HEADLINES - Polio was detected in New York, USA

• This past month, a polio case was detected in New York, USA. The CDC has been coordinating with New York State health authorities on their investigations and response. Any form of poliovirus anywhere in the world is a threat to countries everywhere.  More.
• In Mozambique, three new wild poliovirus type 1 (WPV1) cases are reported this week, including one case from a district bordering Zimbabwe.  See ‘Mozambique’ section below, for more information.  
• “Women front line workers in Pakistan have resolved to reach all children with polio vaccine, even if it means crossing difficult terrain.  As a polio gender champion, I urge all parents and caregivers to vaccinate their children and end polio once and for all.” Amanda Milling, UK Minister for Asia and the Middle East and Polio Gender Champion. 
• Analysis of 2021 data:  In 2021, more than 372 million children were vaccinated multiple times in 30 countries, using more than 1 billion doses of OPV.

• Pakistan: one WPV1 case
• Benin: one cVDPV2 positive environmental sample
• Chad: one cVDPV2 case
• DR Congo: one cVDPV2 case
• Madagascar: three cVDPV1 cases
• Mozambique: three WPV1 cases and two cVDPV1 cases

• No new wild poliovirus type 1 (WPV1) or circulating vaccine-derived poliovirus type 2 (cVDPV2) cases were reported this week. There is one WPV1 case reported in 2022 and four in 2021. The total number of cVDPV2 cases remains 43.

• One WPV1 case was reported in Khyber Pakhtunkhwa province bringing the number of 2022 WPV1 cases to 13. In 2021, the number of WVP1 cases was one and the number of cVDPV2 cases was eight.

• No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was reported this week. There is one case in 2022 that is linked to the Zamfara emergence from Nigeria.

• No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was reported this week. There are two cases in 2022 and three cases reported in 2021. 
• One positive cVDPV2 environmental sample was reported in Donga.

• No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was reported this week. There were two cases reported in 2021.  

• No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was reported this week. There were three cases reported in 2021.

• No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was reported this week. There were no cases reported in 2021.

• One case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was reported in Chari Baguirmi bringing the number of 2022 cases to nine.

• No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was reported this week. There were two cases reported in 2021.

• No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was reported this week. There were no cases reported in 2021.

• No circulating vaccine-derived poliovirus type 2 (cVDPV2) positive environmental samples were reported this week. There are 16 positive environmental samples reported in the country, all linked to the virus circulating in Yemen.

• One case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was reported in Nord Kivu bringing the number of cases in 2022 to 64. There were 28 cases in 2021.

• No circulating vaccine-derived poliovirus type 2 (cVDPV2) positive environmental samples were reported this week. There are 16 positive samples reported in the country.

• No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was reported this week. There were ten cases reported in 2021.

• No circulating vaccine-derived poliovirus type 2 (cVDPV2) positive environmental samples were reported this week. There were nine positive samples in 2021.

• No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was reported this week. There is one case reported in 2022.

• No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was reported this week. There were six cases in 2021.

• No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was reported this week. There are three cases in the country which are linked to the Jigawa outbreak in Nigeria in 2021.

• No case of circulating vaccine-derived poliovirus type 3 (cVDPV3) was reported this week. There is one case reported in 2022.

• No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was reported this week. There were three cVDPV2 cases in 2021. 

• Three cases of circulating vaccine-derived poliovirus type 1 (cVDPV1) were reported; one in Sud-Ouest and two in Menabe, bringing the number of cases in 2022 to eight. There were 13 cases in 2021.

• No case of wild poliovirus type 1 (WPV1) was reported this week. One case from 2021 has been reported this year.
• Malawi continues to participate in the multi-country, subregional outbreak response, to urgently stop the WPV1 outbreak affecting the area.

• No circulating vaccine-derived poliovirus type 2 (cVDPV2) positive environmental sample was reported this week. There were seven positive samples linked to the Jigawa outbreak in 2021.

• Three new WPV1 cases were reported this week from Tete province (the same province as the first WPV1 case with onset of paralysis in March, which was reported in May), with onset of paralysis in May and June 2022. One of the new cases is reported from a district bordering Zimbabwe.  This brings the total number of cases in the country to four. Reporting of these new cases within a short time span indicates that intensified surveillance efforts are working in the province.  
• Two of the three new viruses are more closely linked with the WPV1 isolated from the first case of Mozambique with onset in March 2022 from the same province, indicating local circulation of WPV1 within the province and probably the country. However, the WPV1 found in Magoé district (close to the Zimbabwe and Zambia borders), is an orphan virus which is more closely related to the virus found earlier in Malawi. Genetic analysis further indicates that there are clearly at least two transmission chains that are co-evolved after introduction of the virus in Tete province in Mozambique.  While it is difficult to speculate, distribution of WPV1 and their genetic linkage suggests that missed transmission in bordering areas around Mozambique-Zimbabwe-Zambia cannot be ruled out.
• Mozambique has implemented three immunization rounds using bOPV since the detection of the first case from March.  Assessments of these rounds show gradual improvements in quality, round to round, though quality remains suboptimal in Tete province. 
• A field investigation is ongoing in response to these latest cases, with focus on surveillance and to more clearly assess geographical scope of circulation, and to ultimately guide future response plans
• Two cases of circulating vaccine-derived poliovirus type 1 (cVDPV1) were reported; one each in Nampula and Zambezia. These cases are linked to each other and part of a new emergence. The case from Nampula had an onset of paralysis in January 2020 and the one in Zambezia in May 2022, making it the first cVDPV1 case in the country this year.

• No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was reported this week. There are eight cases in 2022. There were 18 cases reported in 2021.

• No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was reported this week. The number of cases in 2022 remains 30. There were 415 cases reported in 2021.

• No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was reported this week. There were 17 cases reported in 2021.

• No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was reported this week. There were five cases reported in 2021. 

• No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was reported this week. There are two cases reported in 2022. There was one case reported in 2021.

• No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was reported this week. There were nine cVDPV2 cases reported in 2021.

• No circulating vaccine-derived poliovirus type 2 (cVDPV2) positive environmental sample was reported this week. There was one positive sample reported this year in the country.

• No circulating vaccine-derived poliovirus type 2 (cVDPV2) positive environmental sample was reported this week. There were two positive samples linked to the N’Djamena outbreak in Chad reported in 2021.

• No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was reported this week. There were two cases reported in 2021.

• No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was reported this week. The number of cVDPV2 cases in 2022 remains 54. There were 66 cVDPV2 cases and three cVDPV1 cases in 2021.
• Almost two-thirds of the areas reporting the bulk of cVDPV2 cases have not implemented type 2-containing polio vaccination campaigns, underscoring the risk both to local children and to neighbouring countries.
• Intensive efforts are ongoing to access Yemen’s northern governorates with polio vaccine.