WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 48: 25 November - 1 December 2019
Data as reported by: 17:00; 1 December 2019
...
cVDPV2 Ghana
9 Cases
0 Deaths
0% CFR
EVENT DESCRIPTION
The Ministry of Health in Ghana reported four new confirmed
paralytic cases of circulating vaccine-derived poliovirus type 2
(cVDPV2), one each from Savelugu District in Northern Region,
Jaman North in Bono Region, Nkwanta North in Oti Region and
Gonja Central District in Savannah Region. The dates of onset of
paralysis in the reported cases ranged between 8 and 23 October
2019.
In a related event, two environmental samples collected from
Ayawaso East Municipal, Greater Accra Region tested positive
for cVDPV2. The samples were collected on 23 October 2019.
Since 8 July 2019, when cVDPV2 was first isolated in an
environmental sample collected from Tamale Municipal in
Northern Region, a total of nine paralytic cases of cVDPV2 have
been confirmed in Ghana. The other districts that previously
confirmed cVDPV2 are Chereponi in North East Region; Saboba,
Kumbungu and Tamale in Northern Region; and Gonja Central
in Savannah Region. Additionally, cVDPV2 had previously
been isolated from an environmental sample collected from
Agbobloshie and Nima Free Town in Greater Accra Region and
Nyanshegu in Northern Region. The strain of the vaccine-derived
poliovirus type 2 circulating in Ghana is linked to the Jigawa
outbreak in Nigeria, which is circulating in many other countries.
Further investigations and risk assessment into the events are
ongoing and an update will be provided as new information
comes available.
PUBLIC HEALTH ACTIONS
The National Technical Coordinating Committee continues
to hold coordination meetings to strategize, plan, implement
and monitor the response to the cVDPV2 outbreak in the
country.
On 20 August 2019, a national rapid response team
comprising experts from MOH, WHO, CDC, Noguchi Polio
Laboratory was deployed to conduct outbreak investigation,
risk assessment and support local response by the regional
and district teams.
Multi-disciplinary rapid response teams from Ghana MOH,
WHO, CDC and UNICEF have been deployed to the affected
districts and regions to conduct detailed investigations and
risk assessments, and support local response, including
plan to carry out reactive vaccination campaigns in the newly
affected and surrounding high risk districts.
The Ministry of Health in Ghana, with the support of
Gavi, UNICEF, WHO and other partners, plans to conduct
a nationwide inactivated polio vaccine (IPV) catch-up
campaign targeting about 2.4 million vulnerable children of
birth cohorts between 2016 and February 2018 who missed
IPV vaccination because of operations challenges.
Response activities in the other affected regions are being coordinated
effectively through regional emergency operations centres.
Enhanced surveillance activities including active case search for acute flaccid
paralysis are ongoing. Environmental surveillance for poliovirus is being
strengthened in all sentinel sites.
Risk communication and social mobilization activities are ongoing in the
whole country.
SITUATION INTERPRETATION
Health authorities in Ghana reported four new paralytic cases of cVDPV2, scattered
across the country. In addition, cVDPV2 has been isolated from two environmental
samples collected from a sentinel site in Greater Accra Region. With these, the
number of cVDPV2 events is rapidly growing in Ghana, signifying a much deeper
diffusion of the pathogen in the community and thus increasing potential for wider
spread. Response efforts are ongoing to control the outbreak, with four rounds of
monovalent oral poliovirus type 2 (OPV2) vaccination carried out. Preparations are
also ongoing to conduct a country-wide IPV vaccination exercise. It is important for
Ghana and indeed all the countries in the region to step up efforts to improve their
routine immunization coverage to a minimum of 95% in all districts to minimize
the consequences of any new virus introduction. Attaining this target has not been
easy in many countries for various reasons including fragile health systems, conflicts
and social disruption, insecurity, etc. Additionally, all countries in the African region
should strengthen AFP surveillance to rapidly detect any new virus importation and
to facilitate a rapid response.
https://apps.who.int/iris/bitstream/handle/10665/330027/OEW48-02122019.pdf
