End Polio Now Position - 18th July 2017

Highlights and global details:

One WPV1 case and one WPV1 positive environmental sample reported this week in Afghanistan. For polio-free certification purposes the start date is from the onset of paralysis. In Syria there have been another four cases of cVDPV2.

2017 to 18 July 8 31
2016 to similar date 19 3
2016 full year 37 7

The most recent WPV1 cases with onset of paralysis were:
•    In Afghanistan – 19 June 2017 so 4 weeks since the onset of polio.
•    In Pakistan - 11 June 2017 or 5 weeks since the onset of polio.
•    In Nigeria - 21 August 2016 or 47 weeks since the onset of polio.

1.    WPV1 cases:

•    3 cases in Pakistan vs. 13 cases at the same time in 2016. The latest figures I have are the 3 cases were confirmed from 3,883 specimens of infant acute flaccid paralysis and with another 469 specimens awaiting test. This is an aspect of how donations to polio eradication are used.
•    5 cases in Afghanistan vs. 6 cases at the same time in 2016.  
•    No cases in Nigeria. There were no cases in 2015 but cases were identified in 2016 as a result of new initiatives in the northern States where Boko Haram had made access difficult. No new cases since August 2016.
•    No other cases though there is much immunisation activity now in the Lake Chad countries following the Nigerian cases in August 2016.  From 25 to 28 March, synchronised polio campaigns took place across 13 countries in west and central Africa including Nigeria, Chad, Cameroon, Guinea, Mali and Niger. Over 190,000 vaccinators immunised more than 116 million children over the campaigns.

    The total number of WPV1 positive environmental samples collected in 2017 is 61.
    The most recent sample was collected on 21 June. (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.)

For cVDPV, the corresponding most recent dates for onset of paralysis are:

•    cVDPV2 27 cases in Syria – 6 June 2017.
•    cVDPV2 4 cases in DRC - 18 April 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:

•    In 2017 three separate outbreaks have occurred, two in the DRC and the other in Syria. Four cases in total in DRC and the most recent had outbreak of paralysis was 18 April. The Syrian count is now 27. This does not change the operational situation. All the Syrian cases had onset of paralysis between 3 March and 6 June.

Polio is a crippling and potentially fatal infectious disease. There is no cure, but there are safe and effective vaccines. The strategy to eradicate polio is therefore 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):

At the end of May 2017, more than 38 million children under the age of 5 were vaccinated against polio in Pakistan. During the campaign, over 250,000 trained polio workers went from house to house across the length and breadth of the country to vaccinate children against the crippling disease. This was one of five country-wide vaccination campaigns that took place during the 2016/2017 “low season” from October to May for poliovirus transmission when temperatures are low and the virus remains less active, giving polio eradication experts the opportunity to get ahead of the virus.

The end of the May polio campaign marked the start of the “high season” for poliovirus transmission. The ability of the poliovirus to infect children increases in high temperature and during heavy rainfall. As a result, viral circulation is expected to be higher from June to September. But, the total number of WPV1 cases in 2017 remains 3 from 3 districts (compared to 13 cases from 10 districts during 2016 at the same time).

Among 320 environmental samples processed for 2017, 49 (15%) are positive for WPV1.  The July SNID campaign phase-1 was completed last week in all planned districts, except one UC in Shikarpur (Sindh) due to the law and order situation. Total coverage for phase-1 is 6,125,108 (95%) out of the total 6,475,698 children targeted. Post campaign evaluations are underway for phase-1 districts. The Phase-2 campaign has been started in Balochistan and Karachi whereas Thatta, Sujawal and Badin (Sindh) have postponed the activity till 19th July due to heavy rainfalls. Quetta Block along with Mastung will conduct the campaign from
24-30 July.

20 July 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).    
Rotary Zone 18A (Southern England and Gibraltar) End Polio Now Coordinator (EPNC).