POLIOMYELITIS - WORLDWIDE (13): GLOBAL UPDATE, CHALLENGES
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http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] Global update: Polio Eradication Initiative
[2] Pakistan: challenges
[3] Nigeria: challenges
[4] SAGE meeting: OPV2 phaseout
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[1] Global update: Polio Eradication Initiative
Date: Wed 14 Nov 2012
Source: Global Polio Eradication Initiative [excerpted, edited]
http://www.polioeradication.org/Dataand ... sweek.aspx
Global Polio Eradication Initiative update as of 14 Nov 2012
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Total cases
Year-to-date 2012 / Year-to-date 2011 / Total in 2011*
Globally: 187 / 520 / 650
- in endemic countries: 182 / 241 / 341
- in non-endemic countries: 5 / 279 / 309
Case breakdown by country
Country: Year-to-date 2012 WPV1 / WPV3 / W1W3 / Total // Year-to-date 2011 WPV1 / WPV3 / W1W3 / Total // Total in 2011* / Date of most recent case
Pakistan: 51 / 2 / 1 / 54 // 143 / 2 / 0 / 145 // 198 / 27 Oct 2012
Afghanistan: 27 / 0 / 0 / 27 // 53 / 0 / 0 / 53 // 80 / 1 Oct 2012
Nigeria: 83 / 18 / 0 / 101 // 23 / 9 / 0 / 42 // 62 / 15 Oct 2012
India: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 13 Jan 2011
Chad: 5 / 0 / 0 / 5 // 114 / 3 / 0 / 117 // 132 / 14 Jun 2012
DR Congo: 0 / 0/ 0 / 0 // 86 / 0 / 0 / 86 // 93 / 20 Dec 2011
Angola: 0 / 0 / 0 / 0 // 5 / 0 / 0 / 5 // 5 / 7 Jul 2011
Niger: 0 / 0 / 0 / 0 // 1 / 1 / 0 / 2 // 5 / 22 Dec 2011
CAR: 0 / 0 / 0 / 0 // 2 / 0 / 0 / 2 // 4 / 8 Dec 2011
China: 0 / 0 / 0 / 0 // 18 / 0 / 0 / 18 // 21 / 9 Oct 2011
Guinea: 0 / 0/ 0 / 0 // 0 / 3 / 0 / 3 // 3 / 3 Aug 2011
Kenya: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 30 Jul 2011
Cote d'Ivoire: 0 / 0 / 0 / 0 // 0 / 36 / 0 / 36 // 36 / 24 Jul 2011
Mali: 0 / 0 / 0 / 0 // 0 / 7 / 0 / 7 // 7 / 23 Jun 2011
Congo: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 22 Jan 2011
Gabon: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 15 Jan 2011
Total: 166 / 20 / 1 / 187 // 459 / 61 / 0 / 520 // 650
Total in endemic countries: 161 / 20 / 1 / 182 // 230 / 11 / 0 / 241 // 341
Total outbreak: 5 / 0 / 0 / 5 // 229 / 50 / 0 / 279 // 309
*Data in WHO as of 15 Nov 2011 for 2011 data and 13 Nov 2012 for 2012 data.
Afghanistan
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- No new WPV cases were reported in the past week. The total number of WPV cases for 2012 remains 27. The most recent case had onset of paralysis on [1 Oct 2012] (WPV1 from Paktya province).
- The campaign in November [2012] will be held in border areas with Pakistan, and will use a combination of trivalent OPV and bivalent OPV (depending on the area, in response either to recent WPV1 cases in the area, or in response to detection of a circulating vaccine-derived poliovirus type 2 outbreak -- cVDPV2 -- across the border in Pakistan).
Nigeria
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- No new WPV cases were reported in the past week. The total number of WPV cases for 2012 remains 101. The most recent WPV case had onset of paralysis on [15 Oct 2012] (WPV1 from Katsina).
Pakistan
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- 6 new WPV cases were reported in the past week (one WPV1 from Federally Administered Tribal Areas -- FATA -- and 5 WPV1s from Khyber Pakhtunkhwa -- KP), bringing the total number of cases for 2012 to 54. The most recent case was one of the newly reported WPV1 cases from KP with onset of paralysis on [27 Oct 2012].
In addition to transmission of WPV, the country is also responding to a cVDPV2 outbreak (5 cases, all from the greater Quetta area of Balochistan). The most recent NIDs [national immunization days] held in October [2012] had been conducted with trivalent OPV.
Angola
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- No new cases were reported in the past week. No cases have been reported in 2012. The country reported a total of 5 cases in 2011, and the last case had onset of paralysis on [7 Jul 2011] in Uige in the country's north.
- Planned subnational immunization days were postponed because of government transition.
Chad
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- No new WPV cases were reported in the past week. The most recently reported WPV case occurred in the Lac region (WPV1) with onset of paralysis on [14 Jun 2012]. The total number of WPV cases for 2012 remains 5.
- Staggered NIDs with trivalent OPV are ongoing in Chad, officially launched by the Prime Minister. The 1st wave (in the south and east) was held on [27-29 Oct 2012], to be followed by the 2nd wave in the north and west on [9-11 Nov 2012]. Staggering the activities allows the deployment of all available technical support to key high-risk areas. Trivalent OPV is used, including to boost immunity levels to type 2 level, in response to the recent confirmation of the cVDPV2 outbreak affecting the country (5 cases in N'Djamena and 2 close to the border with Sudan). Activities are also planned in the Darfur provinces, Sudan, to minimize the risk and consequences of potential spread across the border.
Democratic Republic of the Congo (DRC)
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- No new WPV cases were reported in the past week. No WPV cases have been reported in 2012. The total number of WPV cases for 2011 is 93 (all WPV1). The most recent case had onset of paralysis on [20 Dec 2011] in Maniema province.
- Although the country has not reported a WPV case since December 2011, it has been affected by a cVDPV2 outbreak in Katanga province in 2012, with 17 cases reported (most recent case: 4 Apr 2012). Efforts are focused on ensuring the cVDPV2 outbreak is fully stopped.
- In some regions, immunization activities have been postponed because of an ongoing Ebola outbreak.
Horn of Africa
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- Efforts are continuing to stop an ongoing cVDPV2 outbreak in Kenya and parts of Somalia (in a Somali refugee camp in Dadaab, Kenya, and Kismayo, south-central Somalia).
- Immunizations of older age groups have taken place in Dadaab. In Somalia, campaigns have been conducted in border areas with Kenya and Ethiopia, and in some areas of central Somalia (access allowing).
West Africa
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No new WPV cases were reported in the past week. No WPV cases have been reported in 2012. The total number of WPV cases for 2011 in West Africa remains 51 (36 from Cote d'Ivoire, 3 from Guinea, 7 from Mali, and 5 from Niger). The most recent case from the region (WPV1 from Niger) had onset of paralysis on [22 Dec 2011].
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[2] Pakistan: challenges
Date: Fri 16 Nov 2012
Source: The Washington Post [edited]
http://www.washingtonpost.com/world/asi ... ory_1.html
Polio fighters in Pakistan struggle against myths and realities
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They gathered in a small room in one of this city's worst slums, a dozen mothers sitting cross-legged with toddlers and newborns on their laps, listening to advice about polio prevention. "Keep your children from playing in garbage cans and sewer drains," said Saddaf Malik, a brightly dressed young woman from UNICEF.
Simple enough, but then came the questions, spiked with suspicion and indicative of why Pakistan remains one of 3 countries in the world where the paralyzing disease still thrives despite constant campaigns in recent years to defeat it.
Why, some mothers wondered, were the vaccination teams coming back once a month, instead of every 3 months, as they used to? Were the repeated doses meant to induce sterility in Muslims?
The polio fighters looked crestfallen. They thought this dangerous myth was dead in Lahore -- a sprawling city with an estimated 1.5 million young children that logged just one polio case a year ago [2011] and none since.
"This is really alarming," the district's chief health officer, Muhammad Saeed Akhtar Ghumman, said in his office later when a UNICEF staffer reported the women's concerns to him.
Troubling, too, was the confirmation of the polio virus in 16 of 28 sewage samples taken so far this year [2012] in Lahore, a marked increase over 2011. And 3 successive positive samples -- in July, August, and September [2012] -- have raised worries about the virus's "silent circulation," as World Health Organization officials call it.
"We take it very seriously if there is even one positive sample," said Ni'ma Abid, a WHO senior medical officer. "It means you have polio in the community."
Still, overall trends in Pakistan, where nearly 30 million children have been vaccinated in recent years, are encouraging. In 1994, when the nation began to fully engage the scourge, polio killed or paralyzed at least 1500 children, by conservative estimates.
Last year's [2011] cases numbered 198 nationwide. This year's tally is 54.
But the intractability of other social ills, including insurgency, poverty, illiteracy, and inadequate sanitation, have conspired to ensure that the country remains years away from meeting its goal of polio eradication by the dawn of 2013.
Last week [11 Nov 2012], a new setback emerged in Balochistan, where doctors reported 5 cases of polio-crippled children in the restive province, which had seen only 4 cases this year.
The new cases are significant because they resulted from the vaccine itself. WHO officials called this extremely rare, but it can happen in places where the level of immunization is exceedingly low and the sanitation poor.
Polio drops contain a weakened polio virus that provides immunity. Once excreted, it has a slim potential to mutate into a strain that can cause paralysis.
The 5 cases of "vaccine-derived polio" -- the 1st seen in Pakistan -- could give skeptical parents another reason to refuse to vaccinate their children, some officials fear.
While refusals have been dropping nationwide, rumors abound that the drops contain religiously proscribed ("non-halal") ingredients or are part of a Western plot to spread infertility and limit Muslim population growth.
A CIA-paid Pakistani doctor's hepatitis immunization campaign, launched to try to collect Osama bin Laden's DNA before his killing last year [2011], also gave a boost to conspiracy theorists and religious leaders who advise parents not to vaccinate their children.
"The problem we already have is trust," said one health official, speaking on the condition of anonymity because of the issue's sensitivity. "The last thing we need right now is giving people another reason to distrust the vaccination campaigns."
Despite significant progress elsewhere in Pakistan, polio has risen in the militancy-hit northwestern province of Khyber Pakhtunkhwa. In North Waziristan and South Waziristan, tribal areas where the Taliban this summer [2012] banned vaccinations in response to US drone strikes, the inoculation teams have no access to 210 000 children. An additional 40 000 in risky frontier zones near the Afghan border also are out of reach.
One key to reducing outbreaks, UN health workers say, is to educate parents such as those at the session in Lahore this month [November 2012]. Those attending were ethnic Pashtuns, the descendants of Afghan refugees who came to Lahore in the 1980s, along with millions of others who swarmed across the border after the Soviets invaded Afghanistan.
Pashto speakers have accounted for 85 percent of the nation's polio cases in the past 3 years, officials report. These include transients from the tribal region who relocate to enclaves here -- and in other cities, such as Karachi -- bringing the virus with them. (Afghanistan and Nigeria are the only other 2 countries where polio is endemic.)
In Lahore, UNICEF dispatches "social mobilizers" to comb flyblown streets and refugee hovels over and over, trying to account for what they term "missed children" -- the still-unvaccinated ones who are potential polio time bombs.
To help find them, Mayor Noor-ul-Amin Mengal hired 34 Pashto-speaking college students to bridge communication gaps in a recent inoculation campaign. He said he also recruited 30 religious leaders to support the effort.
Is it working?
"Parents do not object to the drops," said a 20-year-old teacher leading a class for Afghan children in a 3-walled brick structure. He said all 40 of his pupils younger than 5 had been vaccinated.
Nearby, a frail, thin mother peeked from behind a worn tarp and nervously greeted the vaccinating team -- 2 plump women in nicely pressed Pakistani-style chemises and a young man in Western office wear. They were checking on the 11 children under the age of 3 who lived in the refugee compound and would need follow-up doses.
The thin woman reported a new arrival, a 4-day-old baby. The mobilizers said they would be back to administer drops. She darted quickly back inside.
That morning, the team also visited a preschool drop-in center in search of 5 missed children. The staff provides free breakfast and said they sometimes give polio drops without parental permission. The 5 children weren't to be found.
A few yards down the street, a little girl climbed into a garbage bin in search of nourishment. She found a wrapper containing a morsel, gnawed at it, then skittered off into an alley reeking of sewage.
[Byline: Richard Leiby]
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[3] Nigeria: challenges
Date: Sun 18 Nov 2012
Source: The Guardian [edited]
http://www.ngrguardiannews.com/index.ph ... &id=105217
Insecurity scares anti-polio officials from Kaduna communities
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For fear of being attacked by armed robbers and other criminals, anti-polio officials have declined rendering their services in 16 communities in Birnin Gwari Local Council of Kaduna State, cutting off the children from assessing oral polio vaccination.
It was learnt that the local council has been under the invasion of rampaging robbers in the past few months, with the last bloody attack on Dogo Dawa community where over 20 villagers were allegedly killed and many injured recently.
Already, the state has recorded 14 fresh cases of polio infection between January to November this year [2012], with Northern part of the Kaduna State leading with 13 cases due to non-vaccination of the children for political and religious reasons.
Addressing participants at a workshop organised by Journalists Against Polio (JAP), Sunday [18 Nov 2012], the representative of the State Ministry of Health who is the Secretary, State Action Committee on immunization, Alhaji Lawal Abubakar urged health officials and vaccinators to be responsive to their professional callings by penetrating the so-called danger zones to immunise the children against polio.
According to Abubakar, "if war-torn countries like Somalia and Sudan were in the forefront of immunising children despite the ravaging crises, Nigeria, particularly the Northern part of the country, has no excuse to ward off any danger for the sake of saving children from the transmissible disease.
"Communities not reached by vaccinators because of insecurity due to fear of attack by armed robbers include Kuyello, Magajin Gari 111, Dogo Dawa, and Gayam with 16 settlements under them."
He expressed regrets that Northern Nigeria was dragging the country back in the fight against polio, pointing out that if parents in the zone subject their children to routine vaccination, the scourge would have been kicked out of the country because, "if one child is infected with the virus, it can be transmitted to over 200 children."
The Health Ministry official argued that out of 179 global polio cases, "Nigeria is leading with 100 cases with the entire Northern zone nursing the whole 100 cases of polio infection in the country."
Abubakar advised parents to allow their children to take polio vaccination, saying the rumour that the vaccine is a calculated attempt by western world to reduce population is a campaign of calumny by people who do not want the polio programme to succeed.
Said Alhaji Abubakar: "There is need for immunization against polio as long as children are being born, vaccination will continue even if it is one child that is being born because it is a huge cost to keep a child with polio infection than to prevent it. The parents who are kicking against this immunization usually take the vaccination themselves when they go on pilgrimages. So why take what you prevented your child from taking?"
He therefore urged journalists to help in educating and enlightening the people in the state about importance of vaccination against polio, noting that lack of communication between the vaccinators and parents was one of the reasons for non compliance on the part of the benefactors.
Meanwhile, Governor Patrick Ibrahim Yakowa has lamented the prevalence of polio cases in the country, expressing regret that Nigeria has become the most entrenched reservoir of the wild polio virus in the world.
[Byline: Saxone Akhaine]
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[4] SAGE meeting: OPV2 phaseout
Date: Wed 14 Nov 2012
Source: Global Polio Eradication Initiative [excerpted, edited]
http://www.polioeradication.org/Dataand ... sweek.aspx
- The Strategic Advisory Group of Experts on immunization (SAGE) met last week [week of 5 Nov 2012] in Geneva, Switzerland. During this meeting, the draft polio eradication and endgame strategy for 2013-2018 and current status of the global polio eradication programme were presented to SAGE.
- SAGE endorsed the 4 major objectives and milestones in the new strategic plan. SAGE also recommended that all countries should introduce at least one dose of inactivated polio vaccine (IPV) in their routine immunization programmes to mitigate the risks and consequences associated with the eventual withdrawal of the type 2 component of OPV (OPV2). SAGE will review progress on achieving the pre-requisites for OPV2 withdrawal, including the availability of affordable IPV products, every 6 months to ensure the earliest possible date for OPV2 withdrawal but with sufficient advance notification to ensure programmatic readiness and vaccine availability.
[For more information on the SAGE meeting, follow the links provided at http://www.who.int/immunization/sage/me ... index.html. Links to all the background documents presented to the SAGE at the 6-8 Nov 2012 meeting can be found at http://www.who.int/immunization/sage/me ... index.html. Mod.MPP]
[The reports above paint a picture that is filled with good news and bad news. The exceptionally good news deals with the record low number of reported cases of poliomyelitis in the world -- with the current case count (as of 14 Nov 2012) of a total of 187 cases compared with 520 cases reported during the same time period in 2011. The other good news is that only 4 countries have reported polio cases during 2012 -- Pakistan, Afghanistan, Nigeria, and Chad -- of which Chad is the only non-polio endemic country reporting cases, the date of onset of the last case was 14 Jun 2012, suggesting that the outbreak in Chad may have been contained, and that the other non-endemic countries remain polio free in 2012.
The bad news in the reports above involves the continued obstacles and barriers to vaccination activities and vaccine acceptance in the endemic countries. The safety issues confronting the vaccination teams in the endemic countries and the continued rumors surrounding the safety of the vaccine or rumors speculating nepharious intentions on the part of "the West" to administer sterilizing agents to children.
The other disturbing information in the reports above is the continued appearance of cases of polio associated with infection with circulating vaccine derived poliovirus type 2(cVDPV2) in 6 countries during 2012 -- Pakistan, Chad, Nigeria, Somalia, Kenya, DR Congo (see http://www.polioeradication.org/Dataand ... virus.aspx for a table showing the number of cases of polio due to infection with cVDPV by virus type, year and country.) As cases of polio due to infection with cVDPV occur in areas with low vaccination coverages where the vaccine virus is/was able to continue circulation for prolonged periods allowing reversion of the vaccine virus to a more neurovirulent virus, the occurrence of these cases highlights areas that are at risk of WPV circulation if the virus is introduced due to a high number of susceptibles in the population. The recommendation of the Strategic Advisory Group of Experts on immunization (SAGE) that "all countries should introduce at least one dose of inactivated polio vaccine (IPV) in their routine immunization programmes to mitigate the risks and consequences associated with the eventual withdrawal of the type 2 component of OPV (OPV2)" is a recognition that the risk of disease associated with OPV2 is greater than the risk of disease from WPV2 (the last case of polio associated with WPV2 infection in the world was in 1999).
For a map showing the geographic locations of WPV associated cases, see http://www.polioeradication.org/Dataandmonitoring.aspx. For a map showing the geographic locations of cVDPV cases, see http://www.polioeradication.org/Dataand ... virus.aspx. - Mod.MPP]
Kinderlähmung - Poliomyelitis
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Kinderlähmung - Poliomyelitis weltweit
POLIOMYELITIS - WORLDWIDE (14): PAKISTAN, AFGHANISTAN, CIRCULATING VACCINE DERIVED POLIOVIRUS TYPE 2
****************************************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] Pakistan, Afghanistan: cVDPV2
[2] Pakistan (Balochistan): cVDPV2
[3] Global update: Polio Eradication Initiative
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[1] Pakistan, Afghanistan: cVDPV2
Date: Mon 3 Dec 2012
Source: Dawn [edited]
http://dawn.com/2012/12/03/polio-outbre ... arm-bells/
Polio outbreak in Balochistan sets off alarm bells
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The outbreak of a hitherto unknown strain of polio virus in Qilla [or Killa] Abdullah and Pishin has set alarm bells ringing and prompted the centre to ask the Balochistan government to launch an anti-polio campaign in the province within 30 days.
Over the past 3 weeks, 10 cases of the new virus, named "Sabin-like type 2 poliovirus", were reported in 2 Pakhtun-dominated districts of the province. "The districts are frequented by people from the troubled areas of Fata [Federally Administered Tribal Areas]. The situation is grim because of refusal by parents to get their children vaccinated against the crippling disease as the areas are under the influence of extremist groups opposed to the anti-polio drive.
"The extremists belonging to Lashkar-i-Jhangvi and Tehrik-i-Taliban Pakistan have established their cells in Balochistan and warn people against vaccination of their children," Zohra Yusuf, chairperson of the Human Rights Commission of Pakistan (HRCP), told Dawn.
She said an HRCP team had visited Pishin and Qilla Abdullah in May [2012] to meet the local people and it was revealed that extremists had established their camps and were involved in killing people from Punjab. She said the people mostly coming from Khyber Pakhtunkhwa and other tribal areas brought the virus with them.
The Prime Minister's Office has also declared 'red alert' against the poor state of polio eradication drive in Balochistan and asked the administration to launch an emergency campaign in the province.
In a letter addressed to the chief secretary of Balochistan, copy of which is available with Dawn, Special Assistant to the Prime Minister Shehnaz Wazirali has conveyed the utter disappointment of the highest office in response to the way polio eradication drive is being carried out in Balochistan.
"The situation in Quetta block, which includes Killa Abdullah and Pishin, is aggravated by the continued resistance to and intransigence of the district health authorities and supervisory cadre of vaccinators," it said.
The letter said the new polio virus had not only affected 10 children in Pakistan but also paralysed 2 children in Afghanistan's Kandahar province. "I want to draw your attention to the reporting of Sabin-like polio virus cases in Qilla Abdullah and 2 from neighbouring Afghanistan," Shehnaz Wazirali said in the letter.
The PM Office also expressed concern over the low level of routine immunisation and asked the provincial government to immediately hold three rounds of anti-polio campaign in Qilla Abdullah beginning from the second week of December. "Highest quality should be ensured with strict monitoring and zero tolerance for under performance."
The letter called for urgent steps to institute the WHO's direct disbursement mechanism across the board for payment to the polio team staff. Measures should also be taken to improve the routine immunisation coverage in Qilla Abdullah on an emergency basis with clear targets and milestones given to district health teams.
"Stubbornness of the provincial health department and government supervisors for polio eradication in Balochistan is one of the biggest reasons behind dismal performance of the polio programme that has resulted in detection of new strain of poliovirus in Pakistan and threatens to impose travel restrictions on citizens that may put the country in an extremely embarrassing situation in the near future," the letter said.
WHO Team: A special 6-member international delegation of the World Health Organisation, led by polio eradication expert Dr Mohammed Mohammedi, is currently holding discussions with officials of the Balochistan government on ways of combating the new strain of poliomyelitis virus.
Dr Mohammedi told Dawn that the delegation was holding brainstorming sessions with the provincial officials to control the situation. "We had a fruitful session with the provincial chief secretary today and recommended for holding 3 emergency anti-polio campaigns in Quetta, Qilla Abdullah, and Pishin districts in 30 days to control the spread of the virus to other parts of the country," he said, adding that it was decided that the 1st emergency polio round in the province would be launched on [10 Dec 2012.
When contacted, Noorul Haq Baloch, Additional Secretary of Health in Balochistan, painted a rosy picture and said only 4 cases of polio had been detected this year as compared to 74 cases last year. "Polio cases have been on decline in Balochistan," he claimed.
He said Sabin-like polio virus was a new disease and the provincial health department was planning to conduct 3 rounds on [10 and 23 Dec 2012] and [7 Jan 2013] on the directives of the chief secretary.
Mr Baloch disclosed that some health officials had expressed reservations over the new system of payment to the officials involved in the campaign, but said things would improve in the coming days.
He rejected a perception that the constant movement of people from the troubled areas of Fata to Killa Abdullah was one of the major reasons for the spread of polio and said most of the cases ware detected in areas where people were poor and illiterate.
Shahnaz Wazir Ali told Dawn on Sunday [2 Dec 2012] that most refusal cases came from Pushto-dominated areas of Killa Abdullah. "The main cause of refusal is illiteracy and ignorance," she said.
She expressed concern over the children in Khyber Pakhtunkhwa consistently being missed during anti-polio campaigns. She said Karachi's polio cases also revealed that a child contracted the virus from Khyber Pakhtunkhwa.
"In Balochistan, the problem also occurs due to zonal health supervisors as they want to include their own people in the campaign. We have no objection but we want work," she said.
[Byline: Aamir Yasin]
[For the interactive HealthMap/ProMED map of Pakistan, see http://healthmap.org/r/1iGJ.
For the interactive HealthMap/ProMED map of Afghanistan, see http://healthmap.org/r/1CnW. - Mod.MPP
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[2] Pakistan (Balochistan): cVDPV2
Date: Mon 3 Dec 2012
Source: The Express Tribune [edited]
http://tribune.com.pk/story/473980/new- ... ghanistan/
New polio strain from Pakistan hits Afghanistan
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Officials say newly-discovered Sabin-Like ([type]2) [polio virus that is genetically similar to the oral polio vaccine is referred to as a vaccine-derived poliovirus -- VDPV, and when there are 2 or more cases of the same genetically lined virus, it is considered to be a circulating vaccine derived poliovirus -- cVDPV) poliomyelitis originated in Balochistan.
With the Independent Monitoring Board recommending travel restrictions on polio endemic countries, reports of the transmission of a newly-discovered poliovirus strain from Pakistan to Afghanistan is likely to complicate an already tough situation for Islamabad.
Two Afghan children, living close to the border with Pakistan, have been paralysed by the Sabin Like (2) poliomyelitis [cVDPV2], officials in the Polio Programme told The Express Tribune. The cases were reported from Afghanistan's Kandahar province 2 days ago -- one in Panjwai district and the other in Spin Boldak, they added. The World Health Organisation (WHO) has confirmed the 2 new cases.
According to the officials, genetic sequencing has confirmed the new polio strain originated in Balochistan's Killa Abdullah district. They said Sabin Like (2) [cVDPV2] poliomyelitis develops in children with an extremely poor record of routine immunisation -- a situation rampant in Balochistan.
Since 2006, polio vaccination teams have repeatedly missed an estimated 50 000 children in Killa Abdullah, derailing efforts to eradicate the virus in the country. This is not the 1st case of poliovirus transmission from Pakistan to a neighbouring country either. Last year [2011], 16 children in China's Xinjiang province were paralysed after being infected by a polio strain originating in Pakistan.
"The paramedic association and health department of Balochistan continues to hold the polio-eradication campaign hostage in Killa Abdullah through unfair demands... It has now resulted in embarrassment for Pakistan before the world community," an official of the Expanded Programme on Immunisation (EPI) told The Express Tribune on condition of anonymity.
WHO senior coordinator for polio eradication Dr Elias Durry said the organisation was monitoring the situation in Balochistan closely.
"We are seriously concerned about the new poliovirus strain and are recommending urgent steps to the provincial government to contain the outbreak," said Dr Durry. The only way to contain the spread of the virus is by conducting 3 to 4 high-quality polio vaccination rounds in the infected districts and their nearby areas," he said.
Meanwhile, a special WHO delegation, led by internationally acclaimed polio eradication expert Dr Mohammed Mohammedi, has reached Balochistan and is holding in-depth discussions with the provincial government over ways to combat the outbreak.
"We have asked the provincial government to hold 3 emergency polio campaigns each in Quetta, Killa Abdullah, and Pishin districts during a span of 30 days to control the spread of the virus to other parts of the country," said Dr Mohammedi, adding that the 1st campaign in the 3 districts was scheduled for [10 Dec 2012].
Pakistan has reported a total of 56 polio cases this year [2012] so far. A massive 181 cases were reported in 2011.
[Byline: Sehrish Wasif]
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[3] Global update: Polio Eradication Initiative
Date: Wed 28 Nov 2012
Source: Global Polio Eradication Initiative [excerpted, edited]
http://polioeradication.org/Dataandmoni ... sweek.aspx
Global Polio Eradication Initiative update as of 27 Nov 2012
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Total cases
Year-to-date 2012 / Year-to-date 2011 / Total in 2011*
Globally: 202 / 553 / 650
- in endemic countries: 197 / 265 / 341
- in non-endemic countries: 5 / 288 / 309
Case breakdown by country
Country: Year-to-date 2012 WPV1 / WPV3 / W1W3 / Total // Year-to-date 2011 WPV1 / WPV3 / W1W3 / Total // Total in 2011* / Date of most recent case
Pakistan: 53 / 2 / 1 / 56 // 159 / 2 / 0 / 161 // 198 / 10 Nov 2012
Afghanistan: 31 / 0 / 0 / 31 // 58 / 0 / 0 / 58 // 80 / 9 Nov 2012
Nigeria: 92 / 18 / 0 / 110 // 36 / 9 / 0 / 45 // 62 / 4 Nov 2012
India: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 13 Jan 2011
Chad: 5 / 0 / 0 / 5 // 114 / 3 / 0 / 117 // 132 / 14 Jun 2012
DR Congo: 0 / 0/ 0 / 0 // 87 / 0 / 0 / 87 // 93 / 20 Dec 2011
Angola: 0 / 0 / 0 / 0 // 5 / 0 / 0 / 5 // 5 / 7 Jul 2011
Niger: 0 / 0 / 0 / 0 // 1 / 1 / 0 / 2 // 5 / 22 Dec 2011
CAR: 0 / 0 / 0 / 0 // 2 / 0 / 0 / 2 // 4 / 8 Dec 2011
China: 0 / 0 / 0 / 0 // 18 / 0 / 0 / 18 // 21 / 9 Oct 2011
Guinea: 0 / 0/ 0 / 0 // 0 / 3 / 0 / 3 // 3 / 3 Aug 2011
Kenya: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 30 Jul 2011
Cote d'Ivoire: 0 / 0 / 0 / 0 // 0 / 36 / 0 / 36 // 36 / 24 Jul 2011
Mali: 0 / 0 / 0 / 0 // 0 / 7 / 0 / 7 // 7 / 23 Jun 2011
Congo: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 22 Jan 2011
Gabon: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 15 Jan 2011
Total: 181 / 20 / 1 / 202 // 492 / 61 / 0 / 553 // 650
Total in endemic countries: 176 / 20 / 1 / 197 // 254 / 11 / 0 / 265 // 341
Total outbreak: 5 / 0 / 0 / 5 // 238 / 50 / 0 / 288 // 309
*Data in WHO as of 29 Nov 2011 for 2011 data and 27 Nov 2012 for 2012 data.
Afghanistan
-----------
- One new WPV case was reported in the past week (one WPV1 from Khost), bringing the total number of WPV cases for 2012 to 31. It is the most recent case in the country and had onset of paralysis on [9 Nov 2012].
- Khost province is on the country's eastern border with Pakistan. Though Khost is not an endemic area, a case was reported in September [2012] as well. Both cases are linked to virus circulating in Quetta, capital of Balochistan province in Pakistan.
- The Independent Monitoring Board has stated that Afghanistan has made progress, but too slowly, and that too many children in southern Afghanistan are missed not just due to insecurity but also due to remaining managerial challenges. As with each of the 3 endemic countries, the IMB [Independent Monitoring Board] recommends 'absolute ownership' by leaders at all levels.
