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Progress towards poliomyelitis eradication: Pakistan, January 2015-September 2016

Friday, 25th of November 2016

Progress towards poliomyelitis eradication: Pakistan, January 2015-September 2016

From the Weekly Epidemiological Record

Excerpt below; full text is at http://apps.who.int/iris/bitstream/10665/251644/1/WER9147.pdf?ua=1

As of 1 November 2016, 8 of the 10 WPV1 cases reported in Afghanistan have occurred in the border region with Pakistan. Four WPV1 cases were reported in a south-eastern district in Afghanistan´s Paktika province, an area with regular population movement in both directions across the border with Pakistan´s North and South Wazirstan, where 2 cases have been detected recently. Genetic sequencing data show a close relation between these cases and the 2016 cases in FATA. Cases in south KP and south FATA in Pakistan were genetically linked to transmission detected in Nangarhar, Afghanistan. The 4 cases in Kunar province, Afghanistan, demonstrate sustained local transmission in Afghanistan in 2016 but are also genetically linked to cases circulating in Peshawar and KP in late 2015. Both infected areas highlight the considerable numbers of children remaining unvaccinated due to inaccessibility and low performance of SIAs, and the constant cross-border population movements that facilitate ongoing virus transmission in border areas.

Effective cross-border coordination through weekly communication between EOCs at the national and regional/provincial level in both countries is critical to counter this cross-border threat, through synchronization of SIA schedules, the coordinated response to newly confirmed cases and sharing of epidemiological data. Efforts to eradicate poliovirus in Pakistan are led by the Prime Minister´s National Task Force for Polio Eradication. Critical to these efforts is the continued strong leadership of EOCs at the provincial and national level, allowing effective cross-border coordination and communication between Afghanistan and Pakistan and further strengthening of the quality of SIAs and AFP surveillance to rapidly detect and effectively respond to the presence of poliovirus. Provided that efforts to implement the 2017 NEAP are sufficiently enhanced in all districts to further reduce the number of children missed by SIAs, Pakistan can interrupt WPV transmission.