5 November 2008
Data as at 4 November 2008


Map of polio cases worldwide
Map of infected districts (pdf)
Wild poliovirus list 2000-2008 (pdf)
Circulating vaccine-derived poliovirus (pdf)
For monthly case distribution, infected districts and surveillance indicators (pdf), click here
Monthly situation reports     

Information by country

 

Total cases	Year-to-date 2008	Year-to-date 2007	Total in 2007
Globally	1449	695	1315
- in endemic countries:	1357	611	1208
- in non-endemic countries:	92	84	107

Case breakdown by country

• In Mali, a polio case has been confirmed (pre-notification, to be officially reported next week), the first in the country since 2005. The case had onset of paralysis on 30 August, from Mopti province (close to the border with Burkina Faso); genetic sequencing is ongoing to determine its origin. An immunization response is currently being finalized, with campaigns tentatively scheduled for 27 November. Border areas of Mali had already conducted three rounds of preventive immunization campaigns this year, the most recent on 24 October; however Mopti was not covered during those activities. Countries across west Africa continue to be at risk of international spread of polio from the current WPV1 outbreak in northern Nigeria. WPV1 from northern Nigeria has this year previously spread to Benin, Burkina Faso, Ghana and Niger. See 'importation countries' below, for further details.
• In Egypt, a WPV1 has been isolated from an environmental sample collected in Giza, greater Cairo (collected on 29 September), the first polio isolated in the country since January 2005. Genetic sequencing of the isolated virus confirm it is related to WPV1 currently circulating in the southern Sudan/Ethiopia cross-border area. While Egypt has high population immunity levels (estimated at 98% OPV3 coverage), the country is taking steps to further sensitize surveillance for acute flaccid paralysis (AFP), and is planning to conduct an immunization response using monovalent OPV type 1 (mOPV1).

Endemic countries

• One new case was reported in the past week (WPV1 from Kandahar), bringing the total number of cases for 2008 to 23. The most recent case had onset of paralysis on 15 October (WPV1 from Kandahar).
• Preparations are ongoing for the next Sub-national Immunization Days (SNIDs), to be held on 23-25 November, using mOPV1.

• Three new cases were reported in the past week (all WPV1s), bringing the total number of cases for 2008 to 499. The most recent case had onset of paralysis on 16 October (WPV1 from Uttar Pradesh).
• On a visit to India this week, Bill Gates, Co-chair of the Bill and Melinda Gates Foundation – a key supporter of the global effort to eradicate polio – praised the Government of India's commitment to polio eradication, saying India is on track to rid the country of polio and could be a model for other nations still struggling with the disease. "It's amazing what a large task this is," he commented. "Despite the challenges, I'm more convinced than ever that India will lead the way to the successful eradication of polio."
• In Bihar and Uttar Pradesh, large-scale supplementary immunization activities (SIAs) with mOPV1 are continuing in November.
• The next India Expert Advisory Group on Polio Eradication (IEAG) will convene on 10-11 November (moved forward from December), to further refine eradication strategies and finalize plans for 2009.

• Eight new cases were reported in the past week (six WPV1s and two WPV3s), bringing the total number of cases for 2008 to 744. The most recent case had onset of paralysis on 5 October (WPV1 from Kaduna).
• The next immunization campaigns will add mOPV1 to an integrated measles campaign at end-November (in the north) and December (in the south), with additional Immunization Plus Days (IPDs) planned in highest-risk areas in the north in December.

• Four new cases were reported in the past week (all WPV1s), bringing the total number of cases for 2008 to 91. The most recent case had onset of paralysis on 17 October (WPV1 from North West Frontier Province – NWFP).
• Two of this week's newly-reported cases are from Punjab. Punjab now accounts for nearly one-third (27 of 91 cases) of this year's polio cases in the country. Previously polio-free, Punjab was re-infected in July from known transmission zones of the country (NWFP), and has since experienced an outbreak of the disease. Key to protecting children in this area, and other recently re-infected and polio-free areas of the country, is to increase the number of nationwide campaigns.
• The Health Minister of NWFP Mr Zahir Ali Shah – following a recent review of operations – has vowed to assess the future performance of district-level health staff in the province on the basis of success in polio eradication. The Minister highlighted that as key issues marring the quality of polio campaigns are managerial, improving the performance of district-level staff will improve operations.
• Polio staff in Quetta, Balochistan, are supporting the relief effort following the recent earthquakes, by conducting health assessments and delivering emergency services.
• Preparations are ongoing for the next National Immunization Days (NIDs), on 24-26 November, using trivalent OPV.

Importation countries

• One new case was reported in the past week (WPV1), bringing the total number of cases for 2008 to 26. The most recent case had onset of paralysis on 21 September (WPV1 from Cuanza Sul).
• A mop-up in Cuanza Sul with mOPV1 is planned for 14-16 November. Additionally, following NIDs in September and October (with mOPV3 and mOPV1, respectively), nationwide 'accelerated routine immunization activities' are planned for November and December, during which a range of vaccines – including trivalent OPV – will be offered to communities using a 'fixed vaccination site' approach.

• No new cases were reported in the past week. The total number of cases for 2008 remains two. The most recent case had onset of paralysis on 08 August (WPV1 from RS3 province).
• Three nationwide campaigns have been conducted this year, and two further nationwide campaigns are planned for 28 November (with measles) and 19 December.

• No new cases were reported in the past week. The total number of cases for 2008 remains 26. The most recent case had onset of paralysis on 21 August (WPV3 from Mayo-Kebbi).
• The next SNIDs will be held on 14-16 November in the east of the country, using mOPV1 and on 24-26 November in the west of the country, using mOPV3. The next NIDs are scheduled for December using trivalent OPV.

• No new cases were reported in the past week. The total number of cases for 2008 remains four. The most recent case had onset of paralysis on 5 August (WPV1 from Sud-Kivu).
• OPV is being added to a planned measles campaign launched this week (using mOPV1 in highest-risk provinces and trivalent OPV in other areas).

• One new case was reported in the past week (WPV1 from southern Sudan), bringing the total number of cases for 2008 to eleven (one WPV3 from West Darfur, Sudan; and ten WPV1s from the southern Sudan/western Ethiopia cross-border area). The most recent case had onset of paralysis on 20 September (WPV1 from Juba, southern Sudan).
• Outbreak response activities were held across Sudan on 27 October, with mOPV1 in southern Sudan and trivalent OPV in northern Sudan. The next activities will be conducted on 24 November.
• In Ethiopia, activities were held on 17 October (using a combination of mOPV1 and trivalent OPV), and next activities are planned for 14 November (using mOPV1).

• No new cases were reported in the past week. The total number of cases for 2008 remains five. The most recent case had onset of paralysis on 27 July (WPV3 from Mid-West Development Region).
• Immunization campaigns are planned for November and December.

• No new cases were reported in the past week. The total number of cases for this region remains 18 (two in Benin, one in Burkina Faso, two in Ghana and 13 in Niger). The most recent case had onset of paralysis on 20 September (WPV1 from Ghana).
• Following three rounds of synchronized campaigns in border areas of Benin, Burkina Faso, Mali and Niger (the latest on 24 October); additional activities are planned for November in Mali and Niger. These activities will be particularly important given the confirmation of a polio case in Mali (pre-notification, to be officially reported next week). Ghana will hold its activities in high-risk areas on 13-15 November and on 11-13 December, using mOPV1 (following a trivalent OPV nationwide round on 15-17 October).

The Global Eradication of Polio