Tajikistan hit by deadly polio outbreak: WHO

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Re: Tajikistan hit by deadly polio outbreak: WHO

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ВОЗ и ЮНИСЕФ бьют тревогу. WHO and UNICEF are sounding the alarm. На юго-западе страны отмечена вспышка полиомиелита In the south-west of the country an outbreak of polio

ДУШАНБЕ, 24 апр ? ?Авеста?. Dushanbe, April 24 - "Avesta". - | После 13-летнего отсутствия полиомиелита, Таджикистан столкнулся с повторным появлением этой болезни. - | After 13 years of absence of polio, Tajikistan faced a re-emergence of this disease. На данный момент уже подтверждены семь случаев заражения и более 100 случаев считаются подозрительными. At the moment already confirmed seven cases of infection and more than 100 cases are considered suspicious.

Об этом сговорится в совместном пресс-релизе представительств Всемирной организации здравоохранения и Детского фонда ООН в Таджикистане, распространенном в субботу в Душанбе. This is a deal in a joint press release of the World Health Organization and UN Children's Fund in Tajikistan, issued on Saturday in Dushanbe.

?Таджикистан еще в 2002 г. был сертифицирован как страна, свободная от полиомиелита?, - отметил глава представительства ВОЗ Сантино Северони. "Tajikistan is in 2002 was certified as a country free from polio", - said the head of the WHO Santino Severoni. - Тем не менее, массовое увеличение случаев заражения острым вялым параличом - основного признака полиомиелита - были зафиксированы в юго-западной части Таджикистана. - Nevertheless, the massive increase in cases of infection with acute flaccid paralysis - the main feature of polio - have been recorded in south-western part of Tajikistan. Лабораторные тесты подтвердили, что мы столкнулись с вспышкой полиомиелита в стране. Laboratory tests have confirmed that we are faced with an outbreak of polio in the country. Это первый завозной случай, вызвавший вспышку полиомиелита в Европейском регионе ВОЗ, с тех пор как он был признан свободным от полиомиелита в 2002 года?. This is the first imported case caused an outbreak of polio in the WHO European Region, since he was declared polio free in 2002. "

В свою очередь, по словам главы ЮНИСЕФ в Таджикистане Хонгвей Гао: ?Вспышка заболевания распространяется тревожными темпами. In turn, the head of UNICEF in Tajikistan Hongvey Gao: "The outbreak of the disease spreads at an alarming rate. Большинство подтвержденных случаев заражения - это дети. The majority of confirmed cases - are children. Поэтому, нам немедленно необходимо приступить к иммунизации всех детей в возрасте до 5 лет для того, чтобы остановить распространение полиомиелита и спасти жизни детей в Таджикистане?. Therefore, we must immediately begin to immunize all children under 5 years in order to stop the spread of polio and to save the lives of children in Tajikistan.

Совместно со своими партнерами в рамках Всемирной инициативы по ликвидации полиомиелита, ЮНИСЕФ и ВОЗ сотрудничают с Министерством здравоохранения Таджикистана в разработке плана по немедленному реагированию на создавшуюся ситуацию. Together with its partners in the World Polio Eradication Initiative, UNICEF and WHO are collaborating with the Ministry of Health of Tajikistan in developing a plan for immediate response to the situation. В ближайшие дни ЮНИСЕФ завезет почти 4 миллиона доз оральной вакцины против полиомиелита (ОПВ) для иммунизации каждого ребенка в Таджикистане в возрасте от 0 до 5 лет. In the coming days, UNICEF zavezet almost 4 million doses of oral polio vaccine (OPV) for the immunization of every child in Tajikistan between the ages of 0 to 5 years.

Будет проведена трехраундовая общенародная кампания по иммунизации. There will be an trehraundovaya nation-wide immunization campaign. Каждому из 1,1 миллиона детей страны в возрасте до 5 лет будут даны три дополнительные дозы ОПВ. Each of the 1.1 million children in the age of 5 years will be given three additional doses of OPV. Вакцины прибудут в Душанбе уже во вторник утром. The vaccines will arrive in Dushanbe as early as Tuesday morning.

Полиомиелит - детский спинномозговой паралич, острое, высокозаразное инфекционное заболевание, обусловленное поражением серого вещества спинного мозга полиовирусом и характеризующееся преимущественно патологией нервной системы. Poliomyelitis - Children's spinal paralysis, acute, vysokozaraznoe infectious disease caused by the defeat of the gray matter of the spinal cord poliovirus and characterized mainly by disorders of the nervous system. В основном, протекает бессимптомной или стертой форме. In general, there are no symptoms or abortive form.

В середине XX века рост заболеваемости полиомиелитом придал ему во многих странах Европы и Северной Америки характер национального бедствия. In the middle of XX century increase in the incidence of polio has given him many countries in Europe and North America, the nature of national disaster. Введение в практику вакцин, предупреждающих болезнь, привело к быстрому снижению заболеваемости, а на многих территориях ? к практически полной его ликвидации (например, в СССР с 1961). Introduction of vaccines that prevent disease, has led to rapid reductions in morbidity, and in many areas - to virtually complete elimination (for example, in the USSR in 1961).

В разработке вакцин важную роль сыграли американские учёные Йонас Солк (запатентовал инъекционную вакцину в 1955 году) и А. In vaccine development, the important role played by American scientists Jonas Salk (patented injection vaccine in 1955) and A. Сабин (именно его бесплатная вакцина для приёма внутрь в 1957 году прошла успешные испытания и была признана ВОЗ наиболее действенной и простой). Sabine (namely his free vaccine for oral use in 1957 was successfully tested and has been recognized by WHO the most effective and simple).

 

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Re: Tajikistan hit by deadly polio outbreak: WHO

And the red text gives us an answer.

http://www.npr.org/blogs/health/2010/04/outbreak_of_paralysis_points_t.html

Outbreak Of Paralysis Points To Polio's Return
9:05 am

April 26, 2010

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An outbreak of polio in Tajikistan has public health workers scrambling. (irene2005/Flickr)

By Richard Knox

Polio is clawing its way back, after decades of work had pushed the disease to the brink of eradication.

The World Health Organization says Tajikistan, a Central Asian nation which shares its southern border with Afghanistan, has reported 120 cases of acute flaccid paralysis, most of which occurred within the past two weeks.

Many things can cause acute paralysis, but poliovirus has been confirmed in some of these cases, so the WHO says the Tajik outbreak represents a reintroduction of polio to the group's European region. Tajikistan hadn't recorded a polio case for the past 19 years.

That in itself isn't necessarily ominous, says Sona Bari of the WHO's Polio Eradication Program. Just because polio has been reintroduced to a country doesn't mean it will get reestablished there, she says.

"People working on polio eradication don't see this as a derailing," Bari says. "It's more of a wakeup call."

A series of Tajikistan-like setbacks over the past year has awakened WHO.

This week, Bari says, the polio eradication program will finalize a new strategy that acknowledges vaccination won't be enough to get the job done. It'll take a parallel push to improve sanitation and upgrade health infrastructure.

Otherwise, the new thinking goes, we'll see an endless string of Tajikistan-type reintroductions from the handful of countries -- prominently Afghanistan, Pakistan, India and Nigeria -- where the virus remains rooted.

