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Horn of Africa: Polio Outbreak - Aug 2018

Status
Ongoing
Countries
Somalia
+ 2 more
Disaster types
Epidemic

Circulating vaccine-derived poliovirus type 2 (cVDPV2) and type 3 (cVDPV3) have been confirmed in Somalia. Two cases of cVDPV2 and three cases of cVDPV3 have been confirmed, one of which is confirmed as having co-infection of cVDPV2. The total number of cases is four. (WHO/UNICEF, 2 Aug 2018)

Humanitarian partners and health authorities have stepped up efforts to vaccinate every child under the age of five in Somalia against polio as part of attempts to stem the spread of the circulating Vaccine-Derived Poliovirus (cVDPV) associated with populations with low immunity levels and poor hygiene. Four cases of cVDPV have been reported this year. An unknown number of Somali children remain unvaccinated due to access challenges, creating a conducive environment in which VDPVs can thrive. (OCHA, 5 Sep 2018)

One new cVDPV type 2 case was confirmed this week. Virus was isolated from a contact of child that developed paralysis on the 02 September 2018. These children are both from an inaccessible area of Lower Juba, Somalia. Detailed investigations are underway to determine the best response mechanism. No type 3 cases have been reported this week. The total number of cVDPV cases is eleven (11): five cVDPV2, five cVDPV3 and one case of a child with a coinfection of cVDPV2 and cVDPV3 virus. A nationwide polio vaccination campaign targeting around 2.6 million children under five with bivalent Oral Polio Vaccine is (bOPV) underway this week. (WHO/UNICEF, 8 Oct 2018)

One new cVDPV type 3 case was confirmed this week. Virus was isolated from a child with AFP that developed paralysis on 07 September 2018. This five month old child is from an inaccessible area of Middle Shabelle, Somalia, and had never received polio vaccination previously. Detailed investigations are underway to determine the best response mechanism across the area; no type 2 cases have been reported this week. The total number of cVDPV cases is 12: five cVDPV2, six cVDPV3 and one case of a child with a coinfection of cVDPV2 and cVDPV3 virus. (WHO/UNICEF, 15 Oct 2018)

The current polio outbreak that has left twelve (12) Somali children paralyzed are of the highest priority for humanitarian partners’ action. No new cases of circulating vaccine derived polio virus (cVDPV) were discovered in November. Since the first discovery in January 2018, health partners have conducted ten (10) targeted vaccination campaigns, the latest was conducted in nine (9) districts in South and Central Somalia from 25 – 28 November 2018; seeking to cover approximately 1.5M children. (Health Cluster, 30 Nov 2018)

A new circulating vaccine-derived poliovirus type 2 (cVDPV2)* case was confirmed from an AFP case from Las Anod district in Sool region, Somaliland. The date of onset of paralysis was 15th March 2019 (with final classification results released on 23rd April 2019); The latest case to be detected is considered to be a continuation of the existing outbreak of cVDPV2. Prior to this detection, the last cVDPV2 case had a date of onset of 2 September 2018; A total of 13 cases have been identified in the concurrent outbreaks (6 cVDPV2 and 6 cVPDV3, with one additional child with coinfection of type 2 and 3); (WHO/UNICEF, 28 Apr 2019)

The Somalia Polio Programme has not confirmed any new cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) in children with acute flaccid paralysis (AFP) since 8 May 2019. The last case of circulating vaccine-derived poliovirus type 3 (cVDPV3) in a child with AFP was detected and confirmed on 7 September 2018. A total of three cVDPV2 cases have been reported in Somalia across 2019. In total, 15 children with polio have been detected in Somalia since the onset of the ongoing concurrent cVDPV2 and cVDPV3 outbreaks in 2017.(WHO/UNICEF, 30 Oct 2019)

A cVDPV2 outbreak in the Horn of Africa has been detected in Somali province, Ethiopia. The virus was isolated from an AFP case with onset of paralysis on 20 May 2019. Genetic sequencing confirms that the isolated virus is linked to an ongoing cVDPV2 outbreak detected in the Horn of Africa in 2018, with cases reported in Somalia as well as from an environmental sample in Kenya. Currently, Somalia has reported three cVDPV2 cases in 2019. Since detection of the cVDPVs in the Horn of Africa in 2018, Ethiopia had declared this outbreak – together with the Ministries of Health of Kenya and Somalia – to be a regional public health emergency and has been participating in regional outbreak response. Given cross-border population movements across the Horn of Africa specifically between Somalia, Kenya, and Ethiopia, as well as suboptimal subnational immunity and surveillance gaps, the Horn of Africa is considered at high-risk of further transmission of this cVDPV2. (WHO, 31 Jul 2019)

No new cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) were reported this week. The onsets of paralysis of the last case was on 9 September 2019. A total of five cVDPV2 cases have been reported in Ethiopia in 2019, with four linked to the outbreak in neighbouring Somalia and the fifth case is part of a newly reported Ethiopian outbreak this week. (WHO, 12 Jan 2020)

Three cVDPV2 positive environmental samples were reported in Somalia. (GPEI 13 May 2020)