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Polio Highlight

Polio Recommendations from PAHO's Technical Advisory Group on Vaccine-preventable Diseases, 2013

  • Countries of the Americas must wait for the fulfillment of the conditions stated by SAGE for the cessation of the use of Sabin type 2 containing vaccines; these conditions must be met before making any change in vaccination policy. As long as there are outbreaks caused by cVDPV type 2 and the wild poliovirus continues to circulate in the world, the trivalent oral polio vaccine (tOPV) remains the vaccine of choice for the Americas.
  • PAHO should convene a Working Group to develop a strategic plan describing current options and scenarios, as well as the timelines for the implementation of the polio endgame in the Americas. This plan should discuss the feasibility of using different OPV/IPV schedules; the availability of combination vaccines containing IPV, where the ideal situation would be having an hexavalent DTwP-Hib-IPV-HepB vaccine, among other issues.
  • All countries must reinforce the activities aimed to achieve or maintain vaccination coverage >95% in every district or municipality. If countries do not achieve that coverage they must evaluate the accumulation of non-immunized and conduct vaccination campaigns.
  • All countries must continue to maintain adequate acute flaccid paralysis (AFP) surveillance in order to timely detect any importation or emergence of VDPVs, and must report to PAHO on a timely fashion to allow the proper monitoring of the Regional situation.
  • TAG reinforces its previous recommendations (Argentina 2011) for countries considering the introduction of inactivated polio vaccine (IPV): compliance with sanitary conditions and vaccination coverage guaranteeing an adequate protection to their communities.
  • PAHO must continue to maintain a dialogue with vaccine suppliers in order to guarantee the provision of polio vaccines for the Americas.

 

Last Updated on Friday, 19 July 2013 11:16

WHO sends mission to Israel following detection of wild poliovirus in sewage

As requested by Israeli health authorities, a team of international poliomyelitis (polio) experts, coordinated by WHO, completed a five-day mission to Israel on 26 June 2013. The team assessed the risks and recommended action following the detection of wild poliovirus type 1 (wPV1) in sewage in the Southern District of the country. No cases of paralytic polio have been detected.

Following the mission, a supplementary immunization campaign with oral polio vaccine is planned, even though Israel continues to maintain high vaccination coverage and polio immunity in the population. The decision to launch the campaign reflects both the estimated extent of circulation of the virus and the Israeli authorities’ commitment to interrupt transmission as rapidly as possible.
The virus was originally isolated from sewage samples collected in Beersheva in February 2013. Since then it has been isolated in further samples from different locations, most recently in early June. Genetic sequencing and epidemiological investigations have established that it is of the South Asian genotype and not related to the virus currently affecting the Horn of Africa. WHO experts are working with scientists from Israel’s national polio laboratory to gain further understanding of the origins of the virus.

Israel has systematically conducted environmental sampling for many years, and the poliovirus was detected thanks to this vigilance. Public health authorities continue to monitor the situation carefully, and measures have been taken to increase surveillance and reporting for possible human cases, regardless of age.

The aim of the supplementary immunization campaign is to protect any children in the country who may have missed routine vaccinations for any reason. In southern areas, adults are also being assessed and those thought to be susceptible are being immunized.

Israel’s Minister of Health, Mrs Yael German, and the Director General of the Ministry of Health, Dr Ronni Gamzu, expressed their appreciation for the mission at a press conference on Wednesday, 26 June, praising the team’s professionalism and supportiveness.

Dr Dina Pfeifer, Programme Manager for Vaccine-preventable Diseases and Immunization at WHO/Europe, acknowledged the Israeli public health authorities’ readiness to cooperate with the WHO-led mission: “We have reviewed the evidence and the steps that have been taken to date. We are thankful to the Government of Israel for their openness and we are fully committed to supporting their efforts.”

Israel and polio

Israel has been free of indigenous wPV transmission for 25 years, the last cases of paralytic polio having occurred in 1988. At that time the authorities launched a mass vaccination campaign immunizing the population aged 0–40 years with oral polio vaccine.

