Highlights and global details:
One WPV1 case has been reported from Karachi (pre-notified in the previous week) and four WPV1 positive environmental samples were collected in Pakistan with three of them also from Karachi.
| WPV | cVDPV | |
| 2017 to 5 September | 10 | 47 |
| 2016 to similar date | 23 | 3 |
| 2016 full year | 37 | 7 |
For polio-free certification purposes the start date for WPV monitoring is that of the onset of paralysis. The most recent WPV1 cases with onset of paralysis were:
• In Pakistan - 11 August 2017 or 4 weeks since the onset of polio.
• In Afghanistan – 10 July 2017 so 8 weeks since the onset of polio.
• In Nigeria - 21 August 2016 or 54 weeks since the onset of polio.
1. WPV1 cases:
• 4 cases in Pakistan vs. 13 cases at the same time in 2016.
• 6 cases in Afghanistan vs. 7 cases at the same time in 2016.
• No cases in Nigeria. There were 3 cases in Nigeria confirmed at this time last year.
• No other cases though there is much immunisation activity now in the Lake Chad countries following the Nigerian cases in August 2016.
Four WPV1 positive environmental samples were collected the week in Pakistan. The total number of samples collected in 2017 is 78 (The environmental presence of viral particles last for 7-14 days).
2. WPV2 cases:
• Declared eradicated September 2015. (Last case was in October 1999.)
3. WPV3 cases:
• No cases reported since 10 November 2012. (That was in Nigeria.)
The number of cases of cVDPV this year together with the dates of onset of paralysis for the most recent case are:
• In Syria 33 cases of cVDPV2 – 10 July 2017.
• In the DRC 7 cases of cVDPV2 – 13 June 2017.
1. cVDPV1 cases:
- No cases in 2017. Three cases reported in Laos in 2016. In 2015 there were ten cases in Madagascar, eight cases in the Lao Republic and two cases in the Ukraine.
2. cVDPV2 cases:
- Eight cases in total in DRC in two separate outbreaks:
o 6 cases in Haut Lomami province. The onset of paralysis of the most recent case was on 10 July.
o 2 cases in Maniema province. Onset of paralysis on 26 March and 18 April. - 39 cases in Syria.
o Thirty-seven cases are from Deir Ez-Zour governate. (29 from Mayadeen district.)
o One case from the Talabyad district in the Raqqa governate.
o One case from the Tadmour district in the Homs governate.
o All the Syrian cases had onset of paralysis between 3 March and 10 July. However the outbreak response in Syria is including immunisation of at-risk populations in northwest Syria, Turkey and Lebanon.
The WHO have indicated that for both the DRC and Syria the recent cVDPV2 cases reported should not have been unexpected and do not change the operational situation.
Polio is an infectious, crippling and potentially fatal disease. There is no cure, but there are effective vaccines. The strategy to eradicate polio is based on preventing infection by immunising every child until transmission stops and the world is polio-free. The source of polio virus transmission is infectious humans but only 1 in 200 infections leads to irreversible paralysis. Of those paralysed, 5% to 10% die when their breathing muscles become immobilised.
Other comments (from the internet and other sources):
There have been headline reports of the WPV1 case in Karachi which had previously been a key reservoir for WPV1 in Pakistan. The previous case from Karachi was in January 2016.
The other interesting reports have followed the celebration in Nigerian of having had no polio cases for over a year now. The Chairman of the Rotary International Polio Plus Committee, Michael McGovern, has disclosed that Rotary International has spent close to 1.7 billion US dollars on polio eradication with the largest funding being invested in Nigeria due to the size of the country, the quality of the program and number of children that need to be reached”. Mike McGovern noted that “despite the disappointment a year ago when four cases of wild poliovirus were detected in Borno”, the government rose to the challenge when it mounted robust national and international border campaigns. The Chairman expressed his appreciation to the government and partners for taking up the challenge in Borno very seriously stating “this is one of the real battle-fronts in the effort to eradicate polio.” The Team Leader of the WHO Expanded Programme Immunisation (EPI) Dr Fiona Braka while noting the progress that has been achieved in polio programme in Nigeria however disclosed the challenges currently facing the programme in the North East especially in areas of Borno “where accessibility is still a challenge”. She however disclosed that various innovations that include Reaching Every Settlement (RES), Reaching Inaccessible Communities (RIC) and transit point vaccinations are currently being implemented to reach children in areas that are inaccessible.
10 September 2017
Reg Ling
Rotary Club of Chandler's Ford and Itchen Valley.
Rotary District 1110 (Central Southern England and the Channel Islands).
Rotary Zone 18A (Southern England and Gibraltar) End Polio Now Coordinator (EPNC).