- The Technical Advisory Group (TAG) met in Kabul earlier this week [week of 28 Nov 2012], to review impact of the national polio emergency action plan and discuss additional tactics to address ongoing immunity gaps in known high-risk districts.
- Management trainings of polio staff continue, to address managerial and administrative obstacles in the programme.
- To further boost immunity levels in security-compromised areas, special strategies continue to be implemented including the vaccination of populations moving in and out of such areas. Supplementary immunization activities (SIAs) took place last week, with the next activity planned for December [2012].
Nigeria
-------
- 6 new WPV cases were reported in the past week (5 WPV1s from Katsina and one WPV1 from Borno), bringing the total number of WPV cases for 2012 to 110. A WPV1 from Katsina is the most recent in the country and had onset of paralysis on [4 Nov 2012].
- Katsina has now had 32 cases, and represents nearly one-third of all of Nigeria's cases this year [2012]. The state has the most intense transmission of wild poliovirus in the world at the moment, accounting for more than 15 percent of all polio cases globally this year [2012].
- The new case in Borno is the first since August [2012]. Insecurity in Borno continues to complicate operations, and the state's proximity to Chad is cause for concern. Historically, polio from Borno has spread east into Chad and from there onwards.
- Another area of concern is Sokoto, as in the past polio has spread from Sokoto into neighbouring countries of West Africa. While immunity levels are improving, overall the population is under-immunized, with approximately 60 percent of children having received greater than 3 doses of OPV (compared to a 80 percent national average). Operational challenges in the state continue to hamper basic implementation. However, under the leadership of the State Governor, there is a renewed effort to address these, including by continuing to review and strengthen micro-plans to more clearly identify missed settlement areas; reviewing workloads of individual vaccination teams; and increasing supervision and accountability at the Local Government Area (LGA) level and the ward-level. [For more on this see http://www.polioeradication.org/tabid/4 ... fault.aspx. This press release from the Polio Eradication Initiative discusses the concerns in Sokoto -- a good summary is seen in the following quote: "And while Sokoto has reported a deceptively low 8 cases so far this year [2012], environmental surveillance regularly detects wild poliovirus and the state has reported a case of circulating vaccine-derived poliovirus type 2 -- sure signs that too few children are immunized." - Mod.MPP]
- The Independent Monitoring Board has stated that Nigeria's programme could be on the brink of a breakthrough, but that it continues to represent a risk to other countries. The IMB report concludes that success in Nigeria, and all of Africa, lies in the hands of the Nigerian programme -- "from President to vaccinator." As with each of the 3 endemic countries, the IMB recommends 'absolute ownership' by leaders at all levels.
- Immunization Plus Days (IPDs) were concluded last week [week of 19 Nov 2012]. The activity had been delayed by one week, to allow additional preparatory time.
- In December [2012], trivalent OPV will be added to planned Child Health Days (with meningitis vaccine) on [1-10 Dec 2012], and subnational IPDs will be conducted using bivalent OPV ([15-18 Dec 2012]). This will be an opportunity to administer 2 additional doses of OPV to children in highest-risk areas, within the space of a single month.
Pakistan
--------
- 2 new WPV cases were reported in the past week (WPV1s from Khyber Pakhtunkhwa -- KP, and Federally Administered Tribal Areas -- FATA), bringing the total number of WPV cases for 2012 to 56. The WPV1 from FATA is the most recent case in the country and had onset of paralysis on [10 Nov 2012].
- Additionally, 2 new cVDPV2 cases were reported in the past week, bringing the total number of cVDPV2 cases to 7 (all from the greater Quetta area of Balochistan).
- The Independent Monitoring Board has stated that Pakistan's chances of success have greatly improved over last year [2011], but that next year's [2013] elections and a complex security situation are major risks in 2013. As with each of the 3 endemic countries, the IMB recommends 'absolute ownership' by leaders at all levels.
- Preparations are underway for the next Subnational Immunization Days, scheduled for mid-December [2012], in high-risk areas across the country using bivalent OPV.
Angola
------
- No new cases were reported in the past week. No cases have been reported in 2012. The country reported a total of 5 cases in 2011, and the last case had onset of paralysis on [7 Jul 2011] in Uige in the country's north.
Chad
----
- No new WPV cases were reported in the past week. The most recently reported WPV case occurred in the Lac region (WPV1) with onset of paralysis on [14 Jun 2012]. The total number of WPV cases for 2012 remains 5.
- To urgently stop an ongoing cVDPV2 outbreak (6 cases in N'Djamena and 2 cases close to the border with Sudan), while further boosting immunity to type 1 and type 3 poliovirus, a 2nd round of staggered Sub-national Immunization Days were held [23-25 Nov 2012] (in the south and east), to be followed on [7-9 Dec 2012] (in the north and west), using trivalent OPV.
Democratic Republic of the Congo (DRC)
--------------------------------------
- No new WPV cases were reported in the past week. No WPV cases have been reported in 2012. The total number of WPV cases for 2011 is 93 (all WPV1). The most recent case had onset of paralysis on [20 Dec 2011] in Maniema province.
- Although the country has not reported a WPV case since December 2011, it has been affected by a cVDPV2 outbreak in Katanga province in 2012, with 17 cases reported (most recent case: [4 Apr 2012]). Efforts are focused on ensuring the cVDPV2 outbreak is fully stopped.
- Supplementary immunization activities are ongoing from [27-29 Nov 2012] using a combination of bivalent and trivalent OPV.
Horn of Africa
--------------
- No further cases have been reported in the cVDPV2 outbreak in Kenya and parts of Somalia (in a Somali refugee camp in Dadaab, Kenya, and Kismayo, south-central Somalia).
- New tactics are being explored to further boost immunity levels in and around inaccessible areas of south-central Somalia and to improve integration of polio vaccination with humanitarian activities across the Horn of Africa.
West Africa
-----------
- No new WPV cases were reported in the past week. No WPV cases have been reported in 2012. The total number of WPV cases for 2011 in West Africa remains 51 (36 from Cote d'Ivoire, 3 from Guinea, 7 from Mali, and 5 from Niger). The most recent case from the region (WPV1 from Niger) had onset of paralysis on [22 Dec 2011].
- Multi-country immunization campaigns took place from [23-26 Nov 2012] in 7 countries of West Africa, critical to further boosting immunity levels in areas at highest-risk of potential importations from northern Nigeria.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Confirmed cases of polio associated with infection with the wild poliovirus (WPV) are presently reported from the 3 remaining polio endemic countries (Afghanistan, Nigeria, Pakistan). With the confirmation of 2 cases of cVDPV2 in Afghanistan near the Pakistan border, the number of countries with cVDPV2 outbreaks in 2012 has increased from 6 to 7 (Afghanistan, Pakistan, Nigeria, Chad, Democratic Republic of the Congo, Kenya, and Somalia). Of note, there was a small outbreak of cVDPV3 in Yemen involving 2 cases earlier this year (2012) as well. The common denominator in both situations (WPV and cVDPV outbreaks) is persistent sub-optimal vaccination coverages with polio vaccine in these countries, and specifically with low coverages with the oral polio vaccine that uses an attenuated live virus, especially those containing the type 2 vaccine virus [for an interesting analysis of the impact of the cVDPV2, see the Update on activities of the 27 Oct 2011, Geneva, WHO/HQ SAGE members available at http://www.healthinternetwork.com/immun ... _polio.pdf). As other countries in the world continue to have pockets of populations in which vaccination coverages are sub-optimal, the threat of re-introduction of WPV from one of the endemic countries (as has been seen in prior years and earlier this year (2012) in Chad) is ever present, as is the appearance of cVDPV associated polio cases in these countries.
For maps of countries with confirmed cases of WPV associated polio in 2012 and 2011 respectively, see http://www.polioeradication.org/Dataand ... dwide.aspx.
For a map of countries with confirmed cases of cVDPV associated polio in the preceding 6 months (28 May 2012 - 27 Nov 2012], see http://www.polioeradication.org/Dataand ... virus.aspx. - Mod.MPP]]
****************************************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] Pakistan, Afghanistan: cVDPV2
[2] Pakistan (Balochistan): cVDPV2
[3] Global update: Polio Eradication Initiative
******
[1] Pakistan, Afghanistan: cVDPV2
Date: Mon 3 Dec 2012
Source: Dawn [edited]
http://dawn.com/2012/12/03/polio-outbre ... arm-bells/
Polio outbreak in Balochistan sets off alarm bells
--------------------------------------------------
The outbreak of a hitherto unknown strain of polio virus in Qilla [or Killa] Abdullah and Pishin has set alarm bells ringing and prompted the centre to ask the Balochistan government to launch an anti-polio campaign in the province within 30 days.
Over the past 3 weeks, 10 cases of the new virus, named "Sabin-like type 2 poliovirus", were reported in 2 Pakhtun-dominated districts of the province. "The districts are frequented by people from the troubled areas of Fata [Federally Administered Tribal Areas]. The situation is grim because of refusal by parents to get their children vaccinated against the crippling disease as the areas are under the influence of extremist groups opposed to the anti-polio drive.
"The extremists belonging to Lashkar-i-Jhangvi and Tehrik-i-Taliban Pakistan have established their cells in Balochistan and warn people against vaccination of their children," Zohra Yusuf, chairperson of the Human Rights Commission of Pakistan (HRCP), told Dawn.
She said an HRCP team had visited Pishin and Qilla Abdullah in May [2012] to meet the local people and it was revealed that extremists had established their camps and were involved in killing people from Punjab. She said the people mostly coming from Khyber Pakhtunkhwa and other tribal areas brought the virus with them.
The Prime Minister's Office has also declared 'red alert' against the poor state of polio eradication drive in Balochistan and asked the administration to launch an emergency campaign in the province.
In a letter addressed to the chief secretary of Balochistan, copy of which is available with Dawn, Special Assistant to the Prime Minister Shehnaz Wazirali has conveyed the utter disappointment of the highest office in response to the way polio eradication drive is being carried out in Balochistan.
"The situation in Quetta block, which includes Killa Abdullah and Pishin, is aggravated by the continued resistance to and intransigence of the district health authorities and supervisory cadre of vaccinators," it said.
The letter said the new polio virus had not only affected 10 children in Pakistan but also paralysed 2 children in Afghanistan's Kandahar province. "I want to draw your attention to the reporting of Sabin-like polio virus cases in Qilla Abdullah and 2 from neighbouring Afghanistan," Shehnaz Wazirali said in the letter.
The PM Office also expressed concern over the low level of routine immunisation and asked the provincial government to immediately hold three rounds of anti-polio campaign in Qilla Abdullah beginning from the second week of December. "Highest quality should be ensured with strict monitoring and zero tolerance for under performance."
The letter called for urgent steps to institute the WHO's direct disbursement mechanism across the board for payment to the polio team staff. Measures should also be taken to improve the routine immunisation coverage in Qilla Abdullah on an emergency basis with clear targets and milestones given to district health teams.
"Stubbornness of the provincial health department and government supervisors for polio eradication in Balochistan is one of the biggest reasons behind dismal performance of the polio programme that has resulted in detection of new strain of poliovirus in Pakistan and threatens to impose travel restrictions on citizens that may put the country in an extremely embarrassing situation in the near future," the letter said.
WHO Team: A special 6-member international delegation of the World Health Organisation, led by polio eradication expert Dr Mohammed Mohammedi, is currently holding discussions with officials of the Balochistan government on ways of combating the new strain of poliomyelitis virus.
Dr Mohammedi told Dawn that the delegation was holding brainstorming sessions with the provincial officials to control the situation. "We had a fruitful session with the provincial chief secretary today and recommended for holding 3 emergency anti-polio campaigns in Quetta, Qilla Abdullah, and Pishin districts in 30 days to control the spread of the virus to other parts of the country," he said, adding that it was decided that the 1st emergency polio round in the province would be launched on [10 Dec 2012.
When contacted, Noorul Haq Baloch, Additional Secretary of Health in Balochistan, painted a rosy picture and said only 4 cases of polio had been detected this year as compared to 74 cases last year. "Polio cases have been on decline in Balochistan," he claimed.
He said Sabin-like polio virus was a new disease and the provincial health department was planning to conduct 3 rounds on [10 and 23 Dec 2012] and [7 Jan 2013] on the directives of the chief secretary.
Mr Baloch disclosed that some health officials had expressed reservations over the new system of payment to the officials involved in the campaign, but said things would improve in the coming days.
He rejected a perception that the constant movement of people from the troubled areas of Fata to Killa Abdullah was one of the major reasons for the spread of polio and said most of the cases ware detected in areas where people were poor and illiterate.
Shahnaz Wazir Ali told Dawn on Sunday [2 Dec 2012] that most refusal cases came from Pushto-dominated areas of Killa Abdullah. "The main cause of refusal is illiteracy and ignorance," she said.
She expressed concern over the children in Khyber Pakhtunkhwa consistently being missed during anti-polio campaigns. She said Karachi's polio cases also revealed that a child contracted the virus from Khyber Pakhtunkhwa.
"In Balochistan, the problem also occurs due to zonal health supervisors as they want to include their own people in the campaign. We have no objection but we want work," she said.
[Byline: Aamir Yasin]
[For the interactive HealthMap/ProMED map of Pakistan, see http://healthmap.org/r/1iGJ.
For the interactive HealthMap/ProMED map of Afghanistan, see http://healthmap.org/r/1CnW. - Mod.MPP
--
Communicated by:
Gert van der Hoek
Senior Moderator
FluTrackers
http://flutrackers.com
******
[2] Pakistan (Balochistan): cVDPV2
Date: Mon 3 Dec 2012
Source: The Express Tribune [edited]
http://tribune.com.pk/story/473980/new- ... ghanistan/
New polio strain from Pakistan hits Afghanistan
-----------------------------------------------
Officials say newly-discovered Sabin-Like ([type]2) [polio virus that is genetically similar to the oral polio vaccine is referred to as a vaccine-derived poliovirus -- VDPV, and when there are 2 or more cases of the same genetically lined virus, it is considered to be a circulating vaccine derived poliovirus -- cVDPV) poliomyelitis originated in Balochistan.
With the Independent Monitoring Board recommending travel restrictions on polio endemic countries, reports of the transmission of a newly-discovered poliovirus strain from Pakistan to Afghanistan is likely to complicate an already tough situation for Islamabad.
Two Afghan children, living close to the border with Pakistan, have been paralysed by the Sabin Like (2) poliomyelitis [cVDPV2], officials in the Polio Programme told The Express Tribune. The cases were reported from Afghanistan's Kandahar province 2 days ago -- one in Panjwai district and the other in Spin Boldak, they added. The World Health Organisation (WHO) has confirmed the 2 new cases.
According to the officials, genetic sequencing has confirmed the new polio strain originated in Balochistan's Killa Abdullah district. They said Sabin Like (2) [cVDPV2] poliomyelitis develops in children with an extremely poor record of routine immunisation -- a situation rampant in Balochistan.
Since 2006, polio vaccination teams have repeatedly missed an estimated 50 000 children in Killa Abdullah, derailing efforts to eradicate the virus in the country. This is not the 1st case of poliovirus transmission from Pakistan to a neighbouring country either. Last year [2011], 16 children in China's Xinjiang province were paralysed after being infected by a polio strain originating in Pakistan.
"The paramedic association and health department of Balochistan continues to hold the polio-eradication campaign hostage in Killa Abdullah through unfair demands... It has now resulted in embarrassment for Pakistan before the world community," an official of the Expanded Programme on Immunisation (EPI) told The Express Tribune on condition of anonymity.
WHO senior coordinator for polio eradication Dr Elias Durry said the organisation was monitoring the situation in Balochistan closely.
"We are seriously concerned about the new poliovirus strain and are recommending urgent steps to the provincial government to contain the outbreak," said Dr Durry. The only way to contain the spread of the virus is by conducting 3 to 4 high-quality polio vaccination rounds in the infected districts and their nearby areas," he said.
Meanwhile, a special WHO delegation, led by internationally acclaimed polio eradication expert Dr Mohammed Mohammedi, has reached Balochistan and is holding in-depth discussions with the provincial government over ways to combat the outbreak.
"We have asked the provincial government to hold 3 emergency polio campaigns each in Quetta, Killa Abdullah, and Pishin districts during a span of 30 days to control the spread of the virus to other parts of the country," said Dr Mohammedi, adding that the 1st campaign in the 3 districts was scheduled for [10 Dec 2012].
Pakistan has reported a total of 56 polio cases this year [2012] so far. A massive 181 cases were reported in 2011.
[Byline: Sehrish Wasif]
--
Communicated by:
Gert van der Hoek
Senior Moderator
FluTrackers
http://flutrackers.com
******
[3] Global update: Polio Eradication Initiative
Date: Wed 28 Nov 2012
Source: Global Polio Eradication Initiative [excerpted, edited]
http://polioeradication.org/Dataandmoni ... sweek.aspx
Global Polio Eradication Initiative update as of 27 Nov 2012
------------------------------------------------------------
Total cases
Year-to-date 2012 / Year-to-date 2011 / Total in 2011*
Globally: 202 / 553 / 650
- in endemic countries: 197 / 265 / 341
- in non-endemic countries: 5 / 288 / 309
Case breakdown by country
Country: Year-to-date 2012 WPV1 / WPV3 / W1W3 / Total // Year-to-date 2011 WPV1 / WPV3 / W1W3 / Total // Total in 2011* / Date of most recent case
Pakistan: 53 / 2 / 1 / 56 // 159 / 2 / 0 / 161 // 198 / 10 Nov 2012
Afghanistan: 31 / 0 / 0 / 31 // 58 / 0 / 0 / 58 // 80 / 9 Nov 2012
Nigeria: 92 / 18 / 0 / 110 // 36 / 9 / 0 / 45 // 62 / 4 Nov 2012
India: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 13 Jan 2011
Chad: 5 / 0 / 0 / 5 // 114 / 3 / 0 / 117 // 132 / 14 Jun 2012
DR Congo: 0 / 0/ 0 / 0 // 87 / 0 / 0 / 87 // 93 / 20 Dec 2011
Angola: 0 / 0 / 0 / 0 // 5 / 0 / 0 / 5 // 5 / 7 Jul 2011
Niger: 0 / 0 / 0 / 0 // 1 / 1 / 0 / 2 // 5 / 22 Dec 2011
CAR: 0 / 0 / 0 / 0 // 2 / 0 / 0 / 2 // 4 / 8 Dec 2011
China: 0 / 0 / 0 / 0 // 18 / 0 / 0 / 18 // 21 / 9 Oct 2011
Guinea: 0 / 0/ 0 / 0 // 0 / 3 / 0 / 3 // 3 / 3 Aug 2011
Kenya: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 30 Jul 2011
Cote d'Ivoire: 0 / 0 / 0 / 0 // 0 / 36 / 0 / 36 // 36 / 24 Jul 2011
Mali: 0 / 0 / 0 / 0 // 0 / 7 / 0 / 7 // 7 / 23 Jun 2011
Congo: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 22 Jan 2011
Gabon: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 15 Jan 2011
Total: 181 / 20 / 1 / 202 // 492 / 61 / 0 / 553 // 650
Total in endemic countries: 176 / 20 / 1 / 197 // 254 / 11 / 0 / 265 // 341
Total outbreak: 5 / 0 / 0 / 5 // 238 / 50 / 0 / 288 // 309
*Data in WHO as of 29 Nov 2011 for 2011 data and 27 Nov 2012 for 2012 data.
Afghanistan
-----------
- One new WPV case was reported in the past week (one WPV1 from Khost), bringing the total number of WPV cases for 2012 to 31. It is the most recent case in the country and had onset of paralysis on [9 Nov 2012].
- Khost province is on the country's eastern border with Pakistan. Though Khost is not an endemic area, a case was reported in September [2012] as well. Both cases are linked to virus circulating in Quetta, capital of Balochistan province in Pakistan.
- The Independent Monitoring Board has stated that Afghanistan has made progress, but too slowly, and that too many children in southern Afghanistan are missed not just due to insecurity but also due to remaining managerial challenges. As with each of the 3 endemic countries, the IMB [Independent Monitoring Board] recommends 'absolute ownership' by leaders at all levels.
- The Technical Advisory Group (TAG) met in Kabul earlier this week [week of 28 Nov 2012], to review impact of the national polio emergency action plan and discuss additional tactics to address ongoing immunity gaps in known high-risk districts.
- Management trainings of polio staff continue, to address managerial and administrative obstacles in the programme.
- To further boost immunity levels in security-compromised areas, special strategies continue to be implemented including the vaccination of populations moving in and out of such areas. Supplementary immunization activities (SIAs) took place last week, with the next activity planned for December [2012].
Nigeria
-------
- 6 new WPV cases were reported in the past week (5 WPV1s from Katsina and one WPV1 from Borno), bringing the total number of WPV cases for 2012 to 110. A WPV1 from Katsina is the most recent in the country and had onset of paralysis on [4 Nov 2012].
- Katsina has now had 32 cases, and represents nearly one-third of all of Nigeria's cases this year [2012]. The state has the most intense transmission of wild poliovirus in the world at the moment, accounting for more than 15 percent of all polio cases globally this year [2012].
- The new case in Borno is the first since August [2012]. Insecurity in Borno continues to complicate operations, and the state's proximity to Chad is cause for concern. Historically, polio from Borno has spread east into Chad and from there onwards.
- Another area of concern is Sokoto, as in the past polio has spread from Sokoto into neighbouring countries of West Africa. While immunity levels are improving, overall the population is under-immunized, with approximately 60 percent of children having received greater than 3 doses of OPV (compared to a 80 percent national average). Operational challenges in the state continue to hamper basic implementation. However, under the leadership of the State Governor, there is a renewed effort to address these, including by continuing to review and strengthen micro-plans to more clearly identify missed settlement areas; reviewing workloads of individual vaccination teams; and increasing supervision and accountability at the Local Government Area (LGA) level and the ward-level. [For more on this see http://www.polioeradication.org/tabid/4 ... fault.aspx. This press release from the Polio Eradication Initiative discusses the concerns in Sokoto -- a good summary is seen in the following quote: "And while Sokoto has reported a deceptively low 8 cases so far this year [2012], environmental surveillance regularly detects wild poliovirus and the state has reported a case of circulating vaccine-derived poliovirus type 2 -- sure signs that too few children are immunized." - Mod.MPP]
- The Independent Monitoring Board has stated that Nigeria's programme could be on the brink of a breakthrough, but that it continues to represent a risk to other countries. The IMB report concludes that success in Nigeria, and all of Africa, lies in the hands of the Nigerian programme -- "from President to vaccinator." As with each of the 3 endemic countries, the IMB recommends 'absolute ownership' by leaders at all levels.
- Immunization Plus Days (IPDs) were concluded last week [week of 19 Nov 2012]. The activity had been delayed by one week, to allow additional preparatory time.
- In December [2012], trivalent OPV will be added to planned Child Health Days (with meningitis vaccine) on [1-10 Dec 2012], and subnational IPDs will be conducted using bivalent OPV ([15-18 Dec 2012]). This will be an opportunity to administer 2 additional doses of OPV to children in highest-risk areas, within the space of a single month.
Pakistan
--------
- 2 new WPV cases were reported in the past week (WPV1s from Khyber Pakhtunkhwa -- KP, and Federally Administered Tribal Areas -- FATA), bringing the total number of WPV cases for 2012 to 56. The WPV1 from FATA is the most recent case in the country and had onset of paralysis on [10 Nov 2012].
- Additionally, 2 new cVDPV2 cases were reported in the past week, bringing the total number of cVDPV2 cases to 7 (all from the greater Quetta area of Balochistan).
- The Independent Monitoring Board has stated that Pakistan's chances of success have greatly improved over last year [2011], but that next year's [2013] elections and a complex security situation are major risks in 2013. As with each of the 3 endemic countries, the IMB recommends 'absolute ownership' by leaders at all levels.
- Preparations are underway for the next Subnational Immunization Days, scheduled for mid-December [2012], in high-risk areas across the country using bivalent OPV.
Angola
------
- No new cases were reported in the past week. No cases have been reported in 2012. The country reported a total of 5 cases in 2011, and the last case had onset of paralysis on [7 Jul 2011] in Uige in the country's north.
Chad
----
- No new WPV cases were reported in the past week. The most recently reported WPV case occurred in the Lac region (WPV1) with onset of paralysis on [14 Jun 2012]. The total number of WPV cases for 2012 remains 5.
- To urgently stop an ongoing cVDPV2 outbreak (6 cases in N'Djamena and 2 cases close to the border with Sudan), while further boosting immunity to type 1 and type 3 poliovirus, a 2nd round of staggered Sub-national Immunization Days were held [23-25 Nov 2012] (in the south and east), to be followed on [7-9 Dec 2012] (in the north and west), using trivalent OPV.
Democratic Republic of the Congo (DRC)
--------------------------------------
- No new WPV cases were reported in the past week. No WPV cases have been reported in 2012. The total number of WPV cases for 2011 is 93 (all WPV1). The most recent case had onset of paralysis on [20 Dec 2011] in Maniema province.
- Although the country has not reported a WPV case since December 2011, it has been affected by a cVDPV2 outbreak in Katanga province in 2012, with 17 cases reported (most recent case: [4 Apr 2012]). Efforts are focused on ensuring the cVDPV2 outbreak is fully stopped.
- Supplementary immunization activities are ongoing from [27-29 Nov 2012] using a combination of bivalent and trivalent OPV.
Horn of Africa
--------------
- No further cases have been reported in the cVDPV2 outbreak in Kenya and parts of Somalia (in a Somali refugee camp in Dadaab, Kenya, and Kismayo, south-central Somalia).
- New tactics are being explored to further boost immunity levels in and around inaccessible areas of south-central Somalia and to improve integration of polio vaccination with humanitarian activities across the Horn of Africa.
West Africa
-----------
- No new WPV cases were reported in the past week. No WPV cases have been reported in 2012. The total number of WPV cases for 2011 in West Africa remains 51 (36 from Cote d'Ivoire, 3 from Guinea, 7 from Mali, and 5 from Niger). The most recent case from the region (WPV1 from Niger) had onset of paralysis on [22 Dec 2011].
- Multi-country immunization campaigns took place from [23-26 Nov 2012] in 7 countries of West Africa, critical to further boosting immunity levels in areas at highest-risk of potential importations from northern Nigeria.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Confirmed cases of polio associated with infection with the wild poliovirus (WPV) are presently reported from the 3 remaining polio endemic countries (Afghanistan, Nigeria, Pakistan). With the confirmation of 2 cases of cVDPV2 in Afghanistan near the Pakistan border, the number of countries with cVDPV2 outbreaks in 2012 has increased from 6 to 7 (Afghanistan, Pakistan, Nigeria, Chad, Democratic Republic of the Congo, Kenya, and Somalia). Of note, there was a small outbreak of cVDPV3 in Yemen involving 2 cases earlier this year (2012) as well. The common denominator in both situations (WPV and cVDPV outbreaks) is persistent sub-optimal vaccination coverages with polio vaccine in these countries, and specifically with low coverages with the oral polio vaccine that uses an attenuated live virus, especially those containing the type 2 vaccine virus [for an interesting analysis of the impact of the cVDPV2, see the Update on activities of the 27 Oct 2011, Geneva, WHO/HQ SAGE members available at http://www.healthinternetwork.com/immun ... _polio.pdf). As other countries in the world continue to have pockets of populations in which vaccination coverages are sub-optimal, the threat of re-introduction of WPV from one of the endemic countries (as has been seen in prior years and earlier this year (2012) in Chad) is ever present, as is the appearance of cVDPV associated polio cases in these countries.
For maps of countries with confirmed cases of WPV associated polio in 2012 and 2011 respectively, see http://www.polioeradication.org/Dataand ... dwide.aspx.
For a map of countries with confirmed cases of cVDPV associated polio in the preceding 6 months (28 May 2012 - 27 Nov 2012], see http://www.polioeradication.org/Dataand ... virus.aspx. - Mod.MPP]]
-
Birgitt
- Moderator
- Beiträge: 35230
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Kinderlähmung - Poliomyelitis weltweit
POLIOMYELITIS - WORLDWIDE (15): PAKISTAN, GLOBAL UPDATE
*******************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] Pakistan - Karachi: violence against vaccination teams
[2] Pakistan - Balochistan: vaccination campaign suspended
[3] WHO/UNICEF statement on violence in Pakistan
[4] Pakistan - Balochistan: 10 new cases
[5] Polio eradication initiative global update as of 12 Dec 2012
******
[1] Pakistan - Karachi: violence against vaccination teams
Date: 18 Dec 2012
Source: NY Times [edited]
http://www.nytimes.com/2012/12/19/world ... rs.html?hp
Gunmen kill anti-polio workers in Pakistan
------------------------------------------
A total of 5 Pakistani women and a man were killed on Tuesday [18 Dec 2012] in separate attacks on health workers participating in a national drive to eradicate polio from Pakistan. The attacks forced health officials to temporarily suspend a large polio vaccination drive in Karachi, the country's most populous city, where the disease has been making a worrisome comeback in recent years.
Saghir Ahmed, the health minister for southern Sindh Province, said he had ordered the 24 000 aid workers taking part in the campaign in Karachi to immediately stop work. It was not clear when they would resume.
The shooting represented a brutal setback to polio immunization efforts in Pakistan, one of just 3 countries in the world where the disease remains endemic. Pakistan accounted for 198 new cases last year -- the highest rate in the world, followed by Afghanistan and Nigeria.
There was no immediate claim of responsibility, but Taliban insurgents have repeatedly vowed to target anti-polio workers, accusing them of being spies. In the tribal areas along the Afghan border, Taliban leaders have issued religious edicts declaring that the United States runs a spy network under the guise of vaccination programs.
That perception was strengthened after the American commando raid that killed Osama bin Laden in June 2011, when it emerged that the Central Intelligence Agency had paid a Pakistani doctor to run a vaccination program in Abbottabad, where Bin Laden was hiding, in a bid to obtain DNA evidence from his family. Pakistani authorities arrested the doctor, shortly after the American raid, and he has been sentenced to 33 years in prison.
Despite the negative perceptions, the government has pressed ahead with a large polio vaccination campaign, usually conducted in 3-day spurts involving tens of thousands of health workers who administer medicine to children under 5.
The shootings on Tuesday [18 Dec 2012] came on the 2nd day of the latest drive, which has now been called off in Karachi. After an attack on a United Nations doctor from Ghana in Karachi last July [2012], officials were braced for some sort of militant resistance. But the extent and scale of the attacks Tuesday [18 Dec 2012] caught the government by surprise.
