No events found

Home

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)

This week no WPV1 cases were reported but 4 WPV1 positive environmental samples were collected in Pakistan. These bring the total number of WPV1 positive samples collected in 2017 to 91. There were 7 cVDPV2 cases reported in Syria and 3 cVDPV2 positive environmental samples too. The virus environmental presence lasts for 7-14 days.

 

  WPV cVDPV
2017 to 3 October 11 56
2016 to similar date 25 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 Pakistan - 21 August 2017 or 6 weeks since the onset of polio.
    • 5 cases in 2017 vs. 14 cases at the same time in 2016. NIDs in progress are targeting more than 37 million children.
  • In Afghanistan – 10 July 2017 so 12 weeks since the onset of polio.
    • 6 cases in 2017 vs. 9 cases at the same time in 2016. NIDS targeting 10 million children.
  • In Nigeria - 21 August 2016 or 58 weeks since the onset of polio.
    • No cases in 2017 vs. 3 cases at the same time in 2016.

The numbers of cases of cVDPV this year together with the dates of onset of paralysis for the most recent case are:

  1. In Syria - 47 cases of cVDPV2 – 5 August 2017. All the Syrian cases had onset of paralysis between 3 March and 5 August, but these were before the outbreak response had started. Genetic sequencing suggests that the initial infection was before the switch from tOPV to bOPV.  A nationwide immunisation day in October is aiming to reach more than 2.7 million children.
    • Fourty-two cases are from Deir Ez-Zour governate. (35 from Mayadeen district.)
    • Two cases from the Talabyad district in the Raqqa governate.
    • One case from the Tadmour district in the Homs governate.
    • Also three cVDPV2 positive environmental samples have been recorded this week. One of the samples came from the screening of internally displaced persons (IDPs). The outbreak response in Syria includes immunisation of at-risk populations in northwest Syria, Turkey and Lebanon. IPV is being administered at border points for unvaccinated children crossing from Syria to Lebanon.
  2. In the DRC - Nine cases of cVDPV2 - 27 July.
    • 2 cases in Maniema province. Onset of paralysis first 26 March and second 18 April.
    • 7 cases in Haut Lomami province. The onset of paralysis of the most recent case was on 27 July.
    • Mop up immunisation activities using mOPV2 were completed on 16 September following outbreak responses in June and July.

The WHO has indicated that, for both the DRC and Syria, the 2017 cVDPV2 cases reported were not unexpected and do not change the operational situation.

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 dialogue with Carol Pandak and the GPEI on the long lead times for reporting cVDPV2 case from Syria has produced this statement:

"There are lags in stool sample transportation and results as you noted. There are many challenges getting the specimens out of a conflict zone and the Global Polio Eradication Initiative is working with five different labs: the local labs in Damascus and Ankara, and then regional reference labs in Egypt and the Netherlands. The local labs are wanting to get verification from the regional labs. And finally, some of the specimens end up at the CDC. Results are also delayed if the specimen is shipped from local, to regional, to international. Some samples need to be retested, etc. The difficulty of managing this process in a war zone was mentioned many times and those working on it feel they are doing the best they can noting the dangers to everyone working in the region. They also note it is not ideal in working on an outbreak. "

I think we will all readily understand this. There is a report on the GPEI website on the polio eradication laboratories. See: http://polioeradication.org/polio-today/polio-now/surveillance-indicators/the-global-polio-laboratory-network-gpln/

 

5 October 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).