Dec 9, 2019

Health Ministry denies #polio cases caused by vaccination




HEALTH MINISTER, SILVIA LUTUKUTA, LAUNCHES NEW IMMUNISATION CAMPAIGN AGAINST POLIO. 
PHOTO: ANTÓNIO ESCRIVÃO
In view of news published in the social media, which state that the oral polio antidote being administered has been causing children to acquire the polio disease instead of immunising them, the Health Ministry has responded categorically that these allegations do not correspond to the truth.
“After the finding of new cases of poliomyelitis in May this year vaccination campaigns were held to block its progression (...)”, reads the note issued by the Health Ministry.
The note states also that so far 49 cases were recorded and 4.5 million children bellow the age of five were immunised and in no area covered by the vaccination campaign has been recorded new polio cases.  
This shows that the vaccination programme has actually been avoiding the propagation of the illness, reads the document.
The Health Ministry calls on the citizens to continue to join the vaccination campaign against poliomyelitis, stressing that this is the most effective way to protect children against this illness.
The present vaccination campaign takes place after eighteen new polio cases were recorded four months ago, with major incidence in the eastern provinces of Lunda Norte, Lunda Sul and Moxico.
Luanda Province recorded one case.
Poliomyelitis is an infectious disease caused by a virus that attacks the nervous system and can provoke paralysis of the limbs.





































Post Polio Litaff, Association A.C _APPLAC Mexico

Even one polio case is an outbreak




KUALA LUMPUR (Bernama): The three-month-old infant from Tuaran, Sabah who contracted polio was under-immunised with polio vaccine and was thus not protected, says consultant paediatrician and clinical immunologist Datuk Dr Musa Mohd Nordin.

According to the Malaysian National Immunisation Schedule, infants are to receive the inactivated polio vaccine (IPV) at ages two months, three months and five months. A booster shot also needs to be administered when the child is 18-months-old in order to be fully protected.

However, the infected infant had only received the first dose of polio immunisation, making him under immunised, said Dr Musa.

A statement by the Health Ministry on Sunday (Dec 8) revealed that the baby was admitted to the intensive care unit of a hospital there before being diagnosed with vaccine-derived poliovirus type 1 (VDPV1) on Friday (Dec 6).

"I suspect he acquired the VDPV1 from the environment via contaminated water or food or because of poor sanitation. (The virus was) most probably imported from the Philippines since the genetic lineage of the VDPV1 was similar to the one found during the outbreak in that country,” he told Bernama in an email interview.

This is the first polio case in the country in 27 years.
Health Minister Datuk Seri Dr Dzulkefly Ahmad on Monday said that the infant was already ill when he received the second dosage of the polio vaccine, which was supposed to have an immunisation rate of between 60 to 80 per cent.

"The first dosage has about 30 to 40 per cent immunity against the virus,” he said.

WHAT IS VACCINE-DERIVED POLIO?

Vaccine-derived polio is related to the use of the oral polio vaccine (OPV). According to WHO, OPV contains a weakened vaccine-virus that activates an immune response in the body. When a child is immunised with OPV, the weakened vaccine-virus replicates in the intestine for a limited period, thereby developing immunity by building up antibodies. During this time, the vaccine-virus is also excreted.

The WHO website explains: "In areas of inadequate sanitation, this excreted vaccine-virus can spread in the immediate community before eventually dying out. However, if a population is seriously under-immunised, an excreted vaccine-virus can continue to circulate for an extended period of time. The longer it is allowed to survive, the more genetic changes it undergoes. In very rare instances, the vaccine-virus can genetically change into a form that can paralyse - this is what is known as a circulating vaccine-derived poliovirus (cVDPV).”

The IPV, on the other hand, does not contain live virus, so people who receive this vaccine do not shed the virus or infect others. The vaccine also cannot cause disease.

Given the risks associated with the administration of OPV, why do some countries still use it?

"OPV is cheap, easy to administer and excellent at both protecting the individual and the community,” said Dr Musa.

He said that since 1988, the administration of OPV has helped to decrease the burden of polio by 99.9 per cent - from 350,000 cases to less than 120 wild polio cases in 2019.

"The downside is that it is excreted in the stool and survives for six weeks in the environment. This live-attenuated (weakened) vaccine poliovirus may mutate and regain its neuro-virulence and infect the unimmunised child.

"Since 2000, 10 billion doses of OPV have been used worldwide, preventing 13 million polio cases. Only less than 750 cases of VDPV have been reported,” he revealed.

Malaysia has also been administering the OPV up until 2008 when it started using the IPV.

"Part of the endgame strategy of polio eradication is to shift from OPV to IPV to reduce the risk of VDPV and vaccine-associated paralytic poliomyelitis to zero,” said Dr Musa.

ARE WE PROTECTED?