In the attacks in Karachi, 3 teams of health volunteers were targeted in poor neighborhoods: Landhi, Orangi, and Baldia Town.
Two female aid workers were killed in an attack in Landhi, according to local news reports. In Orangi, unknown gunmen opened fire on a health team, killing one woman and a male volunteer. Another female worker was killed in nearby Baldia Town.
The Karachi neighborhoods where aid workers were targeted Tuesday [18 Dec 2012] are being used as safe havens by militants, who have escaped American drone strikes in North and South Waziristan tribal regions, according to police officials. Security forces regularly conduct search operations in these neighborhoods.
In the north western city of Peshawar, gunmen riding a motorcycle opened fire on 2 sisters who had volunteered to help administer polio drops, killing one.
The attacks on polio workers followed a bold Taliban assault on a major Pakistan Air Force base in Peshawar over the weekend that killed at least 15 people and a militant bomb attack in a nearby tribal village on Monday [17 Dec 2012] that killed another 19.
For Pakistan's beleaguered progressives, the attack on female health workers was another sign of how the country's extremist fringe would stoop to attack the vulnerable and minorities.
"Ahmadis, Shias, Hazaras, Christians, child activists, doctors, anti-polio workers -- who's next on the target list, Pakistan?" asked Mira Hashmi, a lecturer in film studies at the Lahore School of Economics, in a post on Twitter.
[byline: Salman Masood and Declan Walsh, with Zia ur-Rehman contributing from Karachi]
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[2] Pakistan - Balochistan: vaccination campaign suspended
Date: 18 Dec 2012
Source: Dawn [edited]
http://dawn.com/2012/12/18/balochistan- ... -campaign/
Balochistan govt suspends anti-polio campaign
---------------------------------------------
The Balochistan government has suspended its anti-polio campaign in the province in the aftermath of attacks on polio workers in Karachi and Peshawar on Tuesday (18 Dec 2012), an official told DawnNews. Noorul Haq Baloch, the focal person of Balochistan government on polio, said the campaign was suspended for an indefinite period in Quetta, Killa Abdullah, and Pishin districts.
"The reason behind suspension of the campaign is security threat to workers," said Baloch. He said so far 4 confirmed cases of polio were reported in Balochistan this year (2012). Baloch said 11 cases of polio 2 virus were reported in Balochistan.
"Polio 2 virus is curable and can be treated within 3 months," he said [this is an erroneous statement, the only "cure" for polio is to prevent the infection by vaccination. - Mod.MPP]
He said last year 73 cases of polio virus were reported in Balochistan.
The Balochistan Health Department in collaboration with World Health Organization, had decided to restart an anti-polio campaign from [24-28 Dec 2012] in Quetta, Killa Abdullah and Pishin districts. The campaign has now been suspended.
A polio volunteer was killed in Eastern By Pass area of Quetta a month ago [November 2012]. His killers are still at large.
Militants have frequently issued warnings to anti-polio teams in different districts of the sparsely populated province of the country.
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[3] WHO/UNICEF statement on violence in Pakistan
Date: 18 Dec 2012
Source: WHO press release [edited]
http://www.who.int/mediacentre/news/sta ... 121218/en/
WHO and UNICEF condemn attacks on health workers in Pakistan
------------------------------------------------------------
WHO and UNICEF join the Government of Pakistan and the provinces of Sindh and Khyber Pakhtunkhwa in condemning the multiple attacks that have killed 6 health workers in the past 24 hours.
At least 6 people working on a polio vaccination campaign have been reported shot dead in several locations in Pakistan -- Gadap, Landi, Baldia, and Orangi towns of Karachi city, Sindh Province and Peshawar, Khyber Pakhtunkhwa Province. Those killed were among thousands who work selflessly across Pakistan to eradicate polio.
The Government of Pakistan and the affected provinces have temporarily suspended the vaccination campaign due to concerns over safety of health workers.
Such attacks deprive Pakistan's most vulnerable populations -- especially children -- of basic life-saving health interventions. We call on the leaders of the affected communities and everyone concerned to do their utmost to protect health workers and create a secure environment so that we can meet the health needs of the children of Pakistan.
Polio is a highly infectious disease caused by a virus that can cause permanent paralysis in a matter of hours. Safe and effective vaccines protect children from the disease. Currently the disease remains endemic in only 3 countries: Afghanistan, Nigeria, and Pakistan.
WHO, UNICEF, and all their partners in Pakistan and globally express their deepest sympathy to the families of the health workers. We remain committed to supporting the Government of Pakistan and the people of Pakistan in their efforts to rid the country of polio and other diseases.
For further information please contact:
Oliver Rosenbauer
WHO
<rosenbauero@who.int>
Sarah Crowe
UNICEF Spokesperson
<scrowe@unicef.org>
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[4] Pakistan - Balochistan: 10 new cases
Date: 13 Dec 2012
Source: The International News [edited]
http://www.thenews.com.pk/Todays-News-1 ... alochistan
10 new polio cases reported in Balochistan
------------------------------------------
The exertions of the Balochistan government to save the children from the crippling polio disease have turned abortive as at least 10 new cases of the crippling virus, like that of a 2 year old [male], have been reported in the province in the last few weeks.
Of them 9 cases have been reported from the districts of Kila Abdullah Khan and one from Pishin, officials of the World Health Organization (WHO) confided while talking to The News on Wednesday [12 Dec 2012]. Apart from these, 4 cases of wild polio virus of type 1 had been reported in the province this year [2012]. Official sources confided that on Wednesday last [?5 Dec 2012], the last day of the 1st of 3 special anti-polio campaigns, 7530 families refused to administer the anti-polio drops to their children in Quetta, Kila Abdullah and Pishin districts. Of them, 2794 families refused at Quetta, 2788 refusal cases reported at Pishin, while 1948 families refused in Kila Abdullah.
It is worth mentioning here that the infectious disease has been eliminated in developed nations but persists in parts of Nigeria, Afghanistan, and Pakistan.
Pakistan reported 56 cases of the crippling virus in 2012 that had been reduced from 199 in 2011, while Afghanistan has reported 38. Most of the Afghan and Pakistani cases have occurred along their porous border.
In its report, the Independent Monitoring Board (IMB) of global polio eradication initiative, has recommended the International Health Regulations Expert Review Committee to issue urgently a standing recommendation by May 2013 that will introduce pre-travel vaccination or vaccination checks in Afghanistan, Nigeria and Pakistan until national transmission is stopped. "No country should allow a citizen from any endemic polio state to cross their border without a valid vaccination certificate," the IMB recommendations added.
Soon after the IMB report, a high-level meeting was held with the chief minister of Balochistan, Nawab Muhammad Aslam Raisani, in the chair last week. It decided to launch 3 special polio campaigns in the polio-affected areas. It has been [learned] that the ways and means were discussed to eradicate the polio completely from the province. The chief minister expressed his dismay over the presence of the increased number of polio cases in the province. He, on the occasion, said the government would mobilise all its available resources and manpower to achieve the target of "Polio-free Balochistan".
The chief minister said though effective steps are being taken for eradication of the crippling disease in the province, there is still much room to do a lot to achieve complete success in this regard.
On the occasion, the chief secretary expressed the resolve to eradicate the disease from the province saying that the major reason behind the new outbreak is the administrative issue, which needs to be resolved. He directed that it must be ensured to administer the anti-polio drops to every kid in the affected districts.
[byline: Muhammad Ejaz Khan]
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[5] Polio eradication initiative global update as of 12 Dec 2012
Date: 12 Dec 2012
Source: Polio Eradication Initiative [edited]
http://polioeradication.org/Dataandmoni ... sweek.aspx
Global Polio Eradication Initiative update as of 12 Dec 2012
------------------------------------------------------------
Total cases
Year-to-date 2012 / Year-to-date 2011 / Total in 2011*
Globally: 213 / 571 / 650
- in endemic countries: 208 / 281 / 341
- in non-endemic countries: 5 / 290 / 309
Case breakdown by country
Country: Year-to-date 2012 WPV1 / WPV3 / W1W3 / Total // Year-to-date 2011 WPV1 / WPV3 / W1W3 / Total // Total in 2011* / Date of most recent case
Pakistan: 53 / 2 / 1 / 56 // 171 / 2 / 0 / 161 // 198 / 10 Nov 2012
Afghanistan: 34 / 0 / 0 / 34 // 61 / 0 / 0 / 61 // 80 / 19 Nov 2012
Nigeria: 98 / 20 / 0 / 118 // 36 / 10 / 0 / 46 // 62 / 17 Nov 2012
India: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 13 Jan 2011
Chad: 5 / 0 / 0 / 5 // 114 / 3 / 0 / 117 // 132 / 14 Jun 2012
DR Congo: 0 / 0/ 0 / 0 // 88 / 0 / 0 / 88 // 93 / 20 Dec 2011
Angola: 0 / 0 / 0 / 0 // 5 / 0 / 0 / 5 // 5 / 7 Jul 2011
Niger: 0 / 0 / 0 / 0 // 1 / 1 / 0 / 3 // 5 / 22 Dec 2011
CAR: 0 / 0 / 0 / 0 // 2 / 0 / 0 / 2 // 4 / 8 Dec 2011
China: 0 / 0 / 0 / 0 // 18 / 0 / 0 / 18 // 21 / 9 Oct 2011
Guinea: 0 / 0/ 0 / 0 // 0 / 3 / 0 / 3 // 3 / 3 Aug 2011
Kenya: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 30 Jul 2011
Cote d'Ivoire: 0 / 0 / 0 / 0 // 0 / 36 / 0 / 36 // 36 / 24 Jul 2011
Mali: 0 / 0 / 0 / 0 // 0 / 7 / 0 / 7 // 7 / 23 Jun 2011
Congo: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 22 Jan 2011
Gabon: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 15 Jan 2011
Total: 190 / 22 / 1 / 213 // 508 / 63 / 0 / 571 // 650
Total in endemic countries: 185 / 22 / 1 / 208 // 269 / 12 / 0 / 281 // 341
Total outbreak: 5 / 0 / 0 / 5 // 239 / 51 / 0 / 290 // 309
*Data in WHO as of 13 Dec 2011 for 2011 data and 11 Dec 2012 for 2012 data
Two polio vaccinators were killed in Afghanistan last week [week ending 5 Dec 2012] in separate incidents, underlining the dangerous conditions that health and humanitarian workers face in many countries. These tragic events further underline the truly heroic and courageous efforts of the frontline health workers, often working under very dangerous conditions, all in efforts to protect children from lifelong polio-paralysis.
Afghanistan
- One new WPV case was reported in the past week (WPV1 from Hilmand), bringing the total number of WPV cases for 2012 to 34. It is the most recent case in the country, and had onset of paralysis on [19 Nov 2012].
- The Inter-Ministerial Task Force held its 1st meeting on [11 Dec 2012] chaired by the deputy minister and co-chaired by focal person for polio eradication.
- Preparations are ongoing for the December Subnational Immunization Days (SNIDs), to be conducted in 14 high-risk districts and some border districts from [16-19 Dec 2012].
- OPV (oral polio vaccine) was administered as part of a measles campaign began in 18 provinces, which began on [1 Dec 2012].
Nigeria
- 7 new WPV cases were reported in the past week (2 cases of WPV1 from Katsina, 1 WPV1 from Kaduna, 1 WPV1 from Kano, 1 WPV1 from FCT, 1 WPV3 from Taraba, and 1 WPV3 from Yobe), bringing the total number of WPV cases for 2012 to 118. The WPV1 from Kaduna is the most recent in the country and had onset of paralysis on [17 Nov 2012].
- The 2 new WPV3 cases reported are particularly concerning, as Nigeria is now the only country in the world reporting cases due to this strain over the past 6 months. Taraba's previous WPV3 case dates back to July [2012], and a comprehensive outbreak response is urgently needed.
- Trivalent OPV was added to Child Health Days (with meningitis vaccine) from [1-10 Dec 2012], and subnational Immunization Plus Days (IPDs) will be conducted using bivalent OPV (15-18 Dec 2012). This will be an opportunity to administer 2 additional doses of OPV to children in highest-risk areas, within the space of a single month.
Pakistan
- No new WPV cases were reported in the past week. The most recently reported WPV case occurred in Federally Administered Tribal Areas (WPV1) with onset of paralysis on [10 Nov 2012]. The total number of WPV cases for 2012 remains 56.
- However, 2 new circulating vaccine-derived poliovirus type 2 (cVDPV2) cases were reported in the past week from Killa Abdullah in Balochistan, bringing the total number of cVDPV2 cases to 12 (all from the greater Quetta area of Balochistan).
- Response vaccination activities began in all Union-Councils of the Killa Abdullah district this week. Trivalent OPV was used for all union councils except for one team in Boghra that used bivalent OPV. After this campaign is concluded, the micro-plan for Killa Abdullah will be updated.
- An All Political Parties Conference was held in Killa Abdullah on [6 Dec 2012] to sustain the support of all political parties for polio eradication campaigns in the district. The conference provided an opportunity to share the current situation of polio eradication in the district, dispel misconceptions regarding immunization and encourage the parties to actively participate in the upcoming campaigns. Members of 9 political parties participated in the event.
- Preparations for SNIDs scheduled for [17-19 Dec 2012] are underway.
- The Polio Eradication Technical Advisory Group meeting is scheduled for [14-15 Dec 2012] in Islamabad.
Angola
- No new cases were reported in the past week. No cases have been reported in 2012. The country reported a total of 5 cases in 2011, and the last case had onset of paralysis on [7 Jul 2011] in Uige in the country's north.
- SNIDs with trivalent OPV were conducted on [7-10 Dec 2012].
Chad
- No new WPV cases were reported in the past week. The most recently reported WPV case occurred in the Lac region (WPV1) with onset of paralysis on [14 Jun 2012]. The total number of WPV cases for 2012 remains 5.
- One new cVDPV2 case was reported in the past week, bringing the total number of cVDPV2 cases to 12.
- Staggered SNIDs were conducted on [23-25 Nov 2012] in the south and east and were conducted on [9-11 Dec 2012] in the north and west, using trivalent OPV. Staggering activities allows the redeployment of all available technical staff to support the activity in various areas.
- Efforts are ongoing to strengthen subnational surveillance sensitivity, with trainings of health centers staff in key areas being conducted.
Democratic Republic of the Congo (DRC)
- No new WPV cases were reported in the past week. No WPV cases have been reported in 2012. The total number of WPV cases for 2011 is 93 (all WPV1). The most recent case had onset of paralysis on [20 Dec 2011] in Maniema province.
- Although the country has not reported a WPV case since December 2011, it has been affected by a cVDPV2 outbreak in Katanga province in 2012, with 17 cases reported (most recent case: (4 Apr 2012). Efforts are focused on ensuring the cVDPV2 outbreak is fully stopped.
- Following recent insecurity, most UN staff has now returned to Goma. However, the security situation continues to be evaluated.
- A polio campaign for 27 Nov 2012 was postponed in North Kivu. OPV is also being added to measles campaigns and other humanitarian interventions planned in internally-displaced persons (IDPs) camps.
Horn of Africa
- Efforts are continuing to stop an ongoing cVDPV2 outbreak in Kenya and parts of Somalia (in a Somali refugee camp in Dadaab, Kenya, and Kismayo, south-central Somalia).
- Immunizations of older age groups have taken place in Dadaab. In Somalia, campaigns have been conducted in border areas with Kenya and Ethiopia, and in some areas of central Somalia (access allowing).
- Across the region, OPV continues to be added to broader humanitarian response activities.
- New tactics are being explored to further boost immunity levels in and around inaccessible areas of south-central Somalia. Potential activities include focusing on people in transit to/from inaccessible areas, using local negotiators to allow safe passage of vaccination teams to inaccessible areas, and immunizing populations bordering inaccessible areas.
West Africa
- No new WPV cases were reported in the past week. No WPV cases have been reported in 2012. The total number of WPV cases for 2011 in West Africa remains 51 (36 from Cote d'Ivoire, 3 from Guinea, 7 from Mali, and 5 from Niger). The most recent case from the region (WPV1 from Niger) had onset of paralysis on [22 Dec 2011].
- SIAs in Benin with Vitamin A and deworming tablets were conducted from [7-9 Dec 2012].
- OPV continues to be added to broader humanitarian response activities across the region.
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[The above series of reports highlights the challenges to a final interruption of poliovirus (both wild and vaccine derived) transmission/circulation in the 3 remaining polio endemic countries in the world -- Afghanistan, Pakistan, and Nigeria. In both Afghanistan and Pakistan unacceptable violence has been directed at polio vaccination teams, resulting in the deaths of 8 polio campaign workers over the past few weeks. The room for international outcry and action is there. It is totally incomprehensible to this moderator how these violent acts can be directed at humanitarian workers whose sole "infraction" is trying to eradicate a disease responsible for death and disability of predominantly children in these countries.
If one looks at the global polio update as of 12 Dec 2012 from the Polio Eradication Initiative (in section [5] above] one sees that at present the only countries where there are documented wild poliovirus (WPV) cases are the 3 remaining polio endemic countries -- Afghanistan, Pakistan and Nigeria. But, there continue to be paralytic polio cases associated with infection from circulating vaccine derived polioviruses (cVDPV) this year (2012) in Kenya, Somalia, Democratic Republic of the Congo, Yemen, Chad and the 3 remaining polio endemic countries -- Afghanistan, Pakistan and Nigeria. As mentioned in previous polio posts, both WPV and cVDPV circulation occur in areas where there are suboptimal polio vaccination coverages. The challenges have been to sustain high levels of polio vaccination coverage after WPV transmission has been interrupted in an area and the population no longer sees an urgency in vaccinating their children as the disease appears no longer to be a threat.
The obvious concerns here are that while presently the only countries with documented WPV transmission are the 3 remaining polio endemic countries, the danger of reintroduction of WPV to other countries whose vaccination coverages have declined is ever present (and has occurred through the years -- recurrent cases in other African countries, Indonesia, China to name a few of the instances in the not too distant past).
For maps of countries where there have been confirmed cases due to WPV infections in 2011 and 2012, see http://www.polioeradication.org/Dataand ... dwide.aspx.
For a map of countries where there have been confirmed cases due to cVDPV infections
during the preceding 6 months, and tables showing the number of cases of cVDPV by year, country and cVDPV type since 2000, see: http://www.polioeradication.org/Dataand ... virus.aspx. - Mod.MPP]
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In this update:
[1] Pakistan - Karachi: violence against vaccination teams
[2] Pakistan - Balochistan: vaccination campaign suspended
[3] WHO/UNICEF statement on violence in Pakistan
[4] Pakistan - Balochistan: 10 new cases
[5] Polio eradication initiative global update as of 12 Dec 2012
******
[1] Pakistan - Karachi: violence against vaccination teams
Date: 18 Dec 2012
Source: NY Times [edited]
http://www.nytimes.com/2012/12/19/world ... rs.html?hp
Gunmen kill anti-polio workers in Pakistan
------------------------------------------
A total of 5 Pakistani women and a man were killed on Tuesday [18 Dec 2012] in separate attacks on health workers participating in a national drive to eradicate polio from Pakistan. The attacks forced health officials to temporarily suspend a large polio vaccination drive in Karachi, the country's most populous city, where the disease has been making a worrisome comeback in recent years.
Saghir Ahmed, the health minister for southern Sindh Province, said he had ordered the 24 000 aid workers taking part in the campaign in Karachi to immediately stop work. It was not clear when they would resume.
The shooting represented a brutal setback to polio immunization efforts in Pakistan, one of just 3 countries in the world where the disease remains endemic. Pakistan accounted for 198 new cases last year -- the highest rate in the world, followed by Afghanistan and Nigeria.
There was no immediate claim of responsibility, but Taliban insurgents have repeatedly vowed to target anti-polio workers, accusing them of being spies. In the tribal areas along the Afghan border, Taliban leaders have issued religious edicts declaring that the United States runs a spy network under the guise of vaccination programs.
That perception was strengthened after the American commando raid that killed Osama bin Laden in June 2011, when it emerged that the Central Intelligence Agency had paid a Pakistani doctor to run a vaccination program in Abbottabad, where Bin Laden was hiding, in a bid to obtain DNA evidence from his family. Pakistani authorities arrested the doctor, shortly after the American raid, and he has been sentenced to 33 years in prison.
Despite the negative perceptions, the government has pressed ahead with a large polio vaccination campaign, usually conducted in 3-day spurts involving tens of thousands of health workers who administer medicine to children under 5.
The shootings on Tuesday [18 Dec 2012] came on the 2nd day of the latest drive, which has now been called off in Karachi. After an attack on a United Nations doctor from Ghana in Karachi last July [2012], officials were braced for some sort of militant resistance. But the extent and scale of the attacks Tuesday [18 Dec 2012] caught the government by surprise.
In the attacks in Karachi, 3 teams of health volunteers were targeted in poor neighborhoods: Landhi, Orangi, and Baldia Town.
Two female aid workers were killed in an attack in Landhi, according to local news reports. In Orangi, unknown gunmen opened fire on a health team, killing one woman and a male volunteer. Another female worker was killed in nearby Baldia Town.
The Karachi neighborhoods where aid workers were targeted Tuesday [18 Dec 2012] are being used as safe havens by militants, who have escaped American drone strikes in North and South Waziristan tribal regions, according to police officials. Security forces regularly conduct search operations in these neighborhoods.
In the north western city of Peshawar, gunmen riding a motorcycle opened fire on 2 sisters who had volunteered to help administer polio drops, killing one.
The attacks on polio workers followed a bold Taliban assault on a major Pakistan Air Force base in Peshawar over the weekend that killed at least 15 people and a militant bomb attack in a nearby tribal village on Monday [17 Dec 2012] that killed another 19.
For Pakistan's beleaguered progressives, the attack on female health workers was another sign of how the country's extremist fringe would stoop to attack the vulnerable and minorities.
"Ahmadis, Shias, Hazaras, Christians, child activists, doctors, anti-polio workers -- who's next on the target list, Pakistan?" asked Mira Hashmi, a lecturer in film studies at the Lahore School of Economics, in a post on Twitter.
[byline: Salman Masood and Declan Walsh, with Zia ur-Rehman contributing from Karachi]
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[2] Pakistan - Balochistan: vaccination campaign suspended
Date: 18 Dec 2012
Source: Dawn [edited]
http://dawn.com/2012/12/18/balochistan- ... -campaign/
Balochistan govt suspends anti-polio campaign
---------------------------------------------
The Balochistan government has suspended its anti-polio campaign in the province in the aftermath of attacks on polio workers in Karachi and Peshawar on Tuesday (18 Dec 2012), an official told DawnNews. Noorul Haq Baloch, the focal person of Balochistan government on polio, said the campaign was suspended for an indefinite period in Quetta, Killa Abdullah, and Pishin districts.
"The reason behind suspension of the campaign is security threat to workers," said Baloch. He said so far 4 confirmed cases of polio were reported in Balochistan this year (2012). Baloch said 11 cases of polio 2 virus were reported in Balochistan.
"Polio 2 virus is curable and can be treated within 3 months," he said [this is an erroneous statement, the only "cure" for polio is to prevent the infection by vaccination. - Mod.MPP]
He said last year 73 cases of polio virus were reported in Balochistan.
The Balochistan Health Department in collaboration with World Health Organization, had decided to restart an anti-polio campaign from [24-28 Dec 2012] in Quetta, Killa Abdullah and Pishin districts. The campaign has now been suspended.
A polio volunteer was killed in Eastern By Pass area of Quetta a month ago [November 2012]. His killers are still at large.
Militants have frequently issued warnings to anti-polio teams in different districts of the sparsely populated province of the country.
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[3] WHO/UNICEF statement on violence in Pakistan
Date: 18 Dec 2012
Source: WHO press release [edited]
http://www.who.int/mediacentre/news/sta ... 121218/en/
WHO and UNICEF condemn attacks on health workers in Pakistan
------------------------------------------------------------
WHO and UNICEF join the Government of Pakistan and the provinces of Sindh and Khyber Pakhtunkhwa in condemning the multiple attacks that have killed 6 health workers in the past 24 hours.
At least 6 people working on a polio vaccination campaign have been reported shot dead in several locations in Pakistan -- Gadap, Landi, Baldia, and Orangi towns of Karachi city, Sindh Province and Peshawar, Khyber Pakhtunkhwa Province. Those killed were among thousands who work selflessly across Pakistan to eradicate polio.
The Government of Pakistan and the affected provinces have temporarily suspended the vaccination campaign due to concerns over safety of health workers.
Such attacks deprive Pakistan's most vulnerable populations -- especially children -- of basic life-saving health interventions. We call on the leaders of the affected communities and everyone concerned to do their utmost to protect health workers and create a secure environment so that we can meet the health needs of the children of Pakistan.
Polio is a highly infectious disease caused by a virus that can cause permanent paralysis in a matter of hours. Safe and effective vaccines protect children from the disease. Currently the disease remains endemic in only 3 countries: Afghanistan, Nigeria, and Pakistan.
WHO, UNICEF, and all their partners in Pakistan and globally express their deepest sympathy to the families of the health workers. We remain committed to supporting the Government of Pakistan and the people of Pakistan in their efforts to rid the country of polio and other diseases.
For further information please contact:
Oliver Rosenbauer
WHO
<rosenbauero@who.int>
Sarah Crowe
UNICEF Spokesperson
<scrowe@unicef.org>
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[4] Pakistan - Balochistan: 10 new cases
Date: 13 Dec 2012
Source: The International News [edited]
http://www.thenews.com.pk/Todays-News-1 ... alochistan
10 new polio cases reported in Balochistan
------------------------------------------
The exertions of the Balochistan government to save the children from the crippling polio disease have turned abortive as at least 10 new cases of the crippling virus, like that of a 2 year old [male], have been reported in the province in the last few weeks.
Of them 9 cases have been reported from the districts of Kila Abdullah Khan and one from Pishin, officials of the World Health Organization (WHO) confided while talking to The News on Wednesday [12 Dec 2012]. Apart from these, 4 cases of wild polio virus of type 1 had been reported in the province this year [2012]. Official sources confided that on Wednesday last [?5 Dec 2012], the last day of the 1st of 3 special anti-polio campaigns, 7530 families refused to administer the anti-polio drops to their children in Quetta, Kila Abdullah and Pishin districts. Of them, 2794 families refused at Quetta, 2788 refusal cases reported at Pishin, while 1948 families refused in Kila Abdullah.
It is worth mentioning here that the infectious disease has been eliminated in developed nations but persists in parts of Nigeria, Afghanistan, and Pakistan.
Pakistan reported 56 cases of the crippling virus in 2012 that had been reduced from 199 in 2011, while Afghanistan has reported 38. Most of the Afghan and Pakistani cases have occurred along their porous border.
In its report, the Independent Monitoring Board (IMB) of global polio eradication initiative, has recommended the International Health Regulations Expert Review Committee to issue urgently a standing recommendation by May 2013 that will introduce pre-travel vaccination or vaccination checks in Afghanistan, Nigeria and Pakistan until national transmission is stopped. "No country should allow a citizen from any endemic polio state to cross their border without a valid vaccination certificate," the IMB recommendations added.
Soon after the IMB report, a high-level meeting was held with the chief minister of Balochistan, Nawab Muhammad Aslam Raisani, in the chair last week. It decided to launch 3 special polio campaigns in the polio-affected areas. It has been [learned] that the ways and means were discussed to eradicate the polio completely from the province. The chief minister expressed his dismay over the presence of the increased number of polio cases in the province. He, on the occasion, said the government would mobilise all its available resources and manpower to achieve the target of "Polio-free Balochistan".
The chief minister said though effective steps are being taken for eradication of the crippling disease in the province, there is still much room to do a lot to achieve complete success in this regard.
On the occasion, the chief secretary expressed the resolve to eradicate the disease from the province saying that the major reason behind the new outbreak is the administrative issue, which needs to be resolved. He directed that it must be ensured to administer the anti-polio drops to every kid in the affected districts.
[byline: Muhammad Ejaz Khan]
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[5] Polio eradication initiative global update as of 12 Dec 2012
Date: 12 Dec 2012
Source: Polio Eradication Initiative [edited]
http://polioeradication.org/Dataandmoni ... sweek.aspx
Global Polio Eradication Initiative update as of 12 Dec 2012
------------------------------------------------------------
Total cases
Year-to-date 2012 / Year-to-date 2011 / Total in 2011*
Globally: 213 / 571 / 650
- in endemic countries: 208 / 281 / 341
- in non-endemic countries: 5 / 290 / 309
Case breakdown by country
Country: Year-to-date 2012 WPV1 / WPV3 / W1W3 / Total // Year-to-date 2011 WPV1 / WPV3 / W1W3 / Total // Total in 2011* / Date of most recent case
Pakistan: 53 / 2 / 1 / 56 // 171 / 2 / 0 / 161 // 198 / 10 Nov 2012
Afghanistan: 34 / 0 / 0 / 34 // 61 / 0 / 0 / 61 // 80 / 19 Nov 2012
Nigeria: 98 / 20 / 0 / 118 // 36 / 10 / 0 / 46 // 62 / 17 Nov 2012
India: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 13 Jan 2011
Chad: 5 / 0 / 0 / 5 // 114 / 3 / 0 / 117 // 132 / 14 Jun 2012
DR Congo: 0 / 0/ 0 / 0 // 88 / 0 / 0 / 88 // 93 / 20 Dec 2011
Angola: 0 / 0 / 0 / 0 // 5 / 0 / 0 / 5 // 5 / 7 Jul 2011
Niger: 0 / 0 / 0 / 0 // 1 / 1 / 0 / 3 // 5 / 22 Dec 2011
CAR: 0 / 0 / 0 / 0 // 2 / 0 / 0 / 2 // 4 / 8 Dec 2011
China: 0 / 0 / 0 / 0 // 18 / 0 / 0 / 18 // 21 / 9 Oct 2011
Guinea: 0 / 0/ 0 / 0 // 0 / 3 / 0 / 3 // 3 / 3 Aug 2011
Kenya: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 30 Jul 2011
Cote d'Ivoire: 0 / 0 / 0 / 0 // 0 / 36 / 0 / 36 // 36 / 24 Jul 2011
Mali: 0 / 0 / 0 / 0 // 0 / 7 / 0 / 7 // 7 / 23 Jun 2011
Congo: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 22 Jan 2011
Gabon: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 15 Jan 2011
Total: 190 / 22 / 1 / 213 // 508 / 63 / 0 / 571 // 650
Total in endemic countries: 185 / 22 / 1 / 208 // 269 / 12 / 0 / 281 // 341
Total outbreak: 5 / 0 / 0 / 5 // 239 / 51 / 0 / 290 // 309
*Data in WHO as of 13 Dec 2011 for 2011 data and 11 Dec 2012 for 2012 data
Two polio vaccinators were killed in Afghanistan last week [week ending 5 Dec 2012] in separate incidents, underlining the dangerous conditions that health and humanitarian workers face in many countries. These tragic events further underline the truly heroic and courageous efforts of the frontline health workers, often working under very dangerous conditions, all in efforts to protect children from lifelong polio-paralysis.
