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Published Date: 2019-08-09 21:38:22
Subject: PRO/EDR> Poliomyelitis update (67): Pakistan, Congo DR
Archive Number: 20190809.6614717
POLIOMYELITIS UPDATE (67): PAKISTAN, DEMOCRATIC REPUBLIC OF CONGO
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A ProMED-mail post
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International Society for Infectious Diseases
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Date: Thu 8 Aug 2019
Source: Global Polio Eradication Initiative/WHO
http://polioeradication.org/polio-today/polio-now/this-week/


Poliovirus weekly update 7 Aug 2019, WHO
------------------------
New wild poliovirus cases isolates reported this week:
AFP cases: 1
Environment: 8
Total number of wild poliovirus cases in 2019: 60
Total number of wild poliovirus cases in 2018: 33

New cVDPV isolates reported this week:
AFP cases: 0
Environment: 0
Others: 3
Total number of cVDPV cases (all types) in 2019: 44
Total number of cVDPV cases (all types) in 2018: 104

Summary of new viruses this week:
- Pakistan: 1 wild poliovirus type 1 (WPV1) case and 8 WPV1-positive environmental samples;
- Democratic Republic of the Congo (DRC): 1 cVDPV2 sample isolated from a contact case and 2 cVDPV2 community isolates.

Afghanistan
- No wild poliovirus type 1 (WPV1) case has been reported in the past week. There are 12 WPV1 cases reported in 2019. There were 21 WPV1 cases reported in 2018.
- No WPV1-positive environmental samples were reported in the past week.

Pakistan
- 1 wild poliovirus type 1 (WPV1) case was reported in the past week from Killa Abdullah district, Balochistan province. The onset of paralysis was reported on [2 Jul 2019]. There are 48 WPV1 cases in 2019. A total of 12 WPV1 cases were reported in 2018.
- 8 WPV1-positive environmental samples were reported in the past week: 2 from Gadap Town and 1 from Orangi in Karachi district, Sindh province; 4 from Lahore district and 1 from Rawalpindi district, Punjab province. The samples were collected between [11-22 Jul 2019].

Nigeria, Lake Chad, and West Africa
Nigeria:
- No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) has been reported in the past week. There are 13 cVDPV2 cases reported in 2019. There were 34 cVDPV2 cases in 2018.

Lake Chad:
- No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) has been reported in the past week.
- In the Lake Chad region, cVDPV2 linked to the outbreak originating in Nigeria has been detected in Niger (1 case in 2019 and 10 cases in 2018) and Cameroon (1 positive environmental sample, collected on [20 Apr 2019] in Extreme Nord).
- The risk of further cVDPV2 spread across the Lake Chad subregion remains high.

West Africa:
- No cVDPV2-positive environmental sample was reported in the past week. One cVDPV2-positive environmental sample had previously been reported from Ghana, linked to virus circulating in Nigeria.
- Surveillance is also being strengthened in neighbouring Togo, Benin, Cote d'Ivoire, and Burkina Faso.
- The risk of further cVDPV2 spread across West Africa remains high.

Central Africa
Democratic Republic of the Congo (DR Congo)
- 1 cVDPV2 close contact was isolated from Lingomo, Tshuapa province, on [27 Jun 2019].
- 2 cVDPV2 samples were reported on [22 and 27 Jun 2019] from community isolates in Wembo-Nyama, Sankuru province; and Lingomo, Tshuapa province.
- In Tshuapa province, the 2 confirmed cVDPV2 samples from community and contact are linked to newly emerged vaccine virus genotype. This is the 10th cVDPV2 outbreak /emergence in DRC.
- No new case of circulating vaccine-derived poliovirus type 2 (cVDPV2) have been reported this week. There are 15 reported cases of cVDPV2 in 2019. There were 20 cVDPV2 cases reported in 2018. DRC is currently affected by 9 separate cVDPV2 outbreaks: 1 each originated in Haut Katanga, Mongala, Sankuru, Tanganika, Tshuapa, Kasai, and Kasai Central provinces, while 2 originated in Haut Lomami province. 1 cVDPV2 outbreak in Maniema has been declared over.

