Highlights and global details:
No WPV cases reported this week but one WPV1 positive environmental sample was collected in Pakistan. For polio-free certification purposes the start date for WPV cases is from the onset of paralysis. In Syria however 3 cases of cVDPV2 were reported at the regional level and will be reflected at the global level in next week’s data.
| WPV | cVDPV | |
| 2017 to 25 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 6 weeks since the onset of polio.
• In Pakistan - 11 June 2017 or 7 weeks since the onset of polio.
• In Nigeria - 21 August 2016 or 49 weeks since the onset of polio.
1. WPV1 cases:
- 3 cases in Pakistan vs. 13 cases at the same time in 2016. Five country-wide vaccination campaigns have been held in Pakistan since October 2016, preparing for the 2017 c which runs from June until September.
- 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 68.
The six samples reported this week were all collected in July. (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.)
There were no cases of cVDPV this week, but note that in Syria 3 cases of cVDPV2 were reported at the regional level and will be reflected at the global level in next week’s data. The cases of cVDPV this year together with the most recent the dates of onset of paralysis were:
- 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:
- Four cases in total in DRC and 27 cases in Syria. 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):
An interesting article appeared recently in the New York Times about the Heroines of Polio Immunisation. Here are some abstracts from it:
• … as momentous as the (polio) gains are, victory over polio is not yet assured. And one factor – the role of female vaccinators – will be a critical determinant of success.
• … In places like the tribal areas of Pakistan, male vaccinators are often not allowed to enter a stranger’s home, whereas female health workers can deliver the vaccine to vulnerable children, along with other routine immunisations and basic health services.
• Where polio still persists – in Pakistan, Afghanistan, and Nigeria – vaccinators … work tirelessly to reach every child.
• According to the June 2017 report of the IMB, more than a million children remain unvaccinated, including 858,000 in Pakistan alone.
• The hardest-to-reach children in Pakistan are those on the move, travelling from relative to relative as families search for a better life, often crossing the Afghan border. While some of these children are vaccinated at border crossings, many are missed.
• The IMB is now calling for a new approach: finding the children not when they are in transit, but wherever they reside, no matter how short their stay. This strategy calls for deep local knowledge to anticipate when a child will return, so that a vaccinator can be there.
• In the Pakistani district of Kohat, south of Peshawar, female vaccinators have been credited with helping to lower the number of unvaccinated children from 30,000 to 22,000, and to reduce the number of vaccine refusals from around 4,000 to 400.
• Conversely, in Quetta, the area of Pakistan with the highest number of susceptible children, female vaccinators are in short supply, and turnover is high. There, the number of confirmed polio cases is (or has been) on the rise.
• These two cities tell the story of the polio eradication campaign: success, or failure, depends on the role that female vaccinators play.
• Since UNICEF began emphasizing the hiring of women for its polio program in 2014, the number of female vaccinators has increased dramatically. Nearly 62% of vaccinators in Nigeria are women. In Pakistan, the proportion of female vaccinators is 58%, and 30% in Afghanistan.
• Female vaccinators are not the only ones immersed in this global fight... and, of course, political commitments at the highest levels have kept the momentum going. But at the end of the day, women on the ground know their communities best, and are uniquely qualified to finish the job… governments and donors should support the women who will get the world across the finish line, to a world with zero polio cases – forever.
3 August 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).