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End Polio Now Position - 20th February 2018

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.

Wild Polio virus:

WPV1

No new WPV1 cases reported and no positive environmental samples collected this week.

(For positive environmental samples, the viral presence lasts for 7-14 days.)

 

  WPV1 cVDPV
2018 to 20 February 2018
3 0
2017 to 21 February 2017 3 0
2017 to 20 February 2018
22 95
2016 full year
37 5
2015 full year 74 32
2014 full year 359 56

 

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 Afghanistan – 6 January 2018 - or 6 weeks since the onset of polio.
    • 3 cases in 2018 vs. 1 case at the same time in 2017. Total 14 cases in 2017.
    • Immunisation days concluded last week aimed at 6 million children across 24 provinces.
  • In Pakistan - 15 November 2017 - 14 weeks since the onset of polio.
    • No cases in 2018 vs. no cases at the same time in 2017.
    • 8 cases in 2017.
    • Immunisation days concluded last week aiming to vaccinate 37 million children and synchronised with activities in Afghanistan.
  • In Nigeria - 21 August 2016 - 78 weeks since the onset of polio.
    • No cases in 2018. No cases in 2017 vs. 4 cases at the same time in 2016.
    • Post-campaign date from January SIAs is being collated. (The aim was to vaccinate over 26 million children.)
    • The next immunisation days are set for early March.

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

No new cVDPV2 cases reported and no positive environmental samples collected this week The VD virus genetically changed from the weakened virus contained in OPV which can emerge in under-immunised populations. The cases and the dates of onset of paralysis were:

cVDPV1

  • No cases in 2017. Three cases reported in Laos in 2016. In 2015 there were 20 cases, ten cases in Madagascar, eight cases in the Lao Republic and two cases in the Ukraine.

 cVDPV2

  • The DRC: Has not reported a case of wild poliovirus since 2011.
    • 21 cVDPV3 cases in 2017. No cases in 2018.
    • Most recent case – 1 December 2017 – or 11 weeks since the onset of polio.
    • Surveillance and immunisation activities continue.
  • In Syria: There has not been a case of indigenous WPV since 1999. No WPV has been found since January 2014. VDPV cases arose with the defeat of ISIS when pockets of infection were discovered. There have been no cases since the outbreak response.
    • 74 cases in 2017. No cases in 2018.
    • Most recent case 21 September 2017 – or 22 weeks since the onset of polio.
    • An IPV vaccination round has successfully been concluded. 233,518 children received IPV.
    • A nationwide immunisation round using bOPV is planned for March.
  • Three VDPV2s were isolated from two environmental samples collected in Somalia earlier but no AFP cases associated with these samples have been detected. A third SIA is planned for March.

cVDPV3

  • No cases since July 2013 when there was one in the Yemen.

 

Other comments (from the internet and other sources):

Judith Diment was the first to highlight a recent report on “Ending polio and yellow fever hand-in-hand in northern Nigeria”. There is no substitute for reading the report (See:  https://reliefweb.int/report/nigeria/ending-polio-and-yellow-fever-hand-hand-northern-nigeria?utm_medium=social&utm_campaign=shared&utm_source=twitter.com but I will try to summarise the report and include those elements that struck me:

As he climbs out of his car and walks across to the entrance of Bakassi camp for internally displaced persons in Borno, northern Nigeria, Dr Terna Nomwhange is met by a familiar sight. Standing at the gates, greeting a tired, dusty family laden with possessions, is a team of polio vaccinators. As families arrive at this sea of shelters following a long, hard journey, these people offering polio vaccines are the first sign that they have reached a place of protection. Not only are families in northern Nigeria facing insecurity, a humanitarian crisis and the threat of polio, but since September they have also been at risk from an outbreak of yellow fever. By early January 2018, a total of 358 suspected cases had been reported in 16 states, with 45 deaths recorded for 2017. In Borno, the ongoing conflict means that the health infrastructure on the ground to respond to the outbreak is limited to local government and the polio eradication infrastructure. At the camp gates, the polio vaccinators give two drops of vaccine into the mouth of every child; but they also tell the parents where to go to get their yellow fever vaccination.  With weakened health system in parts of north eastern northern Nigeria, the infrastructure that is already on the ground to stop polio is providing the volunteers needed to support the yellow fever vaccination campaign. More than eight million people are being targeted with yellow fever vaccines in the states of Borno, Zamfara Kwara and Kogi states in 2018. Reaching everyone between nine months and 45 years to protect them against yellow fever takes creative thinking. To prepare for the launch of the yellow fever vaccination campaign that took place at the beginning of February, polio experts supported the preparations by developing detailed micro-plans, mapping each community so that every individual can be vaccinated. Volunteer community mobilisers, well versed in educating communities about the risks of infection, used their skills to warn populations of the high mortality rates associated with yellow fever.

GPEI now show an animated video about the OPV and IPV vaccines that you may find interesting. See: http://polioeradication.org/news-post/the-two-polio-vaccines/

 

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.

22 February 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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