In a few years polio may be eradicated and all of us working in health will look back to remember what may be the last outbreak in Myanmar in the last quarter of 2015.
It would be nice to give the last child with polio in the country free, high quality education as a gift. It would be even better to give all children this gift.
I'm taking a break. More in 2016. Happy Holidays to all.
Jamie
++++++++++++++++++
Health ministry strives to curb polio outbreak
The health ministry has given out polio vaccines to 360,000 children in 15 townships after two children were diagnosed with a rare vaccine-derived polio virus (VDPV) in April and October in Maungdaw, Rakhine State.
Ten townships in Rakhine State, two in Chin State and one each in Magway, Ayeyawady and Bago regions received the vaccinations.
The ministry first gave polio vaccines to children from December 5 to 7 and will continue the campaign from December 26 to 28 and January 15 to 17. The outbreak of VDPV is thought to have been caused by the low vaccination coverage in the region. In previous years, routine vaccination coverage in Rakhine State has been below 80 per cent.
In 2014, only 27 per cent of children in some townships of Rakhine State participated in the third phase of the vaccination program.
In the second round of vaccinations, four-month-old babies will receive oral vaccines and injections. Currently, oral polio vaccines are given to children at the ages of two, four and six months. Injections of polio vaccines for four-month-old children will be added to this year’s regular vaccination program.
http://www.elevenmyanmar.com/local/health-ministry-strives-curb-polio-outbreak
++++++++++++++++++
Emergencies preparedness, response
Circulating vaccine-derived poliovirus – Myanmar
Disease outbreak news
21 December 2015
The National IHR Focal Point of Myanmar has notified WHO of 2 cases of circulating vaccine-derived poliovirus type 2 (cVDPV2).
Details of the additional cases
Laboratory confirmation that VDPV type 2 is circulating in Myanmar was received on 7 November 2015. The circulating VDPV2 was isolated from a 16-month old boy who developed acute flaccid paralysis (AFP) on 5 October. The child had not been previously vaccinated against polio. This strain is from the same VDPV2 strain isolated earlier this year from a polio case (a 28-month-old child) that had developed AFP on 16 April. The two cases are from the same township in Rakhine state. The genetic changes of the isolates detected in April and October suggest that the cVDPV2 may have been circulating for more than one year.
A detailed investigation has been undertaken in the area and stool samples from 28 household / community contacts of the AFP case have been collected and sent for laboratory investigation. Three additional AFP cases, detected in the area during the active case search, are currently under investigation.
National vaccination coverage is estimated to be 76% (WHO/UNICEF estimates, 2014). Vaccination coverage is lower among special risk populations. National surveillance indicator rates in Myanmar are good (2015 non-polio AFP rate: 1.8; 93% adequate stool collection percentage); however, subnational gaps persist.
Public health response
The Ministry of Health, supported by WHO and partners of the Global Polio Eradication Initiative, is engaging in implementing an urgent outbreak response plan. From 5 to 7 December, a first response supplementary immunization activity (SIA) with trivalent oral polio vaccine (tOPV) was conducted in 15 townships targeting nearly 360,000 children under the age of five years. The Ministry of Health plans to conduct at least three more large-scale SIAs in Rakhine and neighbouring provinces as well as other identified ‘high risk’ areas of the country, between now and the end of February 2016. The exact dates and extent of the SIAs are still being finalized. Following confirmation of the initial isolate in April, a local immunization response had been implemented.
Considering the globally synchronized withdrawal of type 2 OPV in April 2016 (through the switch from tOPV to bivalent OPV – bOPV), efforts are underway to ensure that transmission of any cVDPV2 is interrupted ahead of that date. Myanmar has developed a national switch plan which was endorsed by the Ministry of Health. The plan is to move from tOPV to bOPV on 29 April. Inactivated polio vaccine (IPV) was launched throughout the country on 3 December.
Active searches for additional AFP and other activities to enhance surveillance for polioviruses are being intensified to more clearly ascertain the extent of circulation of this strain.
Surveillance and immunization activities are being strengthened in neighbouring countries.
WHO advice
It is important that all countries, in particular those with frequent travel and contacts with polio-affected countries and areas, strengthen surveillance for AFP cases in order to rapidly detect any new virus importation and to facilitate a rapid response. Countries, territories and areas should also maintain uniformly high routine immunization coverage at the district level to minimize the consequences of any new virus introduction.
WHO’s International Travel and Health recommends that all travellers to polio-affected areas be fully vaccinated against polio. Residents (and visitors for more than 4 weeks) from infected areas should receive an additional dose of OPV or inactivated polio vaccine (IPV) within 4 weeks to 12 months of travel.
In November 2015, following the advