News
11 July 2007
Polio update
In May 2007, the 60th session of the World Health Assembly in Geneva resolved to step up efforts to eradicate paralytic poliomyelitis [1]. Dr. Margaret Chan, the Director-General of the World Health Organization, has sent a document: “The Case for Completing Polio Eradication” to key global leaders. She is advocating that development ministers, foundations and individual stake holders immediately mobilise additional finances as insufficient funds are jeopardising the eradication programme [1, 2]. World leaders at the annual G8 Summit last month pledged to make overriding efforts to eradicate polio and to work closely with other organisations to close financial shortfalls [2].
The Organization of Islamic Conference (OIC) met in Malaysia in mid-June. They designated polio eradication as an urgent priority and called on countries in conflict zones to adopt “Days of Tranquillity” to allow the safe delivery of vaccination programmes. They also urged OIC member countries, the Islamic Development Bank and the international community to help bridge the funding gap [2].
Four countries, Afghanistan, India, Nigeria and Pakistan, remain polio-endemic. Angola, Chad, Democratic Republic of Congo, Myanmar, Niger, and Somalia have all reported imported cases or cases relating to an importation in the past six months [3, 4]
As of 3 July, reported polio cases worldwide in 2007 currently total 256, with 217 (85%) of these cases in endemic countries and 39 (15%) cases in non-endemic countries [4]. The Global Polio Eradication Initiative (GPEI) states that more than 143 million children were immunised in endemic and reinfected countries in May 2007 [2].
Afghanistan and Pakistan
In 2007, three cases of polio have been reported in Afghanistan and nine in Pakistan [4]. Both countries continue to work together to intensify efforts in regions with known polio transmission as well as improving access to vaccination for mobile, semi-autonomous populations and those living in insecure or border areas [2].
Operational difficulties continue: in the North West Frontier Province of Pakistan, a bomb was placed under the vehicle of a WHO polio surveillance officer, injuring a night watchman and causing extensive damage [5].
India
In 2007, 90 cases have been reported in India: 39 type 1 polio virus and 51 type 3 [4]. There is a focus of type 1 polio in the north of Bihar, whereas type 3 transmission is believed to be restricted to western districts of the state of Uttar Pradesh. In late May, the India Expert Advisory Group on Polio Eradication met and recommended further intensive eradication efforts, particularly the identification of migrant groups and flood areas in Bihar [2].
Nigeria
In 2007, 115 cases have been reported in Nigeria, 28 type 1 and 87 type 3 [4]. Immunisation Plus Days were held in key risk areas in late June, targeting more than 15 million children. The focus of Nigeria’s polio eradication strategy is the reduction of the proportion of children in high risk areas who have had no doses of polio vaccine, improvement in inconsistent coverage and increasing the quality of vaccination teams, particularly in crucial northern states [2].
A type 3 polio case has been reported in Rivers state. This is the first polio case reported in southern Nigeria since August 2005 and genetic sequencing has confirmed that it originated in northern Nigeria [2]. An immunisation campaign is imminent and mOPV3 vaccine has been licensed for use in Nigeria by the National Regulatory Agency.
Re-infected countries
These areas have ongoing transmission following the importation of polio: the cross border areas of northern and central Somalia and the Somali region of Ethiopia, the Bangladesh/Myanmar border, and Angola and the Democratic Republic of the Congo [2]. The GPEI has had advance notification of two cases of polio type 1 in Chad, the first reported cases since November 2006 [4].The GPEI also advise that Niger and Nepal remain at particular risk of repeated polio importation, due to their close proximity to endemic areas [2].
Advice for travellers
Travellers visiting polio risk countries should 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 prior to travel.
References
1. World Health Organization. World Health Assembly closes. Summary of additional decisions and issues discussed at the 60th World Health Assembly. 23 May 2007 [accessed 11 July 2007]. Available at http://www.who.int/mediacentre/news/releases/2007/wha02/
2. Global Polio Eradication Initiative. Monthly Situation Report. 19 June 2007 [accessed 11 July 2007]. Available at:
http://www.polioeradication.org/content/general/current_
3. Centers for Disease Control and Prevention. Outbreak Notice. Update on the Global Status of Polio. 19 June 2007 [accessed 11 July 2007]. Available at:
http://www.cdc.gov/travel/other/poliomyelitis_recent_
4. Global Polio Eradication Initiative. Wild poliovirus weekly update. 4 July 2007 [accessed 11 July 2007]. Available at: http://www.polioeradication.org/casecount.asp
5. Global Polio Eradication Initiative. Wild poliovirus weekly update. 20 June 2007 [accessed 21 June 2007].
Links
NaTHNaC poliomyelitis information sheet
http://www.nathnac.org/travel/factsheets/polio1.htm
Global Polio Erodaication Initiative
http://www.polioeradication.org
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