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End Polio Now Position - 27th 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 but seven positive environmental samples were collected. Four samples in Pakistan, and three samples in Afghanistan. (For positive environmental samples, the viral presence lasts for 7-14 days.)

 

  WPV1 cVDPV
2018 to 27 February 2018
3 0
2017 to 28 February 2017 3 0
2017 to 27 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 7 weeks since the onset of polio.
    • 3 cases in 2018 vs. 2 cases at the same time in 2017. Total 14 cases in 2017.
    • The next set of immunisation days is planned for 12 March.
  • In Pakistan - 15 November 2017 - 15 weeks since the onset of polio.
    • No cases in 2018 vs. 1 case at the same time in 2017. Total 8 cases in 2017.
    • The next set of immunisation days is planned for 12 March synchronised with the immunisations in Afghanistan.
  • In Nigeria - 21 August 2016 - 79 weeks since the onset of polio.
    • No cases in 2018. No cases in 2017 vs. 4 cases at the same time in 2016.
    • The next immunisation days are set for early March synchronised with campaigns Across the Lake Chad basin.

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 12 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 23 weeks since the onset of polio.
    • All empty vials of mOPV2 have been collected and destroyed in Damascus.
    • 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):

Extract from the BMGF 2018 Annual Letter:

Has the fight against polio been worth it?

Yes, it has. In all of history, we have eradicated just one human infectious disease — smallpox in 1978. Forty years later, we’re incredibly close to doing it again with polio. In 2017, there were only 22 cases of wild poliovirus worldwide reported from just a few areas of Pakistan and Afghanistan. Thirty years ago, the polio virus circulated in 125 countries, paralyzing nearly 1,000 children every day. In fact, 16 million people are walking the earth today who — without the effort to end polio — would have been paralyzed by the disease…

A decade ago, the Gates Foundation joined the Global Polio Eradication Initiative (GPEI) with its spearheading partners — Rotary International, UNICEF, the U.S.Centers for Disease Control and Prevention and the World Health Organization — because we were convinced that polio eradication was a worthwhile and achievable goal. Our view hasn’t changed. Today, we’re almost at the finish line. International collaboration, government leadership, financial commitment, and the dedication of individual health workers and groups like Rotary have gotten us to this threshold of ending polio for good. And the world will be a better and more equitable place when all children, everywhere, are free of the risk of death and paralysis caused by the polio virus.

The final push for the interruption of polio transmission in the remaining endemic countries has included an intensification of immunization campaigns and surveillance, which has taxed limited domestic finances and human resources. At the same time, it has helped develop assets that serve other disease control efforts. As we approach the finish line for polio eradication, a concerted transition effort has begun to secure the assets built by GPEI so that they protect the gains of polio eradication and serve other global health priorities in the future.

Last week Sierra Leone introduced IPV into its routine immunisation programme to maximize protection against polio. The new vaccine’s introduction is led by the Ministry of Health and Sanitation with support from the GPEI, Gavi the Vaccine Alliance and the vaccine manufacturers. In 1988 when the Global Polio Eradication Initiative was launched, polio paralysed approximately 10 children every 15 minutes in over 130 countries of the world. The last confirmed polio case in Sierra Leone was reported in 2010. Since then increased surveillance activities for the disease has been ongoing alongside efforts to expand vaccination coverage across all of the country’s 14 districts. The support of the partners on the need for health workers, effective storage of the vaccines, and to continue mobilising all parents and caregivers to take their children to get their routine vaccinations on time to protect against many different life-threatening and debilitating diseases was highlighted.

 

A vaccination campaign during which children under five years of age will be administered the polio vaccine will begin in India on 11 March. As polio viruses are circulating in endemic countries it poses a threat of resurgence of polio.

 

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.

1 March 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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