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Polio Highlight

Update on the Current Horn of Africa Polio Outbreak

Monday, 5th of August 2013    

Background on Outbreak


  • There are currently 105 recorded wild poliovirus (WPV) cases in the Horn of Africa: 95 in Somalia and 10 in Kenya. These are the first laboratory-confirmed cases of wild polio virus since July 2011 in Kenya and March 2007 in Somalia.


  • The first 2013 Somali WPV case had onset of paralysis on 18 April in Mogadishu.
  • Banadir is the epicenter of the outbreak, accounting for more than half of all cases associated with this outbreak (as of 31 July).
  • There have also been reported polio cases in Lower Shabelle, areas of which are inaccessible due to insecurity. Access to families in Lower Shabelle has been compromised for the past three years. As many as 600,000 children in this area are at particular risk for polio.
  • One polio case has been reported in Somaliland. This case is far from the other cases and close to the border with Ethiopia, threatening further spread.


  • The first 2013 Kenyan WPV case had onset of paralysis on 30 April in Dadaab, Kenya.
  • Dadaab, the site of a major refugee camp hosting 500,000 people from across the Horn, is the Kenyan epicenter of the outbreak.


  • As of July 24, twelve vaccination campaigns have been conducted across Somalia, Kenya, Ethiopia and Yemen that aimed to reach more than 17 million children and adults.
  • Immunization campaigns across the Horn of Africa, including in Ethiopia and Yemen, will continue throughout 2013.


Last Updated on Wednesday, 07 August 2013 16:05

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.


Source: WHO/EURO

Original Article: 

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.

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