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Poliomyelitis - Multistate (world) - Monitoring global outbreaks (ECDC/CDTR, August 26 2013, extract)

Giuseppe

Emeritus
[Source: European Centre for Disease Prevention and Control (ECDC), full PDF document: (LINK). Extract.]


COMMUNICABLE DISEASE THREATS REPORT

Week 34, 18-24 August 2013

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Poliomyelitis - Multistate (world) - Monitoring global outbreaks

Opening date: 8 September 2005 Latest update: 22 August 2013


Epidemiological summary

Worldwide, 192 cases of poliomyelitis have been reported (up to 20 August 2013) compared with 123 for the same period in 2012.

Five [six, mod.] countries have reported cases in 2013:
  1. Afghanistan (4),
  2. Pakistan (24),
  3. Nigeria (43),
  4. Somalia (108),
  5. Kenya (12) and
  6. Ethiopia (1).
The majority (121), occurred in three non-endemic countries facing an outbreak with WPV1 that started in May 2013: Somalia, Kenya and Ethiopia. Those 121 cases of acute flaccid paralysis with poliovirus suggest that thousands of asymptomatic people in the region carry the virus.

Outbreak response measures across the region continue to be implemented. Five campaigns have been carried out in Somalia, vaccinating four million people. The large majority of the cases are in southern and central Somalia, where more than 600 000 children are particularly vulnerable to polio. On 18 July, one confirmed case was reported also from the northern Sool region.

The affected area in Kenya is the Dadaab area of North Eastern province, an area with almost half a million Somali refugees and where nearly 50% of children remain under-immunised (compared to less than 5% in Kenya as a whole).

The confirmation of the case in Ethiopia underscores the risk this outbreak continues to pose to countries across the region.

Supplementary immunisation activities (SIAs) had already been conducted in the region, an immunisation campaign is being conducted in response to the case and additional SIAs are planned in the coming months.

Ongoing circulation of the virus in Israel has been detected through sewage sampling and subsequent fecal sampling of healthy individuals.

Please refer to the specific section on Israel in this report for details.
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ECDC assessment

The last polio cases in the EU occurred in 2001 when three young Bulgarian children of Roma ethnicity developed flaccid paralysis caused by WPV. Investigations showed that the virus originated from India. The latest outbreak in the WHO European Region was in Tajikistan in 2010, when WPV1 imported from Pakistan caused an outbreak of 460 reported cases. The last indigenous WPV case in Europe was in Turkey in 1998. An outbreak in the Netherlands in a religious community opposed to vaccinations caused two deaths and 71 cases of paralysis in 1992.


Actions

ECDC follows reports on polio cases worldwide through epidemic intelligence in order to highlight polio eradication efforts and identify events that increase the risk of re-introduction of wild poliovirus into the EU.

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