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POLIOMYELITIS UPDATE (05): MALAYSIA (SABAH) REQUEST FOR INFORMATION
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[1]
Date: Sat 11 Jan 2020, 6:38 AM
Source: The Borneo Post [edited]
https://www.theborneopost.com/2020/01/11/two-more-polio-cases-in-sabah-dg/


Two more children have been confirmed infected with polio virus in Sabah after a 3-month baby boy was recorded having the disease in Tuaran in December last year [2019].

Health director-general Datuk Dr. Noor Hisham Abdullah said the 2 boys, aged 8 and 11 were foreigners. "The 8-year-old boy who is from Sandakan was found not vaccinated against polio. On [Thu 9 Dec 2019], he had fever and 3 days later, he could not walk.

"Another boy in Kinabatangan who was also not vaccinated, had fever on [Sun 17 Nov 2019] and was treated at a clinic. On [Sun 1 Dec 2019], he was admitted to the hospital after complaining of back pain and was unable to walk. The patient is now able to walk with a walking stick," he said in a statement here yesterday [Fri 10 Jan 2020].

He said all patients are still being treated at the hospital and are in stable condition. Dr. Noor Hisham added that tests at the World Health Organization Polio Regional Reference Laboratory (WHO Polio RRL) in Melbourne, Australia found the polio virus which infected all 3 patients have genetic links with the polio case in Philippines. And that detailed investigations conducted to identify the source of infection in the 2 new cases found they were having acute flaccid paralysis (AFP).

To date, 705 residents from the villages of the 2 boys had been screened and there were no AFP cases recorded. The Health Ministry is calling on Sabahans especially parents to pay attention to their children's vaccination requirements by getting 2 dosages of oral polio vaccine during an ongoing campaign. He also reminded the people to obtain early treatment at the clinic and hospital if there were symptoms of polio and take the preventive measures as advised by the Health Ministry.

Earlier during the ceremony, Noor Hisham stressed that it was vital for parents to immunize their children. "For parents out there with children under 5, please make sure your children have complete immunization and immediately take their children to a nearby health care if their child has polio symptoms," he said. "There is no cure for paralysis, however, we can prevent it by ensuring that children under the age of 5 receive polio immunization. Immunization is your child's rights, do not ignore their rights and health," he emphasized.

The director general also proposed for MOH or the Sabah State Health Department to come up with the best sewage system for residents living in water villages such as Pulau Gaya.

Two polio immunization posts were opened at Kampung Kesuapan and Lok Urai here yesterday [Fri 10 Jan 2020] as part of an initiative for Malaysia to regain its polio-free status from the World Health Organization (WHO).

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[2]
Date: Fri 10 Jan 2020
Source: Malay Mail [edited]
https://www.malaymail.com/news/malaysia/2020/01/10/sabah-to-review-mass-polio-immunisation-programme-following-two-new-cases/1826781


Sabah Health Department director Dr. Christina Rundi said today [Fri 10 Jan 2020] that the state health authorities will have to review its mass polio immunisation programme to possibly include children above the age of 5. She said a review has now become necessary after 2 new polio cases emerged in November and December [2019] involving 2 boys aged 8 and 11 in Sandakan and Kinabatangan.

"When we 1st made the policy to provide immunisation for all children aged 5 years and below, it was based on the 1st case in Tuaran involving a 5-year-old boy. But now that we have these 2, we have to address that and relook at the policy. So we have to go back and calculate, from zero to 5 again, or should we go up to 7, 12 or 15 ... these are policy decisions we have to make, taking into consideration risk assessment and our resources," she said during a press conference here today [Fri 10 Jan 2020].

Polio, a viral and crippling disease affecting largely children, returned to Malaysia after 17 years in December last year [2019], affecting a 5-year-old Malaysian boy in Tuaran who is currently still being treated.

Earlier today [Fri 10 Jan 2020], Health director-general Datuk Dr. Noor Hisham Abdullah announced 2 new cases of acute flaccid paralysis (AFP) in Sabah, bringing the total to 3 in the country.