Last summer there was a rash of reintroductions in Africa -- in Uganda, Togo, Ghana, Cote d'Ivoire and Mali.

"There's no way to sugar-coat the last 12 months," Bruce Aylward of the WHO is quoted as saying to philanthropist Bill Gates in an article by the Wall Street Journal's Robert Guth.


One statistic in the WHO's Tajikistan bulletin illustrates the problem. Nearly half of the newly infected children there had had four or more doses of polio vaccine.

Bari says in some parts of the world, it can take as many as a dozen doses of polio vaccine to protect a child against infection. Those are places with the highest population density, the poorest sanitation, and the highest levels of other digestive diseases that can diminish polio vaccine effectiveness.

Clearly, in such hardcore countries polio vaccination is a never-ending exercise. It's why polio eradication can't follow the same model used to stamp out smallpox.

That's why WHO and other actors in the polio eradication campaign -- the Gates Foundation, Unicef, Rotary International -- are rethinking the effort to be less vaccine-centric.

If the new plan is approved next month by the World Health Assembly, it will set a new goal to eradicate polio, or come very close, by 2012. The last goal was 2000.

Despite setbacks, the numbers are encouraging. Until the Tajik outbreak, only 71 polio cases had been confirmed so far this year, compared to 328 this time last year.

Meanwhile, mass vaccination campaigns are continuing full-force. Over the weekend, WHO expected to get 78 million children in 16 African countries vaccinated against polio, and another 77 million in India and Pakistan. Such synchronous campaigns protect wide swaths of terrain, a tactic that aims to minimize the reintroduction of infection.

But something that happened thousands of miles away this month shows how difficult polio eradication can be.

The closure of European airspace due to the eruption of a volcano in Iceland left polio vaccine stranded at airports in Frankfurt and Paris. As a result two African countries will miss this weekend's synchronous vaccination. They'll do it on May 7.

 

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Re: Tajikistan hit by deadly polio outbreak: WHO

With respect to additional doses of polio vaccine in impoverished areas, note the thread below which indicates that in Ukraine, where the health system is likely about the same as in Tajikistan, the standard vaccination schedule involves six doses of vaccine.

http://www.flutrackers.com/forum/showthread.php?p=353250#post353250

 

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Re: Tajikistan hit by deadly polio outbreak: WHO

Source: http://www.happynews.com/news/4262010/emergency-response-polio-outbreak-tajikistan.htm

Rotary Responds to Polio Outbreak in Tajikistan
Rotary International

In response to a recent outbreak of wild poliovirus in Tajikistan, Rotary is providing a total of US$500,000 in emergency grants to UNICEF and WHO for immediate polio immunization efforts throughout the country. The outbreak requires urgent action by governments and partner agencies to again make the country polio-free.
This emergency response is intended to reduce the threat of the virus spreading to other polio-free countries, a process called importation. The emergency grant will support immunization activities scheduled to take place in Tajikistan and neighboring Uzbekistan and Kyrgyzstan. The Tajikistan cases are the first reported in the WHO European Region since it was certified polio-free in 2002.
?Polio importations such as the Tajikistan cases, highlight our global vulnerability to infectious disease,? said Carol Pandak, manager of Rotary International?s PolioPlus Program. ?It highlights the fact that polio ?control? is not an option, and only successful eradication will stop polio in resource-poor countries.?
Outbreaks of imported cases are not uncommon during eradication efforts, underscoring the critical need to stop polio transmission in the remaining polio-endemic countries: Afghanistan -- which borders Tajikistan -- Pakistan, Nigeria and India.
?Our experience shows that where polio transmission has been stopped before, it can be stopped again,? said Pandak. ?A fast, large-scale, high-quality immunization response and strong surveillance are absolutely critical...?

 

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Re: Tajikistan hit by deadly polio outbreak: WHO

http://www.irinnews.org/Report.aspx?ReportId=88935

In Brief: Polio outbreak in southwestern Tajikistan

Photo: Fakhrinisso Kurbonshoeva/IRIN
Some of the children affected had had several doses of oral polio vaccine
DUBAI, 27 April 2010 (IRIN) - The World Health Organization (WHO) has reported 120 cases of ?acute flaccid paralysis? in southwestern Tajikistan, of which seven have been confirmed as Type-1 poliovirus.

Most are children under five. Many had onset of paralysis over the past two weeks and 10 children have died. More than 45 of the children affected had had four or more doses of oral polio vaccine.

"Polio importations such as the Tajikistan cases demonstrate our global vulnerability to infectious disease," said Carol Pandak, head of Rotary International?s (RI) PolioPlus programme. "It highlights the fact that polio `control? is not an option and only successful eradication will stop polio in resource-poor countries."

RI said on 23 April it would provide US$500,000 to the UN Children?s Fund and WHO for immediate polio immunization in Tajikistan. Tajikistan's last case of clinically confirmed polio was in 1997, and the country was certified polio free in 2002.

Tajiksitan borders on one of the world?s four polio-endemic countries - Afghanistan.

at/cb

 

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Re: Tajikistan hit by deadly polio outbreak: WHO

I don't know how to interpret the red text. This is a mildly sloppy source, and could be indicating that only one of the fatalities has been confirmed so far, or it could be indicating that the other cases have been discarded. I can't imagine what diagnosis might explain a large number of discarded cases (and it would be an extreme coincidence if something else hit Tajikistan at the same time as a polio outbreak, something so rare it hadn't been seen there in nearly 20 years).

http://avesta.tj/index.php?newsid=4656

Сегодня, 16:21 Эту новость прочитали 51 человек Today, 16:21 The news was read 51
В Таджикистан в экстренном порядке завезли около 4 млн. вакцин против полиомиелита In Tajikistan, a matter of urgency brought about 4 million polio vaccines

ДУШАНБЕ, 27 апр - «Авеста» /И. Dushanbe, 27 April - Avesta / I. Курбанов/. Kurbanov. - | Всемирная организация здравоохранения (ВОЗ) в экстренном порядке доставила в Таджикистан около 4 млн. доз оральной вакцины против полиомиелита. - | World Health Organization (WHO) urgently delivered to Tajikistan approximately 4 million doses of oral polio vaccine.



Как сообщили «Авесте» в министерстве здравоохранения Таджикистана, вакцины были доставлены в Душанбе сегодня утром чартерным самолетом. According to the Avesta in the Ministry of Health of Tajikistan, the vaccines were delivered in Dushanbe today morning, a chartered plane.



По словам источника, предполагается, что от полиомиелита погибли 11 детей, но по результатам обследования от этой болезни умер один ребенок. According to the source, it is expected that polio killed 11 children, but the results of a survey of the disease died one child. Остальные умерли в результате другой, похожей на полиомиелит болезни», - сказал источник. Others died as a result of other, similar to the polio disease "- the source said.



Ранее специалисты здравоохранения сообщали, что заболевание, вспыхнувшее в центральных районах Таджикистана похоже на полиомиелит. Previously, health professionals reported that the disease broke out in central regions of Tajikistan is similar to polio. Однако выявлены некоторые отличия. However revealed some differences.


