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.
Global position:
| WPV1 | cVDPV | |
| 2018 to 29 May 2018 |
9 | 5 |
| 2017 to 30 May 2017 | 5 | 0 |
| 2017 full year |
22 | 96 |
| 2016 full year |
37 | 5 |
| 2015 full year | 74 | 32 |
| 2014 full year | 359 | 56 |
The emphasis now is on:
- Monitoring the date of the most recent onset of paralysis and the number of weeks elapsed.
- The most recent positive environmental samples and the immunisation response.
Wild Polio virus:
WPV1
For polio-free certification purposes the start date for WPV monitoring is that of the onset of paralysis. For positive environmental samples, the viral presence lasts for 7-14 days.
One WPV1 cases this week in Afghanistan but six WPV1 positive environmental samples were collected; four in Pakistan and one in Afghanistan. The details of the most recent cases in each country are:
- In Afghanistan – 27 April 2018 – or 4 weeks since the onset of polio.
- 8 cases in 2018 vs. 3 cases at the same time in 2017. Total of 14 cases in 2017.
- During May the NIDs reached over 9.6 million children with bOPV.
- In Pakistan – 8 March 2018 – or 11 weeks since the onset of polio.
- One case in 2018 vs. 2 cases at the same time in 2017. Total 8 cases in 2017.
- During May the immunisations reached over 20 million children with bOPV.
- In Nigeria – 21 August 2016 – or 92 weeks since the onset of polio.
- No cases in 2018. No cases in 2017. Four cases in 2016.
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
The virus is genetically changed from the weakened virus contained in OPV. Details of the most recent cases in each country are:
cVDPV1
- No cases in 2018. No cases in 2017. Three cases reported in Laos in 2016.
cVDPV2
- In Nigeria: 1 cVDPV2 case was reported last week.
- Onset of paralysis was on 15 April 2018 – or 5 weeks ago
- The DRC:
- Four cVDPV2 cases in 2018. 22 cases in 2017.
- Most recent case – 19 February 2018 – or 14 weeks since the onset of polio. Surveillance and immunisation in neighbouring countries are being strengthened.
- In Syria: VDPV cases arose after discovery of pockets of infection after the defeat of ISIS
- There have been no cases since the outbreak last year. 74 cases in 2017.
- Most recent case 21 September 2017 – or 35 weeks since the onset of polio.
cVDPV3
-
No cases since July 2013 when there was one in the Yemen.
-
Confirmation of cVDPV samples in Somalia (both types 2 and 3), Kenya (type 2) and in Nigeria (type 2) have not isolated either cVDPV3 or cVDPV2 from AFP cases or their contacts. Rigorous outbreak response to both strains is being implemented.
Other comments (from the internet and other sources):
WHA - Polio transition
With wild poliovirus transmission levels lower than ever before, and the world closer than ever to being polio-free, discussions focused on securing a lasting polio-free world. Delegates paid tribute to ongoing efforts to end polio transmission in the last three endemic countries. This year, only 9 cases due to wild poliovirus had been reported globally, from just 2 countries: Afghanistan and Pakistan. Delegates reviewed emergency plans to interrupt the transmission of the last remaining strains of the virus. Rotary International, speaking on behalf of the GPEI offered an impassioned plea to the global community to eradicate a human disease for only the second time in history, and ensure that no child will ever again be paralysed by any form of poliovirus anywhere.
To prepare for a polio-free world, global poliovirus containment activities continue to be intensified, and Member States adopted a landmark resolution on poliovirus containment. In a limited number of facilities, poliovirus will continue to be retained, post-eradication, to serve critical national and international functions such as the production of polio vaccine or research. It is crucial that poliovirus materials are appropriately contained under strict biosafety and biosecurity handling and storage conditions to ensure that the virus is not released into the environment, either accidentally or intentionally, to again cause outbreaks of the disease in susceptible populations.
Delegates welcomed efforts to plan for a post-polio world, including WHO’s organisation-wide work to identify the key programmatic, financial, human resources and organisational risks associated with the eventual closure of the global polio eradication effort. They requested the Director-General to consider polio transition planning an urgent organisational priority and highlighted the need to ensure that polio transition needs are fully incorporated into the development of the next WHO budget and planning cycle. Member States expressed overwhelming commitment to fully implement and finance all strategies to secure a lasting polio-free world in the very near term.
Delegates considered WHO's 5-year strategic action plan on polio transition designed to strengthen country health systems impacted by the scaling down and eventual closure of the GPEI. The strategic plan was based on the priorities of the national government transition plans and developed in close collaboration with WHO regional and country offices. The implementation of the plan will require coordination with all country-level and global partners. The plan complements the Africa Immunisation Business Case to strengthen immunisation systems in the African continent, and also the significant progress made in the integration of the polio functions in the South-East Asian Region.
The strategy supports country ownership of essential polio functions like surveillance, laboratory networks, and some core infrastructure that are needed to (i) sustain a polio-free world after eradication of polio virus; (ii) strengthen immunisation systems, including surveillance for vaccine-preventable diseases; and (iii) strengthen emergency preparedness, detection and response capacity to ensure full implementation of the International Health Regulations. WHO commits to continue providing technical assistance and resource mobilisation support to countries engaged in polio transition. Delegates noted the importance of integrating essential polio functions into national health systems.
Concern was expressed about the continued shortage of inactivated poliovirus vaccine and noted the urgent need to contain polioviruses in safe facilities, destroy unneeded materials, and appropriately contain resources that can be used for research or other purposes
At the final WHA session, Rotary was praised by the WHA Chair and by Dr Guerra, the Assistant DG of WHO, for its significant contribution to polio eradication.
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.
31 May 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.