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This Week Polio this week as of 22 January 2019. In an extraordinary joint statement by the Chairs of the main independent, advisory and oversight committees of the GPEI, the Chairs urge everyone involved in polio eradication to ensure polio will finally be assigned to the history books by 2023. The authors are the chairs of the Strategic Advisory Group of Experts on immunization (SAGE), the Independent Monitoring Board, the Emergency Committee of the International Health Regulations (IHR) Regarding International Spread of Poliovirus and the Global Commission for the Certification of the Eradication of Poliomyelitis (GCC). The Endgame Plan through 2018 has brought the world to the brink of being polio-free.
A new Strategic Plan 2019-2023 aims to build on the lessons learned since 2013. The joint statement urges everyone involved in the effort to find ways to excel in their roles. If this happens, the statement continues, success will follow.
But otherwise, come 2023, the world will find itself exactly where it is today: tantalizingly close. But in an eradication effort, tantalizingly close is not good enough. The statement therefore issues an impassioned plea to everyone to dedicate themselves to one clear objective: to reach that very last child with polio vaccine. The stull statement is attached herewith and also available.
Summary of new viruses this week: Pakistan – two cases of wild poliovirus type 1 (WPV1) and five WPV1 positive environmental samples; Afghanistan- seven WPV1 positive environmental samples; Nigeria – one case of circulating vaccine derived poliovirus type 2 (cVDPV2) and eight VDPV2 positive environmental samples. See country sections below for more details. No wild poliovirus type 1 (WPV1) case was reported in the past week. The total number of WPV1 cases in 2018 was 21.
Seven WPV1-positive environmental samples were reported this week: three from Kandahar province, two from Jalalabad district, Nangarhar province, and two from Lashkargah district, Hilmand province. All samples were collected on 26 December 2018. Afghanistan recently concluded a targeted national campaign. Read more. Read the latest polio update from to see information on cases, surveillance and vaccination campaigns. Two cases of wild poliovirus type 1 (WPV1) were reported this week.
One case is from Lakki Marwat district in Khyber Pakhtunkhwa province and the other is from Bajour Agency in the Federally Administered Tribal Areas. The onset of paralysis was 16 and 25 December 2018 respectively.
Five WPV1-positive environmental samples were reported in the past week: one each from Peshawar and Bannu districts in Khyber Pakhtunkhwa, one from Lahore in Punjab province, one from Quetta in Balochistan province, and one from Karachi Gadap in Sindh province. Samples were collected from 10-27 December 2018. Read the latest polio update from to see information on cases, surveillance and vaccination campaigns.
One case of circulating vaccine-derived poliovirus type 2 (cVDPV2) case in Baruten LGA in Kwara state (close to Benin border). The case had an onset of paralysis on 5 December 2018. The total number of cVDPV2 cases in 2018 was 34. Three cVDPV2-positive environmental samples were reported in the past week: one from Maiduguri LGA in Borno state, collected on 11 December; one from Zaria and one from Ikara LGAs in Kaduna state, collected on 30 November and 11 December 2018 respectively. No cases of wild poliovirus type 1 (WPV1) were reported. The most recently-detected WPV1 case, from Borno state, had onset of paralysis on 21 August 2016.
The country continues to be affected by two separate cVDPV2 outbreaks, the first centered in Jigawa state with subsequent spread to other states as well as to neighbouring Republic of Niger, and the second in Sokoto state. Recent confirmation of spread of one of the cVDPV2 outbreaks, both within Nigeria and internationally, underscores the urgent need to fill remaining vaccination gaps in the ongoing outbreak response, and to optimize the geographic extent and operational quality of mOPV2 response. At the same time, outbreak response to WPV1 continues, including efforts to address surveillance and immunity gaps in parts of Borno state. Read our country page to see information on surveillance and vaccination campaigns. No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) has been reported in the past week.
The total number of cVDPV2 cases reported in Niger was 9, which are genetically linked to a cVDPV2 outbreak originating in Jigawa, Nigeria. The virus was isolated from children with acute flaccid paralysis (AFP) from Zinder region, located in the south of Niger and on the border with Nigeria, with dates of onset of paralysis ranging from 18 July through 30 October 2018. Acute flaccid paralysis surveillance and routine immunization across the country with focus on the infected provinces and the provinces at the international borders with Nigeria are being reinforced.
Active case finding for additional AFP cases is continuing, and additional surveillance measures such as increasing the frequency and extent of environmental surveillance and community sampling of healthy individuals is being expanded. No cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) were reported this week in the Democratic Republic of the Congo (DRC). The total number of cVDPV2 cases reported in 2018 was 20.
DRC is affected by four separate cVDPV2 outbreaks, in the provinces of Haut Katanga; Mongala, Maniema and Haut Lomami/Tanganika/Haut Katanga/Ituri. Following the Kinshasa Declaration for Polio Eradication in July 2016, the two large scale vaccination rounds implemented during September and October 2018, demonstrated better vaccination quality. Planning is underway to maintain the gains made so far and maintain population immunity as well as sensitive surveillance across the country.
The polio outbreak response is being conducted simultaneously to an ongoing Ebola outbreak affecting North Kivu province, in the east of the country (close to provinces affected by cVDPV2). As in the past, the polio teams are coordinating closely with the broader humanitarian emergency network, to ensure both outbreaks are addressed in a coordinated manner (as was the case during the recent Ebola outbreak in Equateur province, which was successfully stopped). Partners of the Global Polio Eradication Initiative will continue to support authorities across the country, to ensure that this new level of commitment rapidly translates into operational improvements on the ground. Read our to see information on surveillance and vaccination campaigns. Learn more about through this short animation or this video. No circulating vaccine-derived poliovirus type 2 (cVDPV2) cases were reported in the past week.
The Horn of Africa is currently affected by separate outbreaks of circulating vaccine-derived poliovirus type 2 (cVDPV2) and type 3 (cVDPV3), reporting both cases and environmental positives. Somalia has reported a total of 12 cVDPV cases (five type 2, six type 3 and one, coinfection of both type 2 and type 3) in 2018. Circulating VDPV2 has also been detected during 2018 in one environmental sample in Kenya. Outbreak response to both virus types is currently being implemented in line with internationally-agreed guidelines. Large-scale supplementary immunization activities (SIAs) have been implemented in Banadir, Lower Shabelle and Middle Shabelle regions, Somalia. Another vaccination round is planned during end-November as part of the ongoing outbreak response, to further enhance the population immunity in the highest risk areas.
Special surveillance activities continue to be undertaken to determine the origin of the viral circulation. WHO and partners continue to support local public health authorities across the Horn of Africa in conducting field investigations and risk assessments. Read our and to see information on surveillance and vaccination campaigns. Learn more about through this short animation or this video.
No new cases of circulating vaccine-derived poliovirus type 1 (cVDPV1) were reported this week. The total number of cases in 2018 was 26. Emergency Operation Centres are established and operational at the national level and in all affected provinces; environmental surveillance is functional in five sites in two major cities. Three Supplementary Immunization Activities (SIAs) of expanding scope have taken place since late July, from three provinces to nine, to nation-wide.
The most recent was aimed at children under the age of 15, due to large numbers of poorly-immunized older children. Planning is underway for the next steps of the outbreak response, focusing on both vaccination and surveillance for polioviruses. Detection and reporting of new viruses or cases at this point in the outbreak response is not unusual or unexpected, as surveillance is being strengthened and most reported and confirmed cases had onset of paralysis prior to the start of comprehensive outbreak response. Read our country page to see information on surveillance and vaccination campaigns.