В Минздраве сообщили, что вакцинацию с 4 по 7 мая текущего года пройдут порядка 1,5 млн. детей в возрасте до шести лет. In the Ministry of Health reported that vaccination with 4 to 7 May of this year will be about 1,5 million children under the age of six years.



Полиомиелит - детский спинномозговой паралич, острое, высокозаразное инфекционное заболевание, обусловленное поражением серого вещества спинного мозга полиовирусом и характеризующееся преимущественно патологией нервной системы. Poliomyelitis - Children's spinal paralysis, acute, vysokozaraznoe infectious disease caused by the defeat of the gray matter of the spinal cord poliovirus and characterized mainly by disorders of the nervous system. В основном, протекает бессимптомной или стертой форме. In general, there are no symptoms or abortive form.

 

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Re: Tajikistan hit by deadly polio outbreak: WHO

The bold text makes more sense; only one of the fatalities has been confirmed so far. The others are pending. While the are likely a few sporadic cases of AFP invovled, I would expect >90% of the (good) samples tested to come back positive. A previous article in this thread indicates that Tajikistan only sees 25-50 AFP cases per year in a non-polio outbreak year.

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WHO and UNICEF provided Tajikistan 4 million polio vaccines
27.04.2010 17:53 msk 27.04.2010 17:53 msk

Фергана.Ру Fergana.Ru
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Чартерный рейс с грузом вакцин от полиомиелита приземлился в аэропорту столицы Таджикистана Душанбе. The charter flight with a cargo of polio vaccines landed at the airport of the capital Dushanbe. Как сообщили корреспонденту «Ферганы.Ру» в Минздраве Республики Таджикистан, партия вакцин в количестве четырех миллионов доз доставлена из Копенгагена по линии Всемирной организации здравоохранения (ВОЗ) и ЮНИСЕФ (Детского фонда ООН). As the correspondent of "Fergany.Ru" in the Ministry of Health of the Republic of Tajikistan, the party of vaccines in the amount of four million doses delivered from Copenhagen for the World Health Organization (WHO) and UNICEF (UN Children's Fund).

Как сообщил журналистам заместитель министра здравоохранения Таджикистана Азам Мирзоев, теперь все дети в возрасте до 5 лет вновь будут вакцинированы вне зависимости от того, получали они прежде прививку от полиомиелита или нет. Journalists were told by Deputy Minister of Health of Tajikistan Azam Mirzoev, now all children under age 5 will again be vaccinated, regardless of whether they had previously received vaccination against polio or not.

А.Мирзоев также добавил, что в настоящее время в Таджикистане зарегистрировано 123 случая острого вялого паралича, и только 7 случаев официально подтверждены, как полиомиелит. Mirzoev also added that currently in Tajikistan registered 123 cases of acute flaccid paralysis, and only 7 cases officially confirmed as polio. Еще порядка 100 анализов больных со схожими с полиомиелитом симптомами отправлено на исследование. Another analysis of 100 patients with symptoms similar to polio sent to the study.

А.Мирзоев сообщил, что к сегодняшнему дню число погибших детей со схожим диагнозом составило 11 человек, из которых наличие полиомиелита подтвердилось только у одного ребенка (ранее «Фергана.Ру» сообщала о 10 летальных исходах ). Mirzoev reported that to date the number of dead children with a similar diagnosis was 11 people, of which the presence of polio was confirmed in only one child (formerly Fergana.Ru " reported on 10 fatalities ).

Ко вчерашнему дню в Таджикистан прибыла группа экспертов ВОЗ, чтобы на месте определить источники и причины возникновения вспышки этой болезни. By yesterday's Day in Tajikistan A team of WHO experts on site to determine the sources and causes of outbreaks of this disease. Как сообщили в офисе ВОЗ в Таджикистане, процесс изучения истоков болезни может затянуться на несколько дней, так как пробы анализов больных для обследования будут направлены в одну из клиник Москвы. According to the WHO Office in Tajikistan, the process of studying the origins of the disease can be delayed for several days, since the sample analysis of patients for the survey will be sent to one of the clinics in Moscow.

Тем временем таджикские медики приступили к подготовке проведения всеобщей иммунизации от полиомиелита. Meanwhile, Tajik medical workers have begun to prepare for universal immunization against polio. Ожидается, что с 4-г по 7-е мая в стране пройдут иммунизацию от полиомиелита около 1,5 миллиона детей в возрасте до шести лет. It is expected that with the 4-g on the 7 th of May in the country will be immunized against polio about 1,5 million children under the age of six years. Напомним, что в 2008 году в Таджикистане была проведена крупномасштабная кампания иммунизации против полиомиелита, которой было охвачено 87% детей. Recall that in 2008 in Tajikistan was conducted large-scale immunization campaign against polio, which reached 87% of children.

Но, по мнению экспертов, причиной возникновения вспышки данной болезни в Таджикистане могло стать соседство этой среднеазиатской страны с Афганистаном. But, according to experts, the cause of an outbreak of the disease in Tajikistan could be a neighborhood of the Central Asian nation of Afghanistan. Последний является одной из немногих стран мира, в которых до сих пор фиксируются случаи заболевания полиомиелитом. The latter is one of the few countries in the world, which so far recorded cases of polio.

 

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Re: Tajikistan hit by deadly polio outbreak: WHO

And some more confirmations.

http://translate.googleusercontent....le.com&usg=ALkJrhh_VsKqTyrvpYXObfLwYsRJpcrFdQ

WHO is assisting Tajikistan to repay an outbreak of polio
27/04/2010 27/04/2010
4 мая в Таджикистане начнётся масштабная кампания иммунизации против полиомиелита. May 4 in Tajikistan will begin large-scale immunization campaign against polio. Всемирная организация здравоохранения вместе с ЮНИСЕФ помогает стране ликвидировать вспышку заболевания в юго-восточных районах на границе с Афганистаном и Узбекистаном. World Health Organization, together with UNICEF is helping the country to eliminate an outbreak of disease in south-eastern border with Afghanistan and Uzbekistan.

Это первый случай возвращения полиомиелита в европейский регион, где он был полностью ликвидирован ещё в 2002 году. This is the first return of polio in the European region, where he was completely eradicated in 2002. Представитель ВОЗ Даниэль Эпштейн говорит, что эксперты продолжают изучать ситуацию: WHO Representative Daniel Epstein, said that experts are still assessing the situation:


? Мы выявили ряд случаев паралича, которые должны быть подтверждены путём лабораторного анализа. "We have identified several cases of paralysis, which must be confirmed by laboratory analysis. На сегодняшний день подтверждено 12 случаев. To date, confirmed 12 cases. 4 мая в Таджикистане начнётся усиленная кампания иммунизации против полиомиелита ?. May 4 in Tajikistan will begin enhanced immunization campaign against polio.

Предполагается, что в ходе запланированных трёх кампаний по вакцинации, прививки получат 864 тысячи детей в возрасте до пяти лет. It is assumed that during the planned three vaccination campaigns, vaccination will be 864,000 children under five years.

 

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Re: Tajikistan hit by deadly polio outbreak: WHO

This is a ProMED Russian post.

