Giuseppe
Emeritus
[Source: European Centre for Disease Prevention and Control (ECDC), full PDF document: (LINK). Edited.]
COMMUNICABLE DISEASE THREATS REPORT
Week 35, 25-31 August 2013
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Poliovirus - Israel- Detection of WPV1 in environmental samples and healthy individuals
Opening date: 19 August 2013 Latest update: 30 August 2013
Epidemiological summary
In Israel, wild poliovirus type 1 (WPV1) was isolated from sewage samples collected on 9 April 2013 in Rahat, southern Israel. Preliminary analyses indicated that the strain is related to the strains circulating in Pakistan and the strain detected in sewage from Cairo in December 2012. The strain is not related to virus currently affecting the Horn of Africa. WPV1 has now been detected in 85 sewage samples from 27 sampling sites in southern and central Israel, collected from 3 February 2013 to 4 August 2013. As part of subsequent ongoing stool sample survey activities, WPV1 has also been isolated in stool samples from 42 carriers, representing 4.4% of all collected samples. No cases of paralytic polio have been reported in the country. Israel has been free of indigenous WPV transmission since 1988. In the past, wild poliovirus has been detected in environmental samples collected in this region between 1991 and 2002 without occurrence of cases of paralytic polio in the area.
A positive sewage sample collected on 30 June from Tulkarem in the West Bank was reported retrospectively. Previous and subsequent specimens collected through environmental surveillance since 2002 in both Gaza and the West Bank have consistently tested negative for the presence of WPV.
A supplementary immunisation activity (SIA) with bivalent oral polio vaccine (OPV1 and 3) started in parts of southern Israel during the week of 5 August, and was expanded nationwide on 18 August for all children up to the age of nine years. The objective of these SIAs with OPV is to boost mucosal immunity levels in cohorts of children na?ve to OPV to rapidly interrupt virus circulation.
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ECDC assessment
The World Health Organization (WHO) estimates the risk of further international spread of wild poliovirus type 1 (WPV1) from Israel to remain moderate to high. ECDC is preparing a risk assessment on the situation in Israel, Somalia and the region. The risk assessment will consider the risk of importation of wild poliovirus to the EU, and the risk of transmission within the EU.
Actions
WHO recommended that all countries, in particular those with frequent travel and contacts with polio-infected countries, strengthen surveillance for cases of acute flaccid paralysis (AFP), in order to rapidly detect new poliovirus importations and facilitate a rapid response. Countries should also analyse routine immunisation coverage data to identify subnational gaps in population immunity to guide catch-up immunisation activities and thereby minimise the consequences of new virus introduction.
Priority should be given to areas at high risk of importations and where OPV3/DPT3 coverage is <80%. WHO?s International Travel and Health recommends that all travellers to and from polio-infected areas be fully vaccinated against polio. Three countries remain endemic for indigenous transmission of WPV: Nigeria, Pakistan and Afghanistan. Additionally, in 2013, the Horn of Africa is affected by an outbreak of WPV (See global polio monitoring threat).
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COMMUNICABLE DISEASE THREATS REPORT
Week 35, 25-31 August 2013
(...)
Poliovirus - Israel- Detection of WPV1 in environmental samples and healthy individuals
Opening date: 19 August 2013 Latest update: 30 August 2013
Epidemiological summary
In Israel, wild poliovirus type 1 (WPV1) was isolated from sewage samples collected on 9 April 2013 in Rahat, southern Israel. Preliminary analyses indicated that the strain is related to the strains circulating in Pakistan and the strain detected in sewage from Cairo in December 2012. The strain is not related to virus currently affecting the Horn of Africa. WPV1 has now been detected in 85 sewage samples from 27 sampling sites in southern and central Israel, collected from 3 February 2013 to 4 August 2013. As part of subsequent ongoing stool sample survey activities, WPV1 has also been isolated in stool samples from 42 carriers, representing 4.4% of all collected samples. No cases of paralytic polio have been reported in the country. Israel has been free of indigenous WPV transmission since 1988. In the past, wild poliovirus has been detected in environmental samples collected in this region between 1991 and 2002 without occurrence of cases of paralytic polio in the area.
A positive sewage sample collected on 30 June from Tulkarem in the West Bank was reported retrospectively. Previous and subsequent specimens collected through environmental surveillance since 2002 in both Gaza and the West Bank have consistently tested negative for the presence of WPV.
A supplementary immunisation activity (SIA) with bivalent oral polio vaccine (OPV1 and 3) started in parts of southern Israel during the week of 5 August, and was expanded nationwide on 18 August for all children up to the age of nine years. The objective of these SIAs with OPV is to boost mucosal immunity levels in cohorts of children na?ve to OPV to rapidly interrupt virus circulation.
(?)
ECDC assessment
The World Health Organization (WHO) estimates the risk of further international spread of wild poliovirus type 1 (WPV1) from Israel to remain moderate to high. ECDC is preparing a risk assessment on the situation in Israel, Somalia and the region. The risk assessment will consider the risk of importation of wild poliovirus to the EU, and the risk of transmission within the EU.
Actions
WHO recommended that all countries, in particular those with frequent travel and contacts with polio-infected countries, strengthen surveillance for cases of acute flaccid paralysis (AFP), in order to rapidly detect new poliovirus importations and facilitate a rapid response. Countries should also analyse routine immunisation coverage data to identify subnational gaps in population immunity to guide catch-up immunisation activities and thereby minimise the consequences of new virus introduction.
Priority should be given to areas at high risk of importations and where OPV3/DPT3 coverage is <80%. WHO?s International Travel and Health recommends that all travellers to and from polio-infected areas be fully vaccinated against polio. Three countries remain endemic for indigenous transmission of WPV: Nigeria, Pakistan and Afghanistan. Additionally, in 2013, the Horn of Africa is affected by an outbreak of WPV (See global polio monitoring threat).
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