Afghanistan
- One new WPV case was reported in the past week (WPV1 from Hilmand), bringing the total number of WPV cases for 2012 to 34. It is the most recent case in the country, and had onset of paralysis on [19 Nov 2012].
- The Inter-Ministerial Task Force held its 1st meeting on [11 Dec 2012] chaired by the deputy minister and co-chaired by focal person for polio eradication.
- Preparations are ongoing for the December Subnational Immunization Days (SNIDs), to be conducted in 14 high-risk districts and some border districts from [16-19 Dec 2012].
- OPV (oral polio vaccine) was administered as part of a measles campaign began in 18 provinces, which began on [1 Dec 2012].
Nigeria
- 7 new WPV cases were reported in the past week (2 cases of WPV1 from Katsina, 1 WPV1 from Kaduna, 1 WPV1 from Kano, 1 WPV1 from FCT, 1 WPV3 from Taraba, and 1 WPV3 from Yobe), bringing the total number of WPV cases for 2012 to 118. The WPV1 from Kaduna is the most recent in the country and had onset of paralysis on [17 Nov 2012].
- The 2 new WPV3 cases reported are particularly concerning, as Nigeria is now the only country in the world reporting cases due to this strain over the past 6 months. Taraba's previous WPV3 case dates back to July [2012], and a comprehensive outbreak response is urgently needed.
- Trivalent OPV was added to Child Health Days (with meningitis vaccine) from [1-10 Dec 2012], and subnational Immunization Plus Days (IPDs) will be conducted using bivalent OPV (15-18 Dec 2012). This will be an opportunity to administer 2 additional doses of OPV to children in highest-risk areas, within the space of a single month.
Pakistan
- No new WPV cases were reported in the past week. The most recently reported WPV case occurred in Federally Administered Tribal Areas (WPV1) with onset of paralysis on [10 Nov 2012]. The total number of WPV cases for 2012 remains 56.
- However, 2 new circulating vaccine-derived poliovirus type 2 (cVDPV2) cases were reported in the past week from Killa Abdullah in Balochistan, bringing the total number of cVDPV2 cases to 12 (all from the greater Quetta area of Balochistan).
- Response vaccination activities began in all Union-Councils of the Killa Abdullah district this week. Trivalent OPV was used for all union councils except for one team in Boghra that used bivalent OPV. After this campaign is concluded, the micro-plan for Killa Abdullah will be updated.
- An All Political Parties Conference was held in Killa Abdullah on [6 Dec 2012] to sustain the support of all political parties for polio eradication campaigns in the district. The conference provided an opportunity to share the current situation of polio eradication in the district, dispel misconceptions regarding immunization and encourage the parties to actively participate in the upcoming campaigns. Members of 9 political parties participated in the event.
- Preparations for SNIDs scheduled for [17-19 Dec 2012] are underway.
- The Polio Eradication Technical Advisory Group meeting is scheduled for [14-15 Dec 2012] in Islamabad.
Angola
- No new cases were reported in the past week. No cases have been reported in 2012. The country reported a total of 5 cases in 2011, and the last case had onset of paralysis on [7 Jul 2011] in Uige in the country's north.
- SNIDs with trivalent OPV were conducted on [7-10 Dec 2012].
Chad
- No new WPV cases were reported in the past week. The most recently reported WPV case occurred in the Lac region (WPV1) with onset of paralysis on [14 Jun 2012]. The total number of WPV cases for 2012 remains 5.
- One new cVDPV2 case was reported in the past week, bringing the total number of cVDPV2 cases to 12.
- Staggered SNIDs were conducted on [23-25 Nov 2012] in the south and east and were conducted on [9-11 Dec 2012] in the north and west, using trivalent OPV. Staggering activities allows the redeployment of all available technical staff to support the activity in various areas.
- Efforts are ongoing to strengthen subnational surveillance sensitivity, with trainings of health centers staff in key areas being conducted.
Democratic Republic of the Congo (DRC)
- No new WPV cases were reported in the past week. No WPV cases have been reported in 2012. The total number of WPV cases for 2011 is 93 (all WPV1). The most recent case had onset of paralysis on [20 Dec 2011] in Maniema province.
- Although the country has not reported a WPV case since December 2011, it has been affected by a cVDPV2 outbreak in Katanga province in 2012, with 17 cases reported (most recent case: (4 Apr 2012). Efforts are focused on ensuring the cVDPV2 outbreak is fully stopped.
- Following recent insecurity, most UN staff has now returned to Goma. However, the security situation continues to be evaluated.
- A polio campaign for 27 Nov 2012 was postponed in North Kivu. OPV is also being added to measles campaigns and other humanitarian interventions planned in internally-displaced persons (IDPs) camps.
Horn of Africa
- Efforts are continuing to stop an ongoing cVDPV2 outbreak in Kenya and parts of Somalia (in a Somali refugee camp in Dadaab, Kenya, and Kismayo, south-central Somalia).
- Immunizations of older age groups have taken place in Dadaab. In Somalia, campaigns have been conducted in border areas with Kenya and Ethiopia, and in some areas of central Somalia (access allowing).
- Across the region, OPV continues to be added to broader humanitarian response activities.
- New tactics are being explored to further boost immunity levels in and around inaccessible areas of south-central Somalia. Potential activities include focusing on people in transit to/from inaccessible areas, using local negotiators to allow safe passage of vaccination teams to inaccessible areas, and immunizing populations bordering inaccessible areas.
West Africa
- No new WPV cases were reported in the past week. No WPV cases have been reported in 2012. The total number of WPV cases for 2011 in West Africa remains 51 (36 from Cote d'Ivoire, 3 from Guinea, 7 from Mali, and 5 from Niger). The most recent case from the region (WPV1 from Niger) had onset of paralysis on [22 Dec 2011].
- SIAs in Benin with Vitamin A and deworming tablets were conducted from [7-9 Dec 2012].
- OPV continues to be added to broader humanitarian response activities across the region.
--
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[The above series of reports highlights the challenges to a final interruption of poliovirus (both wild and vaccine derived) transmission/circulation in the 3 remaining polio endemic countries in the world -- Afghanistan, Pakistan, and Nigeria. In both Afghanistan and Pakistan unacceptable violence has been directed at polio vaccination teams, resulting in the deaths of 8 polio campaign workers over the past few weeks. The room for international outcry and action is there. It is totally incomprehensible to this moderator how these violent acts can be directed at humanitarian workers whose sole "infraction" is trying to eradicate a disease responsible for death and disability of predominantly children in these countries.
If one looks at the global polio update as of 12 Dec 2012 from the Polio Eradication Initiative (in section [5] above] one sees that at present the only countries where there are documented wild poliovirus (WPV) cases are the 3 remaining polio endemic countries -- Afghanistan, Pakistan and Nigeria. But, there continue to be paralytic polio cases associated with infection from circulating vaccine derived polioviruses (cVDPV) this year (2012) in Kenya, Somalia, Democratic Republic of the Congo, Yemen, Chad and the 3 remaining polio endemic countries -- Afghanistan, Pakistan and Nigeria. As mentioned in previous polio posts, both WPV and cVDPV circulation occur in areas where there are suboptimal polio vaccination coverages. The challenges have been to sustain high levels of polio vaccination coverage after WPV transmission has been interrupted in an area and the population no longer sees an urgency in vaccinating their children as the disease appears no longer to be a threat.
The obvious concerns here are that while presently the only countries with documented WPV transmission are the 3 remaining polio endemic countries, the danger of reintroduction of WPV to other countries whose vaccination coverages have declined is ever present (and has occurred through the years -- recurrent cases in other African countries, Indonesia, China to name a few of the instances in the not too distant past).
For maps of countries where there have been confirmed cases due to WPV infections in 2011 and 2012, see http://www.polioeradication.org/Dataand ... dwide.aspx.
For a map of countries where there have been confirmed cases due to cVDPV infections
during the preceding 6 months, and tables showing the number of cases of cVDPV by year, country and cVDPV type since 2000, see: http://www.polioeradication.org/Dataand ... virus.aspx. - Mod.MPP]
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POLIOMYELITIS - WORLDWIDE (16): COMMENT
***************************************
A ProMED-mail post
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International Society for Infectious Diseases
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Date: 19 Dec 2012
From: Jawad Mofleh <epi@emphnet.net> [edited]
An article was published on 19 Dec 2012 titled "Poliomyelitis - worldwide (15): Pakistan, global update", with archive number: 20121218.1458209. In paragraph 3 of section one of this alert, there is a mistake (on Karachi, Pakistan, re. violence against vaccination teams, quoted from NY Times).
It is reported that "Pakistan accounted for 198 new cases last year [2011], the highest rate in the world, followed by Afghanistan and Nigeria." As a matter of fact, 198 is just a number and not the rate, and numbers are not enough to compare the rate of diseases at different levels. You need to report disease rates (for example, numbers of cases of disease per 100 000 or million population) in order to reduce confusion at the time of comparison. In this case, if one calculates the polio rate in endemic countries, Pakistan is not the number one country with polio case rates at the global level in the last 2 years; in 2011, Pakistan was number 2, and in 2012 to date, Pakistan is 3rd, while Afghanistan was number one in 2011 and holds the same position to date in 2012.
Endemic countries: Total pop (millions) / Cases to date 2012 / Cases to date 2011 / Total cases 2011 // Cases per million pop (to date 2012) / Cases per million pop (to date 2011) / Cases per million pop (all cases 2011)
Pakistan: 173.593 / 56 / 173 / 198 // 0.32 / 1.00 / 1.14
Afghanistan: 31.412 / 34 / 61 / 80 // 1.08 / 1.94 / 2.55
Nigeria: 158.423 / 118 / 46 / 62 // 0.74 / 0.29 / 0.39
Countries are ranked as per data available on the Polio Eradication Initiative website, which was accessed [19 Dec 2012]
http://www.polioeradication.org/Dataand ... sweek.aspx.
On a separate note, killing NID [national immunization day] volunteers is not only limited to Pakistan. We are losing our good people every day all over the world. But some, like Health Authorities of Pakistan, report it to recognize the dedication of the health care workers toward polio eradication, and some countries do not report it for their own reasons, such as Afghanistan. A student who was working as volunteer for polio eradication in her district was shot dead in Kohistan district of Kapisa province in Afghanistan at the beginning of December 2012. http://www.guardian.co.uk/world/2012/de ... sassinated. The polio drive was not stopped, and President Hamid Karzai ordered an investigation of this murder on 7 Dec 2012.
This is not only an ethical issue. Reporting the real situation is a recognition and appreciation of those who give their lives to eradicate poliomyelitis.
--
Dr Jawad Mofleh
Public Health Epidemiologist
Eastern Mediterranean Public Health Network
Amman - Jordan
<epi@emphnet.net>
[ProMED-mail would like to thank Dr Jawad Mofleh for this interesting presentation of the rates per million population of polio cases by country. - Mod.MPP]
***************************************
A ProMED-mail post
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ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: 19 Dec 2012
From: Jawad Mofleh <epi@emphnet.net> [edited]
An article was published on 19 Dec 2012 titled "Poliomyelitis - worldwide (15): Pakistan, global update", with archive number: 20121218.1458209. In paragraph 3 of section one of this alert, there is a mistake (on Karachi, Pakistan, re. violence against vaccination teams, quoted from NY Times).
It is reported that "Pakistan accounted for 198 new cases last year [2011], the highest rate in the world, followed by Afghanistan and Nigeria." As a matter of fact, 198 is just a number and not the rate, and numbers are not enough to compare the rate of diseases at different levels. You need to report disease rates (for example, numbers of cases of disease per 100 000 or million population) in order to reduce confusion at the time of comparison. In this case, if one calculates the polio rate in endemic countries, Pakistan is not the number one country with polio case rates at the global level in the last 2 years; in 2011, Pakistan was number 2, and in 2012 to date, Pakistan is 3rd, while Afghanistan was number one in 2011 and holds the same position to date in 2012.
Endemic countries: Total pop (millions) / Cases to date 2012 / Cases to date 2011 / Total cases 2011 // Cases per million pop (to date 2012) / Cases per million pop (to date 2011) / Cases per million pop (all cases 2011)
Pakistan: 173.593 / 56 / 173 / 198 // 0.32 / 1.00 / 1.14
Afghanistan: 31.412 / 34 / 61 / 80 // 1.08 / 1.94 / 2.55
Nigeria: 158.423 / 118 / 46 / 62 // 0.74 / 0.29 / 0.39
Countries are ranked as per data available on the Polio Eradication Initiative website, which was accessed [19 Dec 2012]
http://www.polioeradication.org/Dataand ... sweek.aspx.
On a separate note, killing NID [national immunization day] volunteers is not only limited to Pakistan. We are losing our good people every day all over the world. But some, like Health Authorities of Pakistan, report it to recognize the dedication of the health care workers toward polio eradication, and some countries do not report it for their own reasons, such as Afghanistan. A student who was working as volunteer for polio eradication in her district was shot dead in Kohistan district of Kapisa province in Afghanistan at the beginning of December 2012. http://www.guardian.co.uk/world/2012/de ... sassinated. The polio drive was not stopped, and President Hamid Karzai ordered an investigation of this murder on 7 Dec 2012.
This is not only an ethical issue. Reporting the real situation is a recognition and appreciation of those who give their lives to eradicate poliomyelitis.
--
Dr Jawad Mofleh
Public Health Epidemiologist
Eastern Mediterranean Public Health Network
Amman - Jordan
<epi@emphnet.net>
[ProMED-mail would like to thank Dr Jawad Mofleh for this interesting presentation of the rates per million population of polio cases by country. - Mod.MPP]
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Birgitt
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POLIOMYELITIS - WORLDWIDE (01): EGYPT ex PAKISTAN, NIGER
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A ProMED-mail post
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ProMED-mail is a program of the
International Society for Infectious Diseases
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In this update:
[1] Egypt ex Pakistan
[2] Worldwide update - Polio Eradication Initiative
******
[1] Egypt ex Pakistan
Date: Mon 21 Jan 2013
Source: Medical Xpress [edited]
http://medicalxpress.com/news/2013-01-p ... istan.html
Pakistani health officials Monday [21 Jan 2013] called for infants leaving the country to be issued polio vaccinations at airports after virus samples linked to a southern Pakistani city were discovered in Egypt.
Two sewage samples from Cairo were analysed and found to resemble a recently discovered strain in the Pakistani city of Sukkur, a joint statement by health officials, the World Health Organization (WHO) and UNICEF said.
"To reduce the possibility of spread of poliovirus beyond Pakistan's borders, the government's Monitoring and Coordination Cell is advising to set up permanent vaccination counters at the international departure lounges of all airports," it said. The statement recommended that "all children under 5 years leaving the country are vaccinated against poliovirus."
Though Egypt has been polio-free since 2004, authorities there have ordered the immediate vaccination of all children less than 5 years of age in the areas where the samples were found.
Polio cases in Pakistan have risen sharply in recent years, hitting 198 in 2011 -- the highest figure for more than a decade and the most of any country in the world, according to the WHO. UNICEF's acting chief of polio unit, Michael Coleman said the incident highlighted the importance of vaccination in Pakistan. "It reinforces the urgent need of all caregivers across Pakistan to vaccinate children under 5 years of age against polio through the nearest health facility or through campaign vaccination teams," he said.
Shahnaz Wazir Ali, the prime minister's advisor on polio eradication, termed the case "a stark reminder of the risks associated with active poliovirus transmission in the country. Pakistan is one of only 3 countries where the highly infectious crippling disease remains endemic, along with Afghanistan and Nigeria.
Earlier this month [January 2013] Pakistan provided paramilitary and police support to polio vaccination teams in the northwest after a series of attacks on medical workers. UN agencies suspended work on a nationwide campaign to inoculate children against the highly infectious disease after 9 health workers were murdered in a string of attacks in the northwest and Karachi in December last year [2012]. Rumours about the vaccine being a plot to sterilise Muslims have long dogged efforts to tackle the disease in Pakistan. Suspicion of vaccination programmes intensified after the jailing of a doctor who helped the CIA find Osama bin Laden in 2011 using a hepatitis campaign.
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******
[2] Worldwide update - Polio Eradication Initiative
Date: 16 Jan 2013
Source: Global Polio Eradication Initiative [excerpted, edited]
http://polioeradication.org/Dataandmoni ... sweek.aspx
Global Polio Eradication Initiative update as of 12 Dec 2012
------------------------------------------------------------
Total cases
Year-to-date 2012 / Year-to-date 2011 / Total in 2011*
Globally: 223 / 642 / 650
- in endemic countries: 217 / 335 / 341
- in non-endemic countries: 6 / 307 / 309
Case breakdown by country
Country: Year-to-date 2012 WPV1 / WPV3 / W1W3 / Total // Year-to-date 2011 WPV1 / WPV3 / W1W3 / Total // Total in 2011* / Date of most recent case
Pakistan: 55 / 2 / 1 / 58 // 195 / 2 / 0 / 197 // 198 / 30 Nov 2012
Afghanistan: 37 / 0 / 0 / 37 // 80 / 0 / 0 / 80 // 80 / 20 Dec 2012
Nigeria: 103 / 19 / 0 / 122 // 44 / 13 / 0 / 57 // 62 / 3 Dec 2012
India: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 13 Jan 2011
Chad: 5 / 0 / 0 / 5 // 128 / 3 / 0 / 131 // 132 / 14 Jun 2012
DR Congo: 0 / 0/ 0 / 0 // 92 / 0 / 0 / 92 // 93 / 20 Dec 2011
Angola: 0 / 0 / 0 / 0 // 5 / 0 / 0 / 5 // 5 / 7 Jul 2011
Niger: 1 / 0 / 0 / 1 // 1 / 3 / 2 / 5 // 5 / 15 Nov 2012
CAR: 0 / 0 / 0 / 0 // 4 / 0 / 0 / 4 // 4 / 8 Dec 2011
China: 0 / 0 / 0 / 0 // 21 / 0 / 0 / 21 // 21 / 9 Oct 2011
Guinea: 0 / 0/ 0 / 0 // 0 / 3 / 0 / 3 // 3 / 3 Aug 2011
Kenya: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 30 Jul 2011
Cote d'Ivoire: 0 / 0 / 0 / 0 // 0 / 36 / 0 / 36 // 36 / 24 Jul 2011
Mali: 0 / 0 / 0 / 0 // 0 / 7 / 0 / 7 // 7 / 23 Jun 2011
Congo: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 22 Jan 2011
Gabon: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 15 Jan 2011
Total: 201 / 21 / 1 / 223 // 576 / 66 / 0 / 642 // 650
Total in endemic countries: 195 / 21 / 1 / 217 // 320 / 15 / 0 / 335 // 341
Total outbreak: 6 / 0 / 0 / 6 // 256 / 51 / 0 / 307 // 309
*Data in WHO as of 17 Jan 2012 for 2011 data and 15 Jan 2013 for 2012 data
Polio this week -- as of 16 Jan 2013
------------------------------------
13 Jan 2013 marked 2 years since the last wild poliovirus (WPV) case in India.
Afghanistan
-----------
- No new WPV cases were reported in the past week. The total number of WPV cases for 2012 remains 37. The most recent case had onset of paralysis on [20 Dec 2012] (WPV1 from Nangarhar).
- No new cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) were reported in the past week. The total number of cVDPV2 cases for 2012 remains 4. The most recent cVDPV2 case had onset of paralysis on [3 Dec 2012] (from Hilmand).
Nigeria
-------
- One new WPV case was reported in the past week (WPV1 from Kano), bringing the total number of WPV cases for 2012 to 122. The most recent WPV case had onset of paralysis on [3 Dec 2012] (WPV1 from Federal Capital Territory - FCT).
- 2 new cases of cVDVP2, both occurring in Sokoto, were reported in the past week, bringing the total number of cVDPV2 cases for 2012 to 8. The most recent cVDPV2 case had onset of paralysis on [24 Nov 2012] (from Kebbi).
- Given the spread of WPV of Nigerian origin to Niger, targeted supplementary immunization activities (SIAs) will take place in high-risk and under-served local government areas (LGAs) in Nigeria. Special Immunization Plus Days (IPDs) for underserved populations were conducted [12-15 Jan 2013] in 11 high-risk states. LGAs of Sokoto, Katsina, and Zamfara bordering the recently-infected province in Niger are synchronizing SIAs with Niger this week ([15-18 Jan 2013]).
Pakistan
--------
- No new WPV cases were reported in the past week. The total number of WPV cases for 2012 remains 58. The most recent WPV case had onset of paralysis on [30 Nov 2012] (WPV1 from Khyber Pakhtunkhwa-KP).
- No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2012 remains 15. The most recent cVDPV2 case had onset of paralysis on [8 Dec 2012] (from Sindh).
- District officials are assessing security conditions locally, in close consultation with law enforcement. A decentralized approach to vaccination activities is being used due to insecurity for polio workers.
Chad
----
- No new WPV cases were reported in the past week. The total number of WPV cases for 2012 remains 5. The most recent WPV case had onset of paralysis on [14 Jun 2012] (WPV1 from Lac).
- No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2012 remains 12. The most recent cVDPV2 case had onset of paralysis on [20 Oct 2012] (from Wadi Fira).
Democratic Republic of the Congo (DRC)
--------------------------------------
- No new WPV cases were reported in the past week. No WPV cases have been reported in 2012. The most recent WPV case had onset of paralysis on [20 Dec 2011] (WPV1 from Maniema).
- No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2012 remains 17. The most recent cVDPV2 case had onset of paralysis on [4 Apr 2012] (from Katanga).
- The security situation in North Kivu continues to be monitored. Approximately 20 000 people have been internally displaced in Katanga and others from the Central African Republic have been displaced to Equateur.
Horn of Africa
--------------
- No new cases were reported in the region in the past week. In 2012 Yemen reported 2 cases of a cVDPV type 3, the most recent of which had onset of paralysis on [24 Aug 2012]; Kenya and Somalia reported 3 cases and one case respectively of cVDPV2 in a related outbreak, with the most recent having onset of paralysis in Somalia on [23 Jul 2012].
Niger
-----
- In the 1st outbreak of polio in 2012 outside of an endemic country or a country with re-established poliovirus, Niger has reported a case of wild poliovirus. This is the 1st case in the country since December 2011 and is related to virus originating in Nigeria.
West Africa
-----------
- No new WPV cases were reported in the past week. One WPV case was reported in the region in 2012, a WPV1 from Tahoua province in Niger with onset of paralysis on [15 Nov 2012]. This is the 1st case in the country since December 2011 and is related to virus originating in Nigeria.
- Outbreak response has been launched, with the 1st immunization activities on [15 Jan 2013], in close coordination with Nigeria. These will be followed by NIDs with trivalent OPV on [2-5 Feb 2013] and with bivalent OPV on [2-5 Mar 2013], synchronized with campaigns in Nigeria.
- Planning has started for surveillance reviews and additional immunization activities in high-risk districts in West African countries which have suffered repeated importations of virus of Nigerian origin. Several countries in the region are in severe humanitarian distress. The risk of further spread from Niger is moderate, but such spread would have serious implications.
--
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[The reports above highlight the ever present risk of spread of wild poliovirus (WPV) from the remaining 3 polio endemic countries to areas where WPV transmission has been interrupted previously. In the 1st report, there was the identification of wild poliovirus (WPV) genetically related to WPV circulating in Sukkur Pakistan in an environmental sampling of sewage in Cairo, Egypt. In the 2nd report, there was a case of WPV associated disease in Niger due to infection with a WPV genetically similar to a virus circulating in Nigeria.
For maps of confirmed WPV associated disease in the world, see http://www.polioeradication.org/Dataand ... dwide.aspx.
For the HealthMap/ProMED map of Pakistan, see http://healthmap.org/r/4XWG. For a map of Pakistan showing the location of the city of Sukkur in Sindh Province, see http://www.vista-tourism.com/sukkur_map.htm. For the HealthMap/ProMED map of Egypt, see http://healthmap.org/r/4XWH. - Mod.MPP]
********************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] Egypt ex Pakistan
[2] Worldwide update - Polio Eradication Initiative
******
[1] Egypt ex Pakistan
Date: Mon 21 Jan 2013
Source: Medical Xpress [edited]
http://medicalxpress.com/news/2013-01-p ... istan.html
Pakistani health officials Monday [21 Jan 2013] called for infants leaving the country to be issued polio vaccinations at airports after virus samples linked to a southern Pakistani city were discovered in Egypt.
Two sewage samples from Cairo were analysed and found to resemble a recently discovered strain in the Pakistani city of Sukkur, a joint statement by health officials, the World Health Organization (WHO) and UNICEF said.
"To reduce the possibility of spread of poliovirus beyond Pakistan's borders, the government's Monitoring and Coordination Cell is advising to set up permanent vaccination counters at the international departure lounges of all airports," it said. The statement recommended that "all children under 5 years leaving the country are vaccinated against poliovirus."
Though Egypt has been polio-free since 2004, authorities there have ordered the immediate vaccination of all children less than 5 years of age in the areas where the samples were found.
Polio cases in Pakistan have risen sharply in recent years, hitting 198 in 2011 -- the highest figure for more than a decade and the most of any country in the world, according to the WHO. UNICEF's acting chief of polio unit, Michael Coleman said the incident highlighted the importance of vaccination in Pakistan. "It reinforces the urgent need of all caregivers across Pakistan to vaccinate children under 5 years of age against polio through the nearest health facility or through campaign vaccination teams," he said.
Shahnaz Wazir Ali, the prime minister's advisor on polio eradication, termed the case "a stark reminder of the risks associated with active poliovirus transmission in the country. Pakistan is one of only 3 countries where the highly infectious crippling disease remains endemic, along with Afghanistan and Nigeria.
Earlier this month [January 2013] Pakistan provided paramilitary and police support to polio vaccination teams in the northwest after a series of attacks on medical workers. UN agencies suspended work on a nationwide campaign to inoculate children against the highly infectious disease after 9 health workers were murdered in a string of attacks in the northwest and Karachi in December last year [2012]. Rumours about the vaccine being a plot to sterilise Muslims have long dogged efforts to tackle the disease in Pakistan. Suspicion of vaccination programmes intensified after the jailing of a doctor who helped the CIA find Osama bin Laden in 2011 using a hepatitis campaign.
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******
[2] Worldwide update - Polio Eradication Initiative
Date: 16 Jan 2013
Source: Global Polio Eradication Initiative [excerpted, edited]
http://polioeradication.org/Dataandmoni ... sweek.aspx
Global Polio Eradication Initiative update as of 12 Dec 2012
------------------------------------------------------------
Total cases
Year-to-date 2012 / Year-to-date 2011 / Total in 2011*
Globally: 223 / 642 / 650
- in endemic countries: 217 / 335 / 341
- in non-endemic countries: 6 / 307 / 309
Case breakdown by country
Country: Year-to-date 2012 WPV1 / WPV3 / W1W3 / Total // Year-to-date 2011 WPV1 / WPV3 / W1W3 / Total // Total in 2011* / Date of most recent case
Pakistan: 55 / 2 / 1 / 58 // 195 / 2 / 0 / 197 // 198 / 30 Nov 2012
Afghanistan: 37 / 0 / 0 / 37 // 80 / 0 / 0 / 80 // 80 / 20 Dec 2012
Nigeria: 103 / 19 / 0 / 122 // 44 / 13 / 0 / 57 // 62 / 3 Dec 2012
India: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 13 Jan 2011
Chad: 5 / 0 / 0 / 5 // 128 / 3 / 0 / 131 // 132 / 14 Jun 2012
DR Congo: 0 / 0/ 0 / 0 // 92 / 0 / 0 / 92 // 93 / 20 Dec 2011
Angola: 0 / 0 / 0 / 0 // 5 / 0 / 0 / 5 // 5 / 7 Jul 2011
Niger: 1 / 0 / 0 / 1 // 1 / 3 / 2 / 5 // 5 / 15 Nov 2012
CAR: 0 / 0 / 0 / 0 // 4 / 0 / 0 / 4 // 4 / 8 Dec 2011
China: 0 / 0 / 0 / 0 // 21 / 0 / 0 / 21 // 21 / 9 Oct 2011
Guinea: 0 / 0/ 0 / 0 // 0 / 3 / 0 / 3 // 3 / 3 Aug 2011
Kenya: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 30 Jul 2011
Cote d'Ivoire: 0 / 0 / 0 / 0 // 0 / 36 / 0 / 36 // 36 / 24 Jul 2011
Mali: 0 / 0 / 0 / 0 // 0 / 7 / 0 / 7 // 7 / 23 Jun 2011
Congo: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 22 Jan 2011
Gabon: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 1 / 15 Jan 2011
Total: 201 / 21 / 1 / 223 // 576 / 66 / 0 / 642 // 650
Total in endemic countries: 195 / 21 / 1 / 217 // 320 / 15 / 0 / 335 // 341
Total outbreak: 6 / 0 / 0 / 6 // 256 / 51 / 0 / 307 // 309
*Data in WHO as of 17 Jan 2012 for 2011 data and 15 Jan 2013 for 2012 data
Polio this week -- as of 16 Jan 2013
------------------------------------
13 Jan 2013 marked 2 years since the last wild poliovirus (WPV) case in India.
Afghanistan
-----------
- No new WPV cases were reported in the past week. The total number of WPV cases for 2012 remains 37. The most recent case had onset of paralysis on [20 Dec 2012] (WPV1 from Nangarhar).
- No new cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) were reported in the past week. The total number of cVDPV2 cases for 2012 remains 4. The most recent cVDPV2 case had onset of paralysis on [3 Dec 2012] (from Hilmand).
Nigeria
-------
- One new WPV case was reported in the past week (WPV1 from Kano), bringing the total number of WPV cases for 2012 to 122. The most recent WPV case had onset of paralysis on [3 Dec 2012] (WPV1 from Federal Capital Territory - FCT).
- 2 new cases of cVDVP2, both occurring in Sokoto, were reported in the past week, bringing the total number of cVDPV2 cases for 2012 to 8. The most recent cVDPV2 case had onset of paralysis on [24 Nov 2012] (from Kebbi).
- Given the spread of WPV of Nigerian origin to Niger, targeted supplementary immunization activities (SIAs) will take place in high-risk and under-served local government areas (LGAs) in Nigeria. Special Immunization Plus Days (IPDs) for underserved populations were conducted [12-15 Jan 2013] in 11 high-risk states. LGAs of Sokoto, Katsina, and Zamfara bordering the recently-infected province in Niger are synchronizing SIAs with Niger this week ([15-18 Jan 2013]).