Faecal and genetic tests conducted by the World Health Organisation (WHO) Polio Regional Reference Laboratory in Australia showed a genetic relation to the same viral strain that broke out in the Philippines last year [2019].

Dr. Rundi said that based on their investigation, the children had not travelled outside of the country and therefore it was likely the children had contracted the virus from carriers who were not showing symptoms and could therefore not be traced.

She said that the mass immunisation programme since the Tuaran case in December last year [2019] had covered areas in Tuaran and Kota Kinabalu so far, affecting some 7000 children, both foreign and locals.

"The process is ongoing and it looks like we will be reaching almost half a million children at the end of it."

Meanwhile, Health and People's Wellbeing Minister Datuk Frankie Poon said the government will heighten its screening process which had tracked and traced the 2 new polio cases.

It also said it would continue efforts to ensure foreign elements do not enter the state easily.

[Byline: Julia Chan]

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[These 2 newly confirmed cases while having dates of onset in November and December 2019, have not previously been included in the GPEI weekly summaries. In yesterday's update (9 Jan 2019 - Poliomyelitis update (03): global (WPV1 Afghan., Pak., cVDPV2 Zambia), Pakistan 20200110.6881006), there was mention of 1 positive cVDPV1 and 1 positive cVDPV2 isolates from environmental sampling in Sabah. The above media reports do not provide the actual virus type isolated from these cases other than say they are related to cases in the Philippines where both cVDPV1 and cVDPV2 have been identified. More information on the laboratory as well as epidemiologic findings would be greatly appreciated.

Unfortunately one undercurrent tone of both media reports is to blame "foreigners" for bringing the disease, as opposed to deal with the failures in the vaccination program so there are pockets of susceptibles that aid in the transmission of the cVDPVs and WPVs when introduced into these pockets.

Looking at a district map of Sabah, https://en.wikipedia.org/wiki/Sabah, the 2 newly confirmed cases come from Sandakan and Kinabatangan, both in the northeast of Sabah in the Sandakan Division, whereas the 1st confirmed case was from Tuaran in the West Coast Division.

In the 2nd media report above, the issue of the target age group for vaccination is an important issue. Vaccination coverages in the areas over the past 10-15 years may well be indicated. In the Americas polio eradication effort, many of the mop up campaigns involved vaccinating the less than 15-year-old population. - Mod.MPP

HealthMap/ProMED map available at:
Sabah, Malaysia: http://healthmap.org/promed/p/3969]

See Also

Poliomyelitis update (04): Ghana (BO, BE, AF) RFI 20200110.6882389
Poliomyelitis update (03): global (WPV1 Afghan., Pak., cVDPV2 Zambia), Pakistan 20200110.6881006
Poliomyelitis update (02): Pakistan (KP, BA, SD) 20200105.6872314
Poliomyelitis update (01): global (WPV1, cVDPV2), Pakistan (KP, SD) 20200103.6869841
2019
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Poliomyelitis update (106): Pakistan (KP) RFI 20191231.6865382
Poliomyelitis update (105): Pakistan (KP, SD) 20191227.6860068
Poliomyelitis update (104): global (WPV1, cVDPV1, cVDPV2) commentary 20191226.6858714
Poliomyelitis update (103): global (WPV1, cVDPV) Pakistan, nOPV2 soon to release 20191220.6850114
Poliomyelitis update (102): Pakistan (BA,KP,SD) 20191219.6848225
Poliomyelitis update (101): Ghana, RFI 20191218.6845754
Poliomyelitis update (100): Pakistan (PB, SD, KP) 20191216.6842210
Poliomyelitis update (90): global, Pakistan, summary status WPV, cVDPV 20191116.6780748
Poliomyelitis update (80): Pakistan, global, RFI 20191020.6737769
Poliomyelitis update (70): Pakistan (KP, SD) 20190826.6641139
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
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Poliomyelitis update (62): (Nigeria, Niger) cVDPV2 20181228.6226490
Poliomyelitis update (01): global (Afghanistan) 20180105.5539242
2017
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Poliomyelitis update (47): Pakistan, global (Congo DR) 20171229.5526565
Poliomyelitis (01): Pakistan (GB), global, RFI 20170314.4898724
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