GPEI Update: Polio this week – As of 26 March 2014
Global Polio Eradication Initiative
Full report: http://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx
[Editor’s extract and bolded text]
:: World’s most populous region certified polio-free: the WHO South East Asia Region was certified polio-free at a ceremony in India this week, meaning that transmission of wild poliovirus has been interrupted in this bloc of 11 countries stretching from Indonesia to India. This achievement marks a significant leap forward in global eradication, with 80% of the world’s population now living in certified polio-free regions.
:: A case of polio due to wild poliovirus type 1 (WPV1) was reported from Iraq this week. This is the first polio case in the country since 2000 and is further evidence of regional spread of the virus. The case, a six-month old boy from Baghdad who had not been immunized, developed paralysis on 10 February 2014. Genetic sequencing indicates the virus is most closely related to virus detected in Syria. WPV1 was also isolated from the child’s three-year old sister, who did not develop symptoms. More
:: The GPEI report to the upcoming World Health Assembly in May is now available online. It summarizes the status against each of the four objectives of the Polio Endgame Strategic Plan, and presents an overview of programmatic priorities for the rest of 2014. The full report is available here and above.
Afghanistan
:: A new case of WPV1 was reported this week from Muhmand Dara district in Nangarhar province (previously without wild poliovirus in 2014) with onset of paralysis on 22 February, bringing the total number of WPV1 cases for 2014 to four. The total number of WPV1 cases for 2013 is 14.
Pakistan
:: Seven new WPV1 cases were reported in the past week, five from North Waziristan, Federally Administered Tribal Areas – FATA, one from Bannu, Khyber Pakhtunkhwa (KP), and one from Peshawar, KP, bringing the total number of cases for 2014 to 36. The most recent case had onset of paralysis on 7 March (WPV1 from North Waziristan, Federally Administered Tribal Areas – FATA).
Central Africa
:: Due to continued poliovirus circulation in Cameroon, gaps in surveillance and influx of vulnerable populations from CAR, WHO is elevating the risk assessment of international spread of polio from Cameroon to very high.
:: Since confirmation of the outbreak in Cameroon in October, five nationwide campaigns have been conducted. However, the quality of implementation varied greatly by region, and serious coverage gaps remain. As many as 40% of children remain under-immunized (with 30% having received zero doses) during SIAs.
:: The recent confirmation of new cases in Cameroon has resulted in planning additional emergency outbreak response activities, including converting a subnational immunization campaign to a full nationwide activity in April 2014, and implementing nationwide campaigns in May and June 2014. Critical to success will be to ensure substantial improvement in the quality campaigns so that all children are reached multiple times with OPV. Equally important will be efforts to rapidly improve the quality of surveillance so that the full extent of the outbreak can be determined and tracked.
:: Immunity levels and surveillance sensitivity are also being assessed in neighbouring countries, in particular in Gabon and the Republic of Congo, and additional immunization activities are being considered in these countries.
Horn of Africa
:: One new WPV1 case was reported in the past week, from Ethiopia. It is the first case in the Horn of Africa in 2014, and had onset of paralysis on 5 January, from Somali region.
Middle East
:: A case of polio due to wild poliovirus type 1 (WPV1) was reported from Iraq last week. This is the first polio case in the country since 2000 and further evidence of regional spread of the virus. The case, a six-month old boy from Baghdad who had not been immunized, developed paralysis on 10 February 2014. Genetic sequencing indicates the virus is most closely related to virus detected in Syria. WPV1 was also isolated from the child’s three-year old sister, who did not develop symptoms.
:: In Iraq, since October, two nationwide immunization campaigns and three subnational campaigns have been conducted, achieving overall high quality. Approximately 95% of children were reported to have been reached during each campaign, though coverage has varied by area. WHO and UNICEF estimates from 2012 put routine immunization levels in Iraq at 70%. Routine immunization levels in Baghdad are estimated to be 81%.
Displacement, violence likely cause of Iraq’s first polio case in 14 years
IRIN – UNOCHA
Excerpt
DUBAI, 24 March 2014 (IRIN) – Health officials in Iraq are stepping up polio immunization and surveillance following the first confirmed case of the virus in the country in more than a decade.
“It is a huge blow because for 14 years Iraq has been polio free,” Syed Jaffar Hussain, head of mission for the World Health Organization (WHO) in Iraq, told IRIN.
WHO’s Eastern Mediterranean Region poliovirus laboratory in Egypt and the Centres for Disease Control and Prevention (CDC) in the USA both confirmed the outbreak, detected after a six-month-old baby living on the outskirts of Baghdad became paralysed.
The strain’s genetic sequence matches the one found last September in Syria – wild polio virus type 1 (WPV1) – but it is not yet clear how the virus made it to the Iraqi capital or how the boy became infected. His family has no links with Syria or record of recent travel there…