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Polio in Kenya
Response involving U.S.-bound East African refugees with possible exposure to poliovirus in Kenya
On October 16, 2006, the Centers for Disease Control and Prevention (CDC) was notified of a laboratory-confirmed case of wild poliovirus type-1 in a 3–year-old female Somali refugee who had onset of paralysis on Sept 17. This case of poliomyelitis occurred in Dadaab, a group of 3 refugee camps with approximately 140,000 mostly Somali refugees close to the border of Somalia. This was the first case of polio reported in Kenya in 22 years. The genetic sequence of the virus links it to recent poliovirus isolates from Kismayo, Somalia, and, more distantly, to wild poliovirus type-1 from Nigeria. During the period in question, there was an additional influx of more than 30,000 refugees into Dadaab due to increased fighting in southern Somalia; the patient lived in an area that houses recent arrivals from Somalia. Additionally, there is free movement among the Dadaab camps, Nairobi, and Somalia.
By the time CDC was notified of this case, over 1,100 refugees with potential exposure to poliovirus had recently arrived in the United States, approximately 50 were en route, and 150 were scheduled to arrive the following week. Potentially exposed refugees included all refugees from Dadaab, as well as those who were housed with Dadaab-area refugees in a transit center in Nairobi. The Nairobi transit center provides temporary dormitory-style housing where refugees from various camps in Kenya and Tanzania may freely mix prior to departure for the United States. Because sanitation at the transit center is excellent (including flush toilets, running water, and centralized food preparation), the risk of transmission of poliovirus in this setting was low.
CDC notified state and local health departments in areas receiving these refugees and issued recommendations for appropriate measures to ensure the health of newly arrived refugees and to protect the receiving community (see attached links). The first set of recommendations, modified on October 20, 2006, addressed potential exposed refugees already in the United States (arriving September 1-October 15), refugees currently en route, and refugees scheduled to arrive in the coming week. The movement of remaining refugees in Dadaab was temporarily halted pending an investigation in the camp and vaccination of U.S.-bound refugees. In addition, another 1,000 refugees were scheduled to depart for the United States in the following months. A second set of recommendations was issued on November 20, 2006, to address the remaining U.S.-bound refugees in Dadaab and these recommendations currently remain in place. U.S.-bound movement out of Dadaab resumed in December, 2006.
Additional links:
- Monovalent Oral Poliovirus Vaccine, Frequently Asked Questions
- Domestic Interim Recommendations, October 20, 2006
(PDF 56 KB) - Recommendations for remaining U.S.-bound refugees in Dadaab, Kenya refugee camps following the reported case of poliomyelitis in the camp, November 24, 2006 (PDF 36 KB)