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POLIO THIS WEEK, AS OF 13 AUGUST 2013

Thursday, 15th of August 2013

From www.polioeradication.org

Polio this week - As of 13 August 2013

The Independent Monitoring Board (IMB) will meet for the ninth time in London, United Kingdom (UK), on Tuesday 1 October and Wednesday 2 October 2013. The IMB will meet with representatives of polio-affected countries and Global Polio Eradication Initiative (GPEI) partners and stakeholders. Anyone wishing to attend the IMB meeting is encouraged to contact Dr Paul Rutter of the IMB Secretariat: imb-prutter@polioeradication.org.

  

Wild Poliovirus (WPV) cases

Total cases	Year-to-date 2013	Year-to-date 2012	Total in 2012
Globally	181	121	223
- in endemic countries	71	116	217
- in non-endemic countries	110	5	6

  

Case breakdown by country

Countries	Year-to-date 2013				Year-to-date 2012				Total in  2012	Date of most   recent case
	WPV	WPV3	W1W3	Total	WPV1	WPV3	W1W3	Total
Pakistan	24			24	26	2	1	29	58	13-Jul-13
Afghanistan	4			4	17			17	37	23-Jul-13
Nigeria	43			43	55	15		70	122	23-Jul-13
Somalia	100			100					0	10-Jul-13
Kenya	10			10					0	6-Jul-13
Chad					5			5	5	14-Jun-12
Niger									1	15-Nov-12
Total	181	0	0	181	103	17	1	121	223
Total in endemic countries	71	0	0	71	98	17	1	116	217
Total outbreak	110	0	0	110	5	0	0	5	6

Data in WHO as of 14 August 2012 for 2012 data and 13 August 2013 for 2013 data.

Afghanistan

No new WPV cases were reported in the past week. The total number of WPV cases for 2013 remains three. The most recent WPV case had onset of paralysis on 6 June (WPV1 from Nangarhar).

All three WPV cases this year were reported from Eastern Region. In the high-risk Southern Region, no WPV cases have been reported since November 2012.

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 three. The most recent cVDPV2 case had onset of paralysis on 13 March (from Kandahar, Southern Region).

Subnational immunization days (SNIDs) were held on 1-3 July, with resources focusing on Southern and Eastern Regions. Planning is underway for nationwide activities in late August. 

Nigeria

One new WPV1 case was reported in the past week, bringing the total of WPV1 cases for 2013 to 43. It is the most recent WPV1 case in the country and had onset of paralysis on 23 July (from Borno).

No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2013 remains one (with onset of paralysis on 6 June from Borno). Although this cVDPV2 case is linked to cVDPV2 currently circulating in Chad which has also been detected in Cameroon, cVDPV2 linked to this transmission chain had previously been isolated from an environmental sample in Kano in March (indicating circulation in Nigeria).

Nearly half of all WPV1 cases in the country this year are from Borno and Yobe state. As many as 35% of children in these states remain under-immunized. This compares to other high-risk states of northern Nigeria (such as Kano, Jigawa, Katsina and Kaduna), where fewer than 20% of children remain under-immunized.

Targeted approaches are being implemented in those LGAs of Borno and Yobe where access is hampered due to insecurity. However, the majority of LGAs in both states continue to participate during campaigns.

Tailored approaches are also focusing on LGAs where performance has stalled, and those where performance has decreased.

Across all areas, strengthened efforts are being made to track the direct engagement and oversight of eradication activities by LGA Chairpersons.

The engagement of communities, and traditional and religious leaders is continuing to be fostered.

The Volunteer Community Mobilizer Network continues to be expanded, and social data analysis is expected to provide further understanding of why children are missed repeatedly. Innovative social mobilization activities being rolled out are: working with polio survivor’s networks as advocates, use of smart phones for data collection and analysis, distribution of pro-OPV messages on CD ROM and DVD, and supporting social mobilization for measles SIAs.

The next subnational Immunization Plus Days (IPDs) are planned across northern states in September. 

