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Since 1988 - when the Global Polio Eradication Initiative (GPEI) was launched - there has been a a 99% reduction in the incidence of Polio around the globe. Just nine years ago polio appeared to be on the verge of eradication, with only three nations (Pakistan, Afghanistan, and Nigeria) still reporting cases.
Despite the remarkable progress over the past 30 years, eliminating that last 1% of the polio cases has proven to be more difficult than originally hoped.Slowly at first, but gaining momentum, we've seen a resurgence in polio cases over the past 10 years, with WPV1 (wild polio type 1) cases continuing to spread in Pakistan and Afghanistan) and vaccine-derived cases reappearing in places like Niger, Angola, Syria, the Horn of Africa, and the DRC.
On May 5th, 2014 - after convening a meeting of their Emergency Committee - we saw the WHO Declare Polio Spread A Public Health Emergency Of International Concern (PHEIC).Since only about 1 person in 100 who is infected develops symptoms of paralysis (AFP), the finding of even a handful of polio-related AFP cases is of concern. Even those who are asymptomatically infected can shed large quantities of the virus for several weeks, increasing the spread of the virus.
Despite concerted international efforts, five years later polio remains a PHEIC (see WHO Oct 3rd Statement), with significant increases WPV1 cases globally over last year, and a resurgence of vaccine-derived poliovirus type 2 (cVDPV2) in regions - like the Philippines - which have been polio free for years.
Two months ago (Sept 19th) the Philippines declared a polio outbreak after diagnosing their first case since it was declared free of the virus 19 years ago. This from the WHO DON of Sept 24th.
Polio outbreak– The Philippines
Disease outbreak news
24 September 2019The following month the Philippines reported the detection of Circulating vaccine-derived poliovirus type 1 in environmental samples collected in Manilla over the summer.
On 19 September 2019, the Philippines declared an outbreak of polio. Two cases have been reported to date, both caused by vaccine-derived poliovirus type 2 (VDPV2). Environmental samples taken from sewage in Manila on 13 August and a waterway in Davao on 22 August have also tested positive for VDPV2.
The first case was confirmed on 14 September following testing by the National Polio Laboratory at the Research Institute for Tropical Medicine, the Japan National Institute of Infectious Diseases (NIID) and the United States Centers for Disease Control and Prevention (CDC). The case-patient is a 3-year-old girl from Lanao del Sur in the southern Philippines. The virus isolated is genetically linked to VDPV2 previously isolated from environmental samples in Manila and Davao. This indicates that the virus is circulating.
The second case was confirmed on 19 September and is a 5-year-old boy from Laguna Province, approximately 100 km south-east of Metro Manila. Investigations and further characterization of the virus are ongoing.
(Continue . . . )
On 27 September 2019 , a circulating vaccine-derived poliovirus type 1 (cVDPV1) has been confirmed in environmental samples in Philippines. The virus has been isolated from ten environmental samples, all genetically related, which were collected from one sewage collection site and its tributary pumping stations in Manila, between 1 July and 23 September 2019. This sewage collection site in the city of Manila has a catchment area of over 600,000 people.
Meanwhile a 3rd case was reported by the Philippine DOH in October, and a 4th case in early November. Overnight, the Philippines DOH has confirmed 3 new cases.
DOH CONFIRMS THREE MORE CASES OF POLIO(Continue . . . )
Press Release/20 November 2019
The Department of Health (DOH) today confirmed three (3) more cases of poliovirus, all from Mindanao, bringing the total of new cases this year to seven (7). Samples from the three (3) new cases that were sent to the Research Institute for Tropical Medicine and the National Institute of Infectious Diseases - Japan came out positive for poliovirus.
All three (3) cases were admitted to the Cotabato Regional Medical Center. The first case is a two year-old female from Maguindanao who presented with fever and weakness in both legs. The second case is a one year-old male from Cotabato City with fever, cough, and weakness in both legs. The third case is a four year-old female from North Cotabato showing fever, weakness of the right leg, neck, and facial muscles.
The first two cases were unvaccinated with the polio vaccine, while the third received incomplete doses.
