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Oct 7, 2013

GPEI Update: Polio this week - As of 02 October 2013

Global Polio Eradication Initiative
Full report:

:: Three wild poliovirus type 1 (WPV1) cases were reported from South Sudan this week. Genetic sequencing is underway to determine the origin of the isolated viruses and possible relation to the ongoing Horn of Africa outbreak. The cases are from North Bahr El Gazal state (close to the border to Sudan) and Eastern Equatoria state (close to the border with Kenya and Uganda). The cases have triggered a full outbreak response from the Global Polio Eradication Initiative (GPEI) operational perspective. For more information see the ‘Horn of Africa’ section below.
:: Eight new WPV cases were reported from north-west Pakistan. Seven are from the Federally Administered Tribal Areas (FATA) and one from Khyber Pakhtoon (KP). The majority (67%) of WPV from Pakistan this year are from FATA, the bulk of which are from North Waziristan (10) and Khyber (10).
:: Pakistan’s Prime Minister Nawaz Sharif reasserted Pakistan’s commitment to eradicate polio in a speech at the UN General Assembly on Friday 27 September 2013: “We have also made eradication of polio in Pakistan a matter of great importance for my Government, as we are determined to make Pakistan a polio free country.”

:: The Independent Monitoring Board met 1-2 October in London, UK. The IMB reviewed the latest epidemiology and programme developments. The next IMB report is expected to be issued within two weeks of the meeting…
:: On 26 September, the Polio Oversight Board (POB) met with donors and other key stakeholders to review progress against the GPEI’s Polio Eradication and Endgame Strategic Plan 2013-2018, launched earlier this year…[see full text of statement below]
:: Two new WPV cases were reported from two previously infected districts in the past week. The two cases were reported from Watapur district in Kunar province and Batikot, Nangahar province. The total number of WPV cases for 2013 is now six. All six are WPV1 and all reported from Eastern Region. The most recent WPV1 case had onset of paralysis on 27 August, from Kunar province…
:: Two new WPV cases were reported this week. The cases were reported from two previously infected districts, one from Bauchi Local Government Area (LGA) in Bauchi state and one from Bichi LGA in Kano state. The total number of WPV cases for 2013 is now 49 (all WPV1s). The most recent WPV1 case in the country had onset of paralysis on 10 September (from Kano)
:: Eight new WPV cases were reported in the past week. Seven of the cases were reported from FATA province (five from North Waziristan, one from Khyber and one from a newly infected district – FR Dikhan).
:: One WPV was reported in Peshawar, KP.
:: The total number of WPV1 cases for 2013 is now 36. Of these, the majority, 24 (67%), are from FATA, of which 10 are from North Waziristan and 10 from Khyber…
:: The situation in North Waziristan is particularly concerning, as it is in an area where immunizations have been suspended by local leaders since last June. 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.
:: The most recent cases in FATA underscore the risk of ongoing polio transmission (be it due to WPV or cVDPV) in this area and the threat it continues to pose to children everywhere, in particular to children living in areas where access has not been possible for extended periods of time. FATA is the major poliovirus reservoir in Pakistan and in Asia, with confirmed circulation of both WPV1 and cVDPV2. More than 350,000 children in this area are regularly missed in inaccessible areas, during immunization activities. Efforts are ongoing to curb transmission in this area, including through vaccination at transit points and conducting Short Interval Additional Dose (SIADs) campaigns in areas that have recently become accessible.
Chad, Cameroon and Central African Republic
:: …In Cameroon, one new cVDPV2 case was reported in Kolofata, Extreme-Nord in the past week. The total number of cVDPV2 cases for 2013 is now four. The most recent case had onset of paralysis on 12 August (from Extreme-Nord). NIDs are planned for 11-13 October.
:: Central African Republic (CAR) continues to be at serious risk of re-infection due to proximity with Chad, ongoing insecurity and humanitarian crises, and destruction of health infrastructure. :: To minimize the risk and consequences of potential re-infection, SNIDs were conducted 30 September – 2 October and NIDs are planned for end October.
Horn of Africa
:: Three cases were reported from North Bahr El Gazal and Eastern Equatoria areas over the past week, all three with onset of paralysis between 15-24 August. The new cases have triggered a full country outbreak response from a GPEI operational perspective.
:: South Sudan will launch immediate response covering children up to 15 years of age in the infected areas, targeting 140,000 children. This will be followed by a SNID in mid-October using bivalent oral polio vaccine (bOPV). Two national immunization days (NIDs) were already planned for November and December…
:: One new wild poliovirus case has been reported from the previously infected Somali region of Ethiopia. Onset of paralysis 7 September. No new WPV1 cases were reported from Somalia and Kenya in the past week. The total number of WPV1 cases for 2013 in the Horn of Africa is now 196 (175 from Somalia, 14 from Kenya, four from Ethiopia and three from South Sudan). The most recent WPV1 case in the region had onset of paralysis on 7 September (from Ethiopia).


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