14 January 2009
Data as at 13 January 2009


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	1625	1083	1315
- in endemic countries:	1488	984	1208
- in non-endemic countries:	137	99	107

Case breakdown by country

• Regional Director (RD) for the WHO Regional Office for the Eastern Mediterranean (EMRO) Dr Hussein A Gezairy this week travelled to Afghanistan and Pakistan, on a high-level visit for polio eradication.
• Dr Gezairy met with senior political leadership in both countries, including in Afghanistan HE President Hamid Karzai and in Pakistan HE Prime Minister Mr Syed Yusuf Raza Gilani, and the Federal Health Ministers in both countries, Dr Sayed Mohammad Amin Fatimi (Afghanistan) Mir Aijaz Hussain Jakhrani (Pakistan).
• Further information on Dr Gezairy's visit to Afghanistan and Pakistan is available at www.polioeradication.org.

Endemic countries

• No new cases were reported in the past week. The total number of cases for 2008 remains 31. The most recent case had onset of paralysis on 27 November (WPV3 from Nangarhar).
• The latest National Immunization Days (NIDs) were officially launched on 11 January by HE President Hamid Karzai, RD EMRO Dr Hussein A Gezairy, and a senior-level delegation including Dr Mojadidi, the President's personal advisor on health and education, and Dr Sayed Mohammad Amin Fatimi, Minister of Health.

• Two new cases were reported in the past week (both WPV1s), bringing the total number of cases for 2008 to 551. The most recent cases had onset of paralysis on 18 December (WPV1 from Uttar Pradesh and Punjab).
• One of the newly-reported cases is from Aligarh in western Uttar Pradesh. The outbreak of WPV1 in this area is continuing at very low levels, however overriding strategic priority is to stop the outbreak completely. Western Uttar Pradesh had been free of indigenous WPV1 for nearly 18 months, before being re-infected in mid-2008 from Bihar.
• The other newly-reported WPV1 case is from Punjab state, in a migrant labour group from western Uttar Pradesh and Bihar. Genetic sequencing is ongoing to determine the exact origin. However, confirmation of this case underscores the importance of fully implementing the targeted strategy of reaching these populations in states with a large number of migrant labourers (ie Punjab, Gujarat, Maharashtra, Delhi).
• Key new appointments have been confirmed within the state governments of both Uttar Pradesh and Bihar. In Uttar Pradesh, Mr Pradeep Shukla has been appointed new Principal Secretary of Health, Mr Lalit Verma is the new Secretary of Health and Chanchal Kumar Tiwari is new Secretary of Family Welfare. In Bihar, Bhanu Pratap Sharma has been appointed as new Secretary of Health.
• The next NID round will be launched on 1 February, following NIDs held on 21 December. Monovalent oral polio vaccine type 1 (mOPV1) will again be used in Bihar, Uttar Pradesh and key re-infected areas, and trivalent OPV in the rest of the country.

• No new cases were reported in the past week. The total number of cases for 2008 remains 788. The most recent case had onset of paralysis on 13 December (WPV1 from Lagos).
• The next nationwide Immunization Plus Days (IPDs) originally scheduled for 24-27 January have been postponed by one week. The activities will now be launched on 31 January, using monovalent OPV type 3 (mOPV3).

