End Polio Now Position - 25th September 2018

Don’t forget polio – the polio viruses have not forgotten us.

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 25 September 2018
18 53
2017 to 26 September 2017 11 49
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: 18 cases in 2018

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.

WPV1 - 18 cases.

No cases reported this week.

The most recent WPV1 cases in each country were:

  • In Afghanistan – 11 August 2018 – 6 weeks since the onset of polio.
    • 14 cases in 2018 vs. 6 cases at the same time in 2017. Total of 14 cases in 2017.
  • In Pakistan – 1 August 2018 – 7 weeks since the onset of polio.
    • 4 cases in 2018 vs. 5 cases at the same time in 2017. Total 8 cases in 2017.
  • In Nigeria – 21 August 2016 – 109 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 - 53 cases in 2018

The virus is genetically changed from the weakened virus contained in OPV. Details of the most recent cases in each country are:

cVDPV1 - 14 cases

  • Two more cases this week in PNG. The total in 2018 is now 14.

  • Onset of paralysis of the most recent case - 13 August - 6 weeks ago.

 cVDPV2 - 33 cases

  • In Nigeria: 11 cases in 2018.
    • Onset of paralysis on 25 August 2018 – 5 weeks ago
  • In the DRC: 15 cases in 2018 vs. 22 cases in 2017.
    • Most recent case – 5 August 2018 – 7 weeks since the onset of polio.
    • Immunisation in neighbouring countries is being strengthened.
  • In Somalia: 5 cases in 2018. No cases in 2017.
    • Most recent onset of paralysis 30 July 2018 - 8 weeks ago.
  • In Syria: 0 cases in 2018
    • 74 cases in 2017. Arose after discovery of pockets of infection after the defeat of ISIS. There have been no cases since the outbreak last year.
    • Most recent case 21 September 2017 – or 48 weeks since the onset of polio.

cVDPV3 - 6 cases

  • In Somalia: 3 cases this week.
    • Onset of paralysis for the most recent case was 30 July – 8 weeks ago.
    • The first cases since July 2013 when there was one in the Yemen.

Confirmation of cVDPV environmental samples in Kenya have not isolated the virus from any AFP cases or their contacts.

 

Other comments (from the internet and other sources):

The Director of Expanded Programme on Immunisation in Pakistan has urged the media to support the eradication of polio, which has been declared national emergency programme by the government. At a media sensitisation workshop, journalists were invited to discuss this. The media can bridge the remaining gaps between government and public by educating and motivating parents and other segments of the society for polio and other immunisation services that are provided free of cost by the government. The efforts for polio eradication have brought the lowest case count since the launch of door-to-door polio vaccination campaign in 1994 and a last push was required to eliminate the poliovirus from the region. It was explained how the OPV and IPV vaccinations build gut and serum immunity and there is a need for repeated vaccination. The reporters are the eyes and ears of society and play a pivotal role in shaping the public opinion and the dream of polio-free Pakistan needs the support of the media. Pakistan and Afghanistan are the last reservoir countries of wild poliovirus and must eradicate polio together as it would be very difficult to stop virus circulation in one country while it was circulating in another due to heavy cross-border movement

Poliovirus that originated in the Northern Corridor in Afghanistan – Kandahar and Helmand – has been detected in Peshawar and other cities in Khyber Pakhtunkhwa. A total of 14 cases or samples have been reported near the border in Afghanistan where polio vaccination campaigns cannot be held in some provinces for security reasons. Children have to be vaccinated as long as the virus exists to keep their immunity levels high. The campaign is fully synchronised with Afghanistan to ensure effective vaccination of mobile children as well. It will target 38.6 million children under the age of five, including approximately 19.2m in Punjab, 8.9m in Sindh, 6.8m in KP, 2.5m in Balochistan, 700,000 in Azad Kashmir, 237,000 in Gilgit-Baltistan and 330,000 in Islamabad. Vitamin A supplement will also be administered to around 35m children aged between six and 59 months during this campaign along with the OPV, aimed at boosting immunity against all infection diseases including measles. A total of 260,000 personnel will participate in the campaign across the country. In 2013, the Syrian government had alleged that poliovirus that originated then in the Federally Administered Tribal Areas had been carried to Syria by Pakistanis who were fighting alongside rebels. (The area where the poliovirus originated can be detected through DNA testing.)

The European Union on Sunday announced it will contribute Euros 25 million (about $29 million) – in the form of a four-year grant – to help Afghani children on the move and to end polio. The four-year grant would enable UNICEF and partners to better reintegrate children on the move and to provide them with a protective environment. It would also support the endeavours to eradicate polio. The grant would provide opportunities to protect Afghan children on their migratory journey, increase their resilience by strengthening their coping mechanism including the provision of psychosocial support which would facilitate their reintegration into their communities. In Afghanistan, the complexity of the situation with increased violence, poverty and natural disasters, pushes children to migrate to Iran and other countries, and exposes them to abuse, neglect and exploitation during their migration journey. The unique feature of this grant is that it is an integrated two-country response that includes Iran and Afghanistan. It will strengthen cross-border information sharing, programme planning and response to safeguard the best interests of children. The grant will also contribute to the eradication of polio, where prioritization of children on the move between Pakistan and Afghanistan is a key strategy.


Reg Ling

Rotary Club of Chandler's Ford and Itchen Valley.

Rotary District 1110 (Central Southern England, the Channel Islands and Gibraltar).

Rotary Region 19 (Southern England and Gibraltar) End Polio Now Coordinator.

28 September 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.

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