Dr Musa said that at least 95 per cent of the community need to be immunised against polio in order to be protected from the crippling disease.

"The IPV as part of the five-in-one combination (shots) provided by the Health Ministry is an excellent vaccine. Apart from polio, it also protects from diphtheria, pertussis, tetanus and haemophilus influenza B,” he said.

Although the uptake of the third dose of the polio vaccine in Malaysia is in excess of 95 per cent, said Dr Musa, there are still pockets of communities where the coverage is low due to either refusal of the vaccine or the failure to access these groups, which include migrants or the stateless.

Health director-general Datuk Dr Noor Hisham Abdullah on Sunday said that as of Dec 5, investigations into polio-infected children living in Sabah had found that 23 out of 199 children (11.6 per cent), aged between two months and 15 years, had not received the polio vaccine.

He said that environmental monitoring in high-risk areas such as settlements of foreign nationals from countries with polio should be expanded while ensuring that polio immunisation coverage exceeds 95 per cent in all localities in Malaysia at all times.

For the state of Sabah, which is closest to the Philippines, high immunisation coverage is essential to protect children from polio infection, said Dr Noor Hisham.

In July, the Philippines' Ambassador to Malaysia Charles C. Jose told a local English daily that there were between 400,000 and 500,000 illegal Filipino workers in Sabah.

Meanwhile, Dr Musa said that just a single case of polio was indicative of the severity of the situation.

"Even one case of polio equals an epidemic. A comprehensive outbreak response must be undertaken to immunise and protect the community to prevent the spread.

"There is no cure for polio but there is an effective and safe vaccine to prevent it.”- Bernama

Post Polio Litaff, Association A.C _APPLAC Mexico

Circulating vaccine-derived poliovirus type 1 – The Philippines


Disease outbreak news: Update 
23 October 2019
On 27 September 2019 , a circulating vaccine-derived poliovirus type 1 (cVDPV1) has been confirmed in environmental samples in Philippines. 
The virus has been isolated from ten environmental samples, all genetically related, which were collected from one sewage collection site and its tributary pumping stations in Manila, between 1 July and 23 September 2019. This sewage collection site in the city of Manila has a catchment area of over 600,000 people. 
Vaccine-derived polioviruses are rarely occurring forms of the poliovirus that have genetically changed from the attenuated (weakened) virus contained in oral polio vaccine. They only occur when the vaccine virus is allowed to pass from person to person for a long time, which can only happen in places with limited immunization coverage and inadequate sanitation and hygiene. Over time, as it is passed between more unimmunized people, it can regain the ability to cause disease. When the population is fully immunized with both oral polio vaccine and inactivated polio vaccine, this kind of transmission cannot take place. The gut immunity in people immunized with oral polio vaccine stops the virus from being passed on. Full immunization therefore protects against both vaccine-derived and wild polio viruses. 
Philippines reported it’s last indigenous wild poliovirus in 1993 and the country is currently having an ongoing circulating vaccine derived poliovirus type 2 (cVDPV2) outbreak since September 2019. There has been persistently suboptimal immunization coverage for oral polio vaccine (OPV) and inactivated polio vaccine (IPV) in the country: 66% and 41% respectively in 2018.

Public health response

The Department of Health is coordinating the response activities, with the support of partners including the Global Polio Eradication Initiative (GPEI) and WHO. Public health response measures include:
  • Outbreak response with bivalent OPV in the National Capital Region, strengthened routine immunization activities including inactivated polio vaccine (IPV) and strengthening of acute flaccid paralysis (AFP) and environmental surveillance.
  • Polio outbreak investigation to determine the number and characteristics of cases and the context for environmental isolates, along with determining the geographic extent and assessing the risk of further transmission.
  • Ongoing retrospective records review in health facilities to identify AFP cases for investigation.

WHO risk assessment

Given the subnational surveillance and immunity gaps and high levels of population movement within the country, the risk of national spread associated with this confirmed cVDPV1 is considered to be high. 
The country is currently being affected by an ongoing cVDPV2 outbreak (Please see the Disease outbreak news published on 24 September 2019).

WHO advice

Countries, territories and areas should maintain uniformly high routine immunization coverage at the district level to minimize the consequences of any possible polio virus introduction or transmission. It is important that all countries, in particular those with frequent travel links and contacts with polio-affected countries and areas, strengthen surveillance for AFP cases in order to rapidly detect any new virus importation and to facilitate a rapid response. 
WHO’s International Travel and Health recommends that all travellers and residents in polio-affected areas be fully vaccinated against polio. Residents (and visitors for more than 4 weeks) from infected areas should receive an additional dose of oral polio vaccine (OPV) or inactivated polio vaccine (IPV) within 4 weeks to 12 months of travel. 
As per the advice of an Emergency Committee convened under the International Health Regulations (2005), efforts to limit the international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC). Countries affected by poliovirus transmission are subject to Temporary Recommendations . To comply with the Temporary Recommendations issued under the PHEIC, any country infected by poliovirus should declare the outbreak as a national public health emergency and consider vaccination of all international travellers.
Post Polio Litaff, Association A.C _APPLAC Mexico

Nigerians living in poverty rise to nearly 61%





Nigeria is Africa's biggest oil producer and among the biggest in the world but most of its people subsist on less than $2 a day.

