Clinical Updates
29 August 2006
Polio update
In 2006, as of 22 August, there have been 1,017 cases of confirmed wild type polio. Ninety-two percent of these cases have occurred in the four countries that remain endemic for polio: Nigeria (687 cases), India (204), Afghanistan (26) and Pakistan (14) [1]. The remaining cases have occurred in polio re-infected countries where increasingly outbreaks have stopped or declined.
Nigeria
Nigeria accounts for nearly 70% of all polio cases worldwide [1, 2]. Five states in the north of the country, Bauchi, Jigawa, Kaduna, Kano and Katsina have reported most of the cases. Nigeria has planned additional Immunization Plus Days to vaccinate the population.
Namibia
Twenty cases of polio have been confirmed in Namibia in 2006, and more than 150 cases of acute flaccid paralysis are being investigated [2]. National Immunization Days (NIDs) have been held in response to this outbreak.
Somalia and Ethiopia
In 2006, 28 cases of polio have been reported in Somalia and eight cases in Ethiopia [1, 2]. Cases now appear to be limited to a cross-border region in the north of Somalia, primarily the Mudug region, and the Somali region of Ethiopia. Both country specific and regional efforts are being made to control the outbreak.
India
Mass vaccination campaigns have been launched in India in response to an outbreak of polio in Moradabad district in western Uttar Pradesh [3].
Western Uttar Pradesh has experienced a four-fold increase in polio cases in 2006 compared to the same period in 2005. A mass polio immunisation campaign in western Uttar Pradesh and Bihar states was launched on 30 July 2006, which aimed to vaccinate 32 million children under five years of age.
Bangladesh
Ten cases of polio have been reported in Bangladesh since the first case was reported in March 2006. Prior to this, Bangladesh had been polio-free for five years [4]. The Government of Bangladesh has ordered a further three polio NIDs in response to these cases. The first of these NIDs was due to be held on 6 August 2006 and aims to immunise 22 million children under the age of five years.
Afghanistan
Twenty five confirmed cases of polio have been reported in Afghanistan in 2006 which represents a six-fold increase compared to the same period last year [1, 5]. All but one of these cases occurred in southern Afghanistan where the current security situation has made it difficult for health teams to reach children in the area. Immunisation programmes are continuing in other areas of the country to prevent spread of polio out of the southern region.
Advice for travellers
It remains important for travellers going to polio risk countries to ensure that their polio vaccination schedule is up to date. Travellers whose last dose of polio vaccine was more than ten years ago should receive a booster.
References
1. Global Polio Eradication Initiative. Global case count. Polio cases in 2006 as of week of 22 August 2006. [cited 29 August 2006]. Available at: http://www.polioeradication.org/casecount.asp
2. Global Polio Eradication Initiative. Monthly situation report. August 2006. 8 August 2006. [cited 29 August 2006]. Available at: http://www.polioeradication.org/content/general/
3. Global Polio Eradication Initiative. Efforts are intensified in India, as new outbreak threatens to spread. 14 August 2006 [cited 29 August 2006] Available at http://www.polioeradication.org/content/general/
4. Global Polio Eradication Initiative. New cases of polio prompts further immunization drive in Bangladesh. 4 August 2006. [cited 29 August 2006] Available at http://www.polioeradication.org/content/pressreleases/
5. Global Polio Eradication Initiative. Polio outbreak in southern Afghanistan. 18 August 2006. [cited 29 August 2006] Available at http://www.polioeradication.org/content/general
Links
Global Polio Eradication Initiative
http://www.polioeradication.org/
NaTHNaC Poliomyelitis information sheet
http://www.NaTHNaC.org/pro/factsheets/polio.htm
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