Pakistan
--------
- No new WPV cases were reported in the past week. The total number of WPV cases for 2012 remains 58. The most recent WPV case had onset of paralysis on [30 Nov 2012] (WPV1 from Khyber Pakhtunkhwa-KP).
- No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2012 remains 15. The most recent cVDPV2 case had onset of paralysis on [8 Dec 2012] (from Sindh).
- District officials are assessing security conditions locally, in close consultation with law enforcement. A decentralized approach to vaccination activities is being used due to insecurity for polio workers.
Chad
----
- No new WPV cases were reported in the past week. The total number of WPV cases for 2012 remains 5. The most recent WPV case had onset of paralysis on [14 Jun 2012] (WPV1 from Lac).
- No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2012 remains 12. The most recent cVDPV2 case had onset of paralysis on [20 Oct 2012] (from Wadi Fira).
Democratic Republic of the Congo (DRC)
--------------------------------------
- No new WPV cases were reported in the past week. No WPV cases have been reported in 2012. The most recent WPV case had onset of paralysis on [20 Dec 2011] (WPV1 from Maniema).
- No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2012 remains 17. The most recent cVDPV2 case had onset of paralysis on [4 Apr 2012] (from Katanga).
- The security situation in North Kivu continues to be monitored. Approximately 20 000 people have been internally displaced in Katanga and others from the Central African Republic have been displaced to Equateur.
Horn of Africa
--------------
- No new cases were reported in the region in the past week. In 2012 Yemen reported 2 cases of a cVDPV type 3, the most recent of which had onset of paralysis on [24 Aug 2012]; Kenya and Somalia reported 3 cases and one case respectively of cVDPV2 in a related outbreak, with the most recent having onset of paralysis in Somalia on [23 Jul 2012].
Niger
-----
- In the 1st outbreak of polio in 2012 outside of an endemic country or a country with re-established poliovirus, Niger has reported a case of wild poliovirus. This is the 1st case in the country since December 2011 and is related to virus originating in Nigeria.
West Africa
-----------
- No new WPV cases were reported in the past week. One WPV case was reported in the region in 2012, a WPV1 from Tahoua province in Niger with onset of paralysis on [15 Nov 2012]. This is the 1st case in the country since December 2011 and is related to virus originating in Nigeria.
- Outbreak response has been launched, with the 1st immunization activities on [15 Jan 2013], in close coordination with Nigeria. These will be followed by NIDs with trivalent OPV on [2-5 Feb 2013] and with bivalent OPV on [2-5 Mar 2013], synchronized with campaigns in Nigeria.
- Planning has started for surveillance reviews and additional immunization activities in high-risk districts in West African countries which have suffered repeated importations of virus of Nigerian origin. Several countries in the region are in severe humanitarian distress. The risk of further spread from Niger is moderate, but such spread would have serious implications.
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[The reports above highlight the ever present risk of spread of wild poliovirus (WPV) from the remaining 3 polio endemic countries to areas where WPV transmission has been interrupted previously. In the 1st report, there was the identification of wild poliovirus (WPV) genetically related to WPV circulating in Sukkur Pakistan in an environmental sampling of sewage in Cairo, Egypt. In the 2nd report, there was a case of WPV associated disease in Niger due to infection with a WPV genetically similar to a virus circulating in Nigeria.
For maps of confirmed WPV associated disease in the world, see http://www.polioeradication.org/Dataand ... dwide.aspx.
For the HealthMap/ProMED map of Pakistan, see http://healthmap.org/r/4XWG. For a map of Pakistan showing the location of the city of Sukkur in Sindh Province, see http://www.vista-tourism.com/sukkur_map.htm. For the HealthMap/ProMED map of Egypt, see http://healthmap.org/r/4XWH. - Mod.MPP]
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Kinderlähmung - Poliomyelitis in Ägypten
Poliovirus detected from environmental samples in Egypt
11.02.2013 - WHO
In Egypt, wild poliovirus type 1 (WPV1) was isolated from sewage samples collected on 2 and 6 December 2012 in two areas of greater Cairo. Virus has been detected in sewage only; no case of paralytic polio has been reported. Genetic sequencing shows that the virus strains are closely related to virus from northern Sindh, Pakistan. Pakistan is one of three countries worldwide affected by ongoing indigenous transmission of WPV (together with Nigeria and Afghanistan). The isolates were detected through routine environmental surveillance in Egypt that involves regular testing of sewage water from multiple sites.
Following detection of these isolates, the Government of Egypt is implementing a comprehensive response in line with international outbreak response guidelines issued by the World Health Assembly (WHA) in Resolution WHA59.1. On 2-6 February, supplementary immunization activities (SIAs) were conducted in the two areas of Cairo from where the environmental samples had been collected, reaching more than 155,000 children with trivalent oral polio vaccine (OPV). In early March, SIAs are planned across Cairo to reach three million children with monovalent OPV type 1, to be followed in April by nationwide SIAs targeting 12 million children with trivalent OPV. A joint national and international team of epidemiologists and public health experts is assisting in the investigations, helping plan response activities and supporting active searches for any potential cases of paralytic polio.
This event confirms ongoing international spread of a pathogen (WPV) slated for eradication. In May 2012, the completion of polio eradication was declared a programmatic emergency for global public health by the WHA in Resolution WHA65.5. Based on the history of previous importations to Egypt and the ongoing response, the World Health Organization (WHO) assesses the risk of further international spread of these virus strains from Egypt as moderate; and, of further international spread of WPV from Pakistan as high. In 2011, WPV from Pakistan spread internationally to China, causing an outbreak in the country’s western Xinjiang province, resulting in 21 cases.
It is important that all countries, in particular those with frequent travel and contacts with polio-infected countries, strengthen surveillance for cases of acute flaccid paralysis (AFP), in order to rapidly detect any new poliovirus importations and facilitate a rapid response. Countries should also analyze routine immunization coverage data to identify any subnational gaps in population immunity to guide catch-up immunization activities and thereby minimize the consequences of any new virus introduction. Priority should be given to areas at high-risk of importations and where OPV3/DPT3 coverage is <80%.
Egypt stopped transmission of indigenous WPV, with its last case in May 2004. The environmental samples which yielded these positive results were collected in December 2012. Previous to this, the last environmental sample which had tested positive for WPV was related to virus from the Sudan, in December 2010.
Gruß
Birgitt
11.02.2013 - WHO
In Egypt, wild poliovirus type 1 (WPV1) was isolated from sewage samples collected on 2 and 6 December 2012 in two areas of greater Cairo. Virus has been detected in sewage only; no case of paralytic polio has been reported. Genetic sequencing shows that the virus strains are closely related to virus from northern Sindh, Pakistan. Pakistan is one of three countries worldwide affected by ongoing indigenous transmission of WPV (together with Nigeria and Afghanistan). The isolates were detected through routine environmental surveillance in Egypt that involves regular testing of sewage water from multiple sites.
Following detection of these isolates, the Government of Egypt is implementing a comprehensive response in line with international outbreak response guidelines issued by the World Health Assembly (WHA) in Resolution WHA59.1. On 2-6 February, supplementary immunization activities (SIAs) were conducted in the two areas of Cairo from where the environmental samples had been collected, reaching more than 155,000 children with trivalent oral polio vaccine (OPV). In early March, SIAs are planned across Cairo to reach three million children with monovalent OPV type 1, to be followed in April by nationwide SIAs targeting 12 million children with trivalent OPV. A joint national and international team of epidemiologists and public health experts is assisting in the investigations, helping plan response activities and supporting active searches for any potential cases of paralytic polio.
This event confirms ongoing international spread of a pathogen (WPV) slated for eradication. In May 2012, the completion of polio eradication was declared a programmatic emergency for global public health by the WHA in Resolution WHA65.5. Based on the history of previous importations to Egypt and the ongoing response, the World Health Organization (WHO) assesses the risk of further international spread of these virus strains from Egypt as moderate; and, of further international spread of WPV from Pakistan as high. In 2011, WPV from Pakistan spread internationally to China, causing an outbreak in the country’s western Xinjiang province, resulting in 21 cases.
It is important that all countries, in particular those with frequent travel and contacts with polio-infected countries, strengthen surveillance for cases of acute flaccid paralysis (AFP), in order to rapidly detect any new poliovirus importations and facilitate a rapid response. Countries should also analyze routine immunization coverage data to identify any subnational gaps in population immunity to guide catch-up immunization activities and thereby minimize the consequences of any new virus introduction. Priority should be given to areas at high-risk of importations and where OPV3/DPT3 coverage is <80%.
Egypt stopped transmission of indigenous WPV, with its last case in May 2004. The environmental samples which yielded these positive results were collected in December 2012. Previous to this, the last environmental sample which had tested positive for WPV was related to virus from the Sudan, in December 2010.
Gruß
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Kinderlähmung - Poliomyelitis in Niger
Polio in Niger
12.02.2013 - WHO
Following the notification on 3 January 2013 of a wild poliovirus type 1 (WPV1) case in Niger, outbreak response is continuing in the country. A WPV1 case had been detected from Tahoua region, with onset of paralysis on 15 November 2012 (the first case in the country since December 2011). Genetic sequencing confirmed that the virus was a new importation into Niger, most closely related to virus circulating in Kaduna state, Nigeria.
The Government of Niger is continuing to implement a comprehensive response in line with international outbreak response guidelines issued by the World Health Assembly (WHA) in Resolution WHA59.1. Following an initial supplementary immunization activity (SIA) on 15 January 2013 to reach approximately two million children with bivalent oral polio vaccine (OPV), nationwide SIAs were conducted from 2-5 February 2013, targeting more than five million children with trivalent OPV. A second nationwide SIA is planned for 2-5 March with bivalent OPV. Previously, nationwide SIAs had been conducted on 23 November 2012 with bivalent OPV. A joint national and international team of epidemiologists and public health experts has been deployed by the World Health Organization’s (WHO) Regional Office for Africa to assist the Government of Niger in the investigations, help plan response activities and support active searches for additional cases of paralytic polio.
This event confirms the risk of ongoing international spread of a pathogen (WPV) slated for eradication. In May 2012, the completion of polio eradication was declared a programmatic emergency for global public health by the WHA in Resolution WHA65.5. Given the history of international spread of polio from northern Nigeria across west Africa, WHO assesses the risk of further international spread from Nigeria as high. Based on the history of previous importations to Niger and the ongoing response, WHO assesses the risk of further international spread from Niger as moderate to high. This risk is currently magnified by large-scale population movements across the region associated with insecurity in Mali. To minimize this risk, multi-country synchronized SIAs are planned across 13 countries of west Africa in late April and late May, using a combination of bivalent and trivalent OPV.
Due to the persistence of subnational surveillance gaps in some areas of west Africa, undetected further circulation cannot be ruled out at this time. Investigations are ongoing to more clearly identify surveillance gaps in the region, including among mobile, migrant and underserved populations. Measures are being implemented to strengthen sub-national surveillance, to ensure that all groups and areas, particularly high-risk populations, are covered by high-quality surveillance.
As per recommendations outlined in WHO's International travel and health, travellers to and from Niger, and other polio-affected countries, should be fully protected by vaccination. It is important that all countries, in particular those with frequent travel and contacts with polio-infected countries, strengthen surveillance for cases of acute flaccid paralysis (AFP), in order to rapidly detect any new poliovirus importations and facilitate a rapid response. Countries should also analyse routine immunization coverage data to identify any subnational gaps in population immunity to guide catch-up immunization activities and thereby minimize the consequences of any new virus introduction. Priority should be given to areas at high-risk of importations and where OPV3/DPT3 coverage is <80%.
Gruß
Birgitt
12.02.2013 - WHO
Following the notification on 3 January 2013 of a wild poliovirus type 1 (WPV1) case in Niger, outbreak response is continuing in the country. A WPV1 case had been detected from Tahoua region, with onset of paralysis on 15 November 2012 (the first case in the country since December 2011). Genetic sequencing confirmed that the virus was a new importation into Niger, most closely related to virus circulating in Kaduna state, Nigeria.
The Government of Niger is continuing to implement a comprehensive response in line with international outbreak response guidelines issued by the World Health Assembly (WHA) in Resolution WHA59.1. Following an initial supplementary immunization activity (SIA) on 15 January 2013 to reach approximately two million children with bivalent oral polio vaccine (OPV), nationwide SIAs were conducted from 2-5 February 2013, targeting more than five million children with trivalent OPV. A second nationwide SIA is planned for 2-5 March with bivalent OPV. Previously, nationwide SIAs had been conducted on 23 November 2012 with bivalent OPV. A joint national and international team of epidemiologists and public health experts has been deployed by the World Health Organization’s (WHO) Regional Office for Africa to assist the Government of Niger in the investigations, help plan response activities and support active searches for additional cases of paralytic polio.
This event confirms the risk of ongoing international spread of a pathogen (WPV) slated for eradication. In May 2012, the completion of polio eradication was declared a programmatic emergency for global public health by the WHA in Resolution WHA65.5. Given the history of international spread of polio from northern Nigeria across west Africa, WHO assesses the risk of further international spread from Nigeria as high. Based on the history of previous importations to Niger and the ongoing response, WHO assesses the risk of further international spread from Niger as moderate to high. This risk is currently magnified by large-scale population movements across the region associated with insecurity in Mali. To minimize this risk, multi-country synchronized SIAs are planned across 13 countries of west Africa in late April and late May, using a combination of bivalent and trivalent OPV.
Due to the persistence of subnational surveillance gaps in some areas of west Africa, undetected further circulation cannot be ruled out at this time. Investigations are ongoing to more clearly identify surveillance gaps in the region, including among mobile, migrant and underserved populations. Measures are being implemented to strengthen sub-national surveillance, to ensure that all groups and areas, particularly high-risk populations, are covered by high-quality surveillance.
As per recommendations outlined in WHO's International travel and health, travellers to and from Niger, and other polio-affected countries, should be fully protected by vaccination. It is important that all countries, in particular those with frequent travel and contacts with polio-infected countries, strengthen surveillance for cases of acute flaccid paralysis (AFP), in order to rapidly detect any new poliovirus importations and facilitate a rapid response. Countries should also analyse routine immunization coverage data to identify any subnational gaps in population immunity to guide catch-up immunization activities and thereby minimize the consequences of any new virus introduction. Priority should be given to areas at high-risk of importations and where OPV3/DPT3 coverage is <80%.
Gruß
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Kinderlähmung - Poliomyelitis weltweit
POLIOMYELITIS UPDATE (03): PAKISTAN, GLOBAL
*******************************************
A ProMED-mail post
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International Society for Infectious Diseases
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In this update:
[1] Pakistan: vaccine refusal
[2] Global update: Polio Eradication Initiative
******
[1] Pakistan: vaccine refusal
Date: Thu 21 Mar 2013
Source: The News International [edited]
http://www.thenews.com.pk/Todays-News-7 ... al-cases-i
The number of families chronically refusing polio vaccines to their children due to its connection with American CIA and Dr Shakeel Afridi have sharply increased, making health officials believe that the polio battle in Lakki Marwat in Khyber Pakhtunkhwa [KP] is about to be lost, if concrete steps are not taken to restore public trust in the conservative southern district.
This correspondent obtained official minutes of a meeting chaired by Khyber Pakhtunkhwa [KP] chief secretary Ghulam Dastagir Akhtar last week [week of 11 Mar 2013] and a 'social map' showing that Lakki Marwat district is fast becoming a massive challenge for countering polio refusals in the country.
The government officials present in the meeting told 'The News' that Lakki Marwat has an important position in polio eradication due to its strategic location as it borders the Taliban-controlled South Waziristan Agency. "Due to the ban on polio immunisation in the adjoining South Waziristan and North Waziristan tribal regions by local Taliban, the only way to vaccinate children against polio is through transit routes in Lakki Marwat," said an official of the Expanded Programme on Immunisation (EPI).
Pleading anonymity, he noted that a sharp increase in the number of families refusing polio vaccine to their children was recorded there. He said up to 733 families only in a single union council refused polio drops to children after the National Research and Development Foundation (NRDF) developed differences with [UNICEF] as Lakki Marwat was being looked after by NRDF very effectively before that.
"We have recorded a huge number of 733 refusals in Marmandi Azim union council during the last polio campaign," he revealed, adding that the propaganda against polio campaign was fast growing in the Lakki Marwat district in general and other parts of KP in particular.
According to the official minutes of the meeting, the district EPI coordinator of Lakki Marwat has himself admitted that despite all efforts of the concerned officials in the district, they had totally failed to restore public trust in the polio vaccination.
"He said that, though, every effort has been made, the number of refusals was still on the rise in Lakki Marwat. Major reasons for refusals were said to be religious sentiments, conspiracies, and demand," he recalled.
The minutes also reveal that Shehnaz Wazir Ali, special assistant to the prime minister for social sectors, directed an officer of [UNICEF], Dr Shamsher to devise a better analysis of refusals to indicate the largest category and house to house isolation.
However, the [UNICEF] official told her that vacancies for the position of communication officers would be advertised soon to counter refusals in Lakki Marwat.
According to the minutes, Senator Rubina Khalid, sister of former KP health minister syed Zahir Ali Shah, intervened and reminded Dr Shamsher that [UNICEF] has made many promises in the past on Lakki Marwat, including a latest one 2 months ago but to no result. "Begum Shehnaz said that a letter to this effect would be sent to [UNICEF] country office," the minutes stated.
Similarly, officials of World Health Organisation (WHO) were also directed to extend support at their earliest to all of the 16 union councils in Lakki Marwat. She informed participants of the meeting that only 5 officials were short-listed for the district to provide support to the provincial government.
The 'Social Map', clearly shows that Lakki Marwat has recorded 235 refusals in Ghazni Khel, 181 in Lakki 2, 212 in Biasat Khel, 192 in PaharKhel, 158 in Mamakhel besides recording a large number of refusals in almost all the union councils of Lakki Marwat.
Deputy Commissioner Lakki Marwat Nisar Ahmad Khan, when approached, admitted growing refusals in the district and blamed misconception and propaganda by religious-cum militant groups for opposing polio drops in the district.
"There are some main reasons behind growing refusals here. 1st, there are some religious and militant groups who are terrorising parents and polio teams. 2nd, some madrassas and clerics published booklets and pamphlets and publicly opposed polio vaccines. There is some misconception based on religion but many people started doubting vaccines after a fake campaign was launched in Abbottabad in May 2011," he explained while referring to a fake vaccination drive conducted by Dr Shakeel Afridi. Nisar Ahmad Khan, however, said they would soon overcome refusals through persuasion and convincing campaign in the district.
[Byline: Mushtaq Yusufzai]
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[Khyber Pakhtunkhwa was formerly known as the NorthWest Frontier Province (NWFP). It has a border with the Federally Administered Tribal Areas (FATA) to its west and south, Gilgit-Baltistan to its northeast, Azad Kashmir on the east, and Punjab and the Islamabad Capital Territory on its southeast. It borders with the province of Balochistan to its south, and Afghanistan to its northwest.
For a map of Pakistan showing administrative divisions, see http://www.technologijos.lt/upload/imag ... kadmin.jpg. - Mod.MPP]
******
[2] Global update: Polio Eradication Initiative
Date: Thu 21 Mar 2013
Source: Global Polio Eradication Initiative [excerpted, edited]
http://polioeradication.org/Dataandmoni ... sweek.aspx
Global Polio Eradication Initiative update as of 20 Mar 2012
------------------------------------------------------------
Total cases
Year-to-date 2013 / Year-to-date 2012 / Total in 2012
Globally: 11 / 31 / 223
- in endemic countries: 11 / 29 / 217
- in non-endemic countries: 0 / 2 / 6
Case breakdown by country
Country: Year-to-date 2013 WPV1 / WPV3 / W1W3 / Total // Year-to-date 2012 WPV1 / WPV3 / W1W3 / Total // Total in 2012 / Date of most recent case
Pakistan: 5 / 0 / 0 / 5 // 12 / 1 / 1 / 14 // 58 / 12 Feb 2013
Afghanistan: 1 / 0 / 0 / 1 // 5 / 0 / 0 / 5 // 37 / 31 Jan 2013
Nigeria: 5 / 0 / 0 / 5 // 7 / 3 / 0 / 10 // 122 / 13 Feb 2013
Chad: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 5 / 14 Jun 2012
Niger: 0 / 0 / 0 / 0 // 0 / 0 / 0 / 0 // 1 / 15 Nov 2012
Total: 11 / 0 / 0 / 11 // 26 / 4 / 1 / 31 // 223 //
Total in endemic countries: 11/ 0 / 0 / 11 // 24 / 4 / 1 / 31 // 217
Total outbreak: 0 / 0 / 0 / 0 // 2 / 0 / 0 / 2 // 6
*Data in WHO as of 21 Mar 2012 for 2012 data and 19 Mar 2013 for 2013 data
In 2013, no WPV3 cases have been reported. Over the past 6 months, only 2 cases due to this strain were reported worldwide (both in Nigeria, the most recent had onset of paralysis on [10 Nov 2013]). In Asia, no WPV3 cases have been reported since last April [2012]. It is the lowest levels of WPV3 transmission ever recorded.
Afghanistan
-----------
- No new WPV cases were reported in the past week. The total number of WPV cases for 2013 remains 1. The total number of WPV cases for 2012 remains 37. The most recent WPV case had onset of paralysis on [31 Jan 2013] (WPV1 from Nangarhar).
- No new circulating vaccine-derived poliovirus type 2 (cVDPV2) cases were reported in the past week. The total number of cVDVP2 cases remains 9 for 2012, and one for 2013. The most recent cVDPV2 case had onset of paralysis on [22 Jan 2013] (from Hilmand).
Nigeria
- One new WPV case was reported in the past week (WPV1 from Bauchi), bringing the total number of WPV cases for 2013 to 5. It is the most recent case in the country and had onset of paralysis on [13 Feb 2013]. The total number of WPV cases for 2012 remains 122.
- No new cases of cVDPV2 were reported in the past week. The total number of cVDPV2 cases for 2012 remains 8. The most recent cVDPV2 case had onset of paralysis on [24 Nov 2012] (from Kebbi).
Pakistan
- No new WPV cases were reported in the past week. The total number of WPV cases for 2013 remains 5. The total number of WPV cases for 2012 remains 58. The most recent WPV case had onset of paralysis on [12 Feb 2013] (from Khyber Pakhtunkhwa - KP).
- No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2013 remains 1. The total number of cVDPV2 cases for 2012 remains 16. The most recent cVDPV2 case had onset of paralysis on [11 Jan 2013] (from Balochistan).
- The security situation continues to be monitored closely, in consultation with law enforcement agencies. Immunization activities continue to be implemented, in some areas staggered or postponed, depending on the security situation at the local level.
Chad
----
- No new WPV cases were reported in the past week. The total number of WPV cases for 2012 remains 5 (no WPV cases in 2013). The most recent WPV case had onset of paralysis on [14 Jun 2012] (WPV1 from Lac).
- One new cVDPV2 case was reported in the past week, with onset of paralysis on [4 Feb 2013] (from Salamat, in the east of the country). It is the 1st cVDPV2 case in Chad in 2013. The total number of cVDPV2 cases for 2012 remains 12.
Democratic Republic of the Congo (DRC)
--------------------------------------
- No new WPV cases were reported in the past week. The most recent WPV case had onset of paralysis on [20 Dec 2011] (WPV1 from Maniema). DR Congo is no longer considered to have re-established WPV transmission.
- No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2012 remains 17. The most recent cVDPV2 case had onset of paralysis on [4 Apr 2012] (from Katanga).
Horn of Africa
--------------
- No new cases were reported in the past week. The most recent case was a cVDPV2 case from Somalia, with onset of paralysis on [9 Jan 2013].
- Outbreak response is continuing in various parts of the Horn of Africa, in response to the ongoing cVDPV2 outbreak in south-central Somalia.
West Africa
-----------
- No new WPV cases were reported in the past week. The most recent case in the region was a WPV1 from Tahoua province in Niger with onset of paralysis on [15 Nov 2012]. It is the only case in the region in 2012 (barring Nigeria), and has been covered by 3 immunization campaigns.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[It is unfortunate that the polio eradication effort has fallen victim to political and fundamentalist religious causes. The real victims in this travesty are the children in these areas who are being left behind in the war against polio. Between the violence perpetrated against vaccinators in Pakistan (and Nigeria) as part of religious movements and the campaigning against the vaccination efforts, the success of the polio eradication effort is being jeopardized. While the case count appears low at this point in time, the impact of reduced vaccination coverages may well start appearing as the number of susceptible children in the areas increases, permitting unstopped transmission of the wild poliovirus (WPV) as well as set the stage with ideal conditions for continued circulation of vaccine derived poliovirus (cVDPV).
In the past month since the last polio update, there has been an increase in the number of confirmed WPV associated cases from 2 cases to 11 cases. All 11 cases to date in 2013 have occurred in known polio endemic countries -- Afghanistan, Pakistan, and Nigeria.
On the positive note, the absence of WPV3 associated disease since the last confirmed case in April 2012 may well be heralding interruption of transmission of WPV3. If this continues, it will be the 2nd WPV type to have had its transmission interrupted worldwide -- the last reported case of WPV2 was in October 1999, in Alighar, Uttar Pradesh, India.
For a map of the locations of confirmed WPV associated polio cases see http://www.polioeradication.org/Dataand ... dwide.aspx.
For a map of confirmed WPV associated polio cases by district of occurrence, see http://www.polioeradication.org/Dataand ... ricts.aspx. - Mod.MPP]
*******************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] Pakistan: vaccine refusal
[2] Global update: Polio Eradication Initiative
******
[1] Pakistan: vaccine refusal
Date: Thu 21 Mar 2013
Source: The News International [edited]
http://www.thenews.com.pk/Todays-News-7 ... al-cases-i
The number of families chronically refusing polio vaccines to their children due to its connection with American CIA and Dr Shakeel Afridi have sharply increased, making health officials believe that the polio battle in Lakki Marwat in Khyber Pakhtunkhwa [KP] is about to be lost, if concrete steps are not taken to restore public trust in the conservative southern district.
This correspondent obtained official minutes of a meeting chaired by Khyber Pakhtunkhwa [KP] chief secretary Ghulam Dastagir Akhtar last week [week of 11 Mar 2013] and a 'social map' showing that Lakki Marwat district is fast becoming a massive challenge for countering polio refusals in the country.
The government officials present in the meeting told 'The News' that Lakki Marwat has an important position in polio eradication due to its strategic location as it borders the Taliban-controlled South Waziristan Agency. "Due to the ban on polio immunisation in the adjoining South Waziristan and North Waziristan tribal regions by local Taliban, the only way to vaccinate children against polio is through transit routes in Lakki Marwat," said an official of the Expanded Programme on Immunisation (EPI).
Pleading anonymity, he noted that a sharp increase in the number of families refusing polio vaccine to their children was recorded there. He said up to 733 families only in a single union council refused polio drops to children after the National Research and Development Foundation (NRDF) developed differences with [UNICEF] as Lakki Marwat was being looked after by NRDF very effectively before that.
"We have recorded a huge number of 733 refusals in Marmandi Azim union council during the last polio campaign," he revealed, adding that the propaganda against polio campaign was fast growing in the Lakki Marwat district in general and other parts of KP in particular.
According to the official minutes of the meeting, the district EPI coordinator of Lakki Marwat has himself admitted that despite all efforts of the concerned officials in the district, they had totally failed to restore public trust in the polio vaccination.
"He said that, though, every effort has been made, the number of refusals was still on the rise in Lakki Marwat. Major reasons for refusals were said to be religious sentiments, conspiracies, and demand," he recalled.
The minutes also reveal that Shehnaz Wazir Ali, special assistant to the prime minister for social sectors, directed an officer of [UNICEF], Dr Shamsher to devise a better analysis of refusals to indicate the largest category and house to house isolation.
However, the [UNICEF] official told her that vacancies for the position of communication officers would be advertised soon to counter refusals in Lakki Marwat.
According to the minutes, Senator Rubina Khalid, sister of former KP health minister syed Zahir Ali Shah, intervened and reminded Dr Shamsher that [UNICEF] has made many promises in the past on Lakki Marwat, including a latest one 2 months ago but to no result. "Begum Shehnaz said that a letter to this effect would be sent to [UNICEF] country office," the minutes stated.
Similarly, officials of World Health Organisation (WHO) were also directed to extend support at their earliest to all of the 16 union councils in Lakki Marwat. She informed participants of the meeting that only 5 officials were short-listed for the district to provide support to the provincial government.
The 'Social Map', clearly shows that Lakki Marwat has recorded 235 refusals in Ghazni Khel, 181 in Lakki 2, 212 in Biasat Khel, 192 in PaharKhel, 158 in Mamakhel besides recording a large number of refusals in almost all the union councils of Lakki Marwat.
Deputy Commissioner Lakki Marwat Nisar Ahmad Khan, when approached, admitted growing refusals in the district and blamed misconception and propaganda by religious-cum militant groups for opposing polio drops in the district.
"There are some main reasons behind growing refusals here. 1st, there are some religious and militant groups who are terrorising parents and polio teams. 2nd, some madrassas and clerics published booklets and pamphlets and publicly opposed polio vaccines. There is some misconception based on religion but many people started doubting vaccines after a fake campaign was launched in Abbottabad in May 2011," he explained while referring to a fake vaccination drive conducted by Dr Shakeel Afridi. Nisar Ahmad Khan, however, said they would soon overcome refusals through persuasion and convincing campaign in the district.
[Byline: Mushtaq Yusufzai]
--
Communicated by:
ProMED-mail from HealthMap alerts
<promed@promedmail.org>
[Khyber Pakhtunkhwa was formerly known as the NorthWest Frontier Province (NWFP). It has a border with the Federally Administered Tribal Areas (FATA) to its west and south, Gilgit-Baltistan to its northeast, Azad Kashmir on the east, and Punjab and the Islamabad Capital Territory on its southeast. It borders with the province of Balochistan to its south, and Afghanistan to its northwest.