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1090,82446

Poliomyelitis (confirmation) - Tajikistan ******************************************** *********** Date: March 27, 2010 From: ProMED-mail Maud HP Source: IA "TsARNovosti, March 26, 2010 [Moderator HF] < http://rnd.cnews.ru/natur_science/ medicine / News / line / index_science.shtml? 2010/04/26/388196 > WHO is concerned about an outbreak of poliomyelitis in Tajikistan -------------------------- - World Health Organization (WHO) has expressed concern at the outbreak of polio in the southwest of Tajikistan in the border areas with Afghanistan and Uzbekistan.

Она немедленно отправила в страну своих экспертов и заявила о готовности поддержать массовую иммунизацию населения против опасного заболевания, поражающего детскую нервную систему и вызывающего паралич конечностей, сообщает центр новостей ООН. Лабораторные исследования образцов вируса, взятых у заболевших, подтвердили, что в стране циркулирует полиовирус типа 1.

She immediately sent to the country of its experts, and was prepared to support mass immunization against dangerous diseases affecting children's nervous system and causes paralysis of the limbs, according to UN news center. Laboratory tests of samples of virus taken from infected, confirmed that the country is circulating poliovirus type 1.

Международное сообщество крайне встревожено этой информацией, поскольку это первый случай вспышки полиомиелита в странах европейского региона ВОЗ с 2002 года. К 22 апреля 2010 года в ВОЗ поступила информация о 128 случаях заболеваний полиомиелитом в Таджикистане. 10 из них закончились фатальными исходами.

The international community is extremely alarmed by this information, because this is the first outbreak of polio in the WHO European Region since 2002. By April 22, 2010, WHO received reports of 128 cases of poliomyelitis in Tajikistan. 10 of them resulted in fatalities.

Сейчас ученые изучают характеристики вируса и его генетические параметры За последние два десятилетия международное сообщество выделило на борьбу с полиомиелитом более пяти миллиардов долларов.

Now scientists are studying the characteristics of the virus and its genetic parameters over the past two decades, the international community has committed to the fight against polio more than five billion dollars.

Кампании по вакцинации проводились во всех странах мира.

Vaccination campaigns were conducted in all countries of the world.

В них участвовали десятки миллионов добровольцев.

The participants were tens of millions of volunteers.

В результате их усилий сегодня более половины населения мира живет в зонах, свободных от полиомиелита.

As a result of their efforts today, more than half the world's population lives in areas free of polio.

Агентства ООН надеются, что полиомиелит может стать одним из первых заболеваний, от которого человечеству удастся полностью избавиться в 21 столетии. На сегодняшний день полиомиелит продолжает оставаться эндемическим лишь в Афганистане, Нигерии, Индии и Пакистане.

The UN hopes that polio could be one of the first disease for which mankind can fully recover in the 21 century. Today, polio remains endemic only in Afghanistan, Nigeria, India and Pakistan.

В Таджикистане последний раз лабораторно подтвержденный случай заражения полиомиелитом был зарегистрирован в 1997 году.

In Tajikistan, the last laboratory-confirmed cases of polio were registered in 1997.

В 2008 году в Таджикистане была проведена крупномасштабная кампания иммунизации против полиомиелита, которой было охвачено 87% детей. [Комментарий мод НР. In 2008,

Tajikistan was conducted large-scale immunization campaign against polio, which reached 87% of children.

[Comment mod HP.

Количество случаев продолжает увеличиваться, на сегодняшний день количество случаев возможно перевалило за 170.

The number of cases continues to grow, to date the number of cases probably exceeded 170.

Граничащий с Таджикистаном Узбекистан, который с 1994 года считается страной свободной от полиомиелита, также обеспокоен возможностью риска в пограничных районах.

Bordering Tajikistan, Uzbekistan, which since 1994 is considered a country free from polio, is also concerned about the possibility of risk in the border areas. - Mod NR]

Смотрите также: 23.04.10 PRO/RUS> Полиомиелит (уточнение информации) - Таджикистан 20100423.11316 6 _______________________________________________ ProMED-RUS mailing list ProMED-RUS@promed.isid.org http://promed.isid.org/mailman/listinfo/promed-rus - Mod NR] See also: 23.04.10 PRO / RUS> Poliomyelitis (update information) - Tajikistan 20100423.11316 6 _______________________________________________ ProMED-RUS Mailing list ProMED-RUS@promed.isid.org http://promed.isid.org/mailman/ listinfo / promed-rus

 

[Treyfish]

Re: Tajikistan hit by deadly polio outbreak: WHO

27 APR-2010
Subject PRO / RUS> Poliomyelitis (confirmation) - Tajikistan

Poliomyelitis (confirmation) - Tajikistan
************************************************** *****

Date: March 27, 2010
From: ProMED-mail Maud HP
Source: IA "TsARNovosti, March 26, 2010 [Moderator HF]
<http://rnd.cnews.ru/natur_science/medicine/news/line/index_science.shtml?2010/04/26/388196>

WHO is concerned about an outbreak of poliomyelitis in Tajikistan
----------------------------
World Health Organization (WHO) has expressed concern at the outbreak of polio in the south-west
Tajikistan's border areas with Afghanistan and Uzbekistan.She immediately sent to the country of their
experts and was prepared to support mass immunization against dangerous diseases,
striking a child's nervous system and causes paralysis of the limbs, according to UN news center.
Laboratory testing of samples of virus taken from infected, confirmed that there is circulating
poliovirus type 1. The international community is extremely alarmed by this information, because this is the first
case of outbreaks of polio in the WHO European Region since 2002.
By April 22, 2010, WHO received reports of 128 cases of poliomyelitis in Tajikistan.
10 of them resulted in fatalities. Now scientists are studying the characteristics of the virus and its genetic
options
Over the past two decades, the international community has committed to the fight against polio for more than five
billion. Vaccination campaigns were conducted in all countries of the world. They involved dozens of
million volunteers. As a result of their efforts today, more than half the world's population lives in areas
polio-free. The UN hopes that polio could be one of the first
diseases from which mankind can fully recover in the 21 century.
Today, polio remains endemic only in Afghanistan, Nigeria, India and
Pakistan. In Tajikistan, the last laboratory-confirmed cases of polio had
registered in 1997. In 2008, Tajikistan was conducted large-scale campaign
immunization against polio, which reached 87% of children.

[Comment mod HP.The number of cases continues to increase, to date the number of cases
probably exceeded 170. Bordering Tajikistan, Uzbekistan, which since 1994 is considered a country
polio-free, is also concerned about possible risks in the border areas. - Mod NR]
:tiphat:where else does it say more than 170

 

[alert]

Re: Tajikistan hit by deadly polio outbreak: WHO

[Comment mod HP.The number of cases continues to increase, to date the number of cases
probably exceeded 170. Bordering Tajikistan, Uzbekistan, which since 1994 is considered a country
polio-free, is also concerned about possible risks in the border areas. - Mod NR]
:tiphat:where else does it say more than 170

It doesn't say that anywhere else. I suspect the ProMED Russian moderator, who is herself in that area, may have information beyond what is contained in the news release.

