POLIO [to 17 October 2015]
Public Health Emergency of International Concern (PHEIC)

GPEI Update: Polio this week as of 14 October 2015
Global Polio Eradication Initiative
Full report link: http://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx
:: In Lao People’s Democratic Republic a circulating vaccine-derived poliovirus type 1 (cVDPV1) outbreak has been confirmed, with one case, an eight year old boy who had onset of paralysis on 7 September. Outbreaks of cVDPVs can arise in areas of low population immunity, emphasizing the importance of strong vaccination coverage. Learn more about VDPVs.
:: Thirty five million children were reached with polio vaccines during the September campaigns in Pakistan. Nearly 3 million children who were previously missed were vaccinated during the catch up days following this campaign. ‘Continuous community-protected vaccination’ (community based vaccinators who carry out immunization activities on an ongoing basis) and health camps are helping to reach children in the most difficult to reach areas.
:: Last week, the Independent Monitoring Board met in London to assess progress towards polio eradication and to make recommendations for the coming months. The report is expected to be published in the next few weeks.
[Selected Country Update Information]
Afghanistan
:: One new wild poliovirus type 1 (WPV1) cases was reported in the past week in Batikot district of Nangarhar with onset of paralysis on 4 September. This is the first case in this district in 2015. The most recent case had onset of paralysis on 6 September in Sherzad district of Nangarhar province. The total number of WPV1 cases for 2015 is now 13.
:: No new positive environmental samples were reported in the past week.
:: Mop-up campaigns are planned in Nangarhar on 18 – 20 October using bivalent oral polio vaccine (OPV), and Gulestan district of Farah using the inactivated polio vaccine (IPV) and bivalent OPV with dates to be confirmed. National Immunization Days (NIDs) will take place on 1 – 3 November using trivalent OPV and Subnational Immunisation Days (SNIDs) are planned from 29 November to 1 December in the south and east of the country using bivalent OPV. Further mop up campaigns will take place in Balabuluk and Khak-E-Safed districts of Farah in November.
Pakistan
:: Two new wild poliovirus type 1 (WPV1) cases were confirmed in the past week, one in Chakwal district of Punjab and one in Karachi-Gulberg, Sindh. The most recent case had onset of paralysis on 16 September in Peshawar. The total number of WPV1 cases for 2015 is now 38, compared to 205 at this time last year.
Lao People’s Democratic Republic
:: One new case of circulating vaccine-derived poliovirus type 1 (cVDPV1) was reported in Lao in the past week, in Bolikhanh district of Borikhamxay province, with onset of paralysis on 7 September. Based on epidemiological considerations and indications that the virus has been circulating for a prolonged period of time, this has been classified as circulating despite it being a single case. This case, an eight year old boy who had received zero doses of polio vaccine, is the only one reported in 2015.
:: Outbreaks of cVDPVs can arise in areas of low population immunity, emphasizing the importance of strong vaccination coverage. Learn more about VDPVs.
:: Planning is underway for an emergency outbreak response
Ukraine
:: No new circulating vaccine-derived poliovirus type 1 (cVDPV1) cases have been reported in the past week. The most recent case had onset of paralysis on 7 July in the Zakarpatskaya oblast, in south-western Ukraine, bordering Romania, Hungary, Slovakia and Poland. The number of cVDPV1 cases reported in 2015 remains 2.
:: Ukraine had been at particular risk of emergence of a cVDPV, due to inadequate vaccination coverage. In 2014, only 50% of children were fully immunized against polio and other vaccine-preventable diseases.
:: Discussions are currently ongoing with national health authorities to plan and implement an urgent outbreak response. More.

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UNICEF and WHO ready to support immediate polio vaccination campaign in Ukraine
UN agencies concerned further delay puts 1.8 million children’s lives at risk
Joint press release
KYIV, Ukraine/COPENHAGEN/GENEVA, 9 October 2015 – Six weeks after the polio outbreak in Ukraine, UNICEF and WHO have stepped up calls for an immediate first round of nationwide polio vaccination…UNICEF and WHO are on standby to support the campaign.

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Vaccination teams work to keep Iraq polio free and combat the spread of cholera
Baghdad, 13 October 2015 – A nationwide campaign to vaccinate 5.8 million children in Iraq against polio was concluded on 11 October after a 2-day extension recommended by the Ministry of Health to achieve maximum vaccination coverage. This effort to ensure that Iraq remains polio free also included the dissemination of life-saving information to 1.5 million households across the country on how to detect, prevent and treat cholera.

Led by the Federal Ministry of Health, in coordination with WHO and UNICEF, the 7-day polio vaccination campaign begun on 4 October included nearly 13 000 vaccination teams deployed throughout Iraq. Each team travelled door to door, visiting individual households to vaccinate children against polio. The current campaign is the eleventh such national effort in Iraq since October 2013, when polio was first detected in neighbouring Syria, and the fourth this year alone.

“WHO is supporting the campaign through a provision of technical expertise at national, regional, and subnational levels in high-risk areas,” said Altaf Musani, acting WHO Representative in Iraq. “Our support also includes financial assistance for polio campaign workers and finger-marking, as well as conducting surveillance activities, which is the only scientific tool to prove that polio has been contained in Iraq,” he added.

Based on preliminary field reports from the campaign, immunization activities are being implemented smoothly. However, security constraints in parts of Ninewa, Al Shergat district in Sala El Din, and parts of Kirkuk are compromising access to all children in these areas.

“UNICEF and partners have taken an innovative approach to the double threat of disease facing children and families in Iraq,” said Peter Hawkins, UNICEF’s Representative in Iraq. “In the context of mass displacement and continuing violence, the humanitarian community has succeeded in administering 36 million doses of oral polio vaccine, doubling the country’s cold chain capacity. Converging existing activities can help the very limited resources make a greater impact, and ultimately save more lives.”