End Polio Now Position - 6th March 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 three positive environmental samples were collected. Two of the samples in Pakistan, and one sample in Afghanistan. (For positive environmental samples, the viral presence lasts for 7-14 days.)

 

  WPV1 cVDPV
2018 to 6 March 2018
3 0
2017 to 7 March 2017 3 0
2017 full year
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 8 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 - 16 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 -  80 weeks since the onset of polio.
    • No cases in 2018. No cases in 2017 vs. 4 cases at the same time in 2016.
    • Immunisation days went ahead last week 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

One cVDPV2 case in the DRC but with onset of paralysis on 22 December 2017 so is additive to the 2017 total. No cVDPV2 environmental samples collected this week The VD virus is 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.
    • 22 cVDPV3 cases in 2017. No cases in 2018.
    • Most recent case – 22 December 2017 – or 10 weeks since the onset of polio.
    • Surveillance and immunisation activities are being strengthened.
  • 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 24 weeks since the onset of polio.
    • Efforts continue to maintain sensitive surveillance in Syria and the neighbouring countries.

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):

Remembering Albert Sabin and the vaccine that changed the world.

(John Sever, vice chair of Rotary’s International PolioPlus Committee,1 March 2018.)

“…With the support of national governments and using the technique of mass immunization, the Global Polio Eradication Initiative - now made up of Rotary International, the World Health Organization, the Centers for Disease Control and Prevention, UNICEF, and the Bill & Melinda Gates Foundation - has reduced the number of children paralyzed by wild poliovirus from 350,000 in 1988 to just 22 cases last year. We have every expectation that the number will soon drop to zero. Through this extensive partnership, Albert Sabin’s spark of breathtaking ambition to eradicate polio flamed into a beacon of cooperation, professionalism, and hope. When its work is done, and the world is free of polio, the achievement will be a testament not only to the vision and determination of one man, but also to the ability of a world united in compassion to determine its own future.”

Pakistan’s new Regional Reference Laboratory

With polio at the lowest levels in history in Pakistan, the country has launched a powerful and hopefully final assault on the disease in 2018. A crucial part of this is to further strengthen the ability of the polio programme to detect virus in stool samples, thereby giving clear indications of where and how the virus is moving in areas where populations remain under-immunized.

To support this effort, the Government of Japan has announced that it will provide US$3.2 million for the procurement of equipment to the Regional Reference Laboratory for polio eradication, located in the National Institute of Health in Islamabad. This will help support the purchase of state-of-the-art molecular-biology equipment, allowing the laboratory to enhance and speed up its ability to process and detect poliovirus in environmental and stool samples.  In 2017, the Islamabad lab tested 30,000 stool samples and 950 environmental samples from both Pakistan and Afghanistan, helping the programme better identify where the virus is hiding. Michel Zaffran (WHO Director for Polio Eradication) commented these funds come at a crucial time in Pakistan’s eradication effort, and are being used in a strategically important manner. The country is on the cusp of being polio-free. Only by finding polio’s last remaining hiding places will we be able to eradicate it once and for all.

Polio awareness-raising

The WHO reports polio cases have decreased by 99 percent across the world since 1988. Yet, even if one child contracts the disease today, the fear of it spreading to 200,000 cases a year lingers. While awareness campaigns, and health camps, have achieved much in terms of spreading awareness, one man embarked on a solo journey on his bicycle, riding the length and breadth of Malaysia, to spread the word. SS Shameem, an assistant professor in the Department of Computer Applications in Manipal Institute of Technology, Karnataka, cycled 2,140 km over two weeks from January 31 to February 14 to spread word on the eradication 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.

8 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.