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Rotary International is committed to continue the eradication of polio campaign until the WHO declares polio is eradicated. By this it means the interruption of the transmission of polio viruses for at least three years, in the presence of certified surveillance and when all polio virus stocks have been contained.

Global position:

  WPV1 cVDPV
2018 to 8 May 2018
8 4
2017 to 9 May 2017 5 0
2017 full year
22 96
2016 full year
37 5
2015 full year 74 32
2014 full year 359 56

 The emphasis now is on:

  • Monitoring the date of the most recent onset of paralysis and the number of weeks elapsed.
  • The most recent positive environmental samples and the immunisation response.

Wild Polio virus:

WPV1

For polio-free certification purposes the start date for WPV monitoring is that of the onset of paralysis. For positive environmental samples, the viral presence lasts for 7-14 days.

No WPV1 cases nor any WPV1 positive environmental samples were collected. Details of the most recent cases in each country are:

  • In Pakistan –  8 March 2018 – or 8 weeks since the onset of polio.
    • One case in 2018 vs. 2 cases at the same time in 2017. Total 8 cases in 2017.
    • During the last week bOPV immunisation reached over 20 million children.
  • In Afghanistan – 3 March 2018 - or 8 weeks since the onset of polio.
    • 7 cases in 2018 vs. 3 cases at the same time in 2017. Total of 14 cases in 2017.
    • During the last week the NIDs using bOPV reached over 9.6 million children.
  • In Nigeria – 21 August 2016 – or 89 weeks since the onset of polio.
    • No cases in 2018. No cases in 2017. Four cases in 2016.

WPV2

  • Declared eradicated September 2015. (Last case was in October 1999.)

WPV3

  • No cases reported since 10 November 2012. (That was in Nigeria.)

Circulating Vaccine Derived Polio Virus

The virus is genetically changed from the weakened virus contained in OPV. Three cVDPV2 positive environmental samples this week were confirmed in Nigeria. Details of the most recent cases in each country are:

cVDPV1

  • No cases in 2017. Three cases reported in Laos in 2016.

 cVDPV2

  • The DRC:
    • 22 cVDPV2 cases in 2017. Four cases in 2018.
    • Most recent case – 19 February 2018 – or 11 weeks since the onset of polio. Surveillance and immunisation in neighbouring countries are being strengthened.
  • In Syria: VDPV cases arose after discovery of pockets of infection after the defeat of ISIS
    • 74 cases in 2017. There have been no cases since the outbreak response.
    • Most recent case 21 September 2017 – or 32 weeks since the onset of polio.

cVDPV3

  • No cases since July 2013 when there was one in the Yemen. However, another two cVDPV3 samples were confirmed in Somalia last week following isolation of the virus from four environmental samples collected between 8-22 March from sites in Banadir province.

  • Earlier confirmation of cVDPV2 samples in Somalia, Kenya and in Nigeria and, this week, another sample in Somalia, have not isolated either cVDPV3 or cVDPV2 from AFP cases or their contacts. Rigorous outbreak response to both strains is being implemented.

 

Other comments (from the internet and other sources):

There were many interesting articles this week but I will content myself here with (the first part only):

Afghanistan battles polio: Rumours, mistrust, and negotiating with the Taliban.

Behind an iron gate in a mud-brick home in southern Afghanistan, one of the country’s newest polio patients is still learning how to walk.

Three-year-old Farid Ahmad teeters forward, his uncle hovering closely behind. “He is so weak, mainly his hands and legs,” Abdul Jalil says, watching as the boy roams unsteadily inside the family’s compound here in Spin Boldak District, which stretches to the Pakistan border in southern Afghanistan’s Kandahar Province. “Sometimes when he tries to walk, he falls down.” Abdul Jalil holds his nephew, Farid Ahmad, at their home in Spin Boldak in Afghanistan’s Kandahar Province. Farid was diagnosed with polio early in 2018. The child had been unable to sit up by himself at age one and only recently started learning to walk.

This week, Afghan authorities launched a new round of polio immunisations – the second nationwide campaign this year. They hope to reach more than 9.9 million children across the country with oral vaccines before the start of the polio “high season” in the warmer summer months, when the virus is most infectious. The front line of the push to wipe out polio runs through places like Kandahar. Here, hard-fought progress is fragile and easily jeopardised by mistrust, missed vaccinations, out-of-reach healthcare, a dearth of female healthcare workers, and pockets of insecurity – where access for vital immunisation programmes must be negotiated with militant groups like the Taliban.

The number of new polio cases recorded in Afghanistan has fallen from a high of 80 in 2011 to 14 last year. Half of last year’s cases were found here in Kandahar. And of the seven confirmed cases of polio recorded so far this year, Kandahar is home to four of the patients, including Farid.

The full article may be found at:

http://www.irinnews.org/feature/2018/05/10/afghanistan-battles-polio-rumours-mistrust-and-negotiating-taliban

In particular note the interactive graphical depictions of the WPV1 cases in the three endemic countries since the year 2000.

 

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 Zone Coordinator.

11 May 2018

Polio is a highly infectious, crippling and potentially fatal viral disease which mainly affects young children. 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 spread mainly through the faecal-oral route or, less frequently, by a common vehicle (e.g. contaminated water or food) and multiplies in the intestine, from where it can invade the nervous system and can cause paralysis. But, less than 1 in 200 infections leads to this. Of those paralysed, 5% to 10% die when their breathing muscles become immobilised.