For a map of Pakistan showing administrative divisions, see http://www.technologijos.lt/upload/imag ... kadmin.jpg. - Mod.MPP]
******
[2] Global update: Polio Eradication Initiative
Date: Thu 21 Mar 2013
Source: Global Polio Eradication Initiative [excerpted, edited]
http://polioeradication.org/Dataandmoni ... sweek.aspx
Global Polio Eradication Initiative update as of 20 Mar 2012
------------------------------------------------------------
Total cases
Year-to-date 2013 / Year-to-date 2012 / Total in 2012
Globally: 11 / 31 / 223
- in endemic countries: 11 / 29 / 217
- in non-endemic countries: 0 / 2 / 6
Case breakdown by country
Country: Year-to-date 2013 WPV1 / WPV3 / W1W3 / Total // Year-to-date 2012 WPV1 / WPV3 / W1W3 / Total // Total in 2012 / Date of most recent case
Pakistan: 5 / 0 / 0 / 5 // 12 / 1 / 1 / 14 // 58 / 12 Feb 2013
Afghanistan: 1 / 0 / 0 / 1 // 5 / 0 / 0 / 5 // 37 / 31 Jan 2013
Nigeria: 5 / 0 / 0 / 5 // 7 / 3 / 0 / 10 // 122 / 13 Feb 2013
Chad: 0 / 0 / 0 / 0 // 1 / 0 / 0 / 1 // 5 / 14 Jun 2012
Niger: 0 / 0 / 0 / 0 // 0 / 0 / 0 / 0 // 1 / 15 Nov 2012
Total: 11 / 0 / 0 / 11 // 26 / 4 / 1 / 31 // 223 //
Total in endemic countries: 11/ 0 / 0 / 11 // 24 / 4 / 1 / 31 // 217
Total outbreak: 0 / 0 / 0 / 0 // 2 / 0 / 0 / 2 // 6
*Data in WHO as of 21 Mar 2012 for 2012 data and 19 Mar 2013 for 2013 data
In 2013, no WPV3 cases have been reported. Over the past 6 months, only 2 cases due to this strain were reported worldwide (both in Nigeria, the most recent had onset of paralysis on [10 Nov 2013]). In Asia, no WPV3 cases have been reported since last April [2012]. It is the lowest levels of WPV3 transmission ever recorded.
Afghanistan
-----------
- No new WPV cases were reported in the past week. The total number of WPV cases for 2013 remains 1. The total number of WPV cases for 2012 remains 37. The most recent WPV case had onset of paralysis on [31 Jan 2013] (WPV1 from Nangarhar).
- No new circulating vaccine-derived poliovirus type 2 (cVDPV2) cases were reported in the past week. The total number of cVDVP2 cases remains 9 for 2012, and one for 2013. The most recent cVDPV2 case had onset of paralysis on [22 Jan 2013] (from Hilmand).
Nigeria
- One new WPV case was reported in the past week (WPV1 from Bauchi), bringing the total number of WPV cases for 2013 to 5. It is the most recent case in the country and had onset of paralysis on [13 Feb 2013]. The total number of WPV cases for 2012 remains 122.
- No new cases of cVDPV2 were reported in the past week. The total number of cVDPV2 cases for 2012 remains 8. The most recent cVDPV2 case had onset of paralysis on [24 Nov 2012] (from Kebbi).
Pakistan
- No new WPV cases were reported in the past week. The total number of WPV cases for 2013 remains 5. The total number of WPV cases for 2012 remains 58. The most recent WPV case had onset of paralysis on [12 Feb 2013] (from Khyber Pakhtunkhwa - KP).
- No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2013 remains 1. The total number of cVDPV2 cases for 2012 remains 16. The most recent cVDPV2 case had onset of paralysis on [11 Jan 2013] (from Balochistan).
- The security situation continues to be monitored closely, in consultation with law enforcement agencies. Immunization activities continue to be implemented, in some areas staggered or postponed, depending on the security situation at the local level.
Chad
----
- No new WPV cases were reported in the past week. The total number of WPV cases for 2012 remains 5 (no WPV cases in 2013). The most recent WPV case had onset of paralysis on [14 Jun 2012] (WPV1 from Lac).
- One new cVDPV2 case was reported in the past week, with onset of paralysis on [4 Feb 2013] (from Salamat, in the east of the country). It is the 1st cVDPV2 case in Chad in 2013. The total number of cVDPV2 cases for 2012 remains 12.
Democratic Republic of the Congo (DRC)
--------------------------------------
- No new WPV cases were reported in the past week. The most recent WPV case had onset of paralysis on [20 Dec 2011] (WPV1 from Maniema). DR Congo is no longer considered to have re-established WPV transmission.
- No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2012 remains 17. The most recent cVDPV2 case had onset of paralysis on [4 Apr 2012] (from Katanga).
Horn of Africa
--------------
- No new cases were reported in the past week. The most recent case was a cVDPV2 case from Somalia, with onset of paralysis on [9 Jan 2013].
- Outbreak response is continuing in various parts of the Horn of Africa, in response to the ongoing cVDPV2 outbreak in south-central Somalia.
West Africa
-----------
- No new WPV cases were reported in the past week. The most recent case in the region was a WPV1 from Tahoua province in Niger with onset of paralysis on [15 Nov 2012]. It is the only case in the region in 2012 (barring Nigeria), and has been covered by 3 immunization campaigns.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[It is unfortunate that the polio eradication effort has fallen victim to political and fundamentalist religious causes. The real victims in this travesty are the children in these areas who are being left behind in the war against polio. Between the violence perpetrated against vaccinators in Pakistan (and Nigeria) as part of religious movements and the campaigning against the vaccination efforts, the success of the polio eradication effort is being jeopardized. While the case count appears low at this point in time, the impact of reduced vaccination coverages may well start appearing as the number of susceptible children in the areas increases, permitting unstopped transmission of the wild poliovirus (WPV) as well as set the stage with ideal conditions for continued circulation of vaccine derived poliovirus (cVDPV).
In the past month since the last polio update, there has been an increase in the number of confirmed WPV associated cases from 2 cases to 11 cases. All 11 cases to date in 2013 have occurred in known polio endemic countries -- Afghanistan, Pakistan, and Nigeria.
On the positive note, the absence of WPV3 associated disease since the last confirmed case in April 2012 may well be heralding interruption of transmission of WPV3. If this continues, it will be the 2nd WPV type to have had its transmission interrupted worldwide -- the last reported case of WPV2 was in October 1999, in Alighar, Uttar Pradesh, India.
For a map of the locations of confirmed WPV associated polio cases see http://www.polioeradication.org/Dataand ... dwide.aspx.
For a map of confirmed WPV associated polio cases by district of occurrence, see http://www.polioeradication.org/Dataand ... ricts.aspx. - Mod.MPP]
-
Birgitt
- Moderator
- Beiträge: 35230
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Kinderlähmung - Poliomyelitis weltweit
POLIOMYELITIS UPDATE (04): SOMALIA, GLOBAL
******************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] Somalia (Banadir)
[2] Global update: Polio Eradication Initiative
******
[1] Somalia (Banadir)
Date: Sat 11 May 2013
Source: WHO Global Alert and Response (GAR), Disease Outbreak News [edited]
http://www.who.int/csr/don/2013_05_11/en/index.html
Wild poliovirus in Somalia
--------------------------
An investigation has been launched into a preliminary report of the detection of a wild poliovirus type 1 (WPV1) in the Banadir region of Somalia. This is the 1st WPV to be reported from Somalia since [25 Mar 2007]. The virus was isolated from specimens collected on [21 Apr 2013] from a 32-month-old girl, who became ill due to acute flaccid paralysis on [18 Apr 2013], and from specimens collected from 3 of her close contacts.
An investigation team is on site; genetic sequencing of the virus is ongoing to determine its origin. The preliminary results of these investigations will be reported as soon as possible.
Given that substantial areas of central and southern Somalia have not conducted vaccination activities since 2009, the confirmation of WPV circulation would constitute a serious national and international risk to public health.
A surveillance alert, highlighting the need for urgent active searches for additional cases of acute flaccid paralysis (AFP) and suspect polio in all health facilities, has been issued for all of Somalia and bordering areas of northern Kenya and eastern Ethiopia. All countries in the WHO Regions of Africa and the Eastern Mediterranean are advised to heighten their surveillance for poliovirus.
An immediate vaccination response with oral polio vaccine (OPV) is being planned to begin on 14-16 May [2013] to reach more than 350 000 children under the age of 5 in all the 16 districts of Banadir region, with a series of subsequent activities, including nationwide OPV campaigns, under discussion.
WHO's International Travel and Health recommends that all travellers to and from polio-infected areas be fully vaccinated against polio.
--
Communicated by:
ProMED-mail Rapporteur Marianne Hopp
******
[2] Global update: Polio Eradication Initiative
Date: Wed 8 May 2013
Source: Polio Eradication Initiative [edited]
http://www.polioeradication.org/Dataand ... sweek.aspx
Global Polio Eradication Initiative update as of 8 May 2012
-----------------------------------------------------------
- Two new wild poliovirus (WPV) cases are officially reported this week [week of 8 May 2013], both from Nigeria, bringing the total number of WPV cases in 2013 to 26 (compared to 53 at this time last year [2012]). Additionally, a new circulating vaccine-derived poliovirus type 2 (cVDPV2) case is reported in Pakistan. Please see country-specific sections below, for more information.
Wild poliovirus (WPV) cases
Total cases: Year-to-date 2013 / Year-to-date 2012 / Total 2012
Globally: 26 / 53 / 223
- in endemic countries: 26 / 50 / 217
- in non-endemic countries: 0 / 3 / 6
Case breakdown by country
Countries: 2013 WPV1 / WPV3 / W1W3 / Total 2013 // 2012 WPV1 / WPV3 / W1W3 / Total year-to-date 2012 / Total 2012 // Date most recent case
Pakistan: 6 / 0 / 0 / 6 // 13 / 2 / 1 / 16/ 58 // 22 Mar 13
Afghanistan: 2 / 0 / 0 / 2 // 6 / 0 / 0 / 6 / 37 // 28 Mar 2013
Nigeria: 18 / 0 / 0 / 18 // 21 / 7 / 0 / 28 / 122 // 12 Apr 13
Chad: 0 / 0 / 0 / 0 // 3 / 0 / 0 / 3 / 5 // 14 Jun 12
Niger: 0 / 0 / 0 / 0 // 0 / 0 / 0 / 0 / 1 // 15 Nov 12
Total: 26 / 0 / 0 / 26 // 43 / 9 / 1 / 53 / 223
Total in endemic countries: 26 / 0 / 0 / 26 // 40 / 9 / 1 / 50 / 217
Total outbreak: 0 / 0 / 0 / 0 // 3 / 0 / 0 / 3 / 6
Data in WHO as of 8 May 2012 for 2012 data and 7 May 2013 for 2013 data.
Afghanistan
-----------
- No new WPV cases were reported in the past week. The total number of WPV cases for 2013 remains 2. The most recent WPV case had onset of paralysis on [28 Mar 2013] (WPV1 from Kunar).
- No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases in 2013 remains 3. The most recent cVDPV2 case had onset of paralysis on [13 Mar 2013] (from Kandahar).
Nigeria
-------
- Two new WPV cases were reported in the past week (WPV1s from Kano and Taraba), bringing the total number of WPV cases for 2013 to 18. The case from Kano is the most recent WPV case in the country, and had onset of paralysis on [12 Apr 2013].
- No new cases of cVDPV2 were reported in the past week. The most recent cVDPV2 case had onset of paralysis on [24 Nov 2012] (from Kebbi).
Pakistan
--------
- No new WPV cases were reported in the past week. The total number of WPV cases for 2013 remains 6. The most recent WPV case had onset of paralysis on [22 Mar 2013] (WPV1 from Sindh).
- One new cVDPV2 case was reported in the past week, bringing the total number of cVDPV2 cases in 2013 to 3. It is the most recent cVDPV2 case in the country, and had onset of paralysis on [10 Apr 2013] (from Federally Administered Tribal Areas, FATA).
- This latest cVDPV2 case is from North Waziristan, an area where immunizations have been suspended by local leaders since last June [2012]. To minimize the risk of an outbreak in this area, it is critical that access to children is granted as quickly as possible. 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.
- Genetic sequencing has confirmed that this cVDPV2 case is linked to the ongoing outbreak previously restricted to Balochistan and parts of Karachi, resulting in 19 cases in Pakistan since middle of last year [2012]. In 2012, this strain had also spread into Afghanistan, causing 12 cases there since August [2012].
- Pakistan is also affected by transmission of WPV1, with 6 cases this year (compared to 13 cases for the same period in 2012). Wild poliovirus type 3 has not been detected in the country in more than 12 months (since April 2012, from Khyber Agency, FATA).
- Confirmation of this latest cases underscores the risk ongoing polio transmission (be it due to WPV or cVDPV) in the country continues to pose to children everywhere, and in particular to children living in areas where access has not been possible for extended periods of time.
- One new positive environmental sample was confirmed this week (WPV1, collected on [10 Apr 2013]), from Hyderabad, Sindh. This year [2013], 14 environmental samples positive for WPV1 have been reported, most from Peshawar, Khyber Pakhtunkhwa, and Hyderabad.
- The security situation continues to be monitored closely, in consultation with law enforcement agencies. Immunization activities continue to be implemented, in some areas staggered or postponed, depending on the security situation at the local level.
Chad
----
- No new WPV cases were reported in the past week. The most recent WPV case had onset of paralysis on [14 Jun 2012] (WPV1 from Lac).
- No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2013 remains one (onset of paralysis on [4 Feb 2013] from Salamat).
Horn of Africa
--------------
- No new cases were reported in the past week. The most recent case was a cVDPV2 case from Somalia, with onset of paralysis on [9 Jan 2013].
- Outbreak response is continuing in various parts of the Horn of Africa, in response to the ongoing cVDPV2 outbreak in south-central Somalia. Staggered SNIDs are being implemented in parts of Somalia throughout May [2013].
West Africa
-----------
- No new WPV cases were reported in the past week. The most recent case in the region was a WPV1 from Tahoua province in Niger with onset of paralysis on [15 Nov 2012]. It is the only case in the region in 2012 (barring Nigeria), and has been covered by 3 immunization campaigns.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The occurrence of confirmed WPV1 cases in Somalia after 6 years of no documented WPV transmission is an unfortunate situation, yet unfortunately not surprising, given the information that there are areas in central and southern Somalia that have not conducted vaccination activities since 2009 (the Banadir region of Somalia is located to the south of Mogadishu in the central region of Somalia; see map at http://www.collinsmaps.com/maps/Somalia ... 14.00.aspx), combined with continued circulation of WPV in Afghanistan, Nigeria, and Pakistan.
The continued insecurities due to civil unrest in the 3 remaining polio endemic countries -- Afghanistan, Nigeria, and Pakistan -- leading to limited to no vaccination activities in geographic areas of high insecurity, are keeping obstacles in the way of achievement of global interruption of WPV transmission.
We await information on the genetic sequencing of the WPV1 involved in Somalia.
For the map of locations of confirmed cases of WPV infection, see http://www.polioeradication.org/Dataandmonitoring.aspx. - Mod.MPP]
******************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] Somalia (Banadir)
[2] Global update: Polio Eradication Initiative
******
[1] Somalia (Banadir)
Date: Sat 11 May 2013
Source: WHO Global Alert and Response (GAR), Disease Outbreak News [edited]
http://www.who.int/csr/don/2013_05_11/en/index.html
Wild poliovirus in Somalia
--------------------------
An investigation has been launched into a preliminary report of the detection of a wild poliovirus type 1 (WPV1) in the Banadir region of Somalia. This is the 1st WPV to be reported from Somalia since [25 Mar 2007]. The virus was isolated from specimens collected on [21 Apr 2013] from a 32-month-old girl, who became ill due to acute flaccid paralysis on [18 Apr 2013], and from specimens collected from 3 of her close contacts.
An investigation team is on site; genetic sequencing of the virus is ongoing to determine its origin. The preliminary results of these investigations will be reported as soon as possible.
Given that substantial areas of central and southern Somalia have not conducted vaccination activities since 2009, the confirmation of WPV circulation would constitute a serious national and international risk to public health.
A surveillance alert, highlighting the need for urgent active searches for additional cases of acute flaccid paralysis (AFP) and suspect polio in all health facilities, has been issued for all of Somalia and bordering areas of northern Kenya and eastern Ethiopia. All countries in the WHO Regions of Africa and the Eastern Mediterranean are advised to heighten their surveillance for poliovirus.
An immediate vaccination response with oral polio vaccine (OPV) is being planned to begin on 14-16 May [2013] to reach more than 350 000 children under the age of 5 in all the 16 districts of Banadir region, with a series of subsequent activities, including nationwide OPV campaigns, under discussion.
WHO's International Travel and Health recommends that all travellers to and from polio-infected areas be fully vaccinated against polio.
--
Communicated by:
ProMED-mail Rapporteur Marianne Hopp
******
[2] Global update: Polio Eradication Initiative
Date: Wed 8 May 2013
Source: Polio Eradication Initiative [edited]
http://www.polioeradication.org/Dataand ... sweek.aspx
Global Polio Eradication Initiative update as of 8 May 2012
-----------------------------------------------------------
- Two new wild poliovirus (WPV) cases are officially reported this week [week of 8 May 2013], both from Nigeria, bringing the total number of WPV cases in 2013 to 26 (compared to 53 at this time last year [2012]). Additionally, a new circulating vaccine-derived poliovirus type 2 (cVDPV2) case is reported in Pakistan. Please see country-specific sections below, for more information.
Wild poliovirus (WPV) cases
Total cases: Year-to-date 2013 / Year-to-date 2012 / Total 2012
Globally: 26 / 53 / 223
- in endemic countries: 26 / 50 / 217
- in non-endemic countries: 0 / 3 / 6
Case breakdown by country
Countries: 2013 WPV1 / WPV3 / W1W3 / Total 2013 // 2012 WPV1 / WPV3 / W1W3 / Total year-to-date 2012 / Total 2012 // Date most recent case
Pakistan: 6 / 0 / 0 / 6 // 13 / 2 / 1 / 16/ 58 // 22 Mar 13
Afghanistan: 2 / 0 / 0 / 2 // 6 / 0 / 0 / 6 / 37 // 28 Mar 2013
Nigeria: 18 / 0 / 0 / 18 // 21 / 7 / 0 / 28 / 122 // 12 Apr 13
Chad: 0 / 0 / 0 / 0 // 3 / 0 / 0 / 3 / 5 // 14 Jun 12
Niger: 0 / 0 / 0 / 0 // 0 / 0 / 0 / 0 / 1 // 15 Nov 12
Total: 26 / 0 / 0 / 26 // 43 / 9 / 1 / 53 / 223
Total in endemic countries: 26 / 0 / 0 / 26 // 40 / 9 / 1 / 50 / 217
Total outbreak: 0 / 0 / 0 / 0 // 3 / 0 / 0 / 3 / 6
Data in WHO as of 8 May 2012 for 2012 data and 7 May 2013 for 2013 data.
Afghanistan
-----------
- No new WPV cases were reported in the past week. The total number of WPV cases for 2013 remains 2. The most recent WPV case had onset of paralysis on [28 Mar 2013] (WPV1 from Kunar).
- No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases in 2013 remains 3. The most recent cVDPV2 case had onset of paralysis on [13 Mar 2013] (from Kandahar).
Nigeria
-------
- Two new WPV cases were reported in the past week (WPV1s from Kano and Taraba), bringing the total number of WPV cases for 2013 to 18. The case from Kano is the most recent WPV case in the country, and had onset of paralysis on [12 Apr 2013].
- No new cases of cVDPV2 were reported in the past week. The most recent cVDPV2 case had onset of paralysis on [24 Nov 2012] (from Kebbi).
Pakistan
--------
- No new WPV cases were reported in the past week. The total number of WPV cases for 2013 remains 6. The most recent WPV case had onset of paralysis on [22 Mar 2013] (WPV1 from Sindh).
- One new cVDPV2 case was reported in the past week, bringing the total number of cVDPV2 cases in 2013 to 3. It is the most recent cVDPV2 case in the country, and had onset of paralysis on [10 Apr 2013] (from Federally Administered Tribal Areas, FATA).
- This latest cVDPV2 case is from North Waziristan, an area where immunizations have been suspended by local leaders since last June [2012]. To minimize the risk of an outbreak in this area, it is critical that access to children is granted as quickly as possible. 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.
- Genetic sequencing has confirmed that this cVDPV2 case is linked to the ongoing outbreak previously restricted to Balochistan and parts of Karachi, resulting in 19 cases in Pakistan since middle of last year [2012]. In 2012, this strain had also spread into Afghanistan, causing 12 cases there since August [2012].
- Pakistan is also affected by transmission of WPV1, with 6 cases this year (compared to 13 cases for the same period in 2012). Wild poliovirus type 3 has not been detected in the country in more than 12 months (since April 2012, from Khyber Agency, FATA).
- Confirmation of this latest cases underscores the risk ongoing polio transmission (be it due to WPV or cVDPV) in the country continues to pose to children everywhere, and in particular to children living in areas where access has not been possible for extended periods of time.
- One new positive environmental sample was confirmed this week (WPV1, collected on [10 Apr 2013]), from Hyderabad, Sindh. This year [2013], 14 environmental samples positive for WPV1 have been reported, most from Peshawar, Khyber Pakhtunkhwa, and Hyderabad.
- The security situation continues to be monitored closely, in consultation with law enforcement agencies. Immunization activities continue to be implemented, in some areas staggered or postponed, depending on the security situation at the local level.
Chad
----
- No new WPV cases were reported in the past week. The most recent WPV case had onset of paralysis on [14 Jun 2012] (WPV1 from Lac).
- No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2013 remains one (onset of paralysis on [4 Feb 2013] from Salamat).
Horn of Africa
--------------
- No new cases were reported in the past week. The most recent case was a cVDPV2 case from Somalia, with onset of paralysis on [9 Jan 2013].
- Outbreak response is continuing in various parts of the Horn of Africa, in response to the ongoing cVDPV2 outbreak in south-central Somalia. Staggered SNIDs are being implemented in parts of Somalia throughout May [2013].
West Africa
-----------
- No new WPV cases were reported in the past week. The most recent case in the region was a WPV1 from Tahoua province in Niger with onset of paralysis on [15 Nov 2012]. It is the only case in the region in 2012 (barring Nigeria), and has been covered by 3 immunization campaigns.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The occurrence of confirmed WPV1 cases in Somalia after 6 years of no documented WPV transmission is an unfortunate situation, yet unfortunately not surprising, given the information that there are areas in central and southern Somalia that have not conducted vaccination activities since 2009 (the Banadir region of Somalia is located to the south of Mogadishu in the central region of Somalia; see map at http://www.collinsmaps.com/maps/Somalia ... 14.00.aspx), combined with continued circulation of WPV in Afghanistan, Nigeria, and Pakistan.
The continued insecurities due to civil unrest in the 3 remaining polio endemic countries -- Afghanistan, Nigeria, and Pakistan -- leading to limited to no vaccination activities in geographic areas of high insecurity, are keeping obstacles in the way of achievement of global interruption of WPV transmission.
We await information on the genetic sequencing of the WPV1 involved in Somalia.
For the map of locations of confirmed cases of WPV infection, see http://www.polioeradication.org/Dataandmonitoring.aspx. - Mod.MPP]
-
Birgitt
- Moderator
- Beiträge: 35230
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Kinderlähmung - Poliomyelitis weltweit
POLIOMYELITIS UPDATE (05): KENYA, GLOBAL
****************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] Kenya
[2] Global update: Polio Eradication Initiative
******
[1] Kenya
Date: 17 May 2013
Source: Relief Web [edited]
http://reliefweb.int/report/kenya/wild-poliovirus-kenya
Report from: Global Polio Eradication Initiative
http://www.polioeradication.org/tabid/4 ... fault.aspx
-----------------
An investigation team is in Dadaab, Kenya following reports of a child paralyzed by wild poliovirus type 1 (WPV1). This is the 1st WPV case confirmed in Kenya since July 2011. The location is close to the border with Somalia, where a child was paralyzed by polio in the capital Mogadishu on [18 Apr 2013]. Dadaab hosts a major refugee camp, housing nearly 500 000 persons from across the Horn of Africa, including from Somalia.
An initial outbreak response is expected to start next week, following international outbreak response standards. Somalia has already conducted an emergency response in the Banadir region including and around Mogadishu.
Countries across the Horn of Africa are now at significant risk of this outbreak due to large-scale population movements and persistent immunity gaps in some areas. In 2005, polio spread from the Horn of Africa and across the Gulf of Aden to cause a devastating outbreak in Yemen, which left 479 children paralysed for life. The adoption of international outbreak response standards and the development of new vaccines since then -- when fully implemented with high-quality vaccination operations -- have considerably reduced the severity and duration of such outbreaks.
--
Communicated by:
ProMED-FRA
<promed@promedmail.org>
[While one suspects that this newly reported WPV1 case will most likely have a WPV1 virus identified as genetically similar to the WPV1 identified in the 32-month old Somalian child from Banadir (see below and prior ProMED-mail report Poliomyelitis update (04): Somalia, global 20130512.1707335 for details on the Somalian case), the possibility that this case represents another line of transmission remains present.
In 2011 (see prior ProMED-mail report Poliomyelitis - worldwide (13): Kenya, China, Pakistan 20110920.2860), there were 3 cases of WPV1 in the Western Province of Kenya that were identified genetically as related to one found in Uganda's Bugiri in District in 2010. In 2009, there was a case of WPV1 in northern Kenya (near the border with Sudan) genetically related to a WPV1 circulating in Sudan. In 2006, there were 2 cases of WPV1 identified in the Hagadera Refugee Camp in Dadaab Division, Garissa District, North Eastern Province in Somalian refugees (see prior ProMED-mail posts listed below).
More information on the epidemiology investigation of this case (age, sex, nationality, history of travel or contact with known travellers) and genetic studies on the WPV1 isolate would be greatly appreciated.
For a map of Kenya showing provinces, see http://www.nationsonline.org/oneworld/map/kenya_map.htm. Note that Dadaab Division includes Hagadera, which can be found in the southern 3rd of the North Eastern Province near the border with Somalia. - Mod.MPP
The ProMED-mail HealthMap of Kenya can be found at http://healthmap.org/r/1zkN.]
******
[2] Global update: Polio Eradication Initiative
Date: Wed 15 May 2013
Source: Polio Eradication Initiative [edited]
http://polioeradication.org/Dataandmoni ... sweek.aspx
Wild poliovirus (WPV) cases
Total cases: Year-to-date 2013 / Year-to-date 2012 / Total 2012
Globally: 33 / 55 / 223
- in endemic countries: 32 / 52 / 217
- in non-endemic countries: 1 / 3 / 6
Case breakdown by country
Countries: 2013 WPV1 / WPV3 / W1W3 / Total 2013 // 2012 WPV1 / WPV3 / W1W3 / Total year-to-date 2012 / Total 2012 // Date most recent case
Pakistan: 8 / 0 / 0 / 8 // 13 / 2 / 1 / 16 / 58 // 24 Apr 2013
Afghanistan: 2 / 0 / 0 / 2 // 6 / 0 / 0 / 6 / 37 // 28 Mar 2013
Nigeria: 22 / 0 / 0 / 22 // 23 / 7 / 0 / 30 / 122 // 24 Apr 2013
Somalia: 1 / 0 / 0 / 1 // 0 / 0 / 0 / 0 / 0 // 18 Apr 2013
Chad: 0 / 0 / 0 / 0 // 3 / 0 / 0 / 3 / 5 // 14 Jun 2012
Niger: 0 / 0 / 0 / 0 // 0 / 0 / 0 / 0 / 1 // 15 Nov 2012
Total: 33 / 0 / 0 / 33 // 45 / 9 / 1 / 55 / 223
Total in endemic countries: 32 / 0 / 0 / 32 // 42 / 9 / 1 / 52 / 217
Total outbreak: 1 / 0 / 0 / 1 // 3 / 0 / 0 / 3 / 6
Data in WHO as of 15 May 2012 for 2012 data and 14 May 2013 for 2013 data.
Afghanistan
- No new WPV cases were reported in the past week. The total number of WPV cases for 2013 remains 2. The most recent WPV case had onset of paralysis on [28 Mar 2013] (WPV1 from Kunar).
- No new circulating vaccine-derived poliovirus type 2 (cVDPV2) cases were reported in the past week. The total number of cVDPV2 cases in 2013 remains 3. The most recent cVDPV2 case had onset of paralysis on [13 Mar 2013] (from Kandahar).
Nigeria
- 4 new WPV cases were reported in the past week (WPV1s from Borno, Kano, Taraba and Yobe), bringing the total number of cases for 2013 to 22. The cases from Borno and Taraba are the most recent WPV cases in the country, both with onset of paralysis on [24 Apr 2013].
- No new cases of cVDPV2 were reported in the past week. The most recent cVDPV2 case had onset of paralysis on [24 Nov 2012] (from Kebbi).
Pakistan
- 2 new WPV cases were reported in the past week (WPV1s from Khyber Pakhtunkhwa - KP, and Federally Administered Tribal Areas - FATA), bringing the total number of WPV cases for 2013 to 8. The case from FATA is the most recent WPV case in the country (and the 1st WPV from FATA in 2013), and had onset of paralysis on [24 Apr 2013].
- No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2013 remains 3. The most recent cVDPV2 case in the country had onset of paralysis on [10 Apr 2013] (from FATA).
- 2 new positive environmental samples were confirmed this week, WPV1s from Gadap, Sindh (collected [11 Apr 2013]) and Peshawar, KP (collected [12 Apr 2013]). This year [2013], 16 environmental samples positive for WPV1 have been reported (of which 11 were collected in Peshawar and Hyderabad, Sindh).
- The security situation continues to be monitored closely, in consultation with law enforcement agencies. Immunization activities continue to be implemented, in some areas staggered or postponed, depending on the security situation at the local level.
Chad
- No new WPV cases were reported in the past week. The most recent WPV case had onset of paralysis on [14 Jun 2012] (WPV1 from Lac).
- No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2013 remains one (onset of paralysis on [4 Feb 2013] from Salamat).
Horn of Africa
- One new WPV case was reported in the past week (WPV1 from Banadir, Somalia), with onset of paralysis on [18 Apr 2013]. It is the 1st WPV in Somalia since March 2007. It is the 1st outbreak outside of an endemic country in 2013.
- The child is a 32-month-old girl from Banadir region.
- An outbreak response activity is being conducted this week (14-16 May 2013), to reach 350 000 children across Banadir (including Mogadishu). Further campaigns are being planned.
- In large areas of south-central Somalia, immunization campaigns have not been implemented since 2009 due to inaccessibility, affecting more than 500 000 children aged less than 5 years. Populations in this area are at particular risk of this polio outbreak. This is also the area affected by an ongoing cVDPV2 outbreak, which has resulted in 18 cases in the country since 2009 (most recent cVDPV2 case had onset of paralysis on [9 Jan 2013]).
West Africa
- No new WPV cases were reported in the past week. The most recent case in the region was a WPV1 from Tahoua province in Niger with onset of paralysis on [15 Nov 2012].
