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Published Date: 2013-05-22 12:24:39
Subject: PRO/EDR> Poliomyelitis update (06): Kenya, Somalia, WHO, Pakistan
Archive Number: 20130522.1730683

POLIOMYELITIS UPDATE (06): KENYA, SOMALIA, WHO, PAKISTAN
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In this update:
[1] Kenya (Dadaab), Somalia (Banaadir): WHO, alert
[2] Pakistan (Federal Administered Tribal Areas): violence against vaccination workers

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[1] Kenya (Dadaab), Somalia (Banaadir): WHO, alert
Date: Wed 22 May 2013
WHO Global Alert and Response (GAR), Disease Outbreak News [edited]
http://www.who.int/csr/don/2013_05_22/en/index.html


Wild poliovirus in the Horn of Africa - 22 May 2013
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The Horn of Africa is currently experiencing an outbreak of wild poliovirus type 1 (WPV1). A 4-month-old girl near Dadaab, Kenya, developed symptoms of acute flaccid paralysis (AFP) on [30 Apr 2013]. 2 healthy contacts of the child tested positive for WPV1. They are the 1st laboratory confirmed cases in Kenya since July 2011. Investigation into this outbreak is ongoing.

In addition, a case of WPV1 in Banadir [Banaadir], Somalia was confirmed on 9 May 2013.

In response to the outbreak, the 1st vaccination campaign, reaching 440 000 children began on 14 May 2013 in Somalia and a 2nd round of vaccination is planned for 26 May 2013 in synchronization with the affected parts of Kenya.

The risk to neighbouring countries is deemed as very high, due to large-scale population movements across the Horn of Africa and persistent immunity gaps in some areas. Dadaab hosts a major refugee camp, housing nearly 500 000 persons from across the Horn of Africa.

An alert for enhanced surveillance for polio has been issued to all countries across the Horn of Africa, highlighting the need to conduct active searches for any suspected cases. All countries are urged to rapidly identify sub-national surveillance gaps and to take measures to fill the gaps.

In 2005, polio spread east across the African continent, and into Yemen and the Horn of Africa, resulting in over 700 cases. Since then, international outbreak responses have been adopted and new monovalent and bivalent oral polio vaccines have been developed, which can significantly reduce the severity and length of polio outbreaks.

Some areas of Somalia (south-central) are also affected by an outbreak due to circulating vaccine-derived poliovirus type 2 (cVDPV2), which has resulted in 18 cases in Somalia since 2009. In 2012, this strain spread to Dadaab, causing 3 cases.

WHO's International Travel and Health recommends that all travellers to and from polio-infected areas be fully vaccinated against polio.

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

[New information in the report above since the last update (see Poliomyelitis update (05): Kenya, global 20130518.1721794) is that 2 healthy contacts of the polio case in Dadaab, Kenya were found to be positive carriers of WPV1 [wild poliovirus type 1]. The reminder of the high population movement in the area and the potential impact of circulation of WPV1 in the area is sobering.

For a map showing the location of cases of WPV globally, see http://www.polioeradication.org/Dataandmonitoring/Poliothisweek/Poliocasesworldwide.aspx. - Mod.MPP

[HealthMap/ProMED-mail interactive maps of Kenya and Somalia can be seen at http://healthmap.org/r/1r1D (Kenya) and http://healthmap.org/r/6ToF (Somalia). A map showing the location of Dadaab Refugee Camp on the border of Kenya & Somalia, can be seen at
http://images.smh.com.au/2011/07/13/2490773/1407africa_map_353px-200x0.jpg. - Sr.Tech.Ed.MJ]

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[2] Pakistan (Federal Administered Tribal Areas): violence against vaccination workers
Date: Mon 20 May 2012
Source: The Wall Street Journal [edited]
http://online.wsj.com/article/SB10001424127887324787004578494402823401718.html


Officials say gunmen have killed a policeman guarding a polio vaccination team in northwestern Pakistan.

Local government administrator Faramosh Khan says the gunmen attacked on Monday [20 May 2013] in the town of Mamound in the Bajur [Bajaur] tribal area [Federal Administered Tribal Areas], just as the team started a vaccination drive.

No one has claimed responsibility for the shooting, but suspicion will likely fall on Islamic militants suspected in similar attacks.

