Polio Update - WHO Report as of June 27, 2012

Wild Poliovirus Weekly Update

27-Jun-2012, World Health Organization

Please scroll to the end for a summary of officially reported polio cases.

New polio cases reported in the past week for 2012: 6

Total number of cases in 2011: 650

Total number of cases in 2012: 84

1. Headlines

In Nigeria, a significant surge in field staff continues to be deployed to the worst-performing Local Government Areas (LGAs) in the highest-priority states in the north of the country. At the World Health Organization (WHO) alone, staff is being increased from 744 professionals to 2,951, an increase of nearly 300%. The bulk of these new staff is already in place, and the full recruitment of the surge is anticipated to be completed over the coming weeks. The Government of Nigeria and UNICEF are undertaking similar staff surges, with UNICEF scaling up its Community Volunteer Network to a planned 2,150 staff (with more than half already in place). The overriding priority is now on rapidly integrating the new surged workforce into a well-functioning and operational outfit.

2. Endemic countries

Afghanistan:

• Two new cases were reported in the past week (both WPV1 from Hilmand), bringing the total number of cases for 2012 to 10. The most recent case had onset of paralysis on 29 May (WPV1 from Hilmand).
• An Afghan delegation comprising five UNICEF Afghanistan staff, one WHO staff, and seven Government of Afghanistan staff, returned from India, where they visited and collaborated with India's polio program. The delegation observed a subnational immunization round, attended an in-depth debriefing with the polio program and the national government, and generated an action matrix of how the Afghan and Indian programs can support each other for the remainder of 2012.
• A management and team-building training will be completed by the end of July for high-risk provinces and 13 high risk district staff.
• More children have been missed because of active fighting in some areas of Hilmand. Activities to reach these areas are continuing to ensure increased access during upcoming activities.
• The next subnational immunization days will be a joint measles/bivalent OPV campaign on 7-13 July, targeting children under the age of 10 with both of these vaccines.

Nigeria:

• Three new cases were reported in the past week (all WPV1 from Kano and Katsina), bringing the total number of cases for 2012 to 48. The most recent case was one of the newly reported cases from Kano with onset of paralysis on 5 June.
• The polio dashboard, which displays several vaccination campaign and surveillance indicators, will be rolled out during the July Immunization Plus Days.
• Fourteen Field Epidemiology and Laboratory Training Program (FELTP) fellows were deployed to assist the Nomad Project with a baseline survey that will assist with microplanning and supervision of polio campaigns for nomadic populations.
• The next subnational Immunization Plus Days (IPDs) will be held on 7-10 July in 11 states in the north using bivalent OPV.

Pakistan:

• No new cases were reported in the past week. The total number of cases for 2012 remains 22. The most recent case had onset of paralysis on 22 May (WPV1 from Federally-Administered Tribal Areas – FATA).
• In Punjab province, a refresher orientation session on the Augmented National Emergency Action Plan for the District Coordination Officers (DCOs) was conducted on 20 June. Attendees included DCOs, Executive District Officers (EDOs) for health, and focal persons for the polio eradication initiative. A similar session is scheduled for 2 July in Lahore, which will be attended by Punjab's Secretary of Health and the Coordinator Prime Minister's Polio Monitoring and Coordination Cell. Balochistan province has planned similar activities to be conducted from 28 June–2 July.
• A mass media campaign is planned for July, including radio, television, cable, and outdoor media.
• The next national immunization days will be held on 16-18 July using trivalent OPV.

3. Importation countries

Angola:

• No new cases were reported in the past week. No cases have been reported in 2012. The country has reported a total of five cases in 2011, the most recent of which had onset of paralysis on 7 July in Uige in the country's north.
• The next national immunization days are planned for 29 June–1 July.

 Chad:

• One new case was reported in the past week (WPV1 from Lac province), bringing the total number of cases for 2012 to four. It is the most recent case in the country, with onset of paralysis on 11 May.
• Genetic sequencing indicates that the latest virus is related to virus circulating in Chad more than 12 months ago. Detection of this orphan virus (a virus which shows genetic evidence of long periods of undetected circulation) is evidence of ongoing subnational surveillance gaps.
• The case occurred in a nomadic population with low routine immunization, low coverage during SIAs, and in adequate surveillance performance.
• An emergency response is now being planned, with cross-border activities to be conducted on 6-9 July in coordination with neighboring Nigeria. WHO and UNICEF are significantly scaling up technical support to Lac province (an additional 31 staff in total), to support the planning and monitoring of the response. Extensive media and targeted social mobilization activities are being implemented.
• As part of the special strategies to reach nomadic children, the age group is again being expanded, to less than 15 years. Three of the four cases found this year are from nomadic populations.
• Chad's national emergency action plan, currently being finalized for the second half of 2012, explicitly highlights urgent measures that need to be taken to more clearly identify, and rapidly fill, subnational surveillance and immunity gaps.
• Confirmation of this latest case is further evidence of low-level transmission and subnational immunity and surveillance gaps pose to countries' eradication efforts.

Democratic Republic of the Congo (DR Congo):

• No new WPV cases were reported in the past week. No WPV cases have been reported in 2012. The total number of cases for 2011 is 93 (all WPV1). The most recent case had onset of paralysis on 20 December in Maniema province.
• Efforts are ongoing to stop the ongoing circulating vaccine-derived poliovirus type 2 (cVDPV type 2) outbreak in Katanga province. Subnational immunization activities will be held in the affected area, targeting all age groups, from 10-14 July with trivalent OPV.

West Africa:

• No new cases were reported in the past week. No cases have been reported in 2012. The total number of cases for 2011 in West Africa remains 51 (36 from Côte d'Ivoire, three from Guinea, seven from Mali, and five from Niger). The most recent case (WPV1) from the region had onset of paralysis on 22 December from Niger.
• From 29 June to 2 July, immunization campaigns will take place in the highest-risk areas of Niger, Burkina Faso, Mali and Guinea, targeting approximately 14 million children.

4. Officially reported wild polio virus cases on 26 Jun 2012

Total global cases in 2012: 84 (compared with 241 for the same period in 2011)

Total in endemic countries in 2012: 80 (compared with 216 for the same period in 2011)

Total in non-endemic countries in 2012: 4 (compared with 25 for the same period in 2011)

· Nigeria: 48 cases in 2012 (compared with 16 for the same period in 2011), onset of paralysis of most recent case: 05-Jun-12

· Afghanistan: 10 cases in 2012 (compared with 8 for the same period in 2011), onset of paralysis of most recent case: 29-May-12

· Pakistan: 22 cases in 2012 (compared with 54 for the same period in 2011), onset of paralysis of most recent case: 22-May-12

· Chad: 4 cases in 2012 (compared with 80 for the same period in 2011), onset of paralysis of most recent case: 11-May-12

· Niger: 0 case in 2012 (compared with 1 for the same period in 2011), onset of paralysis of most recent case: 22-Dec-11

· DRC: 0 case in 2012 (compared with 59 for the same period in 2011), onset of paralysis of most recent case: 20-Dec-11

· CAR: 0 case in 2012 (compared with 0 for the same period in 2011), onset of paralysis of most recent case: 08-Dec-11

· China: 0 case in 2012 (compared with 0 for the same period in 2011), onset of paralysis of most recent case: 09-Oct-11

· Guinea: 0 case in 2012 (compared with 1 for the same period in 2011), onset of paralysis of most recent case: 03-Aug-11

· Kenya: 0 case in 2012 (compared with 0 for the same period in 2011), onset of paralysis of most recent case: 30-Jul-11

· Côte d'Ivoire: 0 case in 2012 (compared with 11 for the same period in 2011), onset of paralysis of most recent case: 24-Jul-11

· Angola: 0 case in 2012 (compared with 4 for the same period in 2011), onset of paralysis of most recent case: 07-Jul-11

· Mali: 0 case in 2012 (compared with 4 for the same period in 2011), onset of paralysis of most recent case: 23-Jun-11

· Congo: 0 case in 2012 (compared with 1 for the same period in 2011), onset of paralysis of most recent case: 22-Jan-11

· Gabon: 0 case in 2012 (compared with 1 for the same period in 2011), onset of paralysis of most recent case: 15-Jan-11

· India: 0 case in 2012 (compared with 1 for the same period in 2011), onset of paralysis of most recent case: 13-Jan-11

· Total global cases in 2011: 650

· Total in endemic countries in: 341

· Total in non-endemic countries in: 309