- Multi-country immunization campaigns will be held on 24-27 May 2013, using trivalent OPV, across West Africa. The activity follows a multi-country campaign at end-April 2013 in Benin, Burkina Faso, Cote d'Ivoire, Guinea, Liberia, Mali and Sierra Leone to reach nearly 30 million children under the age of 5 years. Niger will conduct subnational immunization activities on [15-18 Jun 2013].
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[According to the latest data available on the Polio Eradication Initiative website, there have been a total of 34 cases of WPV-associated disease confirmed since the beginning of 2013 (this total includes the newly reported case from Kenya and is not included in the table presented above, as the date of report was 17 May 2013, and the table above is current with data as of 14 May 2013).
There are now 2 cases of WPV1 disease reported in 2013 from outside of the 3 known polio endemic countries. The occurrence of these 2 new cases suggests that there is ongoing circulation of WPV in the Horn of Africa.
One of the indicators of pockets of inadequate polio vaccination coverages in a country is the presence of circulating vaccine derived polioviruses (cVDPV). Since the beginning of 2012, cVDPV2 cases have been identified in Pakistan, Afghanistan, Chad, Somalia, Nigeria, Kenya and the Democratic Republic of the Congo (DRC). In this same period (since the beginning of January 2012), WPV associated disease has been confirmed in Pakistan, Afghanistan, Chad, Somalia, Nigeria and Kenya. One cannot help but wonder whether there is concurrent WPV transmission ongoing (albeit silently at present) in the DRC as well.
In referring to the newly identified case in Kenya, the Polio Eradication Initiative statement "Countries across the Horn of Africa are now at significant risk of this outbreak, due to large-scale population movements and persistent immunity gaps in some areas" is highly appropriate. Unfortunately, the areas with ongoing WPV transmission in the world include areas with civil unrest and security risks for vaccination workers, the latter situation hard to comprehend from the outside looking in. It is a sorry situation when propaganda leads to violence against workers who are trying to provide life saving and morbidity protection to the children in an area.
For a map showing the locations of confirmed cases of WPV, see http://www.polioeradication.org/Dataand ... dwide.aspx. - Mod.MPP]
****************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] Kenya
[2] Global update: Polio Eradication Initiative
******
[1] Kenya
Date: 17 May 2013
Source: Relief Web [edited]
http://reliefweb.int/report/kenya/wild-poliovirus-kenya
Report from: Global Polio Eradication Initiative
http://www.polioeradication.org/tabid/4 ... fault.aspx
-----------------
An investigation team is in Dadaab, Kenya following reports of a child paralyzed by wild poliovirus type 1 (WPV1). This is the 1st WPV case confirmed in Kenya since July 2011. The location is close to the border with Somalia, where a child was paralyzed by polio in the capital Mogadishu on [18 Apr 2013]. Dadaab hosts a major refugee camp, housing nearly 500 000 persons from across the Horn of Africa, including from Somalia.
An initial outbreak response is expected to start next week, following international outbreak response standards. Somalia has already conducted an emergency response in the Banadir region including and around Mogadishu.
Countries across the Horn of Africa are now at significant risk of this outbreak due to large-scale population movements and persistent immunity gaps in some areas. In 2005, polio spread from the Horn of Africa and across the Gulf of Aden to cause a devastating outbreak in Yemen, which left 479 children paralysed for life. The adoption of international outbreak response standards and the development of new vaccines since then -- when fully implemented with high-quality vaccination operations -- have considerably reduced the severity and duration of such outbreaks.
--
Communicated by:
ProMED-FRA
<promed@promedmail.org>
[While one suspects that this newly reported WPV1 case will most likely have a WPV1 virus identified as genetically similar to the WPV1 identified in the 32-month old Somalian child from Banadir (see below and prior ProMED-mail report Poliomyelitis update (04): Somalia, global 20130512.1707335 for details on the Somalian case), the possibility that this case represents another line of transmission remains present.
In 2011 (see prior ProMED-mail report Poliomyelitis - worldwide (13): Kenya, China, Pakistan 20110920.2860), there were 3 cases of WPV1 in the Western Province of Kenya that were identified genetically as related to one found in Uganda's Bugiri in District in 2010. In 2009, there was a case of WPV1 in northern Kenya (near the border with Sudan) genetically related to a WPV1 circulating in Sudan. In 2006, there were 2 cases of WPV1 identified in the Hagadera Refugee Camp in Dadaab Division, Garissa District, North Eastern Province in Somalian refugees (see prior ProMED-mail posts listed below).
More information on the epidemiology investigation of this case (age, sex, nationality, history of travel or contact with known travellers) and genetic studies on the WPV1 isolate would be greatly appreciated.
For a map of Kenya showing provinces, see http://www.nationsonline.org/oneworld/map/kenya_map.htm. Note that Dadaab Division includes Hagadera, which can be found in the southern 3rd of the North Eastern Province near the border with Somalia. - Mod.MPP
The ProMED-mail HealthMap of Kenya can be found at http://healthmap.org/r/1zkN.]
******
[2] Global update: Polio Eradication Initiative
Date: Wed 15 May 2013
Source: Polio Eradication Initiative [edited]
http://polioeradication.org/Dataandmoni ... sweek.aspx
Wild poliovirus (WPV) cases
Total cases: Year-to-date 2013 / Year-to-date 2012 / Total 2012
Globally: 33 / 55 / 223
- in endemic countries: 32 / 52 / 217
- in non-endemic countries: 1 / 3 / 6
Case breakdown by country
Countries: 2013 WPV1 / WPV3 / W1W3 / Total 2013 // 2012 WPV1 / WPV3 / W1W3 / Total year-to-date 2012 / Total 2012 // Date most recent case
Pakistan: 8 / 0 / 0 / 8 // 13 / 2 / 1 / 16 / 58 // 24 Apr 2013
Afghanistan: 2 / 0 / 0 / 2 // 6 / 0 / 0 / 6 / 37 // 28 Mar 2013
Nigeria: 22 / 0 / 0 / 22 // 23 / 7 / 0 / 30 / 122 // 24 Apr 2013
Somalia: 1 / 0 / 0 / 1 // 0 / 0 / 0 / 0 / 0 // 18 Apr 2013
Chad: 0 / 0 / 0 / 0 // 3 / 0 / 0 / 3 / 5 // 14 Jun 2012
Niger: 0 / 0 / 0 / 0 // 0 / 0 / 0 / 0 / 1 // 15 Nov 2012
Total: 33 / 0 / 0 / 33 // 45 / 9 / 1 / 55 / 223
Total in endemic countries: 32 / 0 / 0 / 32 // 42 / 9 / 1 / 52 / 217
Total outbreak: 1 / 0 / 0 / 1 // 3 / 0 / 0 / 3 / 6
Data in WHO as of 15 May 2012 for 2012 data and 14 May 2013 for 2013 data.
Afghanistan
- No new WPV cases were reported in the past week. The total number of WPV cases for 2013 remains 2. The most recent WPV case had onset of paralysis on [28 Mar 2013] (WPV1 from Kunar).
- No new circulating vaccine-derived poliovirus type 2 (cVDPV2) cases were reported in the past week. The total number of cVDPV2 cases in 2013 remains 3. The most recent cVDPV2 case had onset of paralysis on [13 Mar 2013] (from Kandahar).
Nigeria
- 4 new WPV cases were reported in the past week (WPV1s from Borno, Kano, Taraba and Yobe), bringing the total number of cases for 2013 to 22. The cases from Borno and Taraba are the most recent WPV cases in the country, both with onset of paralysis on [24 Apr 2013].
- No new cases of cVDPV2 were reported in the past week. The most recent cVDPV2 case had onset of paralysis on [24 Nov 2012] (from Kebbi).
Pakistan
- 2 new WPV cases were reported in the past week (WPV1s from Khyber Pakhtunkhwa - KP, and Federally Administered Tribal Areas - FATA), bringing the total number of WPV cases for 2013 to 8. The case from FATA is the most recent WPV case in the country (and the 1st WPV from FATA in 2013), and had onset of paralysis on [24 Apr 2013].
- No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2013 remains 3. The most recent cVDPV2 case in the country had onset of paralysis on [10 Apr 2013] (from FATA).
- 2 new positive environmental samples were confirmed this week, WPV1s from Gadap, Sindh (collected [11 Apr 2013]) and Peshawar, KP (collected [12 Apr 2013]). This year [2013], 16 environmental samples positive for WPV1 have been reported (of which 11 were collected in Peshawar and Hyderabad, Sindh).
- The security situation continues to be monitored closely, in consultation with law enforcement agencies. Immunization activities continue to be implemented, in some areas staggered or postponed, depending on the security situation at the local level.
Chad
- No new WPV cases were reported in the past week. The most recent WPV case had onset of paralysis on [14 Jun 2012] (WPV1 from Lac).
- No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2013 remains one (onset of paralysis on [4 Feb 2013] from Salamat).
Horn of Africa
- One new WPV case was reported in the past week (WPV1 from Banadir, Somalia), with onset of paralysis on [18 Apr 2013]. It is the 1st WPV in Somalia since March 2007. It is the 1st outbreak outside of an endemic country in 2013.
- The child is a 32-month-old girl from Banadir region.
- An outbreak response activity is being conducted this week (14-16 May 2013), to reach 350 000 children across Banadir (including Mogadishu). Further campaigns are being planned.
- In large areas of south-central Somalia, immunization campaigns have not been implemented since 2009 due to inaccessibility, affecting more than 500 000 children aged less than 5 years. Populations in this area are at particular risk of this polio outbreak. This is also the area affected by an ongoing cVDPV2 outbreak, which has resulted in 18 cases in the country since 2009 (most recent cVDPV2 case had onset of paralysis on [9 Jan 2013]).
West Africa
- No new WPV cases were reported in the past week. The most recent case in the region was a WPV1 from Tahoua province in Niger with onset of paralysis on [15 Nov 2012].
- Multi-country immunization campaigns will be held on 24-27 May 2013, using trivalent OPV, across West Africa. The activity follows a multi-country campaign at end-April 2013 in Benin, Burkina Faso, Cote d'Ivoire, Guinea, Liberia, Mali and Sierra Leone to reach nearly 30 million children under the age of 5 years. Niger will conduct subnational immunization activities on [15-18 Jun 2013].
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[According to the latest data available on the Polio Eradication Initiative website, there have been a total of 34 cases of WPV-associated disease confirmed since the beginning of 2013 (this total includes the newly reported case from Kenya and is not included in the table presented above, as the date of report was 17 May 2013, and the table above is current with data as of 14 May 2013).
There are now 2 cases of WPV1 disease reported in 2013 from outside of the 3 known polio endemic countries. The occurrence of these 2 new cases suggests that there is ongoing circulation of WPV in the Horn of Africa.
One of the indicators of pockets of inadequate polio vaccination coverages in a country is the presence of circulating vaccine derived polioviruses (cVDPV). Since the beginning of 2012, cVDPV2 cases have been identified in Pakistan, Afghanistan, Chad, Somalia, Nigeria, Kenya and the Democratic Republic of the Congo (DRC). In this same period (since the beginning of January 2012), WPV associated disease has been confirmed in Pakistan, Afghanistan, Chad, Somalia, Nigeria and Kenya. One cannot help but wonder whether there is concurrent WPV transmission ongoing (albeit silently at present) in the DRC as well.
In referring to the newly identified case in Kenya, the Polio Eradication Initiative statement "Countries across the Horn of Africa are now at significant risk of this outbreak, due to large-scale population movements and persistent immunity gaps in some areas" is highly appropriate. Unfortunately, the areas with ongoing WPV transmission in the world include areas with civil unrest and security risks for vaccination workers, the latter situation hard to comprehend from the outside looking in. It is a sorry situation when propaganda leads to violence against workers who are trying to provide life saving and morbidity protection to the children in an area.
For a map showing the locations of confirmed cases of WPV, see http://www.polioeradication.org/Dataand ... dwide.aspx. - Mod.MPP]
-
Birgitt
- Moderator
- Beiträge: 35230
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Kinderlähmung - Poliomyelitis in Kenia, Somalia und Pakistan
POLIOMYELITIS UPDATE (06): KENYA, SOMALIA, WHO, PAKISTAN
********************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] Kenya (Dadaab), Somalia (Banaadir): WHO, alert
[2] Pakistan (Federal Administered Tribal Areas): violence against vaccination workers
******
[1] Kenya (Dadaab), Somalia (Banaadir): WHO, alert
Date: Wed 22 May 2013
WHO Global Alert and Response (GAR), Disease Outbreak News [edited]
http://www.who.int/csr/don/2013_05_22/en/index.html
Wild poliovirus in the Horn of Africa - 22 May 2013
---------------------------------------------------
The Horn of Africa is currently experiencing an outbreak of wild poliovirus type 1 (WPV1). A 4-month-old girl near Dadaab, Kenya, developed symptoms of acute flaccid paralysis (AFP) on [30 Apr 2013]. 2 healthy contacts of the child tested positive for WPV1. They are the 1st laboratory confirmed cases in Kenya since July 2011. Investigation into this outbreak is ongoing.
In addition, a case of WPV1 in Banadir [Banaadir], Somalia was confirmed on 9 May 2013.
In response to the outbreak, the 1st vaccination campaign, reaching 440 000 children began on 14 May 2013 in Somalia and a 2nd round of vaccination is planned for 26 May 2013 in synchronization with the affected parts of Kenya.
The risk to neighbouring countries is deemed as very high, due to large-scale population movements across the Horn of Africa and persistent immunity gaps in some areas. Dadaab hosts a major refugee camp, housing nearly 500 000 persons from across the Horn of Africa.
An alert for enhanced surveillance for polio has been issued to all countries across the Horn of Africa, highlighting the need to conduct active searches for any suspected cases. All countries are urged to rapidly identify sub-national surveillance gaps and to take measures to fill the gaps.
In 2005, polio spread east across the African continent, and into Yemen and the Horn of Africa, resulting in over 700 cases. Since then, international outbreak responses have been adopted and new monovalent and bivalent oral polio vaccines have been developed, which can significantly reduce the severity and length of polio outbreaks.
Some areas of Somalia (south-central) are also affected by an outbreak due to circulating vaccine-derived poliovirus type 2 (cVDPV2), which has resulted in 18 cases in Somalia since 2009. In 2012, this strain spread to Dadaab, causing 3 cases.
WHO's International Travel and Health recommends that all travellers to and from polio-infected areas be fully vaccinated against polio.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[New information in the report above since the last update (see Poliomyelitis update (05): Kenya, global 20130518.1721794) is that 2 healthy contacts of the polio case in Dadaab, Kenya were found to be positive carriers of WPV1 [wild poliovirus type 1]. The reminder of the high population movement in the area and the potential impact of circulation of WPV1 in the area is sobering.
For a map showing the location of cases of WPV globally, see http://www.polioeradication.org/Dataand ... dwide.aspx. - Mod.MPP
[HealthMap/ProMED-mail interactive maps of Kenya and Somalia can be seen at http://healthmap.org/r/1r1D (Kenya) and http://healthmap.org/r/6ToF (Somalia). A map showing the location of Dadaab Refugee Camp on the border of Kenya & Somalia, can be seen at
http://images.smh.com.au/2011/07/13/249 ... -200x0.jpg. - Sr.Tech.Ed.MJ]
******
[2] Pakistan (Federal Administered Tribal Areas): violence against vaccination workers
Date: Mon 20 May 2012
Source: The Wall Street Journal [edited]
http://online.wsj.com/article/SB1000142 ... 01718.html
Officials say gunmen have killed a policeman guarding a polio vaccination team in northwestern Pakistan.
Local government administrator Faramosh Khan says the gunmen attacked on Monday [20 May 2013] in the town of Mamound in the Bajur [Bajaur] tribal area [Federal Administered Tribal Areas], just as the team started a vaccination drive.
No one has claimed responsibility for the shooting, but suspicion will likely fall on Islamic militants suspected in similar attacks.
Jehanzeb Dawar, a senior regional health official, said a total of 624 teams are taking part in the latest push in Bajur to vaccinate more than 220 000 children. The teams re-launched the drive after taking a couple of months off because of past attacks on vaccination teams in the country.
It's unclear whether the campaign will continue after Monday's [20 May 2013] attack.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The continued violence against vaccination workers in the known polio endemic areas [Afghanistan, Nigeria, and Pakistan] does not bode well for the polio eradication effort. This moderator is unable to comprehend the mentality that permits acts of violence against humanitarian and public health workers.
A HealthMap/ProMED-mail interactive map of Pakistan can be seen at http://healthmap.org/r/6ZUE.
For a map of Pakistan showing the tribal areas, see http://pakistantourguide.blogspot.com/2 ... istan.html. For a map showing the Bajaur Tribal area, (with an accompanying analytic news story) see http://newamerica.net/publications/poli ... tan_bajaur. - Mod.MPP]
********************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] Kenya (Dadaab), Somalia (Banaadir): WHO, alert
[2] Pakistan (Federal Administered Tribal Areas): violence against vaccination workers
******
[1] Kenya (Dadaab), Somalia (Banaadir): WHO, alert
Date: Wed 22 May 2013
WHO Global Alert and Response (GAR), Disease Outbreak News [edited]
http://www.who.int/csr/don/2013_05_22/en/index.html
Wild poliovirus in the Horn of Africa - 22 May 2013
---------------------------------------------------
The Horn of Africa is currently experiencing an outbreak of wild poliovirus type 1 (WPV1). A 4-month-old girl near Dadaab, Kenya, developed symptoms of acute flaccid paralysis (AFP) on [30 Apr 2013]. 2 healthy contacts of the child tested positive for WPV1. They are the 1st laboratory confirmed cases in Kenya since July 2011. Investigation into this outbreak is ongoing.
In addition, a case of WPV1 in Banadir [Banaadir], Somalia was confirmed on 9 May 2013.
In response to the outbreak, the 1st vaccination campaign, reaching 440 000 children began on 14 May 2013 in Somalia and a 2nd round of vaccination is planned for 26 May 2013 in synchronization with the affected parts of Kenya.
The risk to neighbouring countries is deemed as very high, due to large-scale population movements across the Horn of Africa and persistent immunity gaps in some areas. Dadaab hosts a major refugee camp, housing nearly 500 000 persons from across the Horn of Africa.
An alert for enhanced surveillance for polio has been issued to all countries across the Horn of Africa, highlighting the need to conduct active searches for any suspected cases. All countries are urged to rapidly identify sub-national surveillance gaps and to take measures to fill the gaps.
In 2005, polio spread east across the African continent, and into Yemen and the Horn of Africa, resulting in over 700 cases. Since then, international outbreak responses have been adopted and new monovalent and bivalent oral polio vaccines have been developed, which can significantly reduce the severity and length of polio outbreaks.
Some areas of Somalia (south-central) are also affected by an outbreak due to circulating vaccine-derived poliovirus type 2 (cVDPV2), which has resulted in 18 cases in Somalia since 2009. In 2012, this strain spread to Dadaab, causing 3 cases.
WHO's International Travel and Health recommends that all travellers to and from polio-infected areas be fully vaccinated against polio.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[New information in the report above since the last update (see Poliomyelitis update (05): Kenya, global 20130518.1721794) is that 2 healthy contacts of the polio case in Dadaab, Kenya were found to be positive carriers of WPV1 [wild poliovirus type 1]. The reminder of the high population movement in the area and the potential impact of circulation of WPV1 in the area is sobering.
For a map showing the location of cases of WPV globally, see http://www.polioeradication.org/Dataand ... dwide.aspx. - Mod.MPP
[HealthMap/ProMED-mail interactive maps of Kenya and Somalia can be seen at http://healthmap.org/r/1r1D (Kenya) and http://healthmap.org/r/6ToF (Somalia). A map showing the location of Dadaab Refugee Camp on the border of Kenya & Somalia, can be seen at
http://images.smh.com.au/2011/07/13/249 ... -200x0.jpg. - Sr.Tech.Ed.MJ]
******
[2] Pakistan (Federal Administered Tribal Areas): violence against vaccination workers
Date: Mon 20 May 2012
Source: The Wall Street Journal [edited]
http://online.wsj.com/article/SB1000142 ... 01718.html
Officials say gunmen have killed a policeman guarding a polio vaccination team in northwestern Pakistan.
Local government administrator Faramosh Khan says the gunmen attacked on Monday [20 May 2013] in the town of Mamound in the Bajur [Bajaur] tribal area [Federal Administered Tribal Areas], just as the team started a vaccination drive.
No one has claimed responsibility for the shooting, but suspicion will likely fall on Islamic militants suspected in similar attacks.
Jehanzeb Dawar, a senior regional health official, said a total of 624 teams are taking part in the latest push in Bajur to vaccinate more than 220 000 children. The teams re-launched the drive after taking a couple of months off because of past attacks on vaccination teams in the country.
It's unclear whether the campaign will continue after Monday's [20 May 2013] attack.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The continued violence against vaccination workers in the known polio endemic areas [Afghanistan, Nigeria, and Pakistan] does not bode well for the polio eradication effort. This moderator is unable to comprehend the mentality that permits acts of violence against humanitarian and public health workers.
A HealthMap/ProMED-mail interactive map of Pakistan can be seen at http://healthmap.org/r/6ZUE.
For a map of Pakistan showing the tribal areas, see http://pakistantourguide.blogspot.com/2 ... istan.html. For a map showing the Bajaur Tribal area, (with an accompanying analytic news story) see http://newamerica.net/publications/poli ... tan_bajaur. - Mod.MPP]
-
Birgitt
- Moderator
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- Kontaktdaten:
Kinderlähmung - Poliomyelitis weltweit
POLIOMYELITIS UPDATE (07): KENYA, SOMALIA
*****************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] Kenya, Somalia: newswire
[2] Global update: Polio Eradication Initiative
******
[1] Kenya, Somalia: newswire
Date: Wed 29 May 2013
Source: The Star [edited]
http://www.the-star.co.ke/news/article- ... ound-virus
Polio alert after 2 refugees found with virus
---------------------------------------------
The Ministry of Health and WHO are rolling out a massive emergency polio immunisation campaign in Ifo, Hagadera, and Dadaab and within their host communities after 2 confirmed cases of wild poliovirus were reported in the area.
Garissa county coordinator for health Dr Mohamed Abdikadir said 2 young refugee boys from the same family at the Hagadera refugee camp last week [week of 20 May 2013] tested positive for the poliovirus which paralyses its victim's limbs.
"Right now we have 2 confirmed cases, that means in that area you have around 200 people with that virus in their body and those people can also spread it to others. Once that virus is circulating, it can spread like bushfire," he said.
Abdikadir said the immunisation campaign will target children of 15 years and younger and will be done from house to house in the refugee camps while it will be facility based in the host community areas of Dadaab, Fafi, and Habaswein districts.
Dadaab assistant county commissioner Bernard ole Kipury called for thorough screening of refugees streaming into the refugee camps from neighbouring war torn Somalia to prevent the spread of communicable diseases to the Kenyan populace.
In 2006, following a sustained campaign dubbed "Kick Polio out of Kenya" and just as the country was about to receive a certificate from the WHO declaring Kenya a polio free zone, a fresh case was reported at the Dadaab refugee camp.
This latest incident comes days after another polio case was reported in Mogadishu, Somalia, revealing that despite most parts of the world having successfully eradicated the disease from among their population, the virus continues to thrive in some countries at the horn of Africa.
[byline: Stephen Astariko]
--
communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[When this moderator read the newswire above, it sounded like it was referring to the 3 infected cases reported in prior ProMED-mail posts (see Poliomyelitis update (06): Kenya, Somalia, WHO, Pakistan 20130522.1730683, Poliomyelitis update (06): Kenya, Somalia, WHO, Pakistan 20130522.1730683, and Poliomyelitis update (05): Kenya, global 20130518.1721794) where there were reports of WPV1 identified in 2 individuals in the Hagadera refugee camps (one paralytic and one contact), and an earlier case of WPV1 disease in Mogadishu. At that time (29 May 2013), this moderator checked the Polio Eradication Initiative website where information was available as of 22 May 2013. On rechecking this website, it appears that this refers to cases newly identified since 22 May 2013 (see below). - Mod.MPP]
******
[2] Global update: Polio Eradication Initiative
Date: Wed 29 May 2013
Source: Global Polio Eradication Initiative [edited]
http://polioeradication.org/Dataandmoni ... sweek.aspx
Global Polio Eradication Initiative update as of 29 May 2013
------------------------------------------------------------
Wild poliovirus (WPV) cases
Total cases: Year-to-date 2013 / Year-to-date 2012 / Total 2012
Globally: 41 / 64 / 223
- in endemic countries: 35 / 61 / 217
- in non-endemic countries: 6 / 3 / 6
Case breakdown by country
Countries: 2013 WPV1 / WPV3 / W1W3 / Total 2013 // 2012 WPV1 / WPV3 / W1W3 / Total year-to-date 2012 / Total 2012 // Date most recent case
Pakistan: 9 / 0 / 0 / 9 // 13 / 2 / 1 / 16 / 58 // 3 May 2013
Afghanistan: 2 / 0 / 0 / 2 // 7 / 0 / 0 / 7 / 37 // 28 Mar 2013
Nigeria: 24 / 0 / 0 / 24 // 28 / 10 / 0 / 38 / 122 // 25 Apr 2013
Somalia: 4 / 0 / 0 / 4 // 0 / 0 / 0 / 0 / 0 // 9 May 2013
Kenya: 2 / 0 / 0 / 2 // 0 / 0 / 0 / 0 / 0 // 14 May 2013
Chad: 0 / 0 / 0 / 0 // 3 / 0 / 0 / 3 / 5 // 14 Jun 2012
Niger: 0 / 0 / 0 / 0 // 0 / 0 / 0 / 0 / 1 // 15 Nov 2012
Total: 41 / 0 / 0 / 41 // 51 / 12 / 1 / 64 / 223
Total in endemic countries: 35 / 0 / 0 / 35 // 48 / 12 / 1 / 61 / 217
Total outbreak: 6 / 0 / 0 / 6 // 3 / 0 / 0 / 3 / 6
Data in WHO as of 29 May 2012 for 2012 data and 28 May 2013 for 2013 data.
Afghanistan
-----------
- No new WPV cases were reported in the past week. The total number of WPV cases for 2013 remains 2. No WPV cases have been reported from the south western endemic area in 2013. The most recent WPV case had onset of paralysis on [28 Mar 2013] (WPV1 from Kunar, Eastern Region).
- No new circulating vaccine-derived poliovirus type 2 (cVDPV2) cases were reported in the past week. The total number of cVDPV2 cases in 2013 remains 3. The most recent cVDPV2 case had onset of paralysis on [13 Mar 2013] (from Kandahar).
Nigeria
-------
- 2 new WPV cases were reported in the past week (WPV1s from Borno), bringing the total number of WPV cases for 2013 to 24. One of the new cases is the most recent WPV case in the country, with onset of paralysis on [25 Apr 2013].
- No new cases of cVDPV2 were reported in the past week. The most recent cVDPV2 case had onset of paralysis on [24 Nov 2012] (from Kebbi).
Pakistan
--------
- One new WPV case was reported in the past week (WPV1 from Khyber Pakhtunkhwa-KP), bringing the total number of WPV cases for 2013 to 9. It is the most recent WPV case in the country, and had onset of paralysis on [3 May 2013].
- No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2013 remains 4. The most recent cVDPV2 case in the country had onset of paralysis on [22 Apr 2013], from North Waziristan, Federally Administered Tribal Areas (FATA).
- One new positive environmental sample (WPV1) has been confirmed, from Gadap (greater Karachi), Sindh (collected during the week of [22 Apr 2013]). This year [2013], 17 environmental samples positive for WPV1 have been reported (of which 11 were collected in Peshawar, FATA and Hyderabad, Sindh).
Chad
----
- No new WPV cases were reported in the past week. The most recent WPV case had onset of paralysis on [14 Jun 2012] (WPV1 from Lac).
- No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2013 remains one (onset of paralysis on [4 Feb 2013] from Salamat).
Horn of Africa
--------------
- 4 new WPV cases were reported in the past week (one WPV1 from Dadaab, north eastern Kenya, and 3 WPV1s from Somalia), bringing the total number of WPV1 cases in the region to 6 (2 from Kenya and 4 from Somalia). These latest cases had onset of paralysis between [26 Apr 2013 and 14 May 2013].
- Outbreak response activities are continuing in both countries this week. In Kenya, immunization activities began on [26 May 2013], to reach nearly 440 000 children aged less than 15 years across Dadaab. Further subnational immunization days [SNIDs] are planned for a wider area, including parts of Nairobi, on [9 Jun 2013], followed by large-scale SNIDs in late June [2013].
- In Somalia, SNIDs are ongoing (26-29 May 2013), including in Banadir region (which includes Mogadishu).
- Immunization campaigns are also planned and being conducted in other areas of the Horn of Africa, notably Ethiopia and Yemen, to urgently boost population immunity levels and minimize the risk of spread of the outbreak. In Ethiopia, in border areas with Kenya and Somalia, an immunization activity is planned to start on [31 May 2013] (targeting children aged less than 15 years). Focus will be particularly on reaching children in refugee camps. Broader activities are planned for late June [2013].
- Yemen is planning 2 activities in early and late June [2013].
West Africa
-----------
- No new WPV cases were reported in the past week. The most recent case in the region was a WPV1 from Tahoua province in Niger with onset of paralysis on [15 Nov 2012].
--
communicated by:
ProMED-mail
<promed@promedmail.org>
[It looks as though there is ongoing circulation of WPV1 in Somalia with introduction of the virus into the refugee camps in Kenya, which house substantial numbers of Somalian refugees.
If one looks at the history of poliomyelitis in the Horn of Africa in the not too distant past, in 2005 and 2006 there was transmission of the wild poliovirus in the region with initial cases identified in the Sudan, but later on involvement of Yemen, Ethiopia, Kenya, and Somalia. Hence, the prudence of the planned vaccination efforts in the region. One hopes that history will not repeat itself with spread of the WPV to other countries in the region.
For the map showing with geographic location of all recently confirmed cases of WPV, see http://www.polioeradication.org/Dataand ... dwide.aspx. - Mod.MPP]
*****************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] Kenya, Somalia: newswire
[2] Global update: Polio Eradication Initiative
******
[1] Kenya, Somalia: newswire
Date: Wed 29 May 2013
Source: The Star [edited]
http://www.the-star.co.ke/news/article- ... ound-virus
Polio alert after 2 refugees found with virus
---------------------------------------------
The Ministry of Health and WHO are rolling out a massive emergency polio immunisation campaign in Ifo, Hagadera, and Dadaab and within their host communities after 2 confirmed cases of wild poliovirus were reported in the area.