• No new cases were reported in the past week. The total number of cases for 2008 remains 118. The most recent case had onset of paralysis on 11 December (WPV3 from North West Frontier Province – NWFP).
• On his visit to Pakistan this week, RD EMRO Dr Hussein A Gezairy underscored that Pakistan has the capability and capacity to eradicate polio, and commended the visible political will, determination and commitment to achieving this.
• In addition to his meetings with the Prime Minister and the Federal Minister of Health (see 'headlines' section above), Dr Gezairy also met with the Minister of State for Health Chaudhry Muhammad Afzal Sandhu, who highlighted the Prime Minister's intention to launch the 'Prime Minister's Action Plan for Polio Eradication'. In a meeting with the Chief Minister of Punjab province, Mr Mian Shahbaz Sharif, the Chief Minister provided Dr Gezairy with assurance of his personal oversight to polio eradication in the province.
• As a result of such renewed political engagement, important operational improvements in key areas have been noted, particularly in parts of Sindh and Punjab. This is evidenced by the steep decline in new cases over a relatively short period of time during the past few months in Punjab, and no WPV1 cases in Sindh since August, despite the high season for polio transmission.
• However, coverage gaps must urgently be filled in the transmission zones of NWFP (due to hampered access to populations in security-compromised areas) and other areas of Sindh (where operational problems continue to mar the quality of polio operations).
• Key to success is increased accountability and ownership at the district-level, provincial-level action plans to tailor eradication efforts in a targeted manner, and systematic inter-sectoral engagement (including other government departments, the private sector, medical associations, etc).
• To help achieve this, the Federal Minister for Health Mir Aijaz Hussain Jakhrani on 9 January chaired the inaugural meeting of the recently-formed Inter-provincial Committee on Eradication.
• Attended by the provincial Health Ministers and Health Secretaries from Balochistan, NWFP and Sindh, the Committee reviewed recently-developed provincial-level action plans and put forward key recommendations on: monitoring of district-level government ownership, establishing mechanisms to assess and measure accountability, and independent verification of programme performance through systematic use of finger-marking during supplementary immunization activities (SIAs).
• Pakistan kicks off its 2009 eradication effort with NIDs on 19-21 January (parts of Punjab and Sindh held their campaigns on 12-14 January). In total, more than 33 million children under the age of five years will be immunized across the country.

Importation countries

• One new case was reported in the past week (WPV3), bringing the total number of cases for 2008 to 27. The most recent case had onset of paralysis on 17 November (WPV3 from Namibe province).
• An SIA schedule for the first half of 2009 is currently being discussed, including the possibility of conducting four NIDs in February, March, May and June.

• 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).

• One new case was reported in the past week (WPV1), bringing the total number of cases for 2008 to 34. The most recent case had onset of paralysis on 18 November (WPV1 from Lac).
• Immunization campaigns planned for 26 January (measles campaign to which trivalent OPV will be added) has been postponed by one week. The activity was originally supposed to have taken place in December.

• 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 18 October (WPV3 from Kasai Occidental).
• A second-round mop-up with mOPV3 in the south (Kasai Occidental) will be conducted on 20 January, following an initial mop-up in December, in response to the recently-confirmed WPV3 case in the province. In the east of the country, outbreak response with mOPV1 is continuing, with the next campaigns planned for early February.

• Three new cases were reported in the past week (WPV1s from southern Sudan), bringing the total number of cases for 2008 to 26 from two countries (one WPV3 from West Darfur, Sudan; and 25 WPV1 from the southern Sudan/western Ethiopia cross-border area). The most recent case had onset of paralysis on 12 December (WPV1 from southern Sudan).
• Immunization campaigns are currently underway in southern Sudan, using mOPV1. Increasing access to all populations (living in remote areas or areas of insecurity) remains the overriding challenge.
• Further activities are tentatively scheduled nationwide in both northern and southern Sudan in February and March.
• In Ethiopia, OPV was added to a staggered measles campaign throughout December. The campaign continues to the end of January.

• No new cases were reported in the past week. The total number of cases for 2008 remains six. The most recent case had onset of paralysis on 15 October (WPV3 from West Development Region).
• Nepal remains at risk of importations from neighbouring India.
• Nationwide campaigns are planned for February and March.

• One new case was reported in the past week (a WPV1 from Benin), bringing the total number of cases in west Africa to 38 in 2008 from six countries. The most recent case had onset of paralysis on 28 Nov (WPV1 from Benin).
• The six countries currently affected in west Africa are Benin, Burkina Faso, Ghana, Mali, Niger and Togo).
• Outbreak response activities throughout these countries is ongoing from January to March, including planned seven-country synchronized cross-border campaigns in February and March (in the six re-infected countries and Côte d'Ivoire).
• The risk of further circulation or additional importations into these western African countries depends fully on the quality of supplementary immunization activities in Nigeria and of the outbreak response activities in the re-infected countries themselves.

The Global Eradication of Polio