3/05/2014

Polio this week. The data table below is as of 26 February 2014


Polio this week

The data table below is as of 26 February 2014


  • Seven new cases (six wild poliovirus type 1 - WPV1 - and one circulating vaccine-derived poliovirus type 2 - cVDPV2) are reported this week from Federally Administered Tribal Areas and Khyber Pakhtunkhwa in Pakistan. This area is largely considered the ‘engine’ for polio transmission in the country. See ‘Pakistan’ section below for more information.

Wild Poliovirus (WPV) cases


Total cases
Year-to-date 2014
Year-to-date 2013
Total in 2013 
Globally
24
5
404
- in endemic countries
24
5
160
- in non-endemic countries
0
0
245
  

Case breakdown by country



Countries
Year-to-date 2014
Year-to-date 2013

Total in
 2013
Date of most  
 recent case
 WPV1 WPV3  W1W3 Total  WPV1 WPV3 W1W3 Total 
Pakistan21  212 29310-Feb-14
Afghanistan3  31  11431-Jan-14
Nigeria  02 25315 -Dec-13
Cameroon  0   0430-Oct-13
Somalia  0

 019320-Dec-13
Syria  0   02417-Dec-13
Ethiopia     0
  095-Nov-13
Kenya  0   01414-Jul-13
Total24002450 5404
Total in endemic countries     240024505160  
 Total outbreak0   0  000000244 

Data in WHO as of 26 February 2013 for 2013 data and 25 February 2014 for 2014 data.

Afghanistan

  • No new WPV1s were reported in the past week. The total number of WPV1 cases for 2013 is 14, and three for 2014.
  • The most recent WPV1 case had onset of paralysis on 31 January 2014 from Kunar province, Eastern Region.
  • No new 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) using bivalent OPV were completed on 9-11 February in selected southern and eastern districts, and in larger areas in the eastern and southern parts of the country, as well as Kabul city, on 23-25 February (a mop-up was held on 16-18 February in Badakhshan in the north of the country).

Nigeria

    • No new WPV cases were reported this week. The total number of WPV cases for Nigeria 2013 remains 53 (all WPV1). The most recent WPV1 case in the country had onset of paralysis on 15 December and was reported from Damboa, Borno.
    • No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2013 remains 4. The most recent cVDPV case had onset of paralysis on 24 December (from Maiduguri, Borno), linked to previous transmission in Chad from 2013.
    • Of the country’s 53 WPV1 cases in 2013, only six were reported since September, traditionally the ‘high season’ for polio transmission. Four of these are from Kano.
    • SNIDs were conducted on 25-28 January. NIDs are planned for March.

    Pakistan

    • Six new WPV1 cases were reported in the past week, five from North Waziristan, FATA and one from Peshawar, Khyber Pakhtunkhwa (KP). The total number of cases for 2013 remains 93. The total number of cases in 2014 is now 21. The most recent case had onset of paralysis on 10 February (WPV1 from Peshawar).
    • One new cVDPV2 case was reported in the past week, from FR Bannu, FATA, with onset of paralysis on 27 January. It is the most recent cVDPV2 case in the country. The total number of cVDPV2 cases for 2013 is 45, and four for 2014.
    • North Waziristan is the district with the largest number of children being paralyzed by poliovirus in the world (both wild and cVDPV2). Immunization activities have been suspended by local leaders since June 2012. It is critical that children in all areas are vaccinated and protected from poliovirus. 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 densely populated Peshawar valley is considered to be the main 'engine' of poliovirus transmission, alongside North Waziristan, due to large-scale population movements through Peshawar from across this region, and into other areas of Pakistan. The quality of operations must be urgently improved in Peshawar, and immunizations resumed in North Waziristan.
    • However, at the same time, concerning trends have been noted in greater Karachi, Sindh and in Quetta, Balochistan. Environmental positives isolates from every major city of Punjab confirm widespread virus circulation.

