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Polio Highlight

POLIO IN WHO’S AFRO REGION, 2011

Full text, in English and French, is at http://www.who.int/wer/2012/wer8712.pdf

Editorial note

During 2011, polio eradication efforts in Africa have seen both progress and setbacks. While new outbreaks in 8 countries were interrupted—in 6 countries within 6 months of confirmation—WPV transmission persisted in Angola, Chad, DRC, and Nigeria. The number of WPV cases surged in Chad and Nigeria during 2011 compared with 2010.

The 2010–2012 GPEI Strategic Plan established the following milestones to track progress: (1) stopping WPVtransmission following importation in countries with outbreaks in 2009 by mid-2010; (2) stopping WPV transmission following importation in countries with outbreaks in subsequent years within <6 months after confirmation of the outbreak; (3) stopping WPV transmission in countries with re-established transmission by the end of 2010; (4) stopping WPV transmission in at least 2 of the 4 WPV-endemic countries by the end of 2011; and (5) stopping WPV transmission in all countries by the end of 2012.

Substantial obstacles to implementation of the 2010–2012 Strategic Plan in Africa have prevented achievement of important milestones. The first milestone was met for 14 of the 15 outbreaks occurring in 2009. However, transmission persisted during 2009–2011 in adjoining areas of Kenya and Uganda indicating substantial gaps in field surveillance quality; these gaps are being addressed.

Many areas in other countries of the Horn of Africa remain at risk of outbreaks following WPV importation, due to immunity and surveillance quality gaps. For example, civil conflict has prevented vaccination of around 1 million children aged <5 years in south-central Somalia for the past 18 months.

With re-established transmission continuing into 2011in Angola, Chad, and DRC, the GPEI failed to meet the third milestone. Persistent circulation in Angola caused outbreaks in Western DRC in 2011, from where northeastern Angola was re-infected. Seven years after WPV was first imported from India (2005), Angola now appears to be on-track to finally interrupt transmission.

However, to reliably document and maintain interruption of transmission, Angola also needs to strengthen surveillance and continue to conduct SIAs. In Chad, transmission of WPV3 of Nigerian origin was re-established from November 2007 to March 2011, followed by re-established transmission of WPV1 (also imported from Nigeria) since September 2010.

Prolonged re-established transmission in eastern DRC since 2006 and new outbreaks in western DRC are primarily due to chronic gaps in surveillance and low population immunity. An important additional risk factor in eastern DRC is refusal of vaccination among parents from specific religious communities. In an effort to interrupt finally the transmission of re-established WPV in Chad and DRC, the number of national and international staff working on polio eradication was increased substantially in 2011 in both countries.

Regarding the fourth milestone of the 2010–2012 Strategic Plan, India has not detected a poliomyelitis case since mid-January 2011 and is no longer considered to be an endemic country. However, setbacks occurred in Afghanistan, Pakistan and Nigeria. Nigeria is the only country in Africa that has never eliminated transmission of indigenous WPV. The GPEI’s Independent Monitoring Board indicated that Nigeria and Pakistan pose the greatest risks to achieving the 2012 goal of interrupting the transmission of WPV globally.

Multiple polio outbreaks in previously polio-free African countries since 2003 have been traced to WPV imported from Nigeria. The goals of regional and global polio eradication will never be attained as long as WPV circulation continues in Nigeria. Operational problems in implementing high quality supplementary immunization activities (SIAs) continue to be the main reason why children remain unvaccinated in northern Nigeria.

New serious security challenges arose in Nigeria during 2011, further increasing the existing operational and managerial challenges to conducting SIAs with high coverage. In a concerted effort with GPEI partner agencies, the federal government of Nigeria is developing an emergency action plan aimed at restoring the programmatic momentum attained during 2009–2010.

Many innovative approaches to improve the microplanning and implementation of SIAs are being instituted. In May 2012, the World Health Assembly will consider a resolution declaring polio eradication an emergency for global public health. Urgent action is needed to improve the quality of SIAs implementation in the polio-affected countries of Nigeria, Chad and DRC. All other countries in Africa need to urgently improve the sensitivity of surveillance systems, and attain high levels of population immunity to reliably detect circulating or imported WPV and to prevent or limit the impact of new outbreaks.

Source:WHO

We are introducing a new format of our Polio Bulletin beginning this week

Alternative algorithm for poliovirus isolation and characterization

As the countries of the world advance towards the eradication of wild poliovirus, it is necessary to maintain good quality laboratory results and improve the timeliness of polio confirmation.

To achieve this, the Global Polio Laboratory Network (GPLN) of the World Health Organization (WHO) recommended the implementation of a new algorithm for viral isolation, using the cells RD and L2OB simultaneously, permitting the report of results within 14 days of receipt of the stool specimen in the laboratory (previously, 28 days were considered appropriate).

PAHO continues to be committed to the global eradication of polio; therefore it will monitor the implementation of this algorithm, and update its Weekly Polio Bulletin in order to show compliance with laboratory indicators.

For more information, please refer to the "Supplement to the WHO Polio Laboratory Manual" available below: http://www.who.int/immunization_monitoring/laboratory_polio_resources/en/index.html

Last Updated on Wednesday, 28 March 2012 11:04

In Angola, UN chief launches annual polio eradication drive

27 February 2012 – Secretary-General Ban Ki-moon today launched a national polio vaccination campaign in Angola, where the crippling disease has returned despite being eradicated in 2001, and praised the Government for its leadership on the issue.

Angola provides a large majority of the funding needed to vaccinate the country’s children.

“I am deeply grateful to President [Jose Eduardo] dos Santos his personal commitment to this cause,” Mr. Ban told community members participating in the launch in Viana, near the capital city of Luanda.

Angola had eradicated polio in 2001, but the disease returned within the following four years.

The Secretary-General said this showed the importance of responding to any new cases and immunizing every child against polio and other vaccine-preventable diseases.

“Polio eradication must be treated as a public health emergency,” said Mr. Ban, stressing the need to also keep track of the situation, improve the water supply, and a create a clean environment and strong surveillance system. He stressed that all Angolans, “health workers, volunteers, mothers and fathers,” have to play their part to rid the country of polio. “In the future, generations will thank you for your work today,” he said.

The Secretary-General also helped administer vaccine drops to some children. “The vaccine is so easy to administer, even I have done it,” he said.

Also today, Mr. Ban held meetings with the President, the Foreign Minister and civil society, discussing, among other issues, how to strengthen the partnership between the UN and Angola.

He commended the authorities for progress on the anti-poverty targets known as the Millennium Development Goals (MDGs) and encouraged them to push even harder, and to work toward a more equitable distribution of wealth.

Source: UN News Centre

President Goodluck Jonathan launched Nigerian Presidential Task Force

His Excellency the President of Nigeria, Goodluck Jonathan, launched a Presidential Task Force last week to oversee implementation of the national polio emergency action plan.

He emphasized the urgency, and a strong commitment, to complete the goal of polio eradication as rapidly as possible. He also pledged financial commitments from Nigeria of US$30 million per year for polio eradication activities.

"Nigeria is still a sanctuary of wild polio and we are becoming a threat to other countries," he said at the official launching of the Task Force. "It is quite embarrassing especially considering the fact that polio is a disease that we can conveniently eradicate."

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