WPV cases were reported in the past week (WPV1s from Khyber Agency and North Waziristan, Federally Administered Tribal Areas – FATA, and in Peshawar, Khyber Pakhtunkhwa – KP), bringing the total number of WPV cases for 2013 to 21. The case from Peshawar is the most recent WPV in the country, and had onset of paralysis on 30 June…

:: …FATA is the major WPV1 reservoir in Pakistan at the moment. Bara in Khyber Agency is particularly affected. This outbreak is threatening progress achieved elsewhere in the country and in neighbouring Afghanistan.

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

:: The new case in North Waziristan is particularly concerning, as it is in an area where immunizations have been suspended by local leaders since last June. Immunizations in neighbouring high-risk areas are being intensified, to further boost population immunity levels in those areas and prevent further spread of this outbreak. North Waziristan is also affected by cVDPV2 cases.

:: Confirmation of these latest cases underscores the risk ongoing polio transmission (be it due to WPV or cVDPV) in the country continues to pose to children everywhere, and in particular to children living in areas where access has not been possible for extended periods of time.

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). No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2013 remains four (the most recent cVDPV2 case had onset of paralysis on 12 May from Ennedi).

:: In Cameroon, one new cVDPV2 case was reported in the past week, bringing the total number of cVDPV2 cases for 2013 to two. This latest case had onset of paralysis on 27 May, from Extreme-Nord. The first case had onset of paralysis on 9 May, also from Extreme-Nord.

:: Emergency outbreak response plans are currently being finalized in both countries. In Chad, nationwide campaigns were held on 23-26 June with trivalent OPV, with further campaigns planned in late July and in August. Cameroon will conduct its first round in the north of the country on 26-29 July with trivalent OPV, with further activities in August and September.

Horn of Africa
:: 21 new WPV1 cases were reported in the past week (one from Dadaab, Kenya, and 20 from Somalia), bringing the total number of WPV1 cases in the region to 73 (65 WPV1s from Somalia and eight WPV1s from Kenya). The most recent case in the region had onset of paralysis on 14 June (the newly-reported case from Kenya).

:: In Somalia, two immunization campaigns have been conducted since the most recent case occurred.

:: Some of the new cases are from inaccessible areas of south-central Somalia. More than 600,000 children are particularly vulnerable to polio in this area. Vaccination posts are being set up in areas bordering inaccessible areas to immunize all populations entering/leaving such areas (including targeting older age groups). Assessments of high-risk areas and populations continue to be conducted, including mapping chronic conflict-areas and major population movement routes. Local-level access negotiations have intensified, to increase access to populations in inaccessible areas.

:: Outbreak response across the Horn of Africa continues to be implemented. In Somalia, campaigns were held on 1-6 July. Planning is under way for NIDs during Ramadan on 21-24 July. Specific radio messages are being developed with the involvement of the Ministry of Religious Affairs.