GPEI Update: Polio this week – As of 21 August 2013

Update: Polio this week – As of 21 August 2013
Global Polio Eradication Initiative
Full report:
[Editor’s extract and bolded text]

:: In Ethiopia, a case of WPV1 has been detected in an 18-month old child from the Somali Region (Warder district.) (see the Horn of Africa section for details)
:: In Israel, WPV1 has been detected in 68 sewage samples collected from 3 February 2013 to 16 August 2013 from 24 sampling sites. (see the Israel section for details)
:: In Somalia, eight new WPV1 cases have been reported this week from previously infected districts.

:: 1 new cVDPV2 case was reported in the past week from a new district, Mohmand, in FATA with the onset of paralysis on 13 July. The total number of cVDPV2 cases for 2013 is 12.
:: FATA remains the major poliovirus reservoir in Pakistan and in Asia, both due to WPV1 and cVDPV2.

Chad, Cameroon and Central African Republic
:: Central African Republic (CAR) continues to be at serious risk of re-infection due to proximity with Chad, ongoing insecurity and humanitarian crises, and destruction of health infrastructure. :: To minimize the risk and consequences of potential re-infection, two subnational immunization campaigns were conducted in June and July. A SNID is planned for September and a NID for October.

Horn of Africa
:: 11 new WPV1 cases were reported in the past week – in previously infected districts in Kenya and Somalia, and in a previously unaffected country, Ethiopia. The total number of WPV1 cases for 2013 is 121 (108 from Somalia,12 from Kenya, 1 from Ethiopia). The most recent WPV1 case in the region had onset of paralysis on 14 July (from Kenya).
:: On 14 August, a case of WPV1 was reported in a child living in Ethiopia with date of onset of paralysis of 10 July 2013. The case is an 18-month old child from the Somali Region (Warder district) of Ethiopia who had never been vaccinated with oral polio vaccine (OPV).
:: Because of the known routes of poliovirus spread in previous outbreaks in the Horn of Africa, the Somali region of Ethiopia had been considered at ‘high risk’, and since June, two large-scale supplementary immunization activities (SIAs) had already been conducted as part of the broader Horn of Africa outbreak response.
:: In Ethiopia, an immediate local immunization campaign is being conducted in the vicinity of the case, with a larger-scale SIA planned targeting 950,000 children under the age of five years. Additional SIAs are planned from September to November. Confirmation of the case in Ethiopia underscores the risk this outbreak continues to pose to countries across the region.
:: Access in some areas of south-central Somalia remains a significant challenge. Analysis shows that as many as 70% of children in inaccessible areas are under-immunized. This compares to 20% in accessible areas of the country. Of the 108 cases reported from Somalia so far, 33 are from inaccessible or only partially-accessible areas; 75 cases are from accessible areas or accessible areas with security challenges.
:: In Kenya, the priority remains on increasing immunity levels in the Dadaab area of North Eastern province. Nearly 50% of children in this area remain under-immunized (compared to less than 5% in Kenya on the whole).

:: WPV1 has been detected in 67 sewage samples from 24 sampling sites in Israel, collected from 3 February 2013 to 4 August 2013. Initially restricted to southern Israel, WPV1 has now also been detected in environmental sampling sites elsewhere in Israel, indicating widespread transmission throughout the country. No case of paralytic polio has been reported.
:: To interrupt WPV1 transmission, a supplementary immunization activity (SIA) with bivalent oral polio vaccine (OPV) targeting children up to the age of nine years was initiated in the southern district of Israel during the week of 5 August; since August 18, the SIA was expanded to the entire country. The objective of the SIA with OPV is to boost intestinal immunity in children vaccinated with IPV only in order to rapidly interrupt wild poliovirus transmission.