“It is unacceptable that more children are falling victim to this vaccine-preventable disease. We are more determined than ever to make sure that no child shall be missed during the next round of the Sabayang Patak Kontra Polio in Metro Manila and Mindanao,” Health Secretary Francisco Duque III declared.
“We should not be satisfied with our children receiving only 1 or 2 doses of the polio vaccine. Let us ensure that they receive the complete doses of the vaccine to fully protect them from Polio,” the Health Chief added.
The previous round of the Sabayang Patak in October reported a 96% coverage among children 0-59 months old from the 17 cities/municipality in NCR. Davao del Sur recorded a 92% coverage from its 10 city/municipalities while Lanao del Sur reported an 85% coverage from 40 city/municipalities.
“We are reiterating to all parents and caregivers to have their 0-59 months children immunized with the polio vaccine from November 25 to December 7,” Health Secretary Francisco Duque III concluded.
The GPEI's most recent weekly summary of Polio reports from around the world states:
Polio this week as of 13 November 2019
Besides Acute Flaccid Paralysis surveillance and Environmental surveillance, how else do disease surveillance officers track the poliovirus in populated cities, hard-to-reach geographical areas and in conflict zones? Find out here.
With the current VDPV outbreaks in the Philippines, the Government with the support of GPEI and other partners is working hard to tackle the virus. The Government has pledged US$ 9 million in domestic resources and has to date disbursed US$ 6.7 million, complemented by contributions from the GPEI. Read the country’s latest situation report.
Summary of new viruses this week (AFP cases and ES positives):
- Pakistan— two WPV1 cases, three WPV1-positive environmental samples, seven cVDPV2 cases and nine cVDPV2 positive environmental samples;
- Nigeria – one cVDPV2 case;
- Democratic Republic of the Congo (DR Congo)- eight cVDPV2 cases;
- Angola— three cVDPV2 cases;
- Chad— two cVDPV2 community contacts;
- Côte d’Ivoire- one cVDPV2 positive environmental sample.
In light of the return of polio to the Philippines after two decades, the CDC has issued the following travel advice.
Polio in the Philippines
Alert - Level 2, Practice Enhanced Precautions
Key points
- There is a polio outbreak in the Philippines.
- CDC recommends that all travelers to the Philippines be vaccinated fully against polio.
- Before traveling to the Philippines, adults who completed their routine polio vaccine series as children should receive a single, lifetime adult booster dose of polio vaccine.
- The current outbreak in the Philippines is caused by vaccine-derived poliovirus, a sign of low polio vaccine coverage in the country.
What is the current situation?
An outbreak of polio has been reported in the Philippines. This outbreak is caused by vaccine-derived poliovirus (VDPV), a sign of low oral polio vaccine coverage in the country.
What is polio?(Continue . . .)
Polio is a crippling and potentially deadly disease that affects the nervous system. Good hand washing practices can help prevent the spread of this disease. Because the virus lives in the feces (poop) of an infected person, people infected with the disease can spread it to others when they do not wash their hands well after defecating (pooping). People can also be infected if they drink water or eat food contaminated with infected feces.
Most people with polio do not feel sick. Some people have only minor symptoms, such as fever, tiredness, nausea, headache, nasal congestion, sore throat, cough, stiffness in the neck and back, and pain in the arms and legs. In rare cases, polio infection causes permanent loss of muscle function (paralysis). Polio can be fatal if the muscles used for breathing are paralyzed or if there is an infection of the brain.
What is vaccine-derived polio?
The oral polio vaccine (made from a weakened strain of the poliovirus) is given as drops in the mouth to protect against polio. This vaccine has been extremely effective in wiping out polio in developing countries where most of the population gets vaccinated. In areas where there are low rates of vaccination against polio and sanitation is poor, the weakened vaccine virus can spread from person to person. Over time, as the virus spreads, it can regain its ability to cause disease in people who are not vaccinated. Polio caused by a vaccine strain is called vaccine-derived polio.
Vaccine-derived polio cannot spread in the United States because the US has high vaccination rates against polio and the oral polio vaccine is not used here.
