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Poliomyelitis - Multistate (world) - Monitoring global outbreaks (ECDC/CDTR, January 28 2013)

Giuseppe

Emeritus
[Source: European Centre for Disease Prevention and Control (ECDC), full PDF document: (LINK). Edited.]


COMMUNICABLE DISEASE THREATS REPORT - Week 4, 20-26 January 2013

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Poliomyelitis - Multistate (world) - Monitoring global outbreaks

Opening date: 8 September 2005 - Latest update: 24 January 2013


Polio, a crippling and potentially fatal vaccine-preventable disease mainly affecting children under five years of age, is close to being eradicated from the world after a significant global public health investment and effort. The WHO European Region is polio-free. Worldwide, 222 cases were reported in 2012 compared with 650 cases in 2011.



Update of the week

During the week leading up to 23 January 2013, there were no new polio cases reported to WHO. In Egypt, WPV has been isolated from environmental samples in two areas of greater Cairo.

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Epidemiological summary

During the past week no new polio cases were reported to WHO. So far there have been no cases reported with onset of disease in 2013, compared with four for the same period in 2012.

WPV has been isolated from environmental samples in two areas of greater Cairo. Virus has been detected in the sewage only; no case of paralytic polio has been reported. The isolates were detected through routine environmental surveillance in Egypt that involves regular testing of sewage water from multiple sites. The last sample which tested positive for WPV was related to virus from Sudan, in December 2010. Authorities in Egypt, which has been polio-free since 2004, have ordered the immediate vaccination of all children under five years of age in the areas where the samples were found.

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ECDC assessment

Although the Global Polio Eradication Initiative missed its end-2012 milestone of stopping all wild poliovirus transmission globally, the programme brought the world to the brink of eradicating polio as 2012 ended, with the fewest wild polio cases ever reported.

Two hundred and twenty-two wild polio cases were reported in 2012 ? a reduction of over 60% compared with 2011. However, there are profound concerns about the polio situation for 2013, especially due to difficulties in the immunisation programme in Pakistan. The programme has been severely affected by the recent attacks that have killed several polio vaccination campaign workers in Pakistan. This may well have an effect on neighbouring Afghanistan, which, together with Pakistan and Nigeria, is one of the three remaining polio-endemic countries in the world. Other neighbouring countries, such as China where a polio outbreak in 2011, the first one since 1999, was imported from Pakistan, will be equally at risk.

The discovery of the wild polio virus strain in Egypt linked to Pakistan gives cause for further unease.



The WHO European Region remains polio-free.

ECDC follows reports on polio cases worldwide through epidemic intelligence in order to highlight polio eradication efforts and identify events that increase the risk of re-introduction of wild poliovirus (WPV) into the EU.

The last polio cases in the European Union occurred in 2001 when three young Bulgarian children of Roma ethnicity developed flaccid paralysis from WPV. Investigations showed that the virus originated from India. The latest outbreak in the WHO European Region was in Tajikistan in 2010 when WPV1 imported from Pakistan caused an outbreak of 460 reported cases. The last indigenous WPV case in Europe was in Turkey in 1998. An outbreak in the Netherlands in a religious community opposed to vaccinations caused two deaths and 71 cases of paralysis in 1992.

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