 

[alert]

Re: Tajikistan hit by deadly polio outbreak: WHO

And that's why there haven't been any cases in Afghanistan - this outbreak didn't come from Afghanistan.

http://www.reliefweb.int/rw/rwb.nsf/db900SID/EGUA-84XMBS?OpenDocument

Tajikistan starts vaccination campaigns against polio
Source: Global Polio Eradication Initiative (GPEI)

Date: 28 Apr 2010


As WHO European Region countries take protective measures

28 April ? Tajikistan is launching an outbreak response vaccination activity tomorrow in the capital Dushanbe and six surrounding districts, as lab testing confirms that nineteen children in the country have been paralysed by polio. This response is to be followed by three nation-wide vaccination campaigns, the first of which is due to start on 4 May. Four million doses of vaccine have arrived in the country.

Genetic sequencing has now determined that the poliovirus is most closely related to virus from Uttar Pradesh, India. Countries neighbouring Tajikistan have lined up protective measures: Uzbekistan is planning to vaccinate its children under five years of age starting in the last week of May; Kyrgyzstan is conducting polio vaccinations as part of European Immunization Week; Afghanistan has stepped up surveillance along its border with Tajikistan and is focusing staff resources on border provinces during its 2 May nationwide immunization activity.

WHO and UNICEF are urgently seeking emergency funding to support the costs of the field operations and vaccination campaigns. Rotary International, the US Centers for Disease Control and Prevention and the UK Department for International Development have already pledged emergency funding.

The Ministries of Health in Tajikistan and Uzbekistan are supported in their planning and implementation by WHO, the US Centers for Disease Control and Prevention, the United Nations Children's Fund (UNICEF), the International Federation of Red Cross and Red Crescent Societies and other partners in the Global Polio Eradication Initiative.

WHO recommendations for travel to Tajikistan are the same as for any other polio-infected country ? immunization or boosting of past immunization. No further actions or travel restrictions are recommended.

 

[alert]

Re: Tajikistan hit by deadly polio outbreak: WHO

The title contradicts the article; Israel did not recommend against travel; they merely put out an alert recommending vaccination.

http://avesta.tj/index.php?newsid=4669

Israel Ministry of Health recommends that its citizens not to travel to Tajikistan

ДУШАНБЕ, 28 апр ? ?Авеста?. Dushanbe, April 28 - "Avesta". - | Министерство здравоохранения Израиля предостерегает своих граждан, выезжающих в Таджикистан. - | The Ministry of Health of Israel warns its citizens traveling to Tajikistan.


В опубликованном, на сайте IzRus предостережении Минздрава Израиля отмечается, что ?в связи со вспышкой эпидемии полиомиелита, вызванной диким полиовирусом 1-го типа, необходимо принять все необходимые меры по предотвращению заражения этой болезнью?. In published on this site IzRus admonish Israel Ministry of Health notes that "in connection with the outbreak of polio caused by wild poliovirus type 1, it is necessary to take all necessary measures to prevent contracting the disease."



Всем выезжающим в Таджикистан, а также в граничащие с ним страны, рекомендуется обратиться к семейным врачам для получения консультаций относительно мер иммунизации против полиомиелита. Everyone traveling to Tajikistan, as well as in its neighboring countries are advised to contact their general practitioner for advice on the measures of immunization against polio.



По данным министерства здравоохранения Таджикистана по стоянию на 26 апреля от полиомиелита умерли 11 человек. According to the Ministry of Health of Tajikistan, at distances of 26 April, died of polio 11. В стране зарегистрировано около 130 случаев заболевания острым вялым параличом. The country has registered about 130 cases of acute flaccid paralysis.



Накануне в Душанбе прибыл чартерный самолет Всемирной организации здравоохранения с около 4 млн. доз вакцины против полиомиелита. The day before, arrived in Dushanbe on chartered aircraft of the World Health Organization, with about 4 million doses of vaccine against polio. Вакцинацию пройдут 1 млн. детей в возрасте до шести лет. The vaccination will be 1 million children under the age of six years.

 

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Re: Tajikistan hit by deadly polio outbreak: WHO

Note the discrepancy involving children and adults; Tajikistan is reporting anyone over 15 as an adult, whereas the other sources count anyone over 18 as adults. It is thus likely that both "adults" are betwee nage 15 and 18.

We now have a 12th death, and increase to 32 confirmed cases. I really think they will confirm most, if not all, of the AFP cases.

http://www.reliefweb.int/rw/rwb.nsf/db900SID/DNEO-84YGLX?OpenDocument

Polio situation update from Tajikistan
Source: World Health Organization (WHO)

Date: 29 Apr 2010


As of 28 April 2010, the health authorities in Tajikistan have reported 171 cases of acute flaccid paralysis (AFP) to WHO. Laboratory tests have confirmed wild poliovirus type 1 in 32 cases; classification is pending for the remaining 139. Out of 68 administrative territories in Tajikistan, 24 are affected. All cases have been reported from the south-west of the country. So far, 12 deaths have been registered: 10 in children (under 15 years of age) and 2 in adults. Genetic sequencing has determined that the poliovirus found in Tajikistan is most closely related to virus from Uttar Pradesh, India.

A WHO expert team has been in Tajikistan since 16 April 2010, investigating the outbreak and providing technical support to the Government, in partnership with the United Nations Children's Fund (UNICEF) and the US Centers for Disease Control and Prevention (CDC). WHO keeps all WHO Member States informed about its epidemiological and clinical findings through channels established by the International Health Regulations (IHR). On 26 April, 4 million doses of monovalent oral polio vaccine (mOPV1), supplied and deployed by UNICEF, arrived in Tajikistan. According to current plans, 1 090 000 children under 5 years of age will be vaccinated in three rounds of immunization starting next week.

WHO's technical assistance programme in Tajikistan has short- and medium-term goals. In the short term, WHO is conducting a comprehensive outbreak investigation to support authorities in strengthening AFP surveillance and active case finding, ensure appropriate clinical management of patients and coordinate the nationwide vaccination programme. In the medium term, WHO supports the Government in strengthening its health system, including AFP surveillance structures, immunization programmes and capacities for outbreak response. WHO will continue this support until the outbreak is brought under control and advanced surveillance and immunization programmes are put in place.

Prevention and preparedness in the neighbouring region

WHO is in close contact with governments of Kazakhstan, Kyrgyzstan, Turkmenistan and Uzbekistan about preparedness and response measures. In Uzbekistan, 23 AFP cases were reported from the beginning of the year to 28 April 2010. Four of these were reported in weeks 15 and 16 in regions near Tajikistan. With its partners, WHO will assist in managing a two-round national polio immunization campaign in Uzbekistan. The governments of Kazakhstan, Kyrgyzstan and Turkmenistan have formed task forces and strengthened surveillance, and are considering vaccination campaigns. The Government of Kyrgyzstan began a subnational polio immunization campaign this week in the areas bordering Tajikistan. In neighbouring Afghanistan, authorities will begin a nationwide campaign on 3 May 2010. WHO has begun a risk assessment to identify other Member States at high risk of polio importation.

Partnerships and emergency appeals

In preparing their response, the health ministries of Tajikistan and Uzbekistan are receiving support from WHO, UNICEF, CDC, the International Federation of Red Cross and Red Crescent Societies and other members of the Global Polio Eradication Initiative. WHO and UNICEF are urgently seeking funds to support their work. Rotary International, CDC and the Department for International Development (DFID), United Kingdom have already pledged emergency funding to support WHO's work on the ground and UNICEF's vaccination and social mobilization activities. Over US$ 1.2 million was raised during the past week.

