13 January 2006

 

Poliomyelitis in Indonesia and Somalia

 

Indonesia

On 13 January 2006, the Regional Office for Southeast Asia of the World Health Organization reported two cases of wild type polio from Aceh and East Java provinces [1]. This brings the total number of cases of wild type polio in Indonesia to 299. These cases have been from ten provinces: West Java, East Java, Central Java, Banten, and Jakarta on the island of Java, and Lampung, North Sumatra, South Sumatra, Aceh, and Riau on the island of Sumatra.

In addition to these wild type cases, the WHO is investigating a further 45 cases of Vaccine-Derived Poliovirus (VDPV) from Madura Island, East Java province, Indonesia [2]. VDPV cases may occur when there is circulation of oral polio virus in populations with low vaccine coverage [3]. VDPV results from mutations that occur over time allowing the virus to be transmitted between persons and to potentially cause paralytic polio. Control of VDPV cases is the same as the control of wild type polio: assuring high levels of vaccine coverage in the population.  

Two emergency vaccination campaigns were conducted on 31 May and 28 June 2005 in West Java, Banten and Jakarta provinces. In addition, three rounds of National Immunization Days were held on 30 August, 27 September and 30 November 2005. Over 24 million children below five years of age have been targeted.  

Somalia

The ongoing polio outbreak in Somalia has now spread outside of the capital Mogadishu [4]. As of 10 January 2006, a total of 153 cases have been reported [5].

Somalia is the only country in the world with a geographically expanding polio outbreak. With cases occurring outside of the capital there remains the risk of continued spread of wild polio both in Somalia and to neighbouring countries.

Polio immunisation campaigns are planned for January and February to target the country’s 1.6 million children below five years of age.

Six countries remain endemic for polio: Afghanistan, Egypt, India, Niger, Nigeria, and Pakistan. Six countries have re-established transmission following importation of polio beginning in 2003: Burkina Faso, Central African Republic, Chad, Côte d’Ivoire, Mali and Sudan. Countries not previously listed that have reported polio cases arising from importation in 2005 are: Angola, Cameroon, Eritrea, Ethiopia, Nepal, and Yemen. The total global count of case of wild type polio from 1 January 2005 through 10 January 2006 is 1,802 [5].

Recommendations for travellers

On 19 August 2004, NaTHNaC reviewed the current global epidemiology of polio and made a number of changes to recommendations that reflected the global status and the risk of polio to travellers [6]. As of 13 January 2006 these recommendations remain current: all travellers to countries at risk for polio should be up-to-date with the UK immunisation schedule and receive a booster dose of polio if they have not had one within the previous ten years.

 

References

1. Regional Office for Southeast Asia, World Health Organization. Polio News. Indonesia. Online resource [cited 13 January 2005]. Available at: http://w3.whosea.org/en/Section1226.asp

2. World Health Organization. Global Polio Eradication Initiative. Outbreak of polio in Indonesia. Updated 9 January 2005 [cited 13 January 2006) Available at: http://w3.whosea.org/vaccine/linkfiles/polioupdate.pdf

3. Kew OM, Wright PF, Agol VI, et al. Circulating vaccine-derived polioviruses: current state of knowledge. Bull World Health Organ 2004;82:16-23. Available at: http://www.who.int/bulletin/volumes/82/1/16-23.pdf

4. World Health Organization. Global Polio Eradication Initiative. Outbreak update. Somalia. 6 January 2006. [Accessed 13 January 2006] Available at: http://www.polioeradication.org/content/general/Outbreak_Updat

esSOM20051216.asp

5. Global Polio Eradication Initiative. Global case count. Online resource [cited 13 January 2006]. Available at: http://www.polioeradication.org/casecount.asp

6. NaTHNaC. Poliomyelitis and changes to recommendations for travellers. 19 August 2004. [Accessed 13 January 2006] Available at: http://www.NaTHNaC.org/pro/clinical_updates/polio_recommenda

tions.htm