Garissa county coordinator for health Dr Mohamed Abdikadir said 2 young refugee boys from the same family at the Hagadera refugee camp last week [week of 20 May 2013] tested positive for the poliovirus which paralyses its victim's limbs.
"Right now we have 2 confirmed cases, that means in that area you have around 200 people with that virus in their body and those people can also spread it to others. Once that virus is circulating, it can spread like bushfire," he said.
Abdikadir said the immunisation campaign will target children of 15 years and younger and will be done from house to house in the refugee camps while it will be facility based in the host community areas of Dadaab, Fafi, and Habaswein districts.
Dadaab assistant county commissioner Bernard ole Kipury called for thorough screening of refugees streaming into the refugee camps from neighbouring war torn Somalia to prevent the spread of communicable diseases to the Kenyan populace.
In 2006, following a sustained campaign dubbed "Kick Polio out of Kenya" and just as the country was about to receive a certificate from the WHO declaring Kenya a polio free zone, a fresh case was reported at the Dadaab refugee camp.
This latest incident comes days after another polio case was reported in Mogadishu, Somalia, revealing that despite most parts of the world having successfully eradicated the disease from among their population, the virus continues to thrive in some countries at the horn of Africa.
[byline: Stephen Astariko]
--
communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[When this moderator read the newswire above, it sounded like it was referring to the 3 infected cases reported in prior ProMED-mail posts (see Poliomyelitis update (06): Kenya, Somalia, WHO, Pakistan 20130522.1730683, Poliomyelitis update (06): Kenya, Somalia, WHO, Pakistan 20130522.1730683, and Poliomyelitis update (05): Kenya, global 20130518.1721794) where there were reports of WPV1 identified in 2 individuals in the Hagadera refugee camps (one paralytic and one contact), and an earlier case of WPV1 disease in Mogadishu. At that time (29 May 2013), this moderator checked the Polio Eradication Initiative website where information was available as of 22 May 2013. On rechecking this website, it appears that this refers to cases newly identified since 22 May 2013 (see below). - Mod.MPP]
******
[2] Global update: Polio Eradication Initiative
Date: Wed 29 May 2013
Source: Global Polio Eradication Initiative [edited]
http://polioeradication.org/Dataandmoni ... sweek.aspx
Global Polio Eradication Initiative update as of 29 May 2013
------------------------------------------------------------
Wild poliovirus (WPV) cases
Total cases: Year-to-date 2013 / Year-to-date 2012 / Total 2012
Globally: 41 / 64 / 223
- in endemic countries: 35 / 61 / 217
- in non-endemic countries: 6 / 3 / 6
Case breakdown by country
Countries: 2013 WPV1 / WPV3 / W1W3 / Total 2013 // 2012 WPV1 / WPV3 / W1W3 / Total year-to-date 2012 / Total 2012 // Date most recent case
Pakistan: 9 / 0 / 0 / 9 // 13 / 2 / 1 / 16 / 58 // 3 May 2013
Afghanistan: 2 / 0 / 0 / 2 // 7 / 0 / 0 / 7 / 37 // 28 Mar 2013
Nigeria: 24 / 0 / 0 / 24 // 28 / 10 / 0 / 38 / 122 // 25 Apr 2013
Somalia: 4 / 0 / 0 / 4 // 0 / 0 / 0 / 0 / 0 // 9 May 2013
Kenya: 2 / 0 / 0 / 2 // 0 / 0 / 0 / 0 / 0 // 14 May 2013
Chad: 0 / 0 / 0 / 0 // 3 / 0 / 0 / 3 / 5 // 14 Jun 2012
Niger: 0 / 0 / 0 / 0 // 0 / 0 / 0 / 0 / 1 // 15 Nov 2012
Total: 41 / 0 / 0 / 41 // 51 / 12 / 1 / 64 / 223
Total in endemic countries: 35 / 0 / 0 / 35 // 48 / 12 / 1 / 61 / 217
Total outbreak: 6 / 0 / 0 / 6 // 3 / 0 / 0 / 3 / 6
Data in WHO as of 29 May 2012 for 2012 data and 28 May 2013 for 2013 data.
Afghanistan
-----------
- No new WPV cases were reported in the past week. The total number of WPV cases for 2013 remains 2. No WPV cases have been reported from the south western endemic area in 2013. The most recent WPV case had onset of paralysis on [28 Mar 2013] (WPV1 from Kunar, Eastern Region).
- No new circulating vaccine-derived poliovirus type 2 (cVDPV2) cases were reported in the past week. The total number of cVDPV2 cases in 2013 remains 3. The most recent cVDPV2 case had onset of paralysis on [13 Mar 2013] (from Kandahar).
Nigeria
-------
- 2 new WPV cases were reported in the past week (WPV1s from Borno), bringing the total number of WPV cases for 2013 to 24. One of the new cases is the most recent WPV case in the country, with onset of paralysis on [25 Apr 2013].
- No new cases of cVDPV2 were reported in the past week. The most recent cVDPV2 case had onset of paralysis on [24 Nov 2012] (from Kebbi).
Pakistan
--------
- One new WPV case was reported in the past week (WPV1 from Khyber Pakhtunkhwa-KP), bringing the total number of WPV cases for 2013 to 9. It is the most recent WPV case in the country, and had onset of paralysis on [3 May 2013].
- No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2013 remains 4. The most recent cVDPV2 case in the country had onset of paralysis on [22 Apr 2013], from North Waziristan, Federally Administered Tribal Areas (FATA).
- One new positive environmental sample (WPV1) has been confirmed, from Gadap (greater Karachi), Sindh (collected during the week of [22 Apr 2013]). This year [2013], 17 environmental samples positive for WPV1 have been reported (of which 11 were collected in Peshawar, FATA and Hyderabad, Sindh).
Chad
----
- No new WPV cases were reported in the past week. The most recent WPV case had onset of paralysis on [14 Jun 2012] (WPV1 from Lac).
- No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2013 remains one (onset of paralysis on [4 Feb 2013] from Salamat).
Horn of Africa
--------------
- 4 new WPV cases were reported in the past week (one WPV1 from Dadaab, north eastern Kenya, and 3 WPV1s from Somalia), bringing the total number of WPV1 cases in the region to 6 (2 from Kenya and 4 from Somalia). These latest cases had onset of paralysis between [26 Apr 2013 and 14 May 2013].
- Outbreak response activities are continuing in both countries this week. In Kenya, immunization activities began on [26 May 2013], to reach nearly 440 000 children aged less than 15 years across Dadaab. Further subnational immunization days [SNIDs] are planned for a wider area, including parts of Nairobi, on [9 Jun 2013], followed by large-scale SNIDs in late June [2013].
- In Somalia, SNIDs are ongoing (26-29 May 2013), including in Banadir region (which includes Mogadishu).
- Immunization campaigns are also planned and being conducted in other areas of the Horn of Africa, notably Ethiopia and Yemen, to urgently boost population immunity levels and minimize the risk of spread of the outbreak. In Ethiopia, in border areas with Kenya and Somalia, an immunization activity is planned to start on [31 May 2013] (targeting children aged less than 15 years). Focus will be particularly on reaching children in refugee camps. Broader activities are planned for late June [2013].
- Yemen is planning 2 activities in early and late June [2013].
West Africa
-----------
- No new WPV cases were reported in the past week. The most recent case in the region was a WPV1 from Tahoua province in Niger with onset of paralysis on [15 Nov 2012].
--
communicated by:
ProMED-mail
<promed@promedmail.org>
[It looks as though there is ongoing circulation of WPV1 in Somalia with introduction of the virus into the refugee camps in Kenya, which house substantial numbers of Somalian refugees.
If one looks at the history of poliomyelitis in the Horn of Africa in the not too distant past, in 2005 and 2006 there was transmission of the wild poliovirus in the region with initial cases identified in the Sudan, but later on involvement of Yemen, Ethiopia, Kenya, and Somalia. Hence, the prudence of the planned vaccination efforts in the region. One hopes that history will not repeat itself with spread of the WPV to other countries in the region.
For the map showing with geographic location of all recently confirmed cases of WPV, see http://www.polioeradication.org/Dataand ... dwide.aspx. - Mod.MPP]
-
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- Moderator
- Beiträge: 35230
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Kinderlähmung - Poliomyelitis in Israel
POLIOMYELITIS UPDATE (08): ISRAEL, ENVIRONMENTAL ISOLATES, WHO, REQUEST FOR INFORMATION
***************************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: 3 Jun 2013
Source: WHO Global Alert and Response
http://www.who.int/csr/don/2013_06_03/en/index.html
Poliovirus detected from environmental samples in Israel - [3 Jun 2013]
--------------------------------------------------------
In Israel, wild poliovirus type 1 (WPV1) was isolated from sewage samples collected on [9 Apr 2013] in Rahat, southern Israel. The virus has been detected in sewage only; no case of paralytic polio has been reported. Genetic sequencing and epidemiological investigations are ongoing to determine its origin. Preliminary analyses indicate the strain is not related to the virus currently affecting the Horn of Africa. The virus isolate was detected through routine environmental surveillance in Israel that involves regular testing of sewage water. Israel has been free of indigenous WPV transmission since 1988. In the past, wild poliovirus has been detected in environmental samples collected in this region between 1991 and 2002 without occurrence of cases of paralytic polio in the area.
Following detection of the wild poliovirus, health authorities in Israel are conducting a full epidemiological and public health investigation, actively searching for potential cases of paralytic polio as well as for any unimmunized persons. Routine immunization levels are estimated at 94 per cent. Outcomes of the investigation will determine the need for any additional catch-up immunization activities, as necessary. Similar activities are being implemented by health authorities in Gaza and the West Bank. Specimens collected through environmental surveillance since 2002 in both Gaza and the West Bank have consistently tested negative for the presence of WPV.
Given that there are high levels of population immunity levels in the area, and the investigations and response being implemented, the World Health Organization (WHO) assesses the risk of further international spread of this virus strain from Israel as low to moderate.
It is important that all countries, in particular those with frequent travel and contacts with polio affected countries, strengthen surveillance for cases of acute flaccid paralysis (AFP), in order to rapidly detect any new poliovirus importations and facilitate a rapid response. Countries should also analyze routine immunization coverage data to identify any subnational gaps in population immunity to guide catch-up immunization activities and thereby minimize the consequences of any new virus introduction. Priority should be given to areas at high-risk of importations and where OPV3/DPT3 vaccine coverage is less than 80 per cent.
WHO's International Travel and Health recommends that all travellers to and from polio affected areas be fully vaccinated against polio. Three countries remain endemic for indigenous transmission of WPV: Nigeria, Pakistan, and Afghanistan. IN addition, in 2013, the Horn of Africa is affected by an outbreak of WPV, with 6 cases confirmed in Kenya and Somalia.
--
communicated by:
ProMED-mail
<promed@promedmail.org>
[The identification of a WPV1 from the environment is an indication of circulation of the WPV in the area. The most likely explanation in the case of Israel where there are high vaccination coverages and the last documented indigenous WPV transmission in country was in 1988 is the introduction of the WPV through importation from an area with known WPV circulation, either in a resident of Israel returning to the country or from a visitor from the country. The risk here is the introduction of the WPV into a "pocket" of low immunization where there might be sufficient numbers of susceptible individuals to both sustain continued circulation of the WPV as well as produce paralytic disease among one of more of these susceptibles.
ProMED-mail awaits further information on the genetic studies of this current isolate for an understanding of the possible route of introduction, and possible time of introduction (whether this is a newly imported virus, or whether this virus has been silently circulating for a prolonged period of time.
According to wikipedia, Rahat is a predominantly Bedouin city in the South District of Israel, located in the Negev desert, with an estimated population of 53 095 in 2010, considered to be the largest Bedouin settlement in the world. For more information on Rahat, and a map showing its location, see http://en.wikipedia.org/wiki/Rahat.
For a map of Israel, see http://healthmap.org/r/1z-1. - Mod.MPP]
***************************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: 3 Jun 2013
Source: WHO Global Alert and Response
http://www.who.int/csr/don/2013_06_03/en/index.html
Poliovirus detected from environmental samples in Israel - [3 Jun 2013]
--------------------------------------------------------
In Israel, wild poliovirus type 1 (WPV1) was isolated from sewage samples collected on [9 Apr 2013] in Rahat, southern Israel. The virus has been detected in sewage only; no case of paralytic polio has been reported. Genetic sequencing and epidemiological investigations are ongoing to determine its origin. Preliminary analyses indicate the strain is not related to the virus currently affecting the Horn of Africa. The virus isolate was detected through routine environmental surveillance in Israel that involves regular testing of sewage water. Israel has been free of indigenous WPV transmission since 1988. In the past, wild poliovirus has been detected in environmental samples collected in this region between 1991 and 2002 without occurrence of cases of paralytic polio in the area.
Following detection of the wild poliovirus, health authorities in Israel are conducting a full epidemiological and public health investigation, actively searching for potential cases of paralytic polio as well as for any unimmunized persons. Routine immunization levels are estimated at 94 per cent. Outcomes of the investigation will determine the need for any additional catch-up immunization activities, as necessary. Similar activities are being implemented by health authorities in Gaza and the West Bank. Specimens collected through environmental surveillance since 2002 in both Gaza and the West Bank have consistently tested negative for the presence of WPV.
Given that there are high levels of population immunity levels in the area, and the investigations and response being implemented, the World Health Organization (WHO) assesses the risk of further international spread of this virus strain from Israel as low to moderate.
It is important that all countries, in particular those with frequent travel and contacts with polio affected countries, strengthen surveillance for cases of acute flaccid paralysis (AFP), in order to rapidly detect any new poliovirus importations and facilitate a rapid response. Countries should also analyze routine immunization coverage data to identify any subnational gaps in population immunity to guide catch-up immunization activities and thereby minimize the consequences of any new virus introduction. Priority should be given to areas at high-risk of importations and where OPV3/DPT3 vaccine coverage is less than 80 per cent.
WHO's International Travel and Health recommends that all travellers to and from polio affected areas be fully vaccinated against polio. Three countries remain endemic for indigenous transmission of WPV: Nigeria, Pakistan, and Afghanistan. IN addition, in 2013, the Horn of Africa is affected by an outbreak of WPV, with 6 cases confirmed in Kenya and Somalia.
--
communicated by:
ProMED-mail
<promed@promedmail.org>
[The identification of a WPV1 from the environment is an indication of circulation of the WPV in the area. The most likely explanation in the case of Israel where there are high vaccination coverages and the last documented indigenous WPV transmission in country was in 1988 is the introduction of the WPV through importation from an area with known WPV circulation, either in a resident of Israel returning to the country or from a visitor from the country. The risk here is the introduction of the WPV into a "pocket" of low immunization where there might be sufficient numbers of susceptible individuals to both sustain continued circulation of the WPV as well as produce paralytic disease among one of more of these susceptibles.
ProMED-mail awaits further information on the genetic studies of this current isolate for an understanding of the possible route of introduction, and possible time of introduction (whether this is a newly imported virus, or whether this virus has been silently circulating for a prolonged period of time.
According to wikipedia, Rahat is a predominantly Bedouin city in the South District of Israel, located in the Negev desert, with an estimated population of 53 095 in 2010, considered to be the largest Bedouin settlement in the world. For more information on Rahat, and a map showing its location, see http://en.wikipedia.org/wiki/Rahat.
For a map of Israel, see http://healthmap.org/r/1z-1. - Mod.MPP]
-
Birgitt
- Moderator
- Beiträge: 35230
- Registriert: Di 2. Aug 2005, 22:52
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- Kontaktdaten:
Kinderlähmung - Poliomyelitis in Israel
POLIOMYELITIS UPDATE (09): ISRAEL, POSITIVE ENVIRONMENTAL SAMPLES, REQUEST FOR INFORMATION
******************************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Tue 4 Jun 2013
Source: The New York Times [edited]
http://www.nytimes.com/2013/06/04/healt ... srael.html
[Poliovirus] has been found in a sewage sample from Israel for the 1st time since 2002, the World Health Organization announced on Monday [3 Jun 2013]. But no children or adults newly paralyzed by polio have been identified in Israel or in Gaza or the West Bank.
The sample was from Rahat, a city in the Negev Desert near the Egyptian border that has 53 000 residents, primarily Bedouins.
There has not been a case of polio in Israel since 1988. The virus was last found in sewage samples in 1991 and 2002.
Because most Israelis and Palestinians are routinely immunized against polio, it is unlikely the virus will spread further, said Dr Bruce Aylward, director of the WHO's polio campaign. "Things usually dead-end there because immunity is so high," he said.
Only preliminary sequencing of the virus, found on [9 Apr 2013], has been done, so it is not yet clear where it came from, but it is of the same strain as a virus found in January [2013] in sewage samples from Cairo [Egypt], which itself was related to a strain circulating in Pakistan and Afghanistan, Dr Aylward said.
"This shows how it can jump from place to place," Dr Aylward said. "If there's any sense of complacency about the endgame plan, I hope the world has gotten over it."
Polio is very close to eradication; only 223 cases of paralysis occurred in the world last year [2012].
However, every year sees outbreaks in countries far from Pakistan, Afghanistan, and Nigeria, where polio is still endemic, and sometimes the virus is found in sewage even when no cases of paralysis are found. All those outbreaks have been contained by vaccinating millions of people nearby.
The discovery of the virus in Egypt earlier this year [2013] was the 1st time it has been seen there since 2004; no cases of paralysis were found. Egypt vaccinated millions of residents after the virus was found in January [2013], and sewage samples have been negative since then, Dr Aylward said. "But samples are only useful when they're positive, not when they're negative," he said, "so we can't rule out that it's there."
The Rahat strain is definitely not related to the one recently found circulating in Somalia and in a camp in Kenya housing thousands of Somali refugees. That strain comes from Nigeria.
[Byline: Donald G McNeil Jr]
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ProMED-mail
<promed@promedmail.org>
[The newswire above contains the additional information that based on preliminary testing, the virus isolated in Israel is the "same strain as a virus found in January [2013] in sewage samples from Cairo [Egypt], which itself was related to a strain circulating in Pakistan and Afghanistan." According to a prior ProMED-mail report on the isolation of the WPV in Egypt, the isolates (there were 2) were reported to have been similar to a strain recently discovered in Sukkur (Sindh), Pakistan (see prior ProMED-mail post Poliomyelitis - worldwide (01): Egypt ex Pakistan, Niger 20130122.1509210).
As long as there is continued transmission of the wild poliovirus (WPV) in the endemic countries (Afghanistan, Nigeria, and Pakistan) the risk of importation into countries that have interrupted transmission of WPV exists. Hence the continued need to maintain high levels of polio vaccination, even if there is no known circulation of the WPV in a country.
A HealthMap/ProMED-mail interactive map of Israel can be seen at http://healthmap.org/r/1*V*. For a map showing the location of Rahat, see http://en.wikipedia.org/wiki/Rahat. - Mod.MPP]
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A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Tue 4 Jun 2013
Source: The New York Times [edited]
http://www.nytimes.com/2013/06/04/healt ... srael.html
[Poliovirus] has been found in a sewage sample from Israel for the 1st time since 2002, the World Health Organization announced on Monday [3 Jun 2013]. But no children or adults newly paralyzed by polio have been identified in Israel or in Gaza or the West Bank.
The sample was from Rahat, a city in the Negev Desert near the Egyptian border that has 53 000 residents, primarily Bedouins.
There has not been a case of polio in Israel since 1988. The virus was last found in sewage samples in 1991 and 2002.
Because most Israelis and Palestinians are routinely immunized against polio, it is unlikely the virus will spread further, said Dr Bruce Aylward, director of the WHO's polio campaign. "Things usually dead-end there because immunity is so high," he said.
Only preliminary sequencing of the virus, found on [9 Apr 2013], has been done, so it is not yet clear where it came from, but it is of the same strain as a virus found in January [2013] in sewage samples from Cairo [Egypt], which itself was related to a strain circulating in Pakistan and Afghanistan, Dr Aylward said.
"This shows how it can jump from place to place," Dr Aylward said. "If there's any sense of complacency about the endgame plan, I hope the world has gotten over it."
Polio is very close to eradication; only 223 cases of paralysis occurred in the world last year [2012].
However, every year sees outbreaks in countries far from Pakistan, Afghanistan, and Nigeria, where polio is still endemic, and sometimes the virus is found in sewage even when no cases of paralysis are found. All those outbreaks have been contained by vaccinating millions of people nearby.
The discovery of the virus in Egypt earlier this year [2013] was the 1st time it has been seen there since 2004; no cases of paralysis were found. Egypt vaccinated millions of residents after the virus was found in January [2013], and sewage samples have been negative since then, Dr Aylward said. "But samples are only useful when they're positive, not when they're negative," he said, "so we can't rule out that it's there."
The Rahat strain is definitely not related to the one recently found circulating in Somalia and in a camp in Kenya housing thousands of Somali refugees. That strain comes from Nigeria.
[Byline: Donald G McNeil Jr]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The newswire above contains the additional information that based on preliminary testing, the virus isolated in Israel is the "same strain as a virus found in January [2013] in sewage samples from Cairo [Egypt], which itself was related to a strain circulating in Pakistan and Afghanistan." According to a prior ProMED-mail report on the isolation of the WPV in Egypt, the isolates (there were 2) were reported to have been similar to a strain recently discovered in Sukkur (Sindh), Pakistan (see prior ProMED-mail post Poliomyelitis - worldwide (01): Egypt ex Pakistan, Niger 20130122.1509210).
As long as there is continued transmission of the wild poliovirus (WPV) in the endemic countries (Afghanistan, Nigeria, and Pakistan) the risk of importation into countries that have interrupted transmission of WPV exists. Hence the continued need to maintain high levels of polio vaccination, even if there is no known circulation of the WPV in a country.
A HealthMap/ProMED-mail interactive map of Israel can be seen at http://healthmap.org/r/1*V*. For a map showing the location of Rahat, see http://en.wikipedia.org/wiki/Rahat. - Mod.MPP]
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Kinderlähmung - Poliomyelitis in Israel
POLIOMYELITIS UPDATE (10): ISRAEL, POSITIVE ENVIRONMENTAL SAMPLES, MOH
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A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Wed 5 Jun 2013
From: Emilia Anis <emilia.anis@moh.health.gov.il> [edited]
Poliovirus in sewage samples -- Southern Israel -- update
---------------------------------------------------------
Sewage samples collected in Rahat and Beer Sheba are part of routine environmental surveillance for poliovirus implemented in Israel since the polio outbreak of 1988. Samples are collected monthly from selected sites in Israel which either represent large populations or are known to be at high risk for importation of wild poliovirus.
The samples are processed at the Central Virology Laboratory of the Israel Ministry of Health at Tel-Hashomer. Poliovirus is isolated from the sewage samples by infecting recombinant mouse cell line L20B according to WHO guidelines. Individual plaques or tube cultures are then analyzed by real-time PCR using the CDC analytical kits designed for identification of polioviruses and differentiation between vaccine and wild types, and identification confirmed by sequencing.
On [3 Jun 2013] wild poliovirus type 1 (WPV1) was detected in 2 sewage samples taken in Beer Sheba, one on [9 Apr 2013] and the other on [13 May 2013]. Beer Sheba is a city with a population of about 200 000, 20 km [12.4 mi] south of Rahat, the town where the virus was first detected from a sample taken on [9 Apr 2013]. Beer Sheba is the nearest commercial center to Rahat, and there is considerable communication between these towns.
The samples collected in Rahat yielded an exceptionally large number of plaques on L20B cells while the samples from Beer Sheba yielded only a few plaques. Representative isolates from Rahat and all isolates from Beer Sheba were then analyzed and identified as non-Sabin poliovirus type 1. Further analysis by PCR and sequencing revealed that these isolates belong to the SOAS [South Asia] lineage of wild poliovirus type 1 which circulates in Pakistan and Afghanistan, and which was also isolated from sewage in Egypt in December 2012.
Nowhere in the country have any polio cases been identified.
The following actions were decided upon:
1. In Rahat and villages on the same sewage collection line: outreach to complete childhood vaccination for all children and to administer IPV [inactivated poliovirus vaccine] to all adults without evidence of prior vaccination after the age of 18 [years], with special attention to sanitation workers and to immigrants who illegally entered Israel through Egypt. Publicity campaign to raise awareness to hand-washing and personal hygiene. Sewage sampling will be done weekly, and attempts made to pinpoint source(s) by sampling sewage within Rahat and surrounding villages.
2. In the nearby metropolis (Beer Sheba): outreach to complete childhood vaccination for all children up to age 6. Emphasis on completion of school vaccination which includes a dose of dTaP-IPV [diphtheria, tetanus, acellular pertussis-inactivated poliovirus vaccine] at the age of 7 years old.
3. Nationwide: active AFP [acute flaccid paralysis] surveillance will be extended to include all individuals, irrespective of age. Sewage samples taken since March [2013] in Jerusalem, Tel Aviv, Gaza, and the Palestinian authority will be revisited for presence of WPV1. The need for bringing children up to date on their routine vaccinations is emphasized.
[Ella Mendelson, Lester Shulman, Yossi Manor, Shepherd Roee Singer, Eran Kopel, Emilia Anis, Itamar Grotto, all of the Public Health Services Ministry of Health, Israel, contributed to this update]
--
Emilia Anis
<emilia.anis@moh.health.gov.il>
[ProMED-mail would like to thank Dr Emilia Anis and colleagues in the Public Health Services, Ministry of Health, Israel, for sharing this information with us.
As the WPV1 isolate was identified as similar to the WPV1 identified in environmental (sewage) samples in Egypt earlier this year (2012) (see ProMED-mail Poliomyelitis - worldwide (01): Egypt ex Pakistan, Niger 20130122.1509210) one suspects that the virus' itinerary was most likely Afghanistan/Pakistan to Egypt, to Israel. Rahat and Beer Sheba are located in the south of Israel not far from the border with Egypt (see http://www.nationsonline.org/oneworld/m ... l_map2.htm for a map of Israel showing the location of Beer Sheba and its relative proximity to Egypt).
Given the high levels of vaccination coverage in Israel, the recommended strategies of trying to capture those individuals with incomplete vaccination histories, especially those considered at high risk of exposure and transmission in the 2 areas where WPV1 has been identified, as well as a nationwide catch up vaccination effort, are highly appropriate.
For the HealthMap/ProMED map of Israel, see http://healthmap.org/r/1*V*. - Mod.MPP]
**********************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Wed 5 Jun 2013
From: Emilia Anis <emilia.anis@moh.health.gov.il> [edited]
Poliovirus in sewage samples -- Southern Israel -- update
---------------------------------------------------------
Sewage samples collected in Rahat and Beer Sheba are part of routine environmental surveillance for poliovirus implemented in Israel since the polio outbreak of 1988. Samples are collected monthly from selected sites in Israel which either represent large populations or are known to be at high risk for importation of wild poliovirus.
The samples are processed at the Central Virology Laboratory of the Israel Ministry of Health at Tel-Hashomer. Poliovirus is isolated from the sewage samples by infecting recombinant mouse cell line L20B according to WHO guidelines. Individual plaques or tube cultures are then analyzed by real-time PCR using the CDC analytical kits designed for identification of polioviruses and differentiation between vaccine and wild types, and identification confirmed by sequencing.
On [3 Jun 2013] wild poliovirus type 1 (WPV1) was detected in 2 sewage samples taken in Beer Sheba, one on [9 Apr 2013] and the other on [13 May 2013]. Beer Sheba is a city with a population of about 200 000, 20 km [12.4 mi] south of Rahat, the town where the virus was first detected from a sample taken on [9 Apr 2013]. Beer Sheba is the nearest commercial center to Rahat, and there is considerable communication between these towns.
The samples collected in Rahat yielded an exceptionally large number of plaques on L20B cells while the samples from Beer Sheba yielded only a few plaques. Representative isolates from Rahat and all isolates from Beer Sheba were then analyzed and identified as non-Sabin poliovirus type 1. Further analysis by PCR and sequencing revealed that these isolates belong to the SOAS [South Asia] lineage of wild poliovirus type 1 which circulates in Pakistan and Afghanistan, and which was also isolated from sewage in Egypt in December 2012.
Nowhere in the country have any polio cases been identified.
The following actions were decided upon:
1. In Rahat and villages on the same sewage collection line: outreach to complete childhood vaccination for all children and to administer IPV [inactivated poliovirus vaccine] to all adults without evidence of prior vaccination after the age of 18 [years], with special attention to sanitation workers and to immigrants who illegally entered Israel through Egypt. Publicity campaign to raise awareness to hand-washing and personal hygiene. Sewage sampling will be done weekly, and attempts made to pinpoint source(s) by sampling sewage within Rahat and surrounding villages.
2. In the nearby metropolis (Beer Sheba): outreach to complete childhood vaccination for all children up to age 6. Emphasis on completion of school vaccination which includes a dose of dTaP-IPV [diphtheria, tetanus, acellular pertussis-inactivated poliovirus vaccine] at the age of 7 years old.
3. Nationwide: active AFP [acute flaccid paralysis] surveillance will be extended to include all individuals, irrespective of age. Sewage samples taken since March [2013] in Jerusalem, Tel Aviv, Gaza, and the Palestinian authority will be revisited for presence of WPV1. The need for bringing children up to date on their routine vaccinations is emphasized.
[Ella Mendelson, Lester Shulman, Yossi Manor, Shepherd Roee Singer, Eran Kopel, Emilia Anis, Itamar Grotto, all of the Public Health Services Ministry of Health, Israel, contributed to this update]
--
Emilia Anis
<emilia.anis@moh.health.gov.il>
[ProMED-mail would like to thank Dr Emilia Anis and colleagues in the Public Health Services, Ministry of Health, Israel, for sharing this information with us.
As the WPV1 isolate was identified as similar to the WPV1 identified in environmental (sewage) samples in Egypt earlier this year (2012) (see ProMED-mail Poliomyelitis - worldwide (01): Egypt ex Pakistan, Niger 20130122.1509210) one suspects that the virus' itinerary was most likely Afghanistan/Pakistan to Egypt, to Israel. Rahat and Beer Sheba are located in the south of Israel not far from the border with Egypt (see http://www.nationsonline.org/oneworld/m ... l_map2.htm for a map of Israel showing the location of Beer Sheba and its relative proximity to Egypt).
Given the high levels of vaccination coverage in Israel, the recommended strategies of trying to capture those individuals with incomplete vaccination histories, especially those considered at high risk of exposure and transmission in the 2 areas where WPV1 has been identified, as well as a nationwide catch up vaccination effort, are highly appropriate.
For the HealthMap/ProMED map of Israel, see http://healthmap.org/r/1*V*. - Mod.MPP]
