POLIO Public Health Emergency of International Concern (PHEIC); WHO/OCHA Emergencies

Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)

Polio this week as of 19 May 2021
:: Come and join the virtual launch of the Polio Eradication Strategy 2022-2026, at an online event on Thursday 10 June 2021 (at 2pm, Central European Summer Time).  More information, including registration details, are available here, where you will find the ‘Save the Date’.

Summary of new WPV and cVDPV viruses this week (AFP cases and ES positives):
:: Afghanistan: five cVDPV2 cases
:: Pakistan: one cVDPV2 case
:: China: one cVDPV3 positive environmental sample
:: Liberia: two cVDPV2 positive environmental samples
:: Mali: one cVDPV2 case
:: Nigeria: one cVDPV2 case and one cVDPV2 positive environmental sample

Statement following the Twenty-Eighth IHR Emergency Committee for Polio
21 May 2021 Statement
The twenty-eighth meeting of the Emergency Committee under the International Health Regulations (2005) (IHR) on the international spread of poliovirus was convened by the WHO Director-General on 4 May 2021 with Committee members and advisers attending via video conference, supported by the WHO Secretariat.  The Emergency Committee reviewed the data on wild poliovirus (WPV1) and circulating vaccine-derived polioviruses (cVDPV).  The following IHR States Parties provided an update at the video conference on the current situation in their respective countries: Afghanistan, Kenya, Pakistan, Senegal, South Sudan and Tajikistan…

Conclusion
The Committee unanimously agreed that the risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC) and recommended the extension of Temporary Recommendations for a further three months.  The Committee recognizes the concerns regarding the lengthy duration of the polio PHEIC, but concludes that the current situation is extraordinary, with clear ongoing substantial risk of international spread and utmost need for coordinated international response. The Committee considered the following factors in reaching this conclusion:

Continued risk of WPV1 international spread
Based on the following factors, the risk of international spread of WPV1 appears to be currently very high:
:: Despite the reported drop in the number of WPV-1 cases, there is geographically widespread transmission in Pakistan and Afghanistan as evidenced by positive environmental samples.
:: Isolation of long chain viruses in both countries indicates the possibility of missed transmission in the hard-to-reach population groups.
:: The ongoing inaccessibility in many provinces of Afghanistan has led to the increase in size of  highly susceptible populations which continues to drive higher transmission; to date about three million children were missed during all the nation-wide rounds in 2020 and 2021 (the highest in southern Afghanistan), and the cohort of missed children continues to rapidly grow (https://polioeradication.org/wp-content/uploads/2021/05/Afghanistan_NEAP_2021.pdf).
:: Inconsistent vaccination campaigns quality in critical areas of Pakistan and Afghanistan, including Karachi, Quetta Block and accessible areas of southern Afghanistan.
:: Ongoing barriers to reach missed children in the core reservoirs of Pakistan and Afghanistan, including refusals to polio vaccination.
:: The complicated context of WPV eradication activities in Afghanistan and Pakistan created by the need to simultaneously respond to cVDPV2 and COVID-19.
:: The second wave of COVID-19 that appears to be currently underway in Pakistan, Afghanistan and many polio-affected countries, making the interventions more complex and difficult.

Rising risk of cVDPV2 international spread:
Based on the following factors, the risk of international spread of cVDPV2 appears to be currently very high:
:: Despite the reported decline in the number of cVDPV2 cases, the risk of international spread of cVDPV2 remains quite high as evidenced by recent importation in Senegal (never infected before) and Kenya (re-importation from Somalia).
:: The most updated analyses performed by the GPLN on international spread (Oct – Dec 2020), indicates cVDPV2 exportation from one country to another on 17 occasions.
:: The cVDPV2 transmission in Afghanistan has spread to areas that have been inaccessible for vaccination campaigns due to local bans for more than two years. This appears to be driving the intense transmission there, with continued high risk of national and international spread.
:: The ever-widening gap in population intestinal mucosal immunity in young children since the withdrawal of OPV2 in 2016.
:: The same factors regarding the COVID-19 pandemic as mentioned above…

