GPEI Update: Polio this week – As of 25 September 2013

Update: Polio this week – As of 25 September 2013
Global Polio Eradication Initiative
Full report:
[Editor’s extract and bolded text]

:: In the Horn of Africa, intensive outbreak response is continuing. The impact of the response is beginning to be seen, as the number of newly-reported cases from Banadir, Somalia (the epicentre of the outbreak) has declined. At the same time, operations are improving as more children are being reached, including in some inaccessible areas of south-central Somalia. The risk this outbreak poses for the entire region was again underscored this week, however, as two further cases from Ethiopia have been confirmed. See ‘Horn of Africa’ section below, for more information.

:: In Pakistan, 12 new cVDPV2 cases are reported this week, the bulk in North Waziristan, FATA. See ‘Pakistan’ section for more details….

:: …12 new cVDPV2 cases were reported in the past week, 11 from North Waziristan, Federally Administered Tribal Areas (FATA) and one from Gadap, greater Karachi, Sindh. Onsets of paralysis of the new cases are from 3 July to 21 August. This brings the total number of cVDPV2 cases for 2013 to 24.
:: The cases in North Waziristan are 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 WPV1 transmission.
:: Additionally, four new environmental samples tested positive for WPV1, from Peshawar, FATA; Gadap, Sindh; Rawalpindi, Punjab; and, Multan, Punjab. Detection of the sample in Multan is particularly concerning, as WPV1 had not been detected in this area since early 2012.
:: Confirmation of these latest cases in FATA underscores the risk ongoing polio transmission (be it due to WPV or cVDPV) in this area 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. :: FATA is the major poliovirus reservoir in Pakistan and in Asia, with confirmed circulation of both WPV1 and cVDPV2. More than 350,000 children in this area are regularly missed in inaccessible areas, during immunization activities. Efforts are ongoing to curb transmission in this area, including through vaccination at transit points and conducting Short Interval Additional Dose (SIADs) campaigns in areas that have recently become accessible.

Horn of Africa
:: Seven new WPV1 cases were reported in the past week, five from Somalia and two from Ethiopia. The total number of WPV1 cases for 2013 in the Horn of Africa is 191 (174 from Somalia, 14 from Kenya and three from Ethiopia. The most recent WPV1 case in the region had onset of paralysis on 30 August (from Ethiopia).
:: The two new cases from Ethiopia are both from Somali region, bordering Somalia. It is from this region that the first case from the country had been reported. Active case searches for any additional potential cases is continuing.
:: Because of routes of poliovirus spread in previous Horn of Africa outbreaks, this area of Ethiopia had been considered at ‘high risk’, and since June had been conducting large-scale immunization campaigns. The response continues to be further strengthened. For example, World Food Programme (WFP) field monitors have been sensitized on AFP surveillance, and a proposal is being evaluated to use community volunteers to further intensify surveillance.
:: Nationally and regionally, public-private partnership coordination is continuing, with National Command Post meetings being held every Monday, chaired by the Health State Minister or Director MCH. Similar coordination meetings are taking place in Somali region.
:: 28 Permanent Vaccination Posts have now been established along the Ethiopia-Somalia border areas and at large transit points.
:: Social mobilization and mass media activities continue to be scaled up in the country, including jingles on TV and radio and banner productions for local levels…