Wild poliovirus type 1 and Circulating vaccine-derived poliovirus cases

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1 of 5 4/8/2016 5:29 PM Polio this week as of 6 April 2016 The third Outbreak Response Assessment in Madagascar found that the surveillance system is not yet strong enough to conclude that polio transmission has been interrupted. Thirty-nine high-risk districts have been identified to receive focused attention. There is one week to go until the globally synchronized switch from the trivalent to bivalent oral polio vaccine, the first stage of objective 2 of the Polio Eradication and Endgame Strategic Plan 2013-2018. Learn more about preparations for the switch here. Learn more about the rationale for the switch through this series of videos. Wild poliovirus type 1 and Circulating vaccine-derived poliovirus cases Total cases Year-to-date 2016 Year-to-date 2015 Total in 2015 WPV cvdpv WPV cvdpv WPV cvdpv Globally 9 3 22 1 74 32 - in endemic countries 9 0 22 1 74 3 - in non-endemic countries 0 3 0 0 0 29 Case breakdown by country

2 of 5 4/8/2016 5:29 PM Year-to-date 2016 Year-to-date 2015 Total in 2015 Onset of paralysis of most recent case Countries WPV cvdpv WPV cvdpv WPV cvdpv WPV cvdpv Afghanistan 2 0 1 0 20 0 01-Feb-16 NA Pakistan 7 0 21 1 54 2 16-Feb-16 09-Feb-15 Guinea 0 0 0 0 0 7 NA 14-Dect-15 Lao PDR 0 3 0 0 0 8 NA 11-Jan-16 Madagascar 0 0 0 0 0 10 NA 22-Aug-15 Myanmar 0 0 0 0 0 2 NA 05-Oct-15 Nigeria 0 0 0 0 0 1 NA 16-May-15 Ukraine 0 0 0 0 0 2 NA 07-Jul-15 NA: onset of paralysis in most recent case is prior to 2015. Figures exclude non-afp sources. Madagascar, Ukraine and Lao PDR cvdpv1, all others cvdpv2. cvdpv definition: see document "Reporting and classification of vaccine-derived polioviruses" at http://www.polioeradication.org/portals/0/document/resources /VDPV_ReportingClassification.pdf. Implementation as of 15 August 2015.

of 5 http://www.polioeradication.org/dataandmonitoring/poliothisweek.aspx 4/8/2016 5:29 PM Afghanistan No new cases of wild poliovirus type 1 (WPV1) was reported in the past week. The more recent occurred in Nawzad district of Hilmand province, with onset of paralysis on 23 January. The total number of WPV1 cases for 2016 remains 2, compared to 1 reported for 2015 at this point last year. No new WPV1 environmental positive samples were reported in the past week. The most recent environmental positive samples were collected on 27 December 2015 - one in Jalalabad in Nangarhar province and the second in the city of Kabul. Sub-National Immunization Days (SNIDs) are planned from 19 to 22 April, prior to the switch. Read more about the switch here. Pakistan No new wild poliovirus type 1 (WPV1) case was reported in the last week. The last was recorded in Shikarpur district of Sindh province, with onset of paralysis on 5 March. The total number of WPV1 cases for 2016 remains 7, compared to 20 reported at the same date last year. Five new WPV1 environmental positive samples were reported in the past week, with collection dates between 3 February and 12 March 2016. Two were collected from Sindh, one from Balochistan, one from Punjab and one from Khyber Pakhtunkhwa. Sub-National Immunization Days (NIDs) are planned in April using bopv. Lao People's Democratic Republic No new cases of circulating vaccine-derived poliovirus type 1 (cvdpv1) were reported in the past week. The most recent case was reported in Fuang district of Vientiane province, with onset of paralysis on 11 January 2016. The total number of cvdpv1

4 of 5 4/8/2016 5:29 PM cases in 2015 remains 8 and in 2016 remains 3. Outbreaks of cvdpvs can arise in areas with low population immunity, emphasizing the importance of maintaining strong vaccination coverage. Learn more about VDPVs. An emergency outbreak response is continuing in the country, with particular focus on three high-risk provinces. Efforts continue to further strengthen surveillance activities in all provinces of the country, to ensure that no cvpdv1 transmission is missed anywhere. Madagascar No new cases of circulating vaccine-derived poliovirus type 1 (cvdpv1) were reported in the past week. The most recent case had onset of paralysis on 22 August from Sud-Ouest region. The total number of cvdpv1 cases for 2015 remains 10. The third Outbreak Response Assessment in Madagascar found that the surveillance system is not yet strong enough to conclude that polio transmission has been interrupted. Thirty-nine high-risk districts have been identified to receive focused attention. The 2015 cases are genetically linked to the case with onset of paralysis in September 2014, indicating prolonged and widespread circulation of the virus. Learn more about vaccine derived polioviruses here. The emergency outbreak response continues to be intensified. National Immunization Days (NIDs) are planed from 11 to 15 April, using topv. Myanmar No new cases of circulating vaccine-derived poliovirus type 2 (cvdpv2) have been reported in the past week. The most recent case was isolated from a 16-month old child in Maungdaw, Rakhine, with onset of paralysis on 05 October. The total number of cvdpv2 cases in 2015 remains 2. The case was genetically linked to a VDPV isolated in the same township in April 2015 which has been reclassified as a cvdpv type 2. The genetic changes in the isolate suggest the cvdpv2 has been circulating for more than a year. Learn more about vaccine derived polioviruses here. WHO assesses the risk of international spread from Myanmar to be low. Surveillance and immunization activities are being strengthened in neighbouring countries. National Immunization Days (NIDs) are planed from 23 to 25 April, prior to the switch, using topv.

5 of 5 4/8/2016 5:29 PM Nigeria No new wild poliovirus type 1 (WPV1) cases were reported in the past week. No cases were reported in 2015. The most recent case had onset of paralysis on 24 July 2014 in Sumaila Local Government Area (LGA), southern Kano state. No new cases of type 2 circulating vaccine-derived poliovirus (cvdpv2) were reported in the past week. The most recent case had onset of paralysis in Kwali Local Government Area (LGA), Federal Capital Territory (FCT) Abuja, with onset of paralysis on 16 May 2015; this is the only cvdpv2 case reported in Nigeria in 2015. Vigilance must be maintained to ensure that all children are reached with polio vaccines and that surveillance systems remains alert to polioviruses. Sub-National Immunization Days (NIDs) are planned in the North from 14 to 17 May using bivalent oral polio vaccine (bopv). Ukraine No new circulating vaccine-derived poliovirus type 1 (cvdpv1) cases have been reported in the past week. The most recent case had onset of paralysis on 7 July 2015 in the Zakarpatskaya oblast, in south-western Ukraine, bordering Romania, Hungary, Slovakia and Poland. The number of cvdpv1 cases reported in 2015 remains 2. Ukraine had been at particular risk of emergence of a cvdpv, due to very low vaccination coverage. Learn more about vaccine derived polioviruses here. West Africa No new circulating vaccine-derived poliovirus type 2 (cvdpv2) cases were reported from Guinea in the past week. The most recent was reported from Kankan district, with onset of paralysis on 14 December. The total number of cvdpv2 cases for 2015 remains 7. The 2015 cases are genetically linked to the case with onset in August 2014. National Immunization Days (NIDs) will be carried out in Benin, Burkina Faso, Liberia, Mali, Mauritania, Sierra Leone, Guinea, Cote d Ivoire and Niger at the start of April. All campaigns are using trivalent oral polio vaccine (topv).