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Mali - Vaccine-derived polio case confirmed from Guinea

Gert van der Hoek

In Memoriam - Editor, Senior Moderator
WHO@WHO 11m11 minutes ago
A case of circulating vaccine-derived #polio type 2 has been confirmed in #Mali http://goo.gl/z0o2Lj via @WHOAFRO


Mon Sep 7, 2015

Polio resurfaces in Mali from Ebola-hit Guinea: WHO



There is a high risk of polio spreading in Ebola-ravaged Guinea and Mali, the World Health Organization said on Monday, after a Guinean toddler traveled to Mali and became that country's first case of the crippling disease in more than four years.

Preliminary tests by authorities in Mali's capital showed the 19-month-old was paralyzed on July 20, seven days before being brought to Bamako for treatment. The strain of the virus is the same as one detected in Siguiri in Guinea's Kankan region, in August 2014.

The Mali polio case, caused by a strain of the virus known as type 2, is the second setback in a week for global efforts to eradicate polio, after two cases were reported in Ukraine..
 
Polio outbreak confirmed in Mali


Bamako, 7 September 2015 –

A case of circulating vaccine-derived poliovirus type 2 (cVDPV2) has been confirmed in Bamako, the capital and largest city of Mali. The country is on high alert after national authorities detected a paralysis case with onset 20 July 2015. The patient is a 19-month old child of Guinean nationality whose paralysis occurred 7 days prior to the child’s arrival in Bamako to seek health care. The last case of wild polio virus (WPV) in Mali dates back to June 2011 in Goundam, Timbuktu Region.


The current detected virus is genetically linked to a confirmed VDPV detected in Siguiri district, in the Kankan Region of Guinea in August 2014, and has been circulating across international borders for more than 2 years without detection.

The risk of spread of this virus is deemed high and it has the capacity to cause paralytic disease in humans or kill. The emergence and circulation of VDPV2 reveals low population immunity against the virus due to low rates of vaccination coverage in Guinea. Consequently, oral polio vaccine (OPV) must be administered multiple times to stop the outbreak and protect children.

The Ministries of Health in both countries (Mali and Guinea), WHO and the other partners are currently conducting investigations to determine the circumstances behind the emergence and spread of this virus. At the same time, emergency operations to mount a robust and appropriate response are being organized in both countries to stop the spread of the virus and speedily put an end to the outbreak.

“As soon as the new virus was identified, immediate actions were taken to initiate appropriate and targeted immunization activities that are in line with the recent Global Polio Eradication Initiative (GPEI) guidelines,” says Dr Lucien Manga, acting WHO Representative in Mali.

“The Government of Guinea and partners are informed and we have started evaluating all available resources to prepare for the campaign,” says Dr Mamoudou Harouna Djingarey, Deputy WHO Representative in Guinea.

The emergency response must include at least 3 high quality polio campaigns to stop any further spread to other communities. It is highly important for communities to ensure that all under-five children are vaccinated during the 3 rounds of polio campaigns. The first round of immunization will start this week in Mali and within 14 days in Guinea, according to the guidelines.

Experience from other countries indicates that mass vaccination campaigns need to be carefully planned, prepared and implemented with adequate supportive supervision to guarantee their utmost efficiency. In addition, routine immunization systems should be quickly strengthened in both countries to sustain population immunity and avoid the occurrence of poliovirus (wild or cVDPVs) outbreaks.

Polio is a highly contagious, devastating disease that mainly affects young children in areas with poor sanitation. The virus enters the body through the mouth and spreads easily via faecal contaminated food and water. It invades the nervous system and can cause permanent paralysis or death. Initial symptoms include fever, fatigue, headache, vomiting, stiffness in the neck and pain in the limbs.

WHO will continue to support the Ministries of Health of Mali and Guinea to enhance epidemiological surveillance of the virus in order to ensure the timely detection of any outbreaks. It will specifically carry out all necessary actions, including high quality mop-up responses to interrupt all poliovirus transmission.
 
Translation Google

Polio: How a Guinean child arrived in Mali, before being detected with polio (Itinerary)

Posted by: Mosaiqueguinee.com September 9, 2015 in News

Modern problems especially in Africa are summed up by these different threats: conflicts, epidemics, floods, climate change, terrorism, immigration ... But the problem of epidemics causes serious economic and public health consequences for Africans.

Without an end to the epidemic of Ebola virus disease and its harmful and disastrous consequences on the victims countries, now the Republic of Mali also has notified a case of polio on a child from the Republic of Guinea.

Again in Guinea. How did this happened ? Survey of the itinerary of this child of 19 months.

Child's identity:

Ibrahim Kamissoko is a boy, born in Guinea, 19 month old, of Guinean nationality, son of Mamady Kamissoko and Dogomani Dansogo. He resided in Siguiri, Barkoya district with Fakourou Kamissoko (Guinea) with his mother since birth until the onset of paralysis. The child arrived in Mali in search for physiotherapy on July 27, 2015. He is currently staying with his mom in S?b?nikoro, sector 1, Bamako Commune IV District with Badra Alou Kamissoko.

Vaccination status of the child

He would have been vaccinated only once (oral polio vaccine) according to mom, the first week of birth. The child does not have a vaccination card.

Mom said she gave birth to three (3) children born alive of which one died before the age of one month of unknown cause. There is no notion of paralysis in the family.