WHO recommendations for travel to Tajikistan remain the same as for any other polio-infected country ? immunization or boosting of past immunization. No further actions or travel restrictions are recommended

 

[alert]

Re: Tajikistan hit by deadly polio outbreak: WHO

http://www.eht-forum.org/news.html?fileId=news100429012950&from=home&id=0

Polio reappears in Europe
Tajikistan battles outbreak after re-introduction of wild poliovirus amid concerns for further spread


Child receives oral polio vaccine in Afghanistan

Source: UNICEF Sverige

At least 32 cases of infection with wild poliovirus type 1 have been identified in an outbreak of acute flaccid paralysis affecting more than 170 people in Tajikistan, according to the World Heath Organization (WHO). This is the first outbreak of polio in Europe since the region was certified disease-free in 2002. 12 people have died in the outbreak.

The south-west of Tajikistan has been affected, close to the country?s border with Afghanistan and Uzbekistan. So far 24 of the country?s 68 administrative areas have been hit. Although 23 cases of paralysis have been spotted across the border in neighbouring Uzbekistan, it is not clear if these have been caused by poliovirus as the results of diagnostic tests are not yet known.

?We are expecting more cases to be confirmed,? says Soni Bari, the WHO communications coordinator for polio eradication. The organization is awaiting test results for 139 paralysis cases, according to an update issued today.

The WHO is expecting the genetic sequences of the virus ?any day now?, which should indicate the country from which the virus was imported, Bari tells EHTF News.

Europe has been certified polio-free for eight years, and this outbreak poses no immediate threat to the polio status of the region, according to Bari. In response to the re-introduction of the virus the Organization has officially advised all countries in the WHO-Europe region to increase surveillance for the virus, especially at transport hubs, she says. Authorities have been asked to assess levels of polio immunity and to identify under-immunised groups.

Outbreaks of infection with the virus in countries that have been polio-free are usually sparked by the movement of people infected in one of the four remaining polio-endemic countries, where transmission of the virus has yet to be interrupted ? Afghanistan, Pakistan, Nigeria and India.

Experts agree that any country is at risk of re-introduction of the polio virus until the disease has been eradicated.

Risk of further spread

In neighbouring Afghanistan, where polio is still endemic, ongoing conflict in southern areas of the country has left pockets of the population vulnerable to the disease as vaccination teams are unable to reach children living there. Just eight cases of endemic polio have been reported in this region so far this year and Bari believes there is a low risk of the ?newly introduced virus? spreading there, which can increase the chances of more cases or outbreaks.

?Given that people are fleeing the violence in the south, this is unlikely,? suggests Bari. There is very little population movement between the northern areas of Afghanistan, which border Tajikistan, and the southern areas, where vaccine coverage is low, she explains. Nevertheless, the WHO is working on a contingency plan for Afghanistan, she says.

Northern provinces of Afghanistan have been polio-free since 2002, adds Bari. In response to the detection of cases in Tajikistan the WHO has stepped up polio surveillance activities and a nationwide vaccination drive is planned for early May.

Ellie Ehrenfeld, from the US National Institutes of Allergy and Infectious Diseases, suspects the virus has spread into neighbouring countries without having been detected yet. For every one case of paralysis caused by poliovirus there are 100 undetected infections that do not cause paralysis, she explains.

To stem the spread of the virus within Tajikistan the country?s authorities and the WHO plan to top up the immunity of the population using the oral polio vaccine. Supplies of this vaccine have arrived in the country, according to Bari. The first of three rounds of a nationwide immunisation campaign will start in early May, she adds.

Failure to vaccinate?

Bari says that despite polio vaccination campaigns carried out regularly in Tajikistan, the WHO has noted in the past that coverage has ?not been great? in all areas of the country, and kids may not be immunised as often as they need to be. Vaccination coverage may have waned in recent years, leaving younger children susceptible to the virus, she says. It is not yet clear whether the region at the centre of the outbreak is one of these pockets of low immunity.

The WHO has reported that in 2008, Tajikistan?s national polio vaccination campaign covered 87% of the country?s population. According to Ehrenfeld this level of coverage is ?not bad? compared to other parts of the world where polio outbreaks are recorded from time to time. The re-introduction of wild poliovirus to a country free of the disease implies that vaccination coverage is low, she adds.

Ehrenfeld finds it easy to imagine how vaccination coverage may slip in regions that have been polio-free for years. In a country with limited resources that has not seen a case of the disease for 13 years, other public health problems may take priority, she says. ?Polio [vaccination] is not a simple immunisation schedule and it could be a case that other things seem more important.?

The real question now is whether a speedy and large-scale immunisation campaign will stamp out the virus easily, adds Ehrenfeld.

?or vaccine failure?

Scientists recently highlighted the shortcomings of the oral polio vaccine in India, suggesting that kids immunised with more than 10 doses of this vaccine may still be able to transmit the virus to others.

It is too soon to tell whether the oral vaccine has failed in any way in Tajikistan, says Ehrenfeld. Preliminary estimations made by the WHO, based on limited data, suggest that more than 45% of the acute flaccid paralysis cases detected received four or more doses of the oral vaccine. Bari says she expects these estimates will be revised down once more information becomes available. It is not yet clear whether the vaccination histories of the confirmed cases of polio are included in this early estimate.

Ehrenfeld explains that if vaccinated kids are falling ill with polio, responding to the outbreak may not be a simple matter. ?It means the vaccine has not taken, which is much more worrisome in the long term.? It won?t be easy to stamp out the poliovirus using top-up vaccinations, she suggests.

Despite these concerns, the oral polio vaccine is the only tool available to stem the outbreak, says Ehrenfeld. Bari agrees, saying that ?the oral polio vaccine is unquestionably the vaccine for eradication?. It has been used successfully to curb all previous outbreaks of polio caused by a re-introduction of the virus. Although there is an alternative vaccine, a jab containing inactivated polioviruses, scientists do not know how well this protects people in an outbreak situation or how well it stops the virus spreading in the community, according to Ehrenfeld.

 

[alert]

Re: Tajikistan hit by deadly polio outbreak: WHO

And here's the other answer. Apparently, there is a phenomenon in India where people vaccinated with the oral vaccine can still spread the virus to others. And we know now the virus in Tajikistan came from Uttar Pradesh, India. It is possible, even likely, that the oral vaccine may not fully protect against this virus, in which case, the large number of cases would be typical of spread in a population with little herd immunity.

Perhaps the WHO should consider switching to the injected vaccine, as noted in this article, in Tajikistan.

This phenomenon could be a serious setback for eradication efforts.

http://www.eht-forum.org/news.html?targetPage=news/fulltext/news100409083754.html&from=search

Friday 09 April 2010

‘Hidden’ infections sustain polio in India
Report sends strong signal that vaccination strategies are failing in India, could shift international response


Mother shows her child''s polio vaccination record Uttar Pradesh, India, in 2000

Source: CDC/Chris Zahniser

Wild-type poliovirus can be found in the faeces of kids who have received more than 10 doses of the oral vaccine in northern India, say epidemiologists online in the Journal of Infectious Diseases this week. The finding suggests that these kids, who do not fall ill when infected with the virus, may play a part in transmitting the disease to others — and could explain how polio persists in the region despite high levels of vaccination.