    Central Africa

    • In Cameroon, no new WPV1 cases were reported in the past week. The total number of WPV1 cases for 2013 remains four. The most recent case in Cameroon had onset of paralysis on 30 October (WPV1 from Ouest).
    • No new cVDPV2 cases were reported in the past week in Cameroon. The total number of cVDPV2 cases for 2013 remains four. The most recent case had onset of paralysis on 12 August (from Kolfata, Extreme-Nord).
    • NIDs were conducted in Cameroon 16-19 January and again 6-10 February. Further campaigns are planned for end-February.
    • 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).
    • NIDs were conducted in Chad from 22-24 November. Further NIDs are planned for 28 February-2 March with trivalent OPV. These activities will be critical, in particular given the confirmation in early February of a new cVDPV2 in neighbouring Borno, Nigeria (onset of paralysis: 24 December 2013), linked to transmission of this virus in Chad in 2013. 

    Horn of Africa

    • One new WPV1 case was reported from Somalia in the past week, with onset of paralysis on 19 June 2013. The case was reported late due to laboratory processing backlog.
    • The total number of WPV1 cases in the Horn of Africa is now 216 (193 from Somalia, 14 from Kenya and nine from Ethiopia). The most recent WPV1 case in the region had onset of paralysis on 20 December 2013 (from Bari, Somalia).
    • Outbreak response across the Horn of Africa is continuing. Recommendations from the recently held Horn of Africa Technical Advisory Group (TAG) are now actively being incorporated into outbreak response planning. The TAG had underscored that the initial response to the outbreak was appropriate, however expressed grave concern that gaps in SIA quality and surveillance remained in key infected areas of the region. Consequently, the group concluded there is a serious risk of the outbreak continuing and of further spread both within and beyond countries of the Horn of Africa. The group recommended that infected countries should focus efforts on high-risk and infected areas, by conducting high-quality SIAs no more than four weeks apart.

    Israel and West Bank and Gaza

    • WPV1-positive samples have been detected by environmental surveillance in Israel since 3 February 2013 and continue to be detected in 2014 (14 samples collected in 2014, the most recent on 2 February).
    • Since 2005, only inactivated polio vaccine (IPV) has been used for routine childhood immunization in Israel. To interrupt WPV1 transmission, a nationwide supplementary immunization activity (SIA) with bivalent OPV targeting children < 10 years of age was conducted from August to October.
    • Following a consultation with the country's immunization advisory group, the Israeli Ministry of Health has decided to re-introduce OPV into the national immunization schedule.
    • Positive environmental samples have also been detected in West Bank and Gaza Strip, the most recent positive sample was collected on 20 August 2013.
    • SIAs in West Bank and Gaza Strip were conducted 8-15 December and 8-15 January.

    Middle East

    • No new WPV1 cases were reported in the past week. The total number of laboratory-confirmed WPV1 cases is 24. The most recent case had onset of paralysis on 17 December and was reported from Mara, Edleb governorate.
    • Additionally, there are 13 cases confirmed from contested areas but not yet reflected in official figures.
    • In the Middle East, a comprehensive outbreak response continues to be implemented across the region. The most recent SIAs in Syria were held in early January and early February. Initial reporting indicates that over three million children were reached during both SIAs, with OPV reaching most if not all districts, and coverage attaining more than 85% in all but three governorates.
    • WHO and UNICEF are committed to working with all organizations and agencies providing humanitarian assistance to Syrians affected by the conflict. This includes vaccination of all children no matter where they are, whether in government or contested areas, or outside Syria.
    • The WHO/UNICEF Strategic Plan for Polio Outbreak Response in the Middle East outlines the action plan for Syria and neighbouring countries in response to the circulation of wild poliovirus following importation. The objective is to stop the outbreak in Syria by the end of March 2014 and prevent any further international spread.

    West Africa

    • • No new WPV cases were reported in the past week. The most recent case in the region was due to WPV1 from Tahoua province in Niger with onset of paralysis on 15 November 2012. 
      • No new cVDPV2 cases were reported in the past week from Niger. The country has reported a single case of cVDPV2 in 2013, with onset of paralysis on 11 July. Genetic sequencing has shown that the virus is related to that seen in Cameroon, Chad and Nigeria (Borno). 
      • National campaigns were conducted in West Africa 22-25 November. Further national campaigns are planned for 13-16 March in Niger and April and May (multi-country).

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