WHO

March 1, 2016

“….The Committee unanimously agreed that the international spread of polio remains a Public Health Emergency of International Concern (PHEIC) and recommended the extension of the Temporary Recommendations for a further three months. The Committee considered the factors expressed in reaching this conclusion at the seventh meeting still applied:

• The continued international spread of wild poliovirus during 2015 involving Pakistan and Afghanistan.
• The risk and consequent costs of failure to eradicate globally one of the world’s most serious vaccine preventable diseases.
• The continued necessity of a coordinated international response to improve immunization and surveillance for wild poliovirus, stop its international spread and reduce the risk of new spread.
• The serious consequences of further international spread for the increasing number of countries in which immunization systems have been weakened or disrupted by conflict and complex emergencies. Populations in these fragile states are vulnerable to outbreaks of polio. Outbreaks in fragile states are exceedingly difficult to control and threaten the completion of global polio eradication during its end stage.
• The importance of a regional approach and strong cross-border cooperation, as much international spread of polio occurs over land borders, while recognizing that the risk of distant international spread remains from zones with active poliovirus transmission.
• Additionally with respect to cVDPV (circulating vaccine-derived polioviruses):
  • cVDPVs also pose a risk for international spread, and if there is no urgent response with appropriate measures, particularly threaten vulnerable populations as noted above;
  • The emergence and circulation of VDPVs in four WHO regions demonstrates significant gaps in population immunity at a critical time in the polio endgame;
  • There is a particular urgency of stopping type 2 cVDPVs in advance of the globally synchronized withdrawal of type 2 component of the oral poliovirus vaccine in April 2016.

Deccan Herald

Why success?

CDC

Progress Toward Poliomyelitis Eradication — Pakistan, January 2014–September 2015

Weekly

November 20, 2015 / 64(45);1271-1275

Noha H. Farag, MD, PhD1; Mufti Zubair Wadood, MBBS2; Rana Muhammad Safdar, MD3; Nabil Ahmed, MPH1; Sabrine Hamdi, DMD4; Rudolph H. Tangermann, MD2; Derek Ehrhardt, MPH1

“Since Nigeria reported its last case of wild poliovirus type 1 (WPV1) in July 2014, Pakistan and Afghanistan remain the only two countries where WPV transmission has never been interrupted (1). This report describes actions taken and progress achieved toward polio eradication in Pakistan during January 2014–September 2015 and updates previous reports (2,3). A total of 38 WPV1 cases were reported in Pakistan during January–September 2015,* compared with 243 during the same period in 2014 (an 84% decline). Among WPV1 cases reported in 2015, 32 (84%) occurred in children aged <36 months, nine (32%) of whom had never received oral poliovirus vaccine (OPV). Twenty-six (68%) of the 38 reported cases occurred in the Federally Administered Tribal Areas (FATA) and Khyber Pakhtunkhwa (KPK) Province. During January–September 2015, WPV1 was detected in 20% (64 of 325) of environmental samples collected, compared with 34% (98 of 294) of samples collected during the same period in 2014. The quality and scope of polio eradication activities improved considerably following the establishment of a national Emergency Operations Center, which coordinated polio eradication partners’ activities. All activities are following a National Polio Eradication Emergency Action Plan (4) that includes a rigorous action plan for the polio low transmission season (January−April). The presence of WPV1 in environmental samples in areas where no polio cases are detected highlights the need to improve surveillance for acute flaccid paralysis (AFP). Focused efforts to close remaining immunity gaps by locating, tracking, and vaccinating continually missed children and improving coverage with OPV through the routine vaccination program are needed to stop WPV transmission in Pakistan…….”