New polio cases
reported in the past week for 2011: 16
Total
number of cases in 2011: 536
Total
number of cases in 2010: 1352
1.
Headlines
- In
response to the Independent Monitoring Board report which states that 'the
programme is not on track for its end-2012 goal, or for any time soon after
unless fundamental problems are tackled', partners in the Global Polio
Eradication Initiative are building an emergency programme of work, to be put in
place by January next year. The work streams for the change process include
management and accountability, tracking and monitoring plans, systematic
innovation, surge support in outbreak settings and deeper stakeholder
engagement.
- Oral
polio vaccine (OPV) will continue to be administered during measles campaigns in
2012, and may also be given during current and planned campaigns in west and
central Africa using the new conjugate meningococcal A vaccine. Aside from the
obvious efficiencies this creates, it promotes closer cooperation between staff
working on polio eradication as well as accelerated measles and meningitis
control, allowing for further commonalities to be recognized. So, for instance,
measles case data could be used to predict polio outbreaks (because they act as
a marker of low routine immunization).
2. Endemic countries
Afghanistan
- Two
cases were reported in the past week, both wild poliovirus type 1 (WPV1),
bringing the total number of cases for 2011 to 55. The most recent case was
reported with onset of paralysis on 22 October (in Maywand district, Kandahar
province). Afghanistan now has the highest number of infected provinces for a
single year in more than ten years.
- Two
Short Interval Additional Dose (SIAD) rounds will be held on 27-29 November and
4-6 December. These rounds will aim to rapidly build immunity in 28 districts of
Southern Region and 5 districts in the country's west. The second SIAD round is
part of larger Sub-national Immunization Days (SNIDs) which will cover the
south, south-east and east of the country.
- The
focus right now is to improve the quality of supplementary immunization
activities (SIAs) in Farah, with the team leader currently in Herat to discuss
appropriate measures.
- The
country's most recent supplementary immunization activities (SIAs ) were
National Immunization Days (NIDs) using bivalent oral polio vaccine (bOPV) on
24-26 October.
- On
22 November, a meeting took place in Kabul on polio eradication, routine
immunization and the role of Basic Package of Health Services (BPHS)
Non-governmental Organizations (NGOs). A key outcome was that 'permanent OPV
teams' will start work in high-risk districts of Southern Region by the end of
the year, going from house-to-house on a permanent basis.
India
- India
continues its streak without wild poliovirus - having not reported a case in
more than ten months. The country's only case for the year was reported in West
Bengal on 13 January.
- Keeping
up immunity and sensitive surveillance in India will be the top priority in the
coming months. SNIDs began on 13 November in parts of Uttar Pradesh, Bihar, West
Bengal and other high-risk areas. The most recent SIAs were SNIDs held from 25
September.
Nigeria
- Two
cases were reported this week, both in Kano state. The total number of cases for
2011 is now 44. The most recent case had onset of paralysis on 15 October, in
Kumbotso district. The other case reported this week was in Gaya district - a
district which had not previously reported a case of WPV this year.
- Immunization
Plus Day (IPDs) have just been completed in 12 high-risk districts, following
the Maternal and Newborn Child Health Week (MNCHW) held last week. During the
MNCHW, which ran from 14-19 November, infants under the age of one in the
southern half of the country were offered trivalent oral polio vaccine (tOPV).
The IPDs, which began on 20 November, covered the rest of the country, aiming to
vaccinate more than 15 million children under five with tOPV.
Pakistan
- Pakistan
continues to report a high number of cases, officially reporting nine more this
week (all WPV1s). The total number of cases for 2011 is now 154; the most recent
of which had onset of paralysis on 1 November in North Waziristan district in
the Federally Administered Tribal Areas (FATA).