…Based on the current situation regarding WPV1 and cVDPV, and the reports provided by affected countries, the Director-General accepted the Committee’s assessment on 21 May 2021 and determined that the situation relating to poliovirus continues to constitute a PHEIC, with respect to WPV1 and cVDPV…

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WHO/OCHA Emergencies

Editor’s Note:
Continuing with this edition, we include information about the last apparent update evident on the WHO emergency country webpages, recognizing almost universal and significant interims since last update regardless of the level of the emergency listed.

WHO Grade 3 Emergencies [to 22 May 2021]

Democratic Republic of the Congo – No new digest announcements identified [Last apparent update: 3 May 2021]
Mozambique floods – No new digest announcements identified [Last apparent update: 3 November 2020]
Nigeria – No new digest announcements identified [Last apparent update: 29 Jun 2020]
Somalia – No new digest announcements identified [Last apparent update: 13 July 2020]
South Sudan – No new digest announcements identified [Last apparent update: 4 February 2020]
Syrian Arab Republic – No new digest announcements identified [Last apparent update: 24 October 2020]
Yemen – No new digest announcements identified [Last apparent update: 30 June 2020]

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WHO Grade 2 Emergencies [to 22 May 2021]
Burkina Faso
:: Renforcer les capacités du personnel de santé dans la prise en charge des victimes d…
21 mai 2021

Afghanistan – No new digest announcements identified [Last apparent update: 5 July 2020]
Angola – No new digest announcements identified [Last apparent update: 16 March 2021]
Burundi – No new digest announcements identified [Last apparent update: 04 July 2019]
Cameroon – No new digest announcements identified [Last apparent update: 12 March 2020]
Central African Republic – No new digest announcements identified [Last apparent update: 12 June 2018]
Ethiopia – No new digest announcements identified [Last apparent update: 22 August 2019]
Iran floods 2019 – No new digest announcements identified [Last apparent update: 2 March 2020]
Iraq – No new digest announcements identified [Last apparent update: 512 May 2021
Libya – No new digest announcements identified [Last apparent update: 7 October 2019]
Malawi – No new digest announcements identified [Last apparent update: 22 April 2021
Measles in Europe No new digest announcements identified [Last apparent update: 26-04-2021]
MERS-CoV – No new digest announcements identified [Last apparent update: 8 July 2019]
Mozambique – No new digest announcements identified [Last apparent update: 03 November 2020]
Myanmar – No new digest announcements identified [Last apparent update: 29 March 2021]
NigerNo new digest announcements identified [Last apparent update: 16 avril 2021]
occupied Palestinian territory – No new digest announcements identified [Last apparent update: 4 September 2019]
HIV in Pakistan – No new digest announcements identified [Last apparent update: 27 August 2019]
Sao Tome and Principe Necrotizing Cellulitis (2017) – No new digest announcements
Sudan – No new digest announcements identified [Last apparent update: 24 June 2020]
Ukraine – No new digest announcements identified [Last apparent update: 1 May 2019]
Zimbabwe – No new digest announcements identified [Last apparent update: 10 May 2019]

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WHO Grade 1 Emergencies [to 22 May 2021]

Chad – No new digest announcements identified [Last apparent update: 30 June 2018]
Djibouti – No new digest announcements identified [Last apparent update: 25 novembre 2020]
Kenya – No new digest announcements identified [Last apparent update: 21 May 2021
Mali – No new digest announcements identified [Last apparent update: 3 May 2017]
Namibia – viral hepatitis – No new digest announcements identified [Last apparent update: 20 July 2018]
Tanzania – No new digest announcements identified [Last apparent update: 21 October 2019]

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UN OCHA – Current Emergencies
Current Corporate Emergencies
Ethiopia
No new digest announcements identified

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