The authors of the research, Nicholas Grassly from Imperial College London, UK, and colleagues from the World Health Organization (WHO), say that transmission of the wild poliovirus among vaccinated kids could hamper herd immunity (the protective effect of vaccination on unvaccinated people). New immunisation strategies may be needed to eliminate the disease from India, they add.

Experts say the research provides “good” evidence to confirm a phenomenon reported on numerous occasions over the past 25 years, but which has not been widely accepted by the international community.

Only four countries have not yet put an end to the transmission of wild-type polioviruses: India, Afghanistan, Pakistan and Nigeria. The persistence of the disease in India poses a unique problem to polio eradication programmes as the virus continues to spread in the country even though vaccination coverage is high. In the three other endemic countries the virus persists largely because pockets of people remain unvaccinated, maintaining the spread of the disease.

An oral vaccine against all three strains of the wild-type poliovirus is used to immunise children in India. Scientists have known for some time that kids vaccinated in this way are not fully protected from polioviruses and can still become infected without falling ill. A field investigation into an outbreak of polio in Oman in the late 1980s suggested these vaccinated yet infected kids may help to spread the virus to others. Numerous reports from India have also documented the phenomenon, but until recently the idea has not been acknowledged by the WHO, according to experts EHTF News has contacted.

The researchers launched an investigation to see if vaccinated kids in India are shedding poliovirus in their faeces, which could implicate them in the spread of the virus. They looked for the virus in stool samples, collected during routine diagnosis and surveillance for the disease in India between 2003 and 2008, from suspected polio cases as well as kids with whom they had come into contact. Samples from more than 14,000 healthy kids and over 2700 kids with suspected polio were tested, and 42 cases of polio were confirmed.

At least 13% of the healthy children who came into contact with a laboratory-confirmed case of the polio had detectable wild-type virus in their stool sample, say Grassly and colleagues. This proportion increased to 20% for samples collected within three weeks of polio symptoms first appearing in a confirmed case of the disease. “The majority of healthy contacts who excreted wild-type poliovirus were well vaccinated,” add the authors.

Children in areas at risk of polio are given extra doses of the vaccine to top up their immunity. This is in addition to the four doses given routinely in early childhood. Most kids who took part in the study reported receiving more than 10 doses of the oral vaccine.

These findings are “consistent with a potential role for these children in the asymptomatic transmission of wild-type poliovirus in northern India,” write Grassly and colleagues.

Ellie Ehrenfeld, from the US National Institutes of Allergy and Infectious Diseases, agrees with this conclusion. There is no question that this plays a part in the spread of polio in India, she says. “The data is absolutely clear.”

Ehrenfeld explains that the fact that these kids have excreted the virus means it has replicated in their body, and they are passing it into the community.

Although the number of vaccinated kids excreting the virus is low, the fact that it is happening at all is significant, she adds. But it remains unclear how big a part this factor plays in the continued transmission of polio compared with other factors known to fuel the spread of the virus.

For Vipin Vashishtha, of the Mangla Hospital and Research Center in Uttar Pradesh, India, this phenomenon plays a role in spreading the virus — but is less important than other factors. These include poor sanitation, high population density and low rates of routine vaccination in early childhood. The importance of each one varies depending on the area in India, he says.

Nevertheless, polio vaccination strategies should “urgently address” the issues raised by this research, says Vashishtha. “We know [the] oral polio vaccine behaves differently in tropical setting,” he says. “[There is] lower herd [immunity] here than in temperate settings in industrialised countries.” He mentions a report, published some years ago in an Indian medical journal, which documented the continued spread of the virus in a district of Uttar Pradesh where vaccine coverage was as high as 94%.

The USA stopped using the oral polio vaccine back in 2000, says Ehrenfield, and it is no longer used in many Western countries because it does not give kids complete protection from the virus. These countries now use a jab containing inactivated viruses instead, which is more expensive than the oral vaccine. Scientists have been saying for a long time that another vaccination strategy is needed to stop polio circulating in areas where it still has a foothold, she adds.

The WHO has begun to acknowledge this in recent years, but the oral polio vaccine remains a policy mainstay, says Ehrenfield. This paper show the Organization is taking a step away from their original stance, which calls for continued use of the oral vaccine until the disease is eradicated. “There is now a clear acknowledgment by everyone that other tools are needed,” she says. “We are all on the right track now.”

Jacob John, co-chair of the Indian National Technical Advisory Committee on Immunisation, first reported that vaccinated kids may play a role in spreading the disease in the Lancet in 1985. He says the phenomenon is widely accepted in India, but not by international experts.

Although John says the time to review vaccination strategies in India arrived a decade ago, he reports that good progress has been made against the virus using the oral vaccine in 2010. Two Indian states which were hit hard by polio in the past have not seen a single case of type 1 poliovirus since late 2009. It is unprecedented for both states to show such low numbers at the same time, he says. “Success is within sight.”

But this paper explains what has delayed progress in eradicating the disease in India, adds John.

If polio vaccination strategies are to change in light of this evidence, Vashistha says the injected inactivated polio vaccine could be used alongside the existing oral vaccine in India. The results of experiments in several countries suggest that administering the jab shortly after children have taken the oral vaccine boosts immunity against polioviruses in the gut.

 

[alert]

Re: Tajikistan hit by deadly polio outbreak: WHO

Note the red text. I don't think the vaccine is protective against this virus; this is starting to look like a vaccine failure. 90% of the confirmed cases had proper vaccination.

Uh-oh.

http://www.who.int/csr/don/2010_04_29/en/index.html

Polio in Tajikistan - Update
29 April 2010 -- 171 cases of acute flaccid paralysis (AFP) have been reported by the Ministry of Health of the Republic of Tajikistan from January to present. 32 of these cases are confirmed wild poliovirus type 1, results are pending for the remaining cases. The majority of these cases have an onset of paralysis within the past 3 weeks. There have been 12 deaths.

Of the 32 confirmed wild poliovirus cases, 17 are under the age of two years, 14 are between the ages of two and five years, and one is between the ages of six and 15 years. Sixty-six percent are male. To date, 15 of the confirmed polio cases had paralysis onset during March and 17 have had paralysis onset during April. Information on vaccination history is available for 21 of the 32 confirmed cases. Of these cases, 2 (10%) have reported to have received less than three doses of OPV and 19 (90%) received three or more doses of OPV.

All cases are reported from the south-west of the country, including the capital city Dushanbe. This region borders Afghanistan and Uzbekistan,. Genetic sequencing has now determined that the poliovirus is most closely related to virus from Uttar Pradesh, India.

In response to the outbreak, the government of Tajikistan confirmed they are planning three supplementary rounds of immunization targeting every child <5 years (approx. 1.1 million children). Monovalent oral poliovirus type 1 vaccine will be used to quickly build immunity levels among children in the country. The first round will begin in the capital Dushanbe and six surrounding districts on May 1 with other regions to begin vaccination of children <5 years on May 4. Two additional national rounds have been tentatively scheduled for 18-22 May and 1-5 June.

