End Polio Now Position - 2nd May 2017

Highlights and global details:

For five weeks now no polio cases, neither WPV1 nor cVDPs, have been reported. However this week 7 WPV1 positive environmental samples were collected in Pakistan.

2017 to 25 April 5 0
2016 to similar date 13 3
2016 full year 37 7

The most recent WPV1 cases reported were:
•    In Afghanistan - 21 February 2017.
•    In Pakistan - 13 February 2017.
•    In Nigeria - 21 August 2016.

For cVDPV, the most recent cases reported were:
•    cVDPV2 cases in Pakistan - 17 December 2016.
•    cVDPV2 cases in Nigeria - 28 October 2016
•    cVDPV1 cases In Laos - 11 January 2016

In more detail:

WPV1 cases:
•    2 cases in Pakistan vs. 9 cases at the same time in 2016. During 2017 over 2,000 cases of infant acute flaccid paralysis tested which is another aspect of how donations to polio eradication are used.
•    3 cases in Afghanistan vs. 4 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.  Also, 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 will immunise more than 116 million children over the course of the campaigns.

WPV2 cases:
•    Declared eradicated September 2015. (Last case in October 1999 from Aligarh, Uttar Pradesh.)

WPV3 cases:
•    No cases reported since 10 November 2012. (That was in Nigeria.)

cVDPV1 cases:
•    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.

cVDPV2 cases:
•    In 2016 two cases in Nigeria and two cases in Pakistan. In 2015 there were twelve cases, seven in Guinea, two in Myanmar, two in Pakistan and one in Nigeria.

The source of polio virus transmission is infectious humans but only 0.5% of infected persons show any symptoms of polio.

World Immunisation Week ran from 24-30 April. See Margaret Chan’s comments:
http://polioeradication.org/news-post/world-immunization-week-celebrating-progress-towards-polio-eradication/. Also an April GPEI Newsletter has been published.  See: http://polioeradication.org/wp-content/uploads/2017/05/PN201704_EN.pdf

Other comments (from the internet and other sources)

Pakistan, Afghanistan and Nigeria - the only three polio endemic nations in the world - received highest doses of vaccines in 2016. The United Nations Children's Fund, which procured 2.5 billion doses of vaccines for children in nearly 100 nations. Almost 450 million doses were procured to children in Nigeria, 395 million in Pakistan and over 150 million in Afghanistan. (UNICEF report released during World Immunisation Week, April 24-30. According to the UNICEF, access to immunisation has led to a dramatic decrease in deaths of children under five years from vaccine-preventable diseases. Between 2000 and 2015, globally deaths due to measles declined by 85 per cent and those due to neonatal tetanus by 83 per cent. In India the under-five mortality stands at 1.11 million deaths per year. Pneumonia accounted for 13 per cent and diarrhoea contributed to about 10 per cent of the deaths. An estimated 10 million children in India still miss out on full vaccinations every year. In countries where 80 per cent of the world's under-five child deaths occur, over half of the poorest children are not fully vaccinated. Globally, the poorest children are nearly twice as likely to die before the age of five as compared to the richest. Since 1990, immunisation has been a major reason for the substantial drop in child mortality, but despite this progress, 1.5 million children die from vaccine preventable diseases every year.

There has been a plethora of positive internet reports this week. Health organisations are calling for one final push to eradicate the highly contagious disease that usually affects young children under five. Unlike measles, the likelihood of getting polio as an adult is less, but adults can still be carriers and circulate the virus. The UAE have committed an additional $120 million towards polio eradication efforts in Pakistan and Afghanistan. Most of Afghanistan is polio-free but wild poliovirus is still circulating in parts of the country, particularly in the Eastern, Southern and South-Eastern regions. The transmission in the East illustrates the importance of common reservoir transmission between Pakistan’s Khyber Pakhtunkhwa and FATA and the area bordering Afghanistan. The Pakistan governments’ National Emergency Action Plan has ensured optimal vaccine utilisation and strict monitoring system to ensure access of vaccination to every child. The Punjab government is piloting a mobile application to identify children possibly missed in polio immunisation drives. The application leaves no possibility of children being missed by the teams. (Punjab had no polio case in 2016 but has reported one in 2017.) The Federal Government of Nigeria reiterated its commitment to eradicating polio by making funds available early for the purchase of vaccines for immunisation. Tiwa Savage, Nigerian singer and songwriter, will help Rotary achieve its goal of a polio-free world. Savage’s musical career began when she was 16 years of age as a backup singer for George Michael.  Savage announced her partnership with Rotary in New York City at a World Immunisation Week event. As part of the campaign, Savage will be featured in ads raising her thumb and forefinger in the ‘this close’ gesture and she joins other public figures and celebrities participating in the campaign.

Anne Schuchat, acting director of the CDC and acting administrator at the Agency for Toxic Substances and Disease Registry (ATSDR) has said last week “…Until polio is gone everywhere in the world, the risk of new outbreaks persists. To accomplish this goal, we must continue working together to improve immunisation delivery and vaccinate those children in hard-to-reach, insecure areas. A vast global laboratory and surveillance network and a well-trained public health workforce ready to respond to disease outbreaks is essential to this mission. We also depend on scientific and technical expertise that not only supports polio eradication, but has been essential to critical public health responses against measles, Ebola, and other infectious diseases. It has been more than 35 years since the world eradicated smallpox, the first disease ever eradicated from humans. When we succeed in reaching and vaccinating almost every child against polio, we will eradicate it for good - and guarantee future generations a world that is forever free from 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 Coordinator (EPNC).