Polio This Week As of July 27, 2017 

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Afghanistan:

• No new wild poliovirus type 1 (WPV1) cases were reported in the past week.  The total number of WPV1 cases for 2017 remains five.  The most recent case in the country had onset of paralysis on June 19 from Kandahar.
• With most of Afghanistan polio-free, efforts are focused on continuing to strengthen operations, in close coordination with Pakistan, to address remaining low-level transmission in the common reservoir area of the Quetta-Kandahar transmission corridor.
• Afghanistan is carrying out a program review focusing on the implementation of the National Emergency Action Plan and making necessary adjustments for the second half of 2017.

Pakistan:

• No new wild poliovirus type 1 (WPV1) case was reported in the past week; the total number of WPV1 cases for 2017 remains three.  The most recent case in the country had onset of paralysis on June 11, from Killa Abdullah, Balochistan.
• Six new WPV1-positive environmental samples were reported in the past week, all collected in July, from Killa Abdullah, Balochistan; Gadap, Gulberg, Kamari, greater Karachi, Sindh; Islamabad; and, Rawalpindi, Punjab.
• The year 2016 saw the lowest ever annual number of polio cases in the country but poliovirus continues to be isolated through environmental surveillance over a significant geographical range. Efforts are ongoing through the implementation of the national emergency action plan to address remaining gaps in coverage and surveillance, in close coordination with neighbouring Afghanistan.

Nigeria:

• No new cases of wild poliovirus type 1 (WPV1) were reported in the past week.  The total number of WPV1 cases for 2016 remains four and no cases have been reported in 2017.  The most recent case had onset of paralysis on 21 August 2016 in Monguno Local Government Area (LGA), Borno.
• Nigeria continues to implement emergency response to the detected WPV1 strain and circulating vaccine-derived poliovirus type 2 (cVDPV2) strains affecting the country (last detected in 2016).
• The response is part of a broader regional outbreak response, coordinated with neighbouring countries, in particular the Lake Chad sub-region, including northern Cameroon, parts of Central African Republic, Chad and southern Niger.
• Detection of the polio cases in Nigeria underscores the risk posed by low-level undetected transmission and the urgent need to strengthen subnational surveillance.

Lake Chad Basin:

• The detection of wild poliovirus type 1 (WPV1) and circulating vaccine-derived poliovirus type 2 (cVDPV2) in Nigeria poses a risk to the neighbouring countries of the Lake Chad basin and hence an outbreak response plan is being implemented as part of the response to the Nigeria outbreak.
• Emergency outbreak response efforts continue across the Lake Chad basin, together with activities to fill subnational surveillance gaps across the region.

Central Africa:

• No new cases were reported in the past week.  The Democratic Republic of the Congo (DR Congo) is affected by two separate outbreaks of circulating vaccine derived poliovirus type 2 (cVDPV2), in Haut Lomami province (two cases, with onset of paralysis on March 8 and February 20); and in Maniema province (two cases with onset of paralysis on March 26 and April 18, with an additional isolate detected in a healthy individual with sample collection on May 2).
• Outbreak response plans are currently being finalized, with supplementary immunization activities using monovalent oral polio vaccine type 2 (mOPV2) in line with internationally-agreed outbreak response protocols.
• The first mOPV2 campaign was implemented end of June (June 27-29) targeting more than 750,000 children under the age of five years in the two affected provinces.
• Surveillance and immunization activities are being strengthened in neighbouring countries.
• DR Congo is also affected by an Ebola outbreak, in Bas Uele province in the north of the country.  Coordination among both outbreak response teams will be necessary and teams are already working on this.

Syria:

• In Syria, no new cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) were reported in the past week. The total number of cVDPV2 cases is now 27.  All cases had onset of paralysis between March 3 and June 6.  Twenty-six of the cases are from Mayadeen, and one case is from Raqua governorate.
• Confirmation of additional cases is not unexpected at this time and would not change the operational situation, as outbreak response plans are being finalized, in line with internationally-agreed outbreak response protocols.  Although access to Deir-Al-Zour is compromised due to insecurity, the Governorate has been partially reached by several vaccination campaigns against polio and other vaccine-preventable diseases since the beginning of 2016. Most recently, two campaigns have been conducted in March and April 2017 using the bivalent oral polio vaccine (OPV). However, only limited coverage was possible through these campaigns.
• Two outbreak response campaigns are planned covering both Deir-Al-Zour and Raqua, the first to commence on July 22 targeting 328,000 children aged less than five years in Deir-Al-Zour and 120,000 children in Raqua.