Neighbouring countries are responding to the outbreak by heightening surveillance at all health care facilities and reporting sites while reviewing immunization status of children. Uzbekistan (target population 2.89 million children <5 years) is planning two national rounds of supplementary immunization with efforts to synchronize these rounds with Tajikistan in May and June. A campaign in Kyrgyzstan to boost the immunity of children against vaccine preventable disease including polio, which was planned by the government as part of European Immunization Week, will end tomorrow. Kyrgyzstan is planning to conduct additional sub-national immunization days in defined geographic areas.

WHO maintains its recommendation not to impose restrictions to the international movement of persons as a control measure at this time. It is important that international travellers to and from polio affected areas are adequately immunized against polio as recommended in Chapter 6 of International Travel and Health.

 

[alert]

Re: Tajikistan hit by deadly polio outbreak: WHO

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,82529

Archive Number 20100502.1423
Published Date 02-MAY-2010
Subject PRO/EDR> Poliomyelitis - worldwide (06): Tajikistan, WHO

POLIOMYELITIS - WORLDWIDE (06): TAJIKISTAN, WHO
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Date: 29 Apr 2010
Source: WHO Global Alert and Response [edited]
<http://www.who.int/csr/don/2010_04_29/en/index.html>


Polio in Tajikistan - Update 29 Apr 2010
------------------
171 cases of acute flaccid paralysis (AFP) have been reported by the
Ministry of Health of the Republic of Tajikistan from January (2010)
to present. 32 of these cases are confirmed wild poliovirus type 1
[WPV1]; results are pending for the remaining cases. The majority of
these cases have an onset of paralysis within the past 3 weeks. There
have been 12 deaths.

Of the 32 confirmed wild poliovirus cases, 17 are under the age of 2
years, 14 are between the ages of 2 and 5 years, and one is between
the ages of 6 and 15 years. 66 percent are male. To date, 15 of the
confirmed polio cases had paralysis onset during March [2010], and 17
have had paralysis onset during April [2010]. Information on
vaccination history is available for 21 of the 32 confirmed cases. Of
these cases, 2 (10 percent) have reported to have received less than
3 doses of OPV, and 19 (90 percent) received 3 or more doses of OPV.

All cases are reported from the southwest of the country, including
the capital city Dushanbe. This region borders Afghanistan and
Uzbekistan. Genetic sequencing has now determined that the poliovirus
is most closely related to virus from Uttar Pradesh, India.

In response to the outbreak, the government of Tajikistan confirmed
they are planning 3 supplementary rounds of immunization targeting
every child less than 5 years (approx. 1.1 million children).
Monovalent oral poliovirus type 1 vaccine [MOVP1] will be used to
quickly build immunity levels among children in the country. The 1st
round will begin in the capital Dushanbe and 6 surrounding districts
on [1 May 2010] with other regions to begin vaccination of children
less than 5 years on [4 May 2010]. Two additional national rounds
have been tentatively scheduled for 18-22 May [2010] and [1-5 Jun 2010].

Neighbouring countries are responding to the outbreak by heightening
surveillance at all health care facilities and reporting sites while
reviewing immunization status of children. Uzbekistan (target
population 2.89 million children less than 5 years) is planning 2
national rounds of supplementary immunization with efforts to
synchronize these rounds with Tajikistan in May [2010] and June
[2010]. A campaign in Kyrgyzstan to boost the immunity of children
against vaccine preventable disease including polio, which was
planned by the government as part of European Immunization Week, will
end tomorrow [30 Apr 2010]. Kyrgyzstan is planning to conduct
additional sub-national immunization days in defined geographic areas.

WHO maintains its recommendation not to impose restrictions to the
international movement of persons as a control measure at this time.
It is important that international travellers to and from polio
affected areas are adequately immunized against polio as recommended
in Chapter 6 of International Travel and Health.

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[New information in the above WHO report includes some descriptive
epidemiology of the outbreak, including age distribution of the 32
confirmed cases to date (31 out of the 32 cases are 5 years old or
less), and vaccination histories (90 percent of the 21 cases in which
vaccination histories were available had a history of 3 or more doses
of vaccine).

According to newswires, there has been at least one fatality
attributable to polio (see
<http://www.who.int/csr/don/2010_04_29/en/index.html>), and possibly
as many as 12 fatalities (see
<http://www.un.org/apps/news/story.asp?NewsID=34558&Cr=polio&Cr1=>).

We await further information on results of the investigations on the
additional AFP cases (there were a total of 171 AFP cases reported to
date) in Tajikistan, and the results of the investigations on the 3
reported AFP cases in Uzbekistan.

 

[alert]

Re: Tajikistan hit by deadly polio outbreak: WHO

http://www.undispatch.com/node/9844

Polio Outbreak in Tajikistan
Alanna Shaikh - May 3, 2010 - 2:12 pm


PolioHealth
It looks like I am at ground zero of a polio outbreak. In Tajikistan, where I live, 171 cases of acute flaccid paralysis have been reported by the Ministry of Health since January. (Acute flaccid paralysis is what they call it before the tests confirm it?s polio.) 32 cases have been confirmed as polio. Twelve people have died.

The WHO and the Ministry of Health are in rapid response mode. The government of Tajikistan plans to provide three supplementary doses of polio vaccine to every child in the country under five. That?s over a million children, and they plan to vaccinate all of them by June 5th. They have started in Dushanbe already, and they will expand into surrounding regions and throughout the country.

It?s not an over-reaction. The virus in question is the wild poliomyelitis virus. In other words, it hasn?t been caused by the vaccine itself. Gene sequencing indicates that the virus is most closely related to wild polio from Uttar Pradesh, India. We?ve already got polio in Pakistan and India. If Tajikistan doesn?t get on top of this, we could be looking at a polio belt from the subcontinent to Central Asia, with spillover into Iran and possibly China.

I think Tajikistan is going to put a stop to the outbreak. We just completed a national measles vaccination campaign last year, so the systems are in place. International donors are ready to support the immunization effort. We?ll see what it looks like a month from now, but this appears to be a problem that can be solved.

 

[alert]

Re: Tajikistan hit by deadly polio outbreak: WHO

http://www.irinnews.org/Report.aspx?ReportId=89016

In Brief: Polio immunization campaign begins in Tajikistan

Photo: Fakhrinisso Kurbonshoeva/IRIN
Polio immunization campaign underway
DUSHANBE, 4 May 2010 (IRIN) - A nationwide anti-polio immunization campaign targeting thousands of children under seven is under way in Tajikistan, according to the Health Ministry.

The first phase of immunization will be carried out this week, with further rounds in the second half of May and in June. Rail and air passengers under 15 travelling outside the country will be vaccinated at medical points at airports and railway stations.

?The debilitating pathogenic Type-1 poliovirus has been confirmed among dozens of hospitalized persons in our republic and it [the poliovirus] has a particular pathogenic factor,? Shamsiddin Jobirov, head of the Tajikistan Immunoprophylaxis Centre, told IRIN in the Tajik capital Dushanbe.

So far 178 suspected cases have been hospitalized and three people have died, according to the Ministry, though the World Health Organization says 12 have died.