Angola
- No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) has been reported this week. There are a total of 3 cVDPV2 cases from 2 outbreaks reported in 2019.

Central African Republic
- No environmental samples were reported.

Horn of Africa
- No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) has been reported in the past week.
- Somalia has reported a total of 15 cVDPV cases (8 type 2, 6 type 3, and 1 coinfection of both type 2 and type 3) since the beginning of the outbreaks. The most recent cVDPV3 virus was from an AFP case from Runingod district, Middle Shabelle province, with an onset date of paralysis on [7 Sep 2018]. Circulating VDPV2 has also been detected during 2018 in 1 environmental sample in Kenya collected on [21 Mar 2018]. There is also 1 reported case of cVDPV2 in Ethiopia, linked to Somalia, with onset on 20 May 2019.

Papua New Guinea
- No new cases of circulating vaccine-derived poliovirus type 1 (cVDPV1) were reported this week. There were 26 cases reported in 2018.

Mozambique
- No case of circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreak has been reported this week. There was 1 case reported in 2018.

Indonesia
- No circulating vaccine-derived poliovirus type 1 (cVDPV1) cases were reported this week.
- This outbreak is not linked to the cVDPV1 in neighbouring Papua New Guinea.

Iran
- No new WPV1-positive environmental samples were reported in the past week. In total, 3 WPV1-positive environmental samples have been reported in 2019, all from Sistan and Balochistan and genetically linked to WPV1 circulating in Karachi, Pakistan.

China
- No cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases in the country remains 1.

Myanmar
- No case of circulating vaccine-derived poliovirus type 1 (cVDPV1) has been reported.

Officially reported wild poliovirus cases as of 6 Aug 2019
Total global cases in 2019: 60 (compared with 13 for the same period in 2018)
- Total in endemic countries in 2019: 60 (compared with 13 for the same period in 2018)
- Total in non-endemic countries in 2019: 0 (compared with 0 for the same period in 2018)

- Afghanistan: 12 cases in 2019 (compared with 10 for the same period in 2018), onset of paralysis of most recent case: 26 May 2019
- Pakistan: 48 cases in 2019 (compared with 3 for the same period in 2018), onset of paralysis of most recent case: 11 Jul 2019
- Nigeria: 0 case in 2019 (compared with 0 for the same period in 2018), onset of paralysis of most recent case: 21 Aug 2016

Officially reported cVDPV cases as of 6 Aug 2019
- Angola: 3 cases in 2019 (compared with 0 for the same period in 2018), onset of paralysis of most recent case: 30 May 2019
- Central African Republic: 4 cases in 2019 (compared with 0 for the same period in 2018), onset of paralysis of most recent case: 23 Jun 2019
- China: 1 case in 2019 (compared with 0 for the same period in 2018), onset of paralysis of most recent case: 25 Apr 2019
- Democratic Republic of the Congo: 15 cases in 2019 (compared with 11 for the same period in 2018), onset of paralysis of most recent case: 14 Jun 2019
- Ethiopia: 1 case in 2019 (compared with 0 for the same period in 2018), onset of paralysis of most recent case: 20 May 2019
- Indonesia (type 1): 0 case in 2019 (compared with 0 for the same period in 2018), onset of paralysis of most recent case: 27 Nov 2018
- Mozambique: 0 case in 2019 (compared with 0 for the same period in 2018), onset of paralysis of most recent case: 21 Oct 2018
- Myanmar (type 1): 3 cases in 2019 (compared with 0 for the same period in 2018), onset of paralysis of most recent case: 14 Jun 2019
- Niger: 1 case in 2019 (compared with 0 for the same period in 2018), onset of paralysis of most recent case: 3 Apr 2019
- Nigeria: 13 cases in 2019 (compared with 3 for the same period in 2018), onset of paralysis of most recent case: 20 Jun 2019
- Papua New Guinea (type 1): 0 case in 2019 (compared with 0 for the same period in 2018), onset of paralysis of most recent case: 18 Oct 2018
- Somalia (type 2): 3 cases in 2019 (compared with 2 for the same period in 2018), onset of paralysis of most recent case: 8 May 2019
- Somalia (type 3): 0 case in 2019 (compared with 3 for the same period in 2018), onset of paralysis of most recent case: 7 Sep 2018

