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.
Principal polio focus: (Where GPEI surveillance and immunisation activities continue)
No new WPV1 cases reported in either Pakistan or Afghanistan. However, five WPV1 positive environmental samples were collected, one in Pakistan and four in Afghanistan. In Syria seven cVDPV2 cases were reported all from the Deir Ez-Zor governate but no positive environmental samples were collected. (For positive environmental samples, the viral environmental presence lasts for 7-14 days.)
| WPV1 | cVDPV2 | |
| 2017 to 21 November | 15 | 80 |
| 2016 to similar date | 33 | 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 by country with onset of paralysis were:
- In Afghanistan – 17 October 2017 - so 5 weeks since the onset of polio.
- 10 cases in 2017 vs. 12 cases at the same time in 2016.
- Three WPV1 positive environmental samples were collected this week in Kandahar province, and one sample was collected in Kabul province.
- In Pakistan - 21 August 2017 - 13 weeks since the onset of polio.
- 5 cases in 2017 vs.17 cases at the same time in 2016.
- The round of NIDs scheduled for this week aims to reach about 37 million children to protect them from polio.
- In Nigeria - 21 August 2016 - 65 weeks since the onset of polio.
- No cases in 2017 vs. 4 cases at the same time in 2016.
- Continues to implement the emergency response.
The numbers of cases of cVDPV2 this year and the dates of onset of paralysis are:
- In Syria - 9 September 2017 – or 11 weeks since the onset of polio.
- 70 cases in 2017 vs. no cases at the same time in 2016. Genetic sequencing puts the initial infection to before the switch from tOPV to bOPV.
- Until this week most of the cases had occurred before the outbreak response started. The bulk of the cases have been from Deir Ez-Zor governate. (Most from Mayadeen district and some in the Boukamal district.) Other cases have been from the Talabyad district in the Raqqa governate and the Tadmour district in the Homs governate.
- A third mass immunisation round with mOPV2 in areas where evidence of virus transmission continues. One million doses of mOPV2 and 500,000 doses of IPV are being processed to ensure readiness for the second phase of the outbreak response. SNIDs with bOPV started this week in areas of Rural Damascus, districts of Damascus, Homs, Aleppo and accessible areas of Deir EzZor city. Children aged 2-23 months will also be reached with IPV and particularly in areas with large IDP populations. Upgrade of laboratory in-country facilities and the establishment of environmental surveillance continue.
- In the DRC - 14 September 2017 or 10 weeks since the onset of polio
- 10 cases this year but the most recent case in Haut Lomami province was linked to the case on 27 July which was 17 weeks since the onset of polio.
- 2 cases in Maniema province. Onset of paralysis for the first was 26 March and the second 18 April.
Other polio activity positions: (Where no activity beyond surveillance is expected.)
WPV2 cases:
- Declared eradicated September 2015. (Last case was in October 1999.)
WPV3 cases:
- No cases reported since 10 November 2012. (That was in Nigeria.)
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.
Other comments (from the internet and other sources):
A selection of the current country surveillance counts for comparison are:
|
Surveillance by country 23 November 2017 |
AFP specimens tested |
Polio virus confirmed |
| Afghanistan | 2,638 | 10 WPV1 |
| India | 33,599 | none |
| Nigeria | 15,398 | none |
| Pakistan | 8,280 | 5 WPV1 |
| DRC | 1,567 | 10 cVDPV2 |
| Syria | 348 | 70 cVDPV2 |
| World wide total | 88,106 |
15 WPV1 80 cVDPV2 |
At the recent RIBI Rotary Foundation Committee meeting in Alcester, the Rotary Club of Doncaster St Leger polio education pack for use in schools was a talking point. This has been created to fit well with the English school curriculum. The pack consists of a short animated video (featuring two fingerprint friends Indigo and Violet), fact sheets and quizzes. This pack was produced for use in District 1220 so supplies are limited. If you wish to know more please contact me and I will steer your enquiries to Peter Moralee who is the Zone 17 ARRFC with a liaison role with District 1220.
23 November 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).