Jehanzeb Dawar, a senior regional health official, said a total of 624 teams are taking part in the latest push in Bajur to vaccinate more than 220 000 children. The teams re-launched the drive after taking a couple of months off because of past attacks on vaccination teams in the country.

It's unclear whether the campaign will continue after Monday's [20 May 2013] attack.

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

[The continued violence against vaccination workers in the known polio endemic areas [Afghanistan, Nigeria, and Pakistan] does not bode well for the polio eradication effort. This moderator is unable to comprehend the mentality that permits acts of violence against humanitarian and public health workers.

A HealthMap/ProMED-mail interactive map of Pakistan can be seen at http://healthmap.org/r/6ZUE.
For a map of Pakistan showing the tribal areas, see http://pakistantourguide.blogspot.com/2011/05/maps-of-pakistan.html. For a map showing the Bajaur Tribal area, (with an accompanying analytic news story) see http://newamerica.net/publications/policy/the_battle_for_pakistan_bajaur. - Mod.MPP]

See Also

Poliomyelitis update (05): Kenya, global 20130518.1721794
Poliomyelitis update (04): Somalia, global 20130512.1707335
Poliomyelitis update (03): Pakistan, global 20130322.1597804
Poliomyelitis update (02): Niger, Nigeria, Global 20130223.1541658
Poliomyelitis update (01): Egypt ex Pakistan, Niger 20130122.1509210
2012
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Poliomyelitis - worldwide (15): Pakistan, global update 20121218.1458209
Poliomyelitis - worldwide (14): Pakistan, Afghanistan, cVDPV2 20121203.1435756
Poliomyelitis - worldwide (13): global update, challenges 20121119.1414738
Poliomyelitis - worldwide (12): Pakistan 20121020.1354868
Poliomyelitis - worldwide (11): India, not, RFI 20121012.1338396
Poliomyelitis - worldwide (10): India, susp, RFI 20121011.1337616
Poliomyelitis - worldwide (09): Pakistan, Afghanistan, global VDPV 20121004.1324273
Poliomyelitis - worldwide (08): VDPV 20120920.1302548
Poliomyelitis - worldwide (07): Nigeria, global update 20120911.1290030
Poliomyelitis - worldwide (06): update 20120810.1237819
Poliomyelitis - worldwide (05): Nigeria, Pakistan, Afghanistan 20120709.1194958
Poliomyelitis - worldwide (04): India, VDPV2, RFI 20120319.1074212
Poliomyelitis - worldwide (03): India susp, Nigeria, RFI 20120313.1068769
Poliomyelitis - worldwide (02): Ethiopia ex Somalia, susp., RFI 20120125.1020475
Poliomyelitis - worldwide: 2011 new cases 20120107.100291
2011
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Poliomyelitis - worldwide (13): Kenya, China, Pakistan 20110920.2860
Poliomyelitis - worldwide (12): WHO China, Kenya 20110902.2683
2009
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Poliomyelitis - Worldwide (02): Kenya, Uganda ex Sudan 20090226.0808
2006
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Poliomyelitis - Worldwide (19): Kenya ex Somalia 20061226.3612
Poliomyelitis - Worldwide (15): Kenya ex Somalia 20061019.3009
Poliomyelitis - Worldwide (14): Kenya ex Somalia 20061016.2980
2005
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Poliomyelitis - Worldwide (Somalia, Ethiopia, Indonesia) 20060111.0103
Poliomyelitis - Africa (09): Somalia, Eritrea 20050913.2708
Poliomyelitis - Africa (08): Ethiopia 20050907.2649
Poliomyelitis - Africa (07): Ethiopia 20050903.2606
Poliomyelitis - Yemen (08) 20050822.2479
Poliomyelitis - Yemen (06) 20050704.1891
Poliomyelitis - Yemen (05) 20050530.1498
Poliomyelitis - Yemen (03) 20050518.1360
Poliomyelitis - Yemen (03) 20050510.1290
Poliomyelitis - Yemen (02) 20050429.1193
Poliomyelitis - Yemen 20050422.1124
Poliomyelitis - Africa (03): Ethiopia 20050225.0597
Poliomyelitis - Africa (02): Saudi Arabia ex Sudan 20050108.0064
Poliomyelitis - Africa: Sudan, Saudi Arabia ex Sudan, Cote d'Ivoire 20050107.0054
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