ReliefWeb

• A synchronised regional mass polio vaccination campaign in central and western Africa is currently underway to vaccinate nearly 94 million children in 18 countries with oral polio vaccine (OPV).

• On 18 September, Nepal became the first GAVI eligible country to introduce inactivated polio vaccine (IPV) into its routine immunization programme. Plans are underway to introduce IPV into the immunization programmes of the 126 countries currently using only oral polio vaccine, ahead of a planned switch from trivalent OPV to bivalent OPV.

Afghanistan

• Two new wild poliovirus type 1 (WPV1) cases were reported in the past week, both in provinces previously uninfected in 2014. One of the newly-reported cases had onset of paralysis on 1 September, in Kandahar province, Southern Region, and the other case is from Paktika province, close to the border with Pakistan; both cases are linked to cross border transmission with Pakistan The total number of WPV1 cases in 2014 is now 10.

• No new cases of type 2 circulating vaccine-derived poliovirus (cVDPV2) were reported in the past week. No cases of cVDPV2 have been reported in Afghanistan in 2014.

• Subnational Immunization Days (SNIDs) in the south were held 21-23 September, using trivalent OPV in Helmand province and bivalent OPV elsewhere. The next National Immunization Days (NIDs) are scheduled for 19-21 October.

Nigeria

• No new WPV1 cases were reported in the past week. Nigeria’s total case count for 2014 remains 6. The most recent case had onset of paralysis on 24 July in Sumaila Local Government Area (LGA), southern Kano.

• One new cVDPV2 case was reported in the past week with onset of paralysis on 17 August in Minjibir, Kano. The total number of cVDPV2 cases for 2014 is now 20.

• SNIDs will be held in the north on 1-4 November using trivalent OPV.

Pakistan

• Twenty one new WPV1 cases were reported in the past week. Of these, 12 are from the Federally Administered Tribal Areas (FATA) (3 from North Waziristan, 3 from South Waziristan and 6 from Khyber Agency); 4 are from Khyber Pakhtunkhwa (1 from Tank, 1 from Peshawar and 2 from the previously uninfected district of Bunir); 1 from Kabdulah, Balochistan; 1 in the previously uninfected district of Bhakkar in Punjab; and 3 cases in Sindh (2 in Khigadap and 1 in Khiorangi). This brings the total number of polio cases in 2014 to 166 compared to 28 in 2013 by this date. The most recent onset of paralysis was on 2 September in FATA. The bulk of these cases had onset of paralysis in August, and are being cleared as part of a laboratory back-log.

• One new cVDPV2 case was reported in the past week. This case had onset of paralysis in the Khyber district of FATA on 23 June. The country has now reported 19 cases of cVDPV2 in 2014.

• Immunization activities are continuing with particular focus on known high-risk areas, in particular the newly opened areas in Khyber Pakhtunkhwa. At exit and entry points, 182 permanent vaccination points are being used to reach internally displaced persons.

Central Africa

• No new WPV1 cases were reported this week. In 2014, 10 cases have been reported in central Africa: 5 in Cameroon and 5 in Equatorial Guinea.

• Synchronized NIDs are taking place across central Africa this week in Cameroon, Gabon, Republic of Congo and Equatorial Guinea, all using bivalent OPV, and the Democratic Republic of the Congo using trivalent OPV. SNIDs are also taking place in Chad, using trivalent OPV. National Child Health Days are currently underway in Angola, using trivalent OPV.

Horn of Africa

• No new WPV1 cases have been reported in the past week in the Horn of Africa. The most recent case was in Somalia, with onset of paralysis on 11 August in the Hobyo district of Mudug province. The total number of cases that have been reported in the Horn of Africa in 2014 is six: 1 WPV1 in Ethiopia (with date of onset of paralysis on 14 January) and 5 WPV1s in Somalia.

• Outbreak response across the region continues to be implemented, with campaigns being held in September in Somalia, Ethiopia and Yemen, and in Kenya, Djibouti, South Sudan, Sudan, Uganda, Somalia, Ethiopia and Yemen later this year.

Israel and West Bank and Gaza

• WPV1 has not been detected in environmental samples in Israel or the West Bank and Gaza Strip in recent months. The most recent positive sample was collected in southern Israel on 30 March.

• Environmental samples collected since April have been negative.

• NIDs will be held in West Bank and Gaza in October, exact dates to be confirmed.

Middle East

• No new WPV1 cases were reported in the past week. Three cases of WPV1 have been reported in the Middle East in 2014 - two in Iraq and one in Syria. The most recent case reported from Iraq occurred in Mada'in district, Baghdad-Resafa province, with onset of paralysis on 7 April. Syria’s most recent case had onset of paralysis on 21 January.

• Phase 2 of the Middle East Outbreak response continues to be implemented, with campaigns planned across the region in September and October, using a mix of bivalent and trivalent OPV, depending on the area.

West Africa

• No new WPV1 cases have been reported in West Africa in 2014. The most recent WPV1 case in the region had onset of paralysis in Tahoua province, Niger, on 15 November 2012.

• No new cases of cVDPV2 were reported this week. The last case of cVDPV2 had onset of paralysis in Niger on 11 July 2013.

• Even as polio programme staff across West Africa support efforts to control the Ebola outbreak affecting the region, a large scale synchronized vaccination campaign has been rolled out in those countries not affected by Ebola. NIDs took place on 19-22 September in Benin, Burkina Faso, Côte d’Ivoire, Gambia, Ghana, Mali, Niger and Togo, and in Mauritania 20-23 September using trivalent OPV. NIDs in Guinea-Bissau will take place 27-30 September, also using trivalent OPV. Further NIDs are planned in Burkina Faso, Cape Verde, Côte d’Ivoire, Gambia, Ghana, Guinea-Bissau, Mali, Mauritania, Niger, Senegal and Togo on 31 October-2 November.