Pakistan

Two new WPV1 cases were reported in the past week (from North Waziristan, Federally Administered Tribal Areas – FATA; and, Gadap, Sindh), bringing the total number of WPV1 cases for 2013 to 24. The case from North Waziristan is the most recent WPV1 case in the country, and had onset of paralysis on 13 July.

No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2013 remains six. The most recent cVDPV2 case had onset of paralysis on 30 June (from North Waziristan).

The case from Gadap is the first in greater Karachi since January. However, in 2013, five positive environmental samples (WPV1) were confirmed from Gadap, the most recent from 8 July.

FATA remains the major poliovirus reservoir in Pakistan, both due to WPV1 and cVDPV2. Khyber Agency is particularly affected, accounting for 14 of this year’s 24 WPV1 cases in the country (nine of which from Khyber Agency); FATA also accounts for three of this year’s six cVDPV2 cases (all from North Waziristan). North Waziristan is an area where immunization campaigns have been suspended by local leaders since June 2012.

To minimize the risk of a major WPV1 and/or cVDPV2 outbreak in this area, it is critical that access to children is granted as quickly as possible. Immunization campaigns in neighbouring high-risk areas are being intensified, to further boost population immunity levels in those areas and minimize the risk of further spread.

Chad, Cameroon and Central African Republic

In Chad, no new WPV cases were reported in the past week. The most recent WPV case had onset of paralysis on 14 June 2012 (WPV1 from Lac).

No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2013 remains four (the most recent cVDPV2 case had onset of paralysis on 12 May from Ennedi).

The four cVDPV2 cases were reported from various parts of the country, indicating widespread transmission. In some areas, only one immunization round has been conducted in response. A more comprehensive outbreak response to these cVDPV2 cases must be planned and implemented. The risk of further spread within Chad and further international spread remains high (cVDPV2 circulating in Chad has also been detected in Cameroon and Nigeria).

In Cameroon, no new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2013 remains two. The most recent cVDPV2 case had onset of paralysis on 27 May (from Extreme-Nord).

Central African Republic (CAR) continues to be at risk of re-infection, due to proximity with Chad and in some areas insecurity. To minimize the risk and consequences of potential re-infection, two subnational immunization campaigns were conducted in border areas with Chad (in June and July). Further activities are planned in September.

Horn of Africa

No new WPV1 cases were reported in the past week. The total number of WPV1 cases for 2013 remains 110 (100 from Somalia and ten from Kenya). The most recent WPV1 case in the region had onset of paralysis on 10 July (from Somalia).

Access in some areas of south-central Somalia remains a significant challenge. Analysis shows that as many as 70% of children in inaccessible areas are under-immunized. This compares to 20% in accessible areas of the country. Of the 100 cases reported from Somalia, 16 are from inaccessible or only partially-accessible areas (10 districts in total, primarily from Lower Shabelle region).

Special strategies continue to be implemented in particular in the Lower Shabelle region of Somalia, to improve operations in inaccessible areas. Local-level access negotiations are continuing, as are immunizing older age groups and setting up vaccination posts at entry/exit points of inaccessible areas. Community engagement activities continue to foster engagement of all communities in polio eradication activities. Activities include dissemination of public service announcements (PSAs), partnership with organized religious, youth and women’s groups, vaccinator training, media workshops and bulk SMS distribution. The Somali National Women’s Association continues to disseminate key messages about the dangers of polio and the benefits of OPV.

In Kenya, the priority remains on increasing immunity levels in the Dadaab area of North Eastern province. Nearly 50% of children in this area remain under-immunized (compared to less than 5% in Kenya on the whole).

The overriding objective remains stopping the outbreak in the affected areas. Additionally, the comprehensive outbreak response plan is focusing on protecting populations at high risk, increasing operations in inaccessible areas, and protecting remaining areas across the Horn of Africa. Human resource capacity continues to be scaled up to support outbreak response activities.

Within this strategic emergency outbreak response context, immunization campaigns across the Horn of Africa, including in Ethiopia and Yemen, are continuing in the second half of August.  

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 November 2012.

Multi-country immunization campaigns are planned in West Africa for mid-October and mid-November, as well as subnational campaigns in Niger in September.