Circumstances of onset of the disease:

The onset of the disease dates back to July 20, 2015 marked by fever, sudden paralysis of the right lower limb. His mother would have consulted a traditional therapist the next day called Kossa Dansogo living in the same family, her big brother. The latter would have thought of witchcraft and would have given plants to make decoctions and wash the child.

On July 27, 2015, at the persistence of paralysis, the parents decide to take him to Mali for better care.

The same day, Ibrahim Kamissoko and his mom, actually arrive in Bamako, S?b?nikoro district, Commune IV.

On July 28, 2015, he was received at the reception of the Point G hospital in Bamako Service from where he was referred to the Physiotherapy Unit "Functional Rehabilitation Centre and Psychomotor Sundiata 'Health Centre Reference Commune III in Bamako.

He was consulted on the same day at the Physiotherapy Unit of the Common Reference Health Center III of Bamako district for paralysis of the right lower limb. The diagnosis of flaccid paralysis was made and stool samples taken on 1 and 2 August 2015 because the child had no stool the previous days.

The stool samples were sent to the National Directorate of Health (Immunisation Section) August 3, 2015.

On August 4, 2015, samples were sent to the laboratory of the Pasteur Institute in Abidjan. The laboratory received the stool August 6 2015 and the results were disclosed Friday, September 4, 2015 by the WHO Inter-country Support Team (IST) West Africa based in Ouagadougou.

The child was put under treatment based on oral Uteplex funnel, Alvityl syrup and functional rehabilitation sessions of the right leg that he pursues 2 times a week.

History occurred in the event of circumstances:

According to the mother at the time of the onset of paralysis, she lived with her child in Siguiri in Guinea in a family of six (6) households with several other children. The basic needs of water of the family would be provided by well water and tap water and excreta management is done through two (2) family latrines.

In Mali: the mother and her child live with the younger brother of the child's father who is on loan concession with four (4) other households and seven (7) children under the age of 15 years. Of the seven children under 15 years of the concession, one has never received vaccine doses and six (6) others are incompletely vaccinated.

Drinking water: the water supply source of the family is ensured by a public fountain.

Excreta disposal: there is a traditional latrine without cover in the concession; it is in fair condition.

Details of the circumstances:

Ibrahim Kamissoko paralysis occurred suddenly in an array of fever; parents have thought about witchcraft which is part of beliefs where the traditional therapist consultation reflex. According to the mother, no other cases of paralysis were seen in the family and the surrounding before and during the onset of paralysis of the child.

Itinary of the family before the onset of the disease:

The investigation team has not recovered notion of travel of family members during the two months preceding the onset of paralysis. The only trip taken is that of Mali to treat the child after the onset of paralysis.

The mother reports receiving in their families in Siguiri (Guinea) during the two months before disease onset, two women from Nabou, a town 130 km from Siguiri. One of them stayed for fifteen (15) days with her boy of three (3) and the other six (6) days with her daughter of three (3) years. Both children showed no health problem.

The child traveled with his mother from Siguiri to Bamako by road through Kour?mal? without transit.

Arriving at Bamako they stayed with Badra Aliou Kamissoko in S?b?nikoro before consulting the Point G Hospital the day after the "Functional Rehabilitation Centre and Psychomotor Sundiata" of the Commune III.

Response Plan for Mali

For this response, the strategy will be "door to door" and the target, all children 0 to 59 months regardless of their vaccination status. Based on the results of the investigation, Mali decided to organize four passes vaccination inclusive from 09 September to 30 November 2015.

It remains to be seen what strategy the Republic of Guinea will adopt to prevent this epidemic of polio.

Lancei TOURE
Communications Consultant

http://mosaiqueguinee.com/2015/09/0...-detre-detecte-souffrant-de-polio-itineraire/
 
Translation Google

Sept 10 2015

EPIDEMIOLOGICAL SITUATION OF THE 36th WEEK 2015
...
1.4. Flasks Acute Paralysis (AFP):

a. Notification:

Four (4) AFP cases not followed by deaths were reported from the regions of:
 Kayes: 1 case in the health district of Nioro;
 Sikasso: 1 case in the health district Selingue;
 Gao: 1 case in the health district of Ansongo;
 District of Bamako: 1 case in Commune V.

The four (4) stool samples this week have been received and sent to the Institute Pasteur of Abidjan.

The cumulative situation from 1st to 36th week is one hundred thirty (130) cases with zero (0) death.

b. Laboratory:

The cumulative position of 1st to 36th week is one hundred thirty (130) sent samples at the Pasteur Institute in Abidjan.

Of the one hundred and thirty (130) samples, one hundred and four (104) were negative, one (1) Positive to polio vaccine strain virus circulating derivative (cVDPVs) detected by the CSRef Commune III of the District of Bamako. The case comes from Siguiri (Guinea) and lives in S?b?nikoro (Commune IV). The results of twenty-five (25) others are expected.

c. Actions in the framework of case confirmation in cVDPV Town III

District of Bamako:

Following this case of polio virus derived from circulating vaccine (cVDPVs) actions mare the following:
 Investigation of the case;
 Holding of the meeting of the outbreak management committee;
 Developing a response plan;
 Treatment of five (5) latrines;
 Vaccination of fifteen (15) children in the family and surroundings.

...

http://www.sante.gov.ml/index.php/ep...e-semaine-2015
 
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