- Aside
from reporting high numbers of WPV cases, environmental sampling continues to
test positive to WPV1 at every single sampling site across the country (seven in
Punjab, six in Sindh, two in Khyber Pakhtunkhwa and two in Balochistan). The
only positive indication from environmental sampling is that wild poliovirus
type 3 (WPV3) has not been isolated in over a year.
- SNIDs
wound up yesterday in some of the highest risk districts. The round aimed to
vaccinate 4.8 million children under five in three districts of Punjab, five
districts of northern Sindh and one district of FATA, along with high-risk union
councils (UCs) in 12 districts of Khyber Pakhtunkhwa (KP ). A Short Interval
Additional Dose (SIAD) round will follow the SNIDs in Bajour (in FATA), Swabi
(in KP) and several districts of northern Sindh. Punjab is using its own funds
to finance 'enhanced outreach' to cover mobile and migrant populations.
- Prime
Minister Yousaf Raza Gilani will preside over the meeting of the National Polio
Task Force taking place on November 24. A renewed version of the National
Emergency Acton Plan for polio eradication (NEAP) will be presented to the Task
Force for their review. It is hoped that this meeting will help to 'reboot'
Pakistan's polio eradication programme.
- Of
the more than 300 WHO polio worker positions to be filled in high-risk
sub-district areas in Pakistan, appropriate candidates have been found for 67%
of the planned positions. Every position in Sindh and Karachi has been filled,
and 97% of the positions in Balochistan have been filled. On the other hand,
only 9% of the 88 positions in FATA have been filled. How ever, many of the
positions in FATA will be filled from the more than 50 existing staff members.
CVs have been collected, and a review is currently being conducted.
3. Importation countries
Angola
- No
new cases were reported in the past week. The total number of cases for 2011
remains five. The most recent case had onset of paralysis on 7 July (WPV1 from
Uige).
- SNIDs,
using monovalent oral polio vaccine type 1 (mOPV1), are scheduled for 25-27
November in Luanda, Lunda Norte, Lunda Sul, Cabinda, Zaire, Uige, Cuando Cabango
and northern Malange, covering most of the north and the southwest of the
country and vaccinating more than 3 million children under five. Similar SNIDs
were conducted in late October, covering the same districts except for Cuando
Cabango.
- A
further round of SNIDs is currently being considered for early December, to
increase immunity in Uige. The site of the country's most recent case, Uige is
close to the border with the Democratic Republic of the Congo, and the case is
closely linked to the Democratic Republic of the Congo's Bas Congo/Bandundu
transmission chain. Technical support is being scaled up to Uige, to assist effo
rts to prevent further spread across the border.
Chad and central Africa
- Two
cases were reported in Chad in the past week (both WPV1s). The total number of
cases for 2011 has risen to 119 (116 WPV1s and three WPV3s). The most recent
case had onset of paralysis on 14 October in N'Djamena Sud, a district of
N'Djamena. Both the cases reported this week were in districts which had not
previously reported a case this year (the other case was from Ati district in
Batha province).
- Chad's
most recent SIAs were NIDs using bOPV from 28 October. Further NIDs, again using
bOPV, will take place from 25-27 November.
- While
monitoring data from Chad's last round showed it to be less-than-perfect, with
seven districts rejected at 90% coverage, such data provides the kind of sharp
focus that is crucial. This shows that the recent scale-up of technical support
is already beginning to have an impact. This can also be seen in the fact that
improved microplanning is being used to plan the upcoming vaccination round.
- Representatives
of WHO, UNICEF, CDC and the Bill & Melinda Gates Foundation visited Chad
last week to lend their technical expertise to the process of reviewing the
country's emergency action plan. Dr Robert Scott, the chair of Rotary's
International PolioPlus Committee, will visit Chad in the coming weeks.
- No
new cases were reported from the Central African Republic (CAR) in the past
week. The total number of cases for 2011 remains two (both WPV1s), the most
recent of which had onset of paralysis on 6 October in Region Sanitaire 3 (RS3),
in the country's north. CAR will hold NIDs using bOPV from 25 November
(synchronised with Chad). In RS3, children up to the age of 15 will be targeted,
in the rest of the country the round will target the usual age-range - children
under five. A SIAD round will be held in December in RS3, again vaccinating
children under 15 years of age.
