Update: Polio this week – As of 30 October 2013
Global Polio Eradication Initiative
Full report: http://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx
[Editor’s extract and bolded text]

:: Following reports of a cluster of 22 acute flaccid paralysis (AFP) cases on 17 October 2013 in the Syrian Arab Republic, wild poliovirus type 1 (WPV1) has been isolated from ten of the cases under investigation. Final genetic sequencing results are pending. Wild poliovirus was last reported in Syria in 1999. A wide-ranging outbreak response plan is urgently being finalized for Syria and countries in the region. For more on the Syria outbreak, please click here
:: South Sudan has been removed from the list of countries with WPV1. Results of additional molecular and genetic testing by the Global Polio Specialized Laboratory at the US Centers for Disease Control and Prevention (CDC) have revealed that an initial instance of simultaneous handling of test specimens from a number of countries in the Horn of Africa resulted in the unintended contamination of the South Sudan specimens with WPV1.
:: The Independent Monitoring Board (IMB) for polio eradication, following its 1-3 October meeting, has published its IMB report to the Polio Oversight Board. For the full report in English, please click here [see excerpt above]

Pakistan
:: Seven new WPV1 cases were reported in the past week. Four were reported from Federally Administered Tribal Areas (FATA) and one from Khyber Pakhtunkhwa (KP), Punjab and Sindh respectively.
:: The total number of WPV1 cases for Pakistan in 2013 is now 53. The most recent WPV1 case had onset of paralysis on 5 October (from Khyber Agency, FATA). The majority of WPV1 cases in Pakistan this year, 38 (72%), are from FATA, of which 16 are from Khyber Agency and 15 from North Waziristan.
:: One new cVDPV2 case was reported in the past week. The total number of cVDPV2 cases for Pakistan is now 30. The most recent cVDPV2 case had onset of paralysis 26 September (from North Waziristan).
:: The situation in North Waziristan is dire. It is the area with the largest number of children being paralyzed by poliovirus in all of Asia (15 WP1 and 23 cVDPV2 cases). It is in an area where immunization activities have been suspended by local leaders since June 2012. It is critical that children in these areas are vaccinated and protected from poliovirus. Immunizations in neighboring high-risk areas are being intensified, to further boost population immunity levels in those areas and prevent further spread of this outbreak.

Horn of Africa
:: In Ethiopia, one new WPV1 case was reported from the Somali region in the past week.
:: In Somalia, six new WPV1 cases were reported this week (two from Bay region and one from Bakool, Lower Juba, Middle Juba, and Lower Shabelle regions respectively).
:: The total number of WPV cases (all WPV1) for 2013 in the Horn of Africa is now 201 (180 from Somalia, 14 from Kenya and seven from Ethiopia). The most recent WPV1 case in the region had onset of paralysis on 30 September (from Lower Shabelle, Somalia)

Syrian Arab Republic
:: Following reports of a cluster of 22 acute flaccid paralysis (AFP) cases on 17 October 2013 in the Syrian Arab Republic, wild poliovirus type 1 (WPV1) has been isolated from ten of the cases under investigation. Final genetic sequencing results are pending. Wild poliovirus was last reported in Syria in 1999.
:: A comprehensive outbreak response is currently underway. Supplementary immunization activities commenced in Syria on 24 October. The main aim is to rapidly reach children in the immediately-affected and high-risk areas, followed by wider scale immunization campaigns.
:: In further response to the Syria outbreak, multiple large-scale SIAs targeting 22 million children over the next 6 months (starting from early November) are being planned across the region (including Lebanon, Jordan, Turkey, Egypt, Iraq and occupied Palestinian territory (West Bank and Gaza).

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WHO: Global Alert and Response (GAR) – Disease Outbreak News
http://www.who.int/csr/don/2013_03_12/en/index.html
Polio in the Syrian Arab Republic
29 October 2013 – Following reports of a cluster of 22 acute flaccid paralysis (AFP) cases on 17 October 2013 in the Syrian Arab Republic, wild poliovirus type 1 (WPV1) has been isolated from ten of the cases under investigation. Final genetic sequencing results are pending to determine the origin of the isolated viruses. Wild poliovirus had not been detected in the Syrian Arab Republic since 1999.

Most of the cases are very young (below two years of age), and were un- or under-immunized. Estimated immunization rates in the Syrian Arab Republic declined from 91 percent in 2010 to 68 percent in 2012.

Even before this laboratory confirmation, health authorities in the Syrian Arab Republic and neighbouring countries had begun the planning and implementation of a comprehensive outbreak response. On 24 October 2013, an already-planned large-scale supplementary immunization activity (SIA) was launched in the Syrian Arab Republic to vaccinate 1.6 million children against polio, measles, mumps and rubella, in both government-controlled and contested areas.

Implementation of an SIA in Deir Al Zour province commenced promptly when the first ‘hot cases’ were reported. Larger-scale outbreak response across the Syrian Arab Republic and neighbouring countries is anticipated to begin in early November 2013, to last for at least six to eight months depending on the area and based on evolving epidemiology.

Given the current situation in the Syrian Arab Republic, frequent population movements across the region and subnational immunity gaps in key areas, the risk of further international spread of wild poliovirus type 1 across the region is considered to be high. A surveillance alert has been issued for the region to actively search for additional potential cases.

WHO’s International Travel and Health recommends that all travellers to and from polio-infected areas be fully vaccinated against polio.
http://www.who.int/csr/don/2013_10_29/en/index.html