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SASTM Newsflash - Poliomyelitis update: Somalia and Global update on the polio eradication initiative

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POLIOMYELITIS UPDATE: SOMALIA AND GLOBAL

 

UPDATE ON THE POLIO ERADICATION INITIATIVE

 

Wild poliovirus in Somalia

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An investigation has been launched into a preliminary report of the detection of a wild poliovirus type 1 (WPV1) in the Banadir region of Somalia. This is the 1st WPV to be reported from Somalia since [25 Mar 2007]. The virus was isolated from specimens collected on [21 Apr 2013] from a 32-month-old girl, who became ill due to acute flaccid paralysis on [18 Apr 2013], and from specimens collected from 3 of her close contacts.

 

An investigation team is on site; genetic sequencing of the virus is ongoing to determine its origin. The preliminary results of these investigations will be reported as soon as possible.

 

Given that substantial areas of central and southern Somalia have not conducted vaccination activities since 2009, the confirmation of WPV circulation would constitute a serious national and international risk to public health.

 

A surveillance alert, highlighting the need for urgent active searches for additional cases of acute flaccid paralysis (AFP) and suspect polio in all health facilities, has been issued for all of Somalia and bordering areas of northern Kenya and eastern Ethiopia. All countries in the WHO Regions of Africa and the Eastern Mediterranean are advised to heighten their surveillance for poliovirus.

 

An immediate vaccination response with oral polio vaccine (OPV) is being planned to begin on 14-16 May [2013] to reach more than 350 000 children under the age of 5 in all the 16 districts of Banadir region, with a series of subsequent activities, including nationwide OPV campaigns, under discussion.

 

WHO's International Travel and Health recommends that all travellers to and from polio-infected areas be fully vaccinated against polio.

 

Global update: Polio Eradication Initiative

 

Global Polio Eradication Initiative update as of 8 May 2012

 

Two new wild poliovirus (WPV) cases are officially reported this week [week of 8 May 2013], both from Nigeria, bringing the total number of WPV cases in 2013 to 26 (compared to 53 at this time last year [2012]). Additionally, a new circulating vaccine-derived poliovirus type 2 (cVDPV2) case is reported in Pakistan.

 

Afghanistan

 

No new WPV cases were reported in the past week. The total number of WPV cases for 2013 remains 2. The most recent WPV case had onset of paralysis on [28 Mar 2013] (WPV1 from Kunar).

No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases in 2013 remains 3. The most recent cVDPV2 case had onset of paralysis on [13 Mar 2013] (from Kandahar).

 

Nigeria

 

Two new WPV cases were reported in the past week (WPV1s from Kano and Taraba), bringing the total number of WPV cases for 2013 to 18. The case from Kano is the most recent WPV case in the country, and had onset of paralysis on [12 Apr 2013].

No new cases of cVDPV2 were reported in the past week. The most recent cVDPV2 case had onset of paralysis on [24 Nov 2012] (from Kebbi).

 

Pakistan

 

No new WPV cases were reported in the past week. The total number of WPV cases for 2013 remains 6. The most recent WPV case had onset of paralysis on [22 Mar 2013] (WPV1 from Sindh). One new cVDPV2 case was reported in the past week, bringing the total number of cVDPV2 cases in 2013 to 3. It is the most recent

cVDPV2 case in the country, and had onset of paralysis on [10 Apr 2013] (from Federally Administered Tribal Areas, FATA). This latest cVDPV2 case is from North Waziristan, an area where immunizations have been suspended by local leaders since last June [2012]. To minimize the risk of an outbreak in this area, it is critical that access to children is granted as quickly as possible. 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.

Genetic sequencing has confirmed that this cVDPV2 case is linked to the ongoing outbreak previously restricted to Balochistan and parts of Karachi, resulting in 19 cases in Pakistan since middle of last year [2012]. In 2012, this strain had also spread into Afghanistan, causing 12 cases there since August [2012].

Pakistan is also affected by transmission of WPV1, with 6 cases this year (compared to 13 cases for the same period in 2012). Wild poliovirus type 3 has not been detected in the country in more than 12 months (since April 2012, from Khyber Agency, FATA). Confirmation of this latest cases underscores the risk ongoing polio transmission (be it due to WPV or cVDPV) in the country continues to pose to children everywhere, and in particular to children living in areas where access has not been possible for extended periods of time. One new positive environmental sample was confirmed this week (WPV1, collected on [10 Apr 2013]), from Hyderabad, Sindh. This year [2013], 14 environmental samples positive for WPV1 have been reported, most from Peshawar, Khyber Pakhtunkhwa, and Hyderabad.

The security situation continues to be monitored closely, in consultation with law enforcement agencies. Immunization activities continue to be implemented, in some areas staggered or postponed, depending on the security situation at the local level.

 

Chad

 

No new WPV cases were reported in the past week. The most recent WPV case had onset of paralysis on [14 Jun 2012] (WPV1 from Lac). No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2013 remains one (onset of paralysis on [4 Feb 2013] from Salamat).

 

Horn of Africa

 

No new cases were reported in the past week. The most recent case was a cVDPV2 case from Somalia, with onset of paralysis on [9 Jan 2013]. Outbreak response is continuing in various parts of the Horn of Africa, in response to the ongoing cVDPV2 outbreak in south-central Somalia. Staggered SNIDs are being implemented in parts of Somalia throughout May [2013].

 

West Africa

 

No new WPV cases were reported in the past week. The most recent case in the region was a WPV1 from Tahoua province in Niger with onset of paralysis on [15 Nov 2012]. It is the only case in the region in 2012 (barring Nigeria), and has been covered by 3 immunization campaigns.

 

Communicated by: ProMED-mail

 

The occurrence of confirmed WPV1 cases in Somalia after 6 years of no documented WPV transmission is an unfortunate situation, yet unfortunately not surprising, given the information that there are areas in central and southern Somalia that have not conducted vaccination activities since 2009 (the Banadir region of Somalia is located to the south of Mogadishu in the central region of Somalia combined with continued circulation of WPV in Afghanistan, Nigeria, and Pakistan.

 

The continued insecurities due to civil unrest in the 3 remaining polio endemic countries -- Afghanistan, Nigeria, and Pakistan -- leading to limited to no vaccination activities in geographic areas of high insecurity, are keeping obstacles in the way of achievement of global interruption of WPV transmission.

 

We await information on the genetic sequencing of the WPV1 involved in Somalia.

 

 


 

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The information provided in SASTM Newsflashes is collected from various news sources, health agencies and government agencies. Although the information is believed to be accurate, any express or implied warranty as to its suitability for any purpose is categorically disclaimed. In particular, this information should not be construed to serve as medical advice for any individual. The health information provided is general in nature, and may not be appropriate for all persons. Medical advice may vary because of individual differences in such factors as health risks, current medical conditions and treatment, allergies, pregnancy and breast feeding, etc. In addition, global health risks are constantly evolving and changing. International travelers should consult a qualified physician for medical advice prior to departure.

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