- A
case of WPV3 reported just inside Cameroon's border has been found to have been
a Nigerian child who contracted the virus in Nigeria, just across the border in
Borno state. As such, it looks highly likely that the case will be reassigned to
Nigeria. Despite this, Cameroon has decided to maintain its current SIA
schedule, acting as a further barrier to the virus' spread. The country's next
round will be SNIDs using bOPV in the three northern-most regions.
China
- No
new cases were reported in the past week - the total number of cases for 2011
therefore remains 18 (all WPV1). The most recent case had onset of paralysis on
18 September (from Kashgar, in Xinjiang Uygur autonomous region).
- SNIDs
took place last week (12-16 November). Monovalent OPV1 was used to vaccinate
people up to 39 years of age in five prefectures around the outbreak, while
children up to five years of age received the vaccine in the rest of Xianjiang
Uygur Autonomous Region.
Democratic Republic of the Congo
- One
new case was reported in the past week. The total number of cases for 2011 is
now 87 (all WPV1s). The most recent case had onset of paralysis on 29 September
(from the outbreak district of Popokabaka in Bandundu).
- SNIDs
took place in high-risk areas of Bandundu, Bas-Congo, Katanga, Maniema and Sud
Kivu from 10-12 November. Further SNIDs will take place in these same districts
from 10-12 December, aiming to reach more than 1.3 million children under the
age of five years with an additional dose of bOPV. On 13 December, tOPV will be
given alongside measles vaccine in Nord Kivu, Kinshasa and the districts of Bas
Congo and Bandundu that weren't covered in the SNIDs.
Horn of Africa
- There
were no cases reported in the Horn of Africa this week. There has only been one
case reported in the Horn of Africa this year - a WPV1 with onset of paralysis
on 30 July in Nyanza Province, on Lake Victoria in western Kenya.
- SNIDs
on 12-16 November covered much of Kenya with bOPV, including districts
surrounding this year's case. A further round is planned for 3-7 December.
Reports from those who witnessed Kenya's recent round are 'guardedly
optimistic'.
- Uganda
recently held SNIDs in areas bordering Kenya on 19-21 November, targeting more
than 700,000 children under the age of five years with mOPV1. Two SIAD campaigns
in 22 districts along the border with the Democratic Republic of the Congo will
be held on 3-5 December (using bOPV) and on 17-19 December (using tOPV), each
time targeting more than 2.1 million children under the age of five.
- Child
Health Days (CHDs) were held in Tanzania from 12-15 November. The round targeted
nearly 7 million children in districts near to the case in Kenya with measles
vaccine and bOPV.
- Technical
staff from India's National Polio Surveillance Project (NPSP) stationed in Kenya
have extended their stay. This will allow them to continue to provide expert
guidance on Kenya's polio eradication and surveillance strategies, and to help
in the preparations for Kenya's December round.
- For
the first time in almost two years, Banadir and Mogadishu in Somalia have been
able to be covered more than once with polio vaccine. Given the increased
access, NIDs using tOPV are planned for 4-8 December. Wherever children are
accessible, they will be vaccinated against polio.
West Africa
- No
cases were reported in west Africa in the past week. The total number of cases
for 2011 in the west African region remains 48 (36 from Côte d'Ivoire, three
from Guinea, seven from Mali and two from Niger). All cases are WPV3, except for
one WPV1 case from Niger.
- Much
of the west African importation belt took part in the multi-country round which
took place on 28 October. Togo postponed participation in the multi-country
round, instead vaccinating children under five using tOPV on 11 November. A
smaller multi-country round has been planned for 25 November, covering all of
Mali and Côte d'Ivoire along with parts of Guinea, Liberia and Niger.
