Polio this week as of 3 December 2014
 

• In the north of Madagascar, supplementary immunization activities are planned for December in response to the outbreak of circulating vaccine derived poliovirus. National Immunization Days are planned for January. The aim is to boost immunity across the country against all strains of poliovirus using trivalent oral polio vaccine.
• For the first time ever, only 1 case of wild poliovirus has been reported in Africa in the last 4 months. The case had onset of paralysis on 11 August in Somalia.

Wild Poliovirus (WPV) cases

Case breakdown by country

• Two new wild poliovirus type 1 (WPV1) cases were reported in the past week in Afghanistan, 1 in Behsud district (previously uninfected in 2014) of Nangarhar province and 1 in Qalat district of Zabul province (previously uninfected in 2014). The most recent case had onset of paralysis on 5 November in Kandahar district.
• The total number of WPV1 cases for 2014 in Afghanistan is now 23 compared to 11 at this time last year.
• No cases of cVDPV2 have been reported in Afghanistan in 2014.
• Given the growing outbreak in neighbouring Pakistan, Afghanistan continues to conduct supplementary immunization activities (SIAs) to limit the spread of imported polioviruses. Subnational Immunization Days (SNIDs) are planned in high risk areas of the south and east using bivalent oral polio vaccine (OPV) on 7 – 9 and 21 – 23 December.

• No new wild poliovirus type 1 (WPV1) cases were reported in the past week. Nigeria’s total WPV1 case count for 2014 remains 6, compared to 50 at this time last year. The most recent case had onset of paralysis on 24 July in Sumaila Local Government Area (LGA), southern Kano state.
• Over 4 months has passed since the last case of polio was reported in Nigeria.
• No new type 2 circulating vaccine-derived poliovirus (cVDPV2) cases were reported in the past week. The total number of cVDPV2 cases for 2014 in Nigeria remains 26. The most recent cVDPV2 case had onset of paralysis on 16 October, in Barde district, Yobe state.
• Large-scale Subnational Immunization Days (SNIDs) are planned for 13 – 16 December across northern Nigeria. 

• Eight new wild poliovirus type 1 (WPV1) cases were reported in the past week. Two are from Balochistan province (1 in Killa Abdullah district and 1 in Killa Saifulah district, which has not previously been infected in 2014); 5 from Khyber Pakhtunkhwa (KP) province (2 from Peshawar district, 2 from Tank district and 1 from Swat district, which has not reported cases so far in 2014); and 1 from Shikarpur in Sindh province, which has also not reported cases so far in 2014. The total number of WPV1 cases in Pakistan in 2014 is now 268, compared to 70 at this time last year. The most recent WPV1 case had onset of paralysis on 16 November, from Peshawar, KP.
• No cases of type 2 circulating vaccine-derived poliovirus (cVDPV2) were reported in the past week. This most recent cVDPV2 case had onset of paralysis in Khyber Agency, FATA, on 16 September. The country has reported 20 cases of cVDPV2 in 2014.
• Immunization activities are continuing with particular focus on known high-risk areas, in particular newly opened previously inaccessible areas of FATA. At exit and entry points of conflict-affected areas that are still inaccessible during polio campaigns, 100 permanent vaccination points are being used to reach internally displaced families as they move in and out of the inaccessible area. Over 1 million people have been vaccinated in the past few months at transit points and in host communities, including over 850,000 children under 10 years old.

• No new wild poliovirus type 1 (WPV1) cases were reported this week. In 2014, 10 cases have been reported in central Africa: 5 in Cameroon and 5 in Equatorial Guinea.
• National Immunization Days (NIDs) in Cameroon and the Subnational Immunization Days (SNIDs) in DRC are planned for December and Central African Republic in January. From 17-21 December, campaigns in refugee camps in eastern and northern Cameroon will reach children with inactivated polio vaccine (IPV). NIDS are planned in Cameroon, the Republic of Congo and Equatorial Guinea in January.

• No new wild poliovirus type 1 (WPV1) cases have been reported in the past week in countries of the Horn of Africa. The most recent case, which had onset of paralysis on 11 August, was from Hobyo district of Mudug province, central Somalia. The total number of cases that have been reported in the Horn of Africa in 2014 is six: 1 WPV1 in Ethiopia (date of onset of paralysis on 5 January) and 5 WPV1s in Somalia.
• No cases of type 2 circulating vaccine derived poliovirus (cVDPV2) were reported in the past week. The most recent case of cVDPV2 had onset of paralysis in South Sudan on 12 September.
• Following confirmation of two cases of circulating vaccine derived poliovirus type 2 (cVDPV2) in a refugee camp area of Unity state, South Sudan, outbreak response plans are in place to hold rounds of supplementary immunization activities (SIAs) in high risk areas. Over 19,000 children were vaccinated on 13 - 15 November in Bentiu Poc where the 2 cases were reported in September. The objective is to rapidly stop the cVDPV2 in the infected area, while further boosting immunity to type 1 wild poliovirus and to minimize the risk of renewed outbreaks following virus re-introduction from infected countries and areas.
• National Immunization Days (NIDs) are taking place in December in Ethiopia, Djibouti, Somalia, South Sudan, Uganda and Yemen, and Subnational Immunization Days (SNIDs) in Kenya and Sudan.

• Wild poliovirus type 1 (WPV1) has not been detected in environmental samples in Israel or the West Bank and Gaza Strip for more than 6 months. The most recent WPV positive sample was collected in southern Israel on 30 March. All environmental samples collected since April have been negative for WPV.

• No new wild poliovirus type 1 (WPV1) cases were reported in the past week. Three cases of WPV1 have been reported in the Middle East in 2014 - two in Iraq and one in Syria.
• It has been nearly 8 months since the last reported cases of WPV1 in the Middle East. The most recent case reported from Syria had onset of paralysis on 21 January, while the most recent case in Iraq occurred in Mada'in district, Baghdad-Resafa province, with onset of paralysis on 7 April.
• Phase 2 of the Middle East Outbreak response is drawing to an end in December, and efforts are gearing up towards phase 3 of the outbreak response which will run from January until May to keep the Middle East polio free. 
   

• No wild poliovirus type 1 (WPV1) cases have been reported in West Africa in 2014. The most recent WPV1 case in the region occurred in Tahoua province, Niger, with onset of paralysis on 15 November 2012.
• No new cases of type 2 circulating vaccine-derived poliovirus (cVDPV2) were reported this week. The last case of cVDPV2 was reported in Niger on 11 July 2013.
• The Ebola crisis in western Africa is impacting on the implementation or polio eradication activities in Liberia, Guinea and Sierra Leone. Supplementary immunization activities in these countries have been postponed and the quality of acute flaccid paralysis surveillance has markedly decreased this year.
• Even as polio programme staff across West Africa support efforts to control the Ebola outbreak affecting the region, efforts are being made in those countries not affected by Ebola to vaccinate children against polio.
• Subnational Immunization Days (SNIDs) are planned in Niger in December and tentatively for Mali in January.