--
Communicated by:
ProMED-mail
<promed@pormedmail.org>

[As a reminder, in the last post (Poliomyelitis update (66): Pakistan (KP) 20190807.6610623) there were an additional 5 newly confirmed cases of WPV-associated paralytic disease reported from Khyber Pakhtunkhwa, Pakistan, that will most likely be included in next week's update. The widespread isolation of WPV in all 4 major provinces of Pakistan (Khyber Pakhtunkhwa, Punjab, Sindh, and Balochistan) is further confirmation of the widespread circulation of the WPV in Pakistan.

As for the cVDPV outbreaks, transmission is continuing in the DR Congo, and most likely still circulating in Nigeria and Somalia. The disturbing information is that there have been 10 separate introductions of cVDPV in the DR Congo. A challenging year.

As done in previous posts, to visualize all of this activity, I am putting links to HealthMap/ProMED-mail maps of countries with poliovirus activity during the past 12 months below. The size of the list remains impressive.

- WPV1
Afghanistan: http://healthmap.org/promed/p/137
Pakistan: http://healthmap.org/promed/p/140
Iran: http://healthmap.org/promed/p/128
- cVDPV
Ethiopia: http://healthmap.org/promed/p/95
Angola: http://healthmap.org/promed/p/165
Democratic Republic of the Congo: http://healthmap.org/promed/p/194
Nigeria: http://healthmap.org/promed/p/62
Niger: http://healthmap.org/promed/p/58
Kenya: http://healthmap.org/promed/p/174
Somalia: http://healthmap.org/promed/p/125
Cameroon: http://healthmap.org/promed/p/65
Mozambique: http://healthmap.org/promed/p/177
Ghana: http://healthmap.org/promed/p/53
Central African Republic: http://healthmap.org/promed/p/66
Papua New Guinea: http://healthmap.org/promed/p/188
Indonesia: http://healthmap.org/promed/p/184
Myanmar: http://healthmap.org/promed/p/148
China: http://healthmap.org/promed/p/155

For a map showing the locations of cases of WPV and cVDPV, see http://polioeradication.org/polio-today/polio-now/. - Mod.MPP]

See Also

Poliomyelitis update (66): Pakistan (KP) 20190807.6610623
Poliomyelitis update (65): Pakistan (BA) 20190805.6607252
Poliomyelitis update (64): global (WPV1 & cVDPV) 20190803.6602126
Poliomyelitis update (63): African region, cVDPV, WHO 20190801.6599377
Poliomyelitis update (62): Pakistan (KP, BA) Nigeria 20190728.6591786
Poliomyelitis update (61): global (Congo DR), Pakistan 20190725.658519
Poliomyelitis update (60): global WPV1, cVDPV2, cVDPV1 20190719.6577836
Poliomyelitis update (50): Afghanistan (OZ) 20190619.6528976
Poliomyelitis update (40): Central African Republic (MP,UK) cVDPV, WHO, RFI 20190529.6493464
Poliomyelitis update (30): (Afghanistan, Pakistan) social media 20190503.6454173
Poliomyelitis update (20): (Pakistan, Nigeria) isolates, real-time surveill. 20190315.6367838
Poliomyelitis update (10): (Afghanistan, Pakistan, Nigeria) positive environ. 20190131.6288339
Poliomyelitis update (01): global 20190104.6241814
2018
----
Poliomyelitis update (62): (Nigeria, Niger) cVDPV2 20181228.6226490
Poliomyelitis update (01): global (Afghanistan) 20180105.5539242
2017
----
Poliomyelitis update (47): Pakistan, global (Congo DR) 20171229.5526565
Poliomyelitis (01): Pakistan (GB), global, RFI 20170314.4898724
2016
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Poliomyelitis update (21): IPV shortage, global 20161231.4733243
Poliomyelitis update (01): India, VDPV, wild type-free 20160115.3939297
.................................................mpp/tw/jh

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