POLIO [to 31 January 2015]
Public Health Emergency of International Concern (PHEIC)

GPEI Update: Polio this week – As of 28 January 2014
Global Polio Eradication Initiative
[Editor’s Excerpt and text bolding]
Full report: http://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx
:: Over 6 months have passed since the most recent case of wild poliovirus type 1 had onset of paralysis in Nigeria. This signifies dramatic progress in the drive to end polio for good in the last polio-endemic country on the African continent.
:: Ministers of Health from around the world are convening this week at WHO’s Executive Board meeting to set global public health policies. Among other topics, representatives are anticipated to review the current polio epidemiology and global preparedness plans for the phased removal of oral polio vaccines. A report has been prepared to facilitate discussions.
:: This week, a review meeting of experts is taking place in Beirut, Lebanon, to review the impact of current outbreak response activities in the Middle East and agree on strategies for moving forward for phase III of the outbreak response. [see UNICEF announcement below]

Selected country report content:
Pakistan
:: Four new wild poliovirus type 1 (WPV1) cases were reported in the past week, including 2 with onset of paralysis in 2015. One case was reported in Khyber Pakhtunkhwa (KP) province, in Lakki Marwat district; one in the Federally Administered Tribal Areas (FATA), in Khyber Agency; and 2 in Balochistan province (1 in Killa Abdullah and 1 in the newly infected district of Jafarabad). The total number of WPV1 cases in 2014 is now 305, and 3 for 2015. The most recent case had onset of paralysis on 7 January, from KP.
:: To urgently address the intense transmission affecting the country, the government has put in place emergency measures to take advantage of the current ‘low season’ for poliovirus transmission. A ‘low season plan’ has been established, based on lessons learned on accessing populations in insecure areas, engaging communities and fixing remaining operational challenges. Implementation is being overseen by Emergency Operations Centres at federal and provincial levels to ensure accountability for the quality of polio eradication operations. More
West Africa
:: Even as polio programme staff across West Africa help to control the Ebola outbreak affecting the region, efforts are being made in those countries not affected by Ebola to vaccinate children against polio to create a buffer zone surrounding the affected countries. The Ebola crisis in western Africa continues to have an impact on the implementation of polio eradication activities in Liberia, Guinea and Sierra Leone. Supplementary immunization activities (SIAs) in these countries have been postponed and the quality of acute flaccid paralysis surveillance has markedly decreased throughout 2014.
:: NIDs are planned using bivalent oral polio vaccine (OPV) in Niger and Benin on 27 February to 2 March, and Subnational Immunization Days (SNIDs) tentatively in Mali in February with dates to be confirmed. From 27 to 31 March, NIDs will take place in Benin, Burkina Faso, Côte d’Ivoire, Mali, Niger and Senegal using trivalent OPV. NIDs are also scheduled on those dates for the three Ebola-affected countries Guinea, Liberia and Sierra Leone.
UNICEF: Devastating Middle East polio outbreak on verge of being stopped, say experts
Polio experts cautiously optimistic, but warn that disease could make renewed comeback
BEIRUT, 27 January 2015 – A 12-month emergency immunization response across the Middle East appears to have halted an outbreak of polio that began in Syria and Iraq, according to health experts meeting in Beirut.

The outbreak, which paralysed at least 38 children in Syria and Iraq and prompted fears of a major epidemic, triggered an unprecedented response that immunized more than 27 million children across 8 countries. The outbreak in Syria – which spread to Iraq in early 2014 — occurred due to the introduction of poliovirus from Pakistan.

One year has now passed since the last confirmed case of the virus in Syria and nine months since the last in Iraq, in spite of the ongoing conflict and mass population displacement in the region. Experts say this remarkable achievement is the result of the enormous efforts and commitment shown by governments, health workers, and parents to ensure that their children receive the vaccine.

“In normal conditions we would say that the epidemic has stopped,” said Maria Calivis, UNICEF Regional Director for the Middle East and North Africa. “But given the ongoing conflict, UNICEF and its partners will spare no efforts to ensure that children continue to receive the protection they need against this terrible disease.”

Experts attending a regional Polio review meeting in Beirut January 26-27 warned that with violence still sweeping Syria and Iraq, there is a serious risk that some children are not being reached regularly by vaccination teams. They say that given the gaps in vaccine coverage and potentially in surveillance for new cases, further immunization campaigns are essential over the months ahead.

“This is no time to relax,” said Chris Maher, Manager for Polio Eradication and Emergency Support of the World Health Organization (WHO). “In spite of our success so far, we continue to work with governments and local authorities, United Nations organizations and local and international nongovernmental organizations to ensure that all children across the region are fully protected against polio, including those living in areas most affected by conflict.”

A response plan for the next six months was formulated at the Beirut meeting which was attended by expert teams from Ministries of Health from Syria, Iraq, Jordan, Lebanon, Egypt, Turkey, Gaza and the West Bank and Iran and polio experts from the World Health Organization (WHO), UNICEF, the US Centers for Disease Control (CDC), Rotary International, and the Bill and Melinda Gates Foundation. The plan will focus on strengthening the basic delivery of immunization services, and identifying children and communities who are not being reached due to conflict or population movement….