Pathfinder
Editor, Senior Moderator
WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 29: 17 - 23 July 2023
Data as reported by: 17:00; 23 July 2023
...
Kenya
Circulating Vaccine-derived Poliovirus type 2
2 cases
0 Deaths
0 % CFR
2 Grade
EVENT DESCRIPTION
The Ministry of Health of Kenya has notified WHO of
two cases of circulating vaccine-derived poliovirus type
2 (cVDPV2) confirmed on 28 June 2023 in Hagadera
Refugee Camp, Fafi Sub-county, Garissa County. The
cases were detected and confirmed as part of routine
Acute Flaccid Paralysis (AFP) surveillance activities
ongoing across the country.
The first case is a 34-month-old male with onset of
paralysis on 26 May 2023, while the second case, who
has a recent history of travel to Somalia, is a 19-month
old female with onset of paralysis on 27 May 2023. Both
cases are residents of the Hagadera Refugee Camp in
Kenya.
Analysis of stool samples among asymptomatic contacts
of the cases also shows cVDPV2 isolates from a 2-year
old male in the same area. This asymptomatic community
contact reportedly had a recent travel history to the
Lower Juba region of southern Somalia.
Genetic sequencing analysis revealed that all three
isolates have between 65 and 73 nucleotide changes
from Sabin and are linked to cVDPV2s currently
circulating in the Banadir region of southern Somalia.
Residents of the Hagadera Refugee Camp are known to
have frequent population movements with neighbouring
Somalia.
The last reported case of cVDPV2 in Kenya was in
January 2021. The country remains wild poliovirus free
since it reported its last indigenous wild polio cases
in 2013. According to the WHO-UNICEF estimates of
national immunization coverage, the oral polio vaccine
third dose (OPV3) and the inactivated polio vaccine first
dose (IPV1) was 87% and 89%, respectively in 2022.
PUBLIC HEALTH ACTIONS
The Ministry of Health, through the Division of
Disease Surveillance and Response and the Public
Health Emergency Operations Center, has activated
a Technical Coordinating Committee to mount an
emergency response to the outbreak.
Field investigation and risk assessment of the event,
led by the Ministry of Health with support from the
Global Polio Eradication Initiative (GPEI) partners
have been conducted.
The response to the outbreak is designed to be
consistent with internationally agreed guidelines for
outbreak response, including the rapid implementation
of large-scale supplementary immunization activities
with the most appropriate and available type 2 polio
vaccine.
Routine acute flaccid paralysis surveillance for the
detection of polio cases remains ongoing across the
affected areas and the rest of the country.
An analysis of population immunity levels with
focus on subnational areas is being conducted to
identify under-immunized populations for targeted
interventions
SITUATION INTERPRETATION
The recent detection of cVDPV2 cases in Kenya, linked to
an ongoing outbreak in Somalia where frequent population
movements and exchanges between the two countries
can facilitate transboundary exposure and spread of the
pathogen is of concern. This is occurring in the context
of suboptimal immunization coverage among the refugee
population, where overcrowding, high rates of malnutrition,
inadequate water and sanitation, and an influx of new
arrivals to the camp from Somalia can exacerbate the
situation. WHO advises Member States and State Parties
to maintain uniformly high routine immunization coverage
at the subnational level to minimize the consequences of
any new virus introduction. The current outbreak response
strategy should be comprehensive in nature, including
encompassing areas in neighbouring Somalia for an
effective response.
...
https://apps.who.int/iris/bitstream/handle/10665/371956/OEW29-1723072023.pdf
AND OTHER EMERGENCIES
Week 29: 17 - 23 July 2023
Data as reported by: 17:00; 23 July 2023
...
Kenya
Circulating Vaccine-derived Poliovirus type 2
2 cases
0 Deaths
0 % CFR
2 Grade
EVENT DESCRIPTION
The Ministry of Health of Kenya has notified WHO of
two cases of circulating vaccine-derived poliovirus type
2 (cVDPV2) confirmed on 28 June 2023 in Hagadera
Refugee Camp, Fafi Sub-county, Garissa County. The
cases were detected and confirmed as part of routine
Acute Flaccid Paralysis (AFP) surveillance activities
ongoing across the country.
The first case is a 34-month-old male with onset of
paralysis on 26 May 2023, while the second case, who
has a recent history of travel to Somalia, is a 19-month
old female with onset of paralysis on 27 May 2023. Both
cases are residents of the Hagadera Refugee Camp in
Kenya.
Analysis of stool samples among asymptomatic contacts
of the cases also shows cVDPV2 isolates from a 2-year
old male in the same area. This asymptomatic community
contact reportedly had a recent travel history to the
Lower Juba region of southern Somalia.
Genetic sequencing analysis revealed that all three
isolates have between 65 and 73 nucleotide changes
from Sabin and are linked to cVDPV2s currently
circulating in the Banadir region of southern Somalia.
Residents of the Hagadera Refugee Camp are known to
have frequent population movements with neighbouring
Somalia.
The last reported case of cVDPV2 in Kenya was in
January 2021. The country remains wild poliovirus free
since it reported its last indigenous wild polio cases
in 2013. According to the WHO-UNICEF estimates of
national immunization coverage, the oral polio vaccine
third dose (OPV3) and the inactivated polio vaccine first
dose (IPV1) was 87% and 89%, respectively in 2022.
PUBLIC HEALTH ACTIONS
The Ministry of Health, through the Division of
Disease Surveillance and Response and the Public
Health Emergency Operations Center, has activated
a Technical Coordinating Committee to mount an
emergency response to the outbreak.
Field investigation and risk assessment of the event,
led by the Ministry of Health with support from the
Global Polio Eradication Initiative (GPEI) partners
have been conducted.
The response to the outbreak is designed to be
consistent with internationally agreed guidelines for
outbreak response, including the rapid implementation
of large-scale supplementary immunization activities
with the most appropriate and available type 2 polio
vaccine.
Routine acute flaccid paralysis surveillance for the
detection of polio cases remains ongoing across the
affected areas and the rest of the country.
An analysis of population immunity levels with
focus on subnational areas is being conducted to
identify under-immunized populations for targeted
interventions
SITUATION INTERPRETATION
The recent detection of cVDPV2 cases in Kenya, linked to
an ongoing outbreak in Somalia where frequent population
movements and exchanges between the two countries
can facilitate transboundary exposure and spread of the
pathogen is of concern. This is occurring in the context
of suboptimal immunization coverage among the refugee
population, where overcrowding, high rates of malnutrition,
inadequate water and sanitation, and an influx of new
arrivals to the camp from Somalia can exacerbate the
situation. WHO advises Member States and State Parties
to maintain uniformly high routine immunization coverage
at the subnational level to minimize the consequences of
any new virus introduction. The current outbreak response
strategy should be comprehensive in nature, including
encompassing areas in neighbouring Somalia for an
effective response.
...
https://apps.who.int/iris/bitstream/handle/10665/371956/OEW29-1723072023.pdf