 The oil is produced in the south-east and some militant groups there want to keep a greater share of the wealth which comes from under their feet. Attacks by militants on oil installations led to a sharp fall in Nigeria's output during the last decade. But in 2010, a government amnesty led thousands of fighters to lay down their weapons.
Nigerians living in poverty  rise Poverty has risen in Nigeria, with almost 100 million people living on less than a $1 (£0.63) a day, despite economic growth, statistics have shown.
The National Bureau of Statistics said 60.9% of Nigerians in 2010 were living in "absolute poverty" - this figure had risen from 54.7% in 2004.
The bureau predicted this rising trend was likely to continue.
Nigeria is Africa's biggest oil producer but the sector has been tainted by accusations of corruption.
According to the report, absolute poverty is measured by the number of people who can afford only the bare essentials of shelter, food and clothing.
North-south divide

The NBS, a government agency, said there was a paradox at the heart of Nigeria as the economy was going from strength to strength, mainly because of oil production - yet Nigerians were getting poorer.
"Despite the fact that the Nigerian economy is growing, the proportion of Nigerians living in poverty is increasing every year, although it declined between 1985 and 1992, and between 1996 and 2004," head of the NBS bureau Yemi Kale said.
Nigeria's population in poverty

1980: 17.1 million
1985: 34.7 million
1992: 39.2 million
1996: 67.1 million
2004: 68.7 million
2010: 112.47 million

Source: Nigeria's National Bureau of Statistics
Oil accounts for some 80% of Nigeria's state revenues but it has hardly any capacity to refine crude oil into fuel, which has to be imported.
Last month, there was a nationwide strike when the government tried to remove the subsidy on fuel, angering many Nigerians who see it as the only benefit they received from the country's vast oil wealth.
The NBS said that relative poverty was most apparent in the north of the country, with Sokoto state's poverty rate the highest at 86.4%.
In the north-west and north-east of the country poverty rates were recorded at 77.7% and 76.3% respectively, compared to the south-west at 59.1%.
BBC Africa analyst Richard Hamilton says it is perhaps no surprise that extremist groups, such as Boko Haram, continue to have an appeal in northern parts of the country, where poverty and underdevelopment are at their most severe.
The report also revealed that Nigerians consider themselves to be getting poorer.
In 2010, 93.9% of respondents felt themselves to be poor compared to 75.5% six years earlier.
Mr Kale says releasing such statistics from time to time is crucial for effective government planning.
"This kind of data helps them to know what is really happening so they can track their policies and programmes," he told the BBC's Focus on Africa programme.
"It gives them the opportunity to look at what they are doing... and if there are areas they need to change, it makes it easier to modify strategies," he added.
Nigeria: A nation divided




Despite its vast resources, Nigeria ranks among the most unequal countries in the world, according to the UN. The poverty in the north is in stark contrast to the more developed southern states. While in the oil-rich south-east, the residents of Delta and Akwa Ibom complain that all the wealth they generate flows up the pipeline to Abuja and Lagos.



Nigeria's 160 million people are divided between numerous ethno-linguistic groups and also along religious lines. Broadly, the Hausa-Fulani people based in the north are mostly Muslims. The Yorubas of the south-west are divided between Muslims and Christians, while the Igbos of the south-east and neighbouring groups are mostly Christian or animist. The Middle Belt is home to hundreds of groups with different beliefs, and around Jos there are frequent clashes between Hausa-speaking Muslims and Christian members of the Berom community.




Female literacy is seen as the key to raising living standards for the next generation. For example, a newborn child is far likelier to survive if its mother is well-educated. In Nigeria we see a stark contrast between the mainly Muslim north and the Christian and animist south. In some northern states less than 5% of women can read and write, whereas in some Igbo areas more than 90% are literate.




Nigeria is Africa's biggest oil producer and among the biggest in the world but most of its people subsist on less than $2 a day. The oil is produced in the south-east and some militant groups there want to keep a greater share of the wealth which comes from under their feet. Attacks by militants on oil installations led to a sharp fall in Nigeria's output during the last decade. But in 2010, a government amnesty led thousands of fighters to lay down.


Nigeria's population in poverty

  • 1980: 17.1 million
  • 1985: 34.7 million
  • 1992: 39.2 million
  • 1996: 67.1 million
  • 2004: 68.7 million
  • 2010: 112.47 million
Source: Nigeria's National Bureau of Statistics


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