Three new circulating vaccine-derived poliovirus type 2 (cVDPV2) - positive sewage samples have been identified this week from three environmental surveillance (ES) sites in Mogadishu, collected on the 22 December. All virus is genetically linked to the two environmental positives identified from 10 November 2019, from two of four ES sites in the city. These new results confirm that there is currently active circulation of this type of poliovirus in the Banadir region.
No new cases of children with cVDPV2 were reported this week. The date of onset of the most recent case of cVDPV2 in a child with acute flaccid paralysis (AFP) was 8 May 2019. A total of three cVDPV2 cases were reported in Somalia in 2019.
No circulating vaccine-derived poliovirus type 3 (cVDPV3) - positive cases or environmental samples were identified in 2019. The onset of the most recent case of cVDPV3 in a child with AFP was 7 September 2018.
In total, 15 children with polio infection have been identified across Somalia since the initial detection of the ongoing cVDPV2 and cVDPV3 outbreaks in late 2017.
Operations and Outbreak Coordination
_ The cVDPV2-positive environmental samples collected in November and December reflect undetected virus transmission, indicating gaps in surveillance and population immunity likely stemming from areas where the polio programme cannot access populations with surveillance and immunization activities.
A targeted mOPV2 response is currently being designed in response to these recent virus isolations. mOPV2 has not been used since late 2018 across south and central regions, and there are a number of susceptible children born since the last case response activities who are unvaccinated. The polio programme aims to implement the first round of mOPV2 in selected areas in early February depending on arrival of vaccine into the country.
Priorities for outbreak response in view of the new epidemiology include further strengthening surveillance and conducting active case search, including in hard-to-access areas, identifying population groups susceptible to harbouring the virus, monitoring population movement and continuing efforts to gain access to security compromised areas with vaccines.