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Pakistan: Polio Outbreak - May 2019

Disaster types

The Committee is gravely concerned by the significant further increase in WPV1 cases globally in 2019, particularly in Pakistan where 15 cases have already been reported. In Pakistan transmission continues to be widespread, as indicated by the number of positive environmental isolates in many areas of the country, and the proportion of samples that detect WPV1 is rising. The recent cluster of cases in Lahore also indicates that vulnerabilities still exist outside the high-risk corridors. Notably, the increased rate of infection during what is usually the low season may herald even higher rates of infection in the coming high season unless urgent remedial steps are taken. The committee was very concerned about attacks on vaccinators and on the police protecting them. The increasing refusal by individuals and communities to accept vaccination also needs to be actively addressed. While the committee understood that the recent elections and political transition may have adversely affected delivery of the polio program, it is now essential that the new government renews its efforts, noting that the eradication program in the country is no longer on-track. The committee suggested a thorough analysis of the situation in Pakistan be urgently undertaken, to understand what factors have led to the recent but most serious deterioration in polio eradication seen since 2014. Government, program and community factors need to be all included in such a review. (Emergency Committee under the International Health Regulations (IHR), 29 May 2019).

One wild poliovirus type 1 (WPV1) case was reported in the past week, from North Waziristan, Khyber Pakhtunkhwa (KP) province, with onset of paralysis on 19 May, bringing the total number of WPV1 cases in 2019 to 19. (GPEI, 12 Jun 2019).

According to National Emergency Operations Center, since in 2019, there are 23 cases of wild poliovirus reported in the country including seven from district Bannu, one from district Hangu, one from DIKhan and one from district Shangla in Khyber Pakhtunkhwa, three cases from Mir Ali, two cases from Miran Shah, one from Khyber and one from Bajaur of tribal districts of Khyber Pakhtunkhwa, two from Karachi and one from Larkana in Sindh and three cases from Lahore in Punjab. The special polio vaccination campaign will start on June 17, targeting 10.25 million children under five years old. (Govt. of Pakistan, 16 Jun 2019)

Two wild poliovirus type 1 (WPV1) cases were reported in the past week, from Khyber Pakhtunkhwa (KP) province, one from Shangla district and the other one from Bannu district. The onset dates of paralysis are 18 and 22 May respectively, bringing the total number of WPV1 cases in 2019 to 24. (GPEI, 19 Jun 2019)

On 27 June 2019, the National Emergency Operation Center (NEOC) announced that five new polio cases have been detected in Bannu, Torghar and North Waziristan districts in Khyber Pakhtunkhwa. So far in 2019, a total of 32 polio cases have been reported including 26 from Khyber Pakhtunkhwa and Tribal districts, 3 from Punjab and 3 from Sindh. (Govt. of Pakistan, 27 Jun 2019)

Nine wild poliovirus type 1 (WPV1) cases have been confirmed: one each from Jaffarabad and Killa Abdullah districts, Balochistan province, five from Bannu district and two from Torghar district, Khyber Pakhtunkhwa province. The total number of WPV1 cases are 41. (GPEI, 10 Jul 2019)

Four wild poliovirus type 1 (WPV1) cases have been reported in the past week: One each from Jehlum and Lahore districts, Punjab province, with onset of paralysis on 21 and 22 June 2019; one each from Bannu and Lakkimarwat districts, Khyber Pakhtunkhwa province, with onset of paralysis on 22 June and 01 July 2019. The total number of WPV1 cases are 45. Three WPV1-positive environmental samples were reported in the past week: one each from Quetta district in Balochistan province; Karachi district in Sindh province; Bannu district in Khyber Pakhtunkhwa province. The samples were collected between 20-27 June 2019. (GPEI, 17 Jul 2019)

Five wild polioviruses type 1 (WPV1) cases were reported in the past week: three from Bannu district and one from Charsadda district, Khyber Pakhtunkhwa province; and, one from South Waziristan, Khyber Pakhtunkhwa province. All cases had onset of paralysis in July 2019. There are 53 WPV1 cases in 2019 and 12 WPV1 cases were reported in 2018. (GPEI, 14 Aug 2019)

Four wild poliovirus type 1 (WPV1) cases were reported this week: one each from Killa Abdullah district, Balochistan province; Lakki Marwat and South Waziristan districts, Khyber Pakhtunkhwa province; and, Orangi Town, Karachi district, Sindh province. The onsets of paralysis were on 8, 5, and 20 August 2019 respectively. There are 62 WPV1 cases reported in 2019. There were 12 WPV1 cases reported in 2018. (GPEI, 11 Sep 2019)