4. Officially reported wild virus cases on 22 Nov 2011
- Total
global cases in 2011: 536 (compared with 799 for the same period in
2010)
- Total
in endemic countries: 254 (compared with 189 for the same period in
2010)
- Total
in non-endemic countries: 282 (compared with 610 for the same period in
2010)
+ Pakistan:
154 cases (compared with 118 for the same period in 2010), onset of paralysis of
most recent case: 01 Nov 2011
+ Afghanistan:
55 cases (compared with 20 for the same period in 2010), onset of paralysis of
most recent case: 22 Oct 2011
+ Nigeria:
44 cases (compared with 11 for the same period in 2010), onset of paralysis of
most recent case: 15 Oct 2011
+ Chad:
119 cases (compared with 14 for the same period in 2010), onset of paralysis of
most recent case: 14 Oct 2011
+ CAR:
2 cases (compared with 0 for the same period in 2010), onset of paralysis of
most recent case: 06 Oct 2011
+ DRC:
87 cases (compared with 49 for the same period in 2010), onset of paralysis of
most recent case: 29 Sep 2011
+ China:
18 cases (compared with 0 for the same period in 2010), onset of paralysis of
most recent case: 18 Sep 2011
+ Guinea:
3 cases (compared with 0 for the same period in 2010), onset of paralysis of
most recent case: 03 Aug 2011
+ Kenya:
1 case (compared with 0 for the same period in 2010), onset of paralysis of most
recent case: 30 Jul 2011
+ Côte
d'Ivoire: 36 cases (compared with 0 for the same period in 2010), onset of
paralysis of most recent case: 24 Jul 2011
+ Niger:
2 cases (compared with 2 for the same period in 2010), onset of paralysis of
most recent case: 09 Jul 2011
+ Angola:
5 cases (compared with 29 for the same period in 2010), onset of paralysis of
most recent case: 07 Jul 2011
+ Mali:
7 cases (compared with 4 for the same period in 2010), onset of paralysis of
most recent case: 23 Jun 2011
+ Congo:
1 case (compared with 3 for the same period in 2010), onset of paralysis of most
recent case: 22 Jan 2011
+ Gabon:
1 case (compared with 0 for the same period in 2010), onset of paralysis of most
recent case: 15 Jan 2011
+ India:
1 case (compared with 40 for the same period in 2010), onset of paralysis of
most recent case: 13 Jan 2011
+ Uganda:
0 case (compared with 1 for the same period in 2010), onset of paralysis of most
recent case: 15 Nov 2010
+ Russian
Federation: 0 case (compared with 14 for the same period in 2010), onset of
paralysis of most recent case: 25 Sep 2010
+ Liberia:
0 case (compared with 2 for the same period in 2010), onset of paralysis of most
recent case: 08 Sep 2010
+ Nepal:
0 case (compared with 6 for the same period in 2010), onset of paralysis of most
recent case: 30 Aug 2010
+ Kazakhstan:
0 case (compared with 1 for the same period in 2010), onset of paralysis of most
recent case: 12 Aug 2010
+ Tajikistan:
0 case (compared with 458 for the same period in 2010), onset of paralysis of
most recent case: 04 Jul 2010
+ Turkmenistan:
0 case (compared with 3 for the same period in 2010), onset of paralysis of most
recent case: 28 Jun 2010
+ Senegal:
0 case (compared with 18 for the same period in 2010), onset of paralysis of
most recent case: 30 Apr 2010
+ Mauritania:
0 case (compared with 5 for the same period in 2010), onset of paralysis of most
recent case: 28 Apr 2010
+ Sierra
Leone: 0 case (compared with 1 for the same period in 2010), onset of paralysis
of most recent case: 28 Feb 2010
- Total
global cases in 2010: 1352
- Total
in endemic countries: 232
- Total
in non-endemic countries: 1120