GPEI Update: Polio this week – As of 26 February 2014
Global Polio Eradication Initiative
Full report: http://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx

[Editor’s extract and bolded text]
:: Seven new cases (six wild poliovirus type 1 – WPV1 – and one circulating vaccine-derived poliovirus type 2 – cVDPV2) are reported this week from Federally Administered Tribal Areas and Khyber Pakhtunkhwa in Pakistan. This area is largely considered the ‘engine’ for polio transmission in the country.

Pakistan
:: Six new WPV1 cases were reported in the past week, five from North Waziristan, FATA and one from Peshawar, Khyber Pakhtunkhwa (KP). The total number of cases for 2013 remains 93. :: The total number of cases in 2014 is now 21. The most recent case had onset of paralysis on 10 February (WPV1 from Peshawar).
:: One new cVDPV2 case was reported in the past week, from FR Bannu, FATA, with onset of paralysis on 27 January. It is the most recent cVDPV2 case in the country. The total number of cVDPV2 cases for 2013 is 45, and four for 2014.
:: North Waziristan is the district with the largest number of children being paralyzed by poliovirus in the world (both wild and cVDPV2). Immunization activities have been suspended by local leaders since June 2012. It is critical that children in all areas are vaccinated and protected from poliovirus. 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.
:: The densely populated Peshawar valley is considered to be the main ‘engine’ of poliovirus transmission, alongside North Waziristan, due to large-scale population movements through Peshawar from across this region, and into other areas of Pakistan. The quality of operations must be urgently improved in Peshawar, and immunizations resumed in North Waziristan.
:: However, at the same time, concerning trends have been noted in greater Karachi, Sindh and in Quetta, Balochistan. Environmental positives isolates from every major city of Punjab confirm widespread virus circulation.

Horn of Africa
:: One new WPV1 case was reported from Somalia in the past week, with onset of paralysis on 19 June 2013. The case was reported late due to laboratory processing backlog.
:::The total number of WPV1 cases in the Horn of Africa is now 216 (193 from Somalia, 14 from Kenya and nine from Ethiopia). The most recent WPV1 case in the region had onset of paralysis on 20 December 2013 (from Bari, Somalia).
:: Outbreak response across the Horn of Africa is continuing. Recommendations from the recently held Horn of Africa Technical Advisory Group (TAG) are now actively being incorporated into outbreak response planning. The TAG had underscored that the initial response to the outbreak was appropriate, however expressed grave concern that gaps in SIA quality and surveillance remained in key infected areas of the region. Consequently, the group concluded there is a serious risk of the outbreak continuing and of further spread both within and beyond countries of the Horn of Africa. The group recommended that infected countries should focus efforts on high-risk and infected areas, by conducting high-quality SIAs no more than four weeks apart.

Associated Press: Bombs Kill 11 Pakistan Police Guarding Polio Teams
Two Bombs Struck Minutes Apart
March 1, 2014 7:16 a.m. ET
PESHAWAR, Pakistan—Two bombs minutes apart struck tribal police assigned to guard polio workers in northwest Pakistan on Saturday, killing 11, police said.
Police official Nawabzada Khan said the first of the two bombs struck an escort vehicle in the Lashora village of Jamrud tribal region in Khyber Pakhtunkhwa province. It wounded six officers, but caused no deaths.

Mr. Khan said minutes later, another roadside bomb struck a convoy of tribal police officers dispatched there to transport victims of the first attack, killing 11 officers and wounding six. He said gunmen also opened fire on officers, triggering a shootout that was still going on.

A government administrator named Nasir Khan said a hunt had been launched to trace and arrest the attackers. He confirmed 11 deaths and 12 injuries.

No one claimed responsibility for the two separate bombings, but antipolio teams or their guards have been frequently targeted in Pakistan by Islamic militants, who say the campaigns are a tool for spying and claim the vaccine makes boys sterile…