Ending Polio - The Fight is not over!

THIS WEEK

Polio this week as of 20 February 2019

• On 19 February, the 20th IHR Emergency Committee including members, advisers, and invited Member States convened to discuss the status of international spread of poliovirus. The Committee unanimously agreed that the risk of polio spread continues to be a Public Health Emergency of International Concern (PHEIC) and proposed an extension of Temporary Recommendations for an additional three months. The recommendations come amid outbreak notification of cVDPV1 and cVDPV2 in Indonesia and Mozambique respectively. The official WHO Statement and the Temporary Recommendations will be issued shortly.
• The GPEI has developed the Global Polio Surveillance Action Plan 2018-2020, incorporating newer strategies and innovations to help endemic, outbreak and high-risk countries measure and enhance sensitivity of their surveillance systems. Read more here.
• WHO is seeking input on draft guidance for managing human exposure to live polioviruses in facilities such as labs and vaccine plants. The document is open for public comment and WHO is particularly seeking feedback from national authorities for containment and others working in public health.
• Summary of new viruses this week: Afghanistan— one case of wild poliovirus type 1 (WPV1) and four WPV1-positive environmental samples; Pakistan – two cases of WPV1 and four WPV1-positive environmental samples. See country sections below for more details.

NA: Onset of paralysis in most recent case is prior to 2017. Figures exclude non-AFP sources. In 2018, cVDPV includes all three serotypes 1, 2 and 3.
For Somalia: 1 cVDPV2 and cVDPV3 isolated from one AFP case.
cVDPV definition: see document “Reporting and classification of vaccine-derived polioviruses” at [pdf].

• In an extraordinary joint statement by the Chairs of the main independent, advisory and oversight committees of the GPEI, the Chairs urge everyone involved in polio eradication to ensure polio will finally be assigned to the history books by 2023. The authors are the chairs of the Strategic Advisory Group of Experts on immunization (SAGE), the Independent Monitoring Board, the Emergency Committee of the International Health Regulations (IHR) Regarding International Spread of Poliovirus and the Global Commission for the Certification of the Eradication of Poliomyelitis (GCC).  The Endgame Plan through 2018 has brought the world to the brink of being polio-free.  A new Strategic Plan 2019-2023 aims to build on the lessons learned since 2013.  The joint statement urges everyone involved in the effort to find ways to excel in their roles.  If this happens, the statement continues, success will follow.  But otherwise, come 2023, the world will find itself exactly where it is today:  tantalizingly close.  But in an eradication effort, tantalizingly close is not good enough.  The statement therefore issues an impassioned plea to everyone to dedicate themselves to one clear objective:  to reach that very last child with polio vaccine.

• No wild poliovirus type 1 (WPV1) case was reported in the past week.  The total number of WPV1 cases in 2018 was 21.
• Seven WPV1-positive environmental samples were reported this week: three from Kandahar province, two from Jalalabad district, Nangarhar province, and two from Lashkargah district, Hilmand province.  All samples were collected on 26 December 2018.

• Two cases of wild poliovirus type 1 (WPV1) were reported this week. One case is from Lakki Marwat district in Khyber Pakhtunkhwa province and the other is from Bajour Agency in the Federally Administered Tribal Areas. The onset of paralysis was 16 and 25 December 2018 respectively.
• Five WPV1-positive environmental samples were reported in the past week: one each from Peshawar and Bannu districts in Khyber Pakhtunkhwa, one from Lahore in Punjab province, one from Quetta in Balochistan province, and one from Karachi Gadap in Sindh province. Samples were collected from 10-27 December 201

• One case of circulating vaccine-derived poliovirus type 2 (cVDPV2) case in Baruten LGA in Kwara state (close to Benin border). The case had an onset of paralysis on 5 December 2018.  The total number of cVDPV2 cases in 2018 was 34.
• Three cVDPV2-positive environmental samples were reported in the past week: one from Maiduguri LGA in Borno state, collected on 11 December; one from Zaria and one from Ikara LGAs in Kaduna state, collected on 30 November and 11 December 2018 respectively.
• No cases of wild poliovirus type 1 (WPV1) were reported. The most recently-detected WPV1 case, from Borno state, had onset of paralysis on 21 August 2016.