Risk and preparedness

Given the high level of population immunity and the continuing response to the detection of wPV in the environment, WHO assesses the risk of the further international spread of this virus strain from Israel as moderate. The relevant WHO regional offices are working closely to ensure a coordinated response in the area and neighbouring Member States.

Nevertheless, it is vital that all countries, particularly those with frequent travel and contacts with polio-affected countries, strengthen surveillance for cases of acute flaccid paralysis, to rapidly detect any new poliovirus importation and respond.

Countries should also analyse data on routine immunization coverage to identify any susceptible groups in the population. Such information can guide catch-up immunization activities and thereby minimize the consequences of new poliovirus introduction. Priority should be given to areas where the risk of importation is high and vaccine coverage is less than 80%.

WHO’s information on international travel and health recommends that all travellers to and from polio-affected areas be fully vaccinated against polio. Indigenous transmission of wPV remains endemic in 3 countries: Afghanistan, Nigeria and Pakistan. In addition, The Horn of Africa is experiencing an outbreak of wPV, with 31 cases confirmed in Kenya and Somalia.

01-Jul-2013

Source: WHO/EURO

Original Article: http://www.euro.who.int/en/what-we-do/health-topics/communicable-diseases/poliomyelitis/news/news/2013/07/who-sends-mission-to-israel-following-detection-of-wild-poliovirus-in-sewage 

TAG 2013

PAHO's Technical Advisory Group (TAG) on Vaccine-preventable Diseases is meeting this week to provide technical recommendations on immunization, a session on maintaining the Region of the Americas polio-free was held on Friday 5 July.

Livestream recordings http://www.livestream.com/opsenvivo/folder?dirId=8be28672-c961-4b23-bc4a-558f36d9d248

Outbreak of Wild Poliovirus Type 1 Continues in Pakistan threatening Progress in Polio Eradication in the Area

In Pakistan, the WPV1 outbreak in Bara in Khyber Agency (Federally Administered Tribal Areas – FATA), is continuing.  Seven cases have now been reported since end-April.  This outbreak is the major WPV reservoir in all of Asia, and is threatening progress achieved elsewhere in the country and in neighboring Afghanistan.

Last Updated on Thursday, 27 June 2013 10:53

Polio update: outbreak in the Horn of Africa

Horn of Africa

    Five new WPV cases were reported in the past week (two WPV1s from Somalia and three WPV1s from Kenya), bringing the total number of WPV1 cases in the region to 14 (nine WPV1s from Somalia and five WPV1s from Kenya).  Two of these new cases are the most recent and had onset of paralysis on 18 May (both from Kenya).

      Outbreak response activities are continuing across the Horn of Africa:

      • In Somalia, two large-scale immunization campaigns have already been implemented, including in Banadir (which includes Mogadishu), including targeting children aged less than ten years.   Lessons from these campaigns are now being addressed in preparation of the next rounds starting on 12 June.  In Banadir, all age groups are being targeted.  Focus is on fine-tuning microplans to include schools, more clearly define vaccinator team daily workloads, improving supervision and expanding the scope and content of monitoring activities.
      • In Kenya, immunization activities began on 26 May to reach nearly 440,000 children aged less than 15 years across the Dadaab area.  Preparations are ongoing for the next SNIDs, on 15 June, covering broader areas including all age groups in the Dadaab area.  Further campaigns planned for late June and mid-August.
      • Immunization campaigns are also planned and being conducted in other areas of the Horn of Africa, notably Ethiopia and Yemen, to urgently boost population immunity levels and minimize the risk of spread of the outbreak.
      • In Ethiopia, in border areas with Kenya and Somalia, an immunization activity was held on 31 May (targeting children aged less than 15 years).  Focus was particularly on reaching children in refugee camps.  Broader activities are planned to start 16 June and in early July.
      • In Yemen, activities were held last week (2-5 June) to reach 2.1 million children, with a second round planned for late June to reach 3.5 million children and National Immunization Days in August.


      Source: Poliovirus Weekly Update 12-Jun-2013, World Health Organization

      Read more about wild poliovirus in the Horn of Africa here: http://www.who.int/csr/don/2013_05_22/en/index.html

      Last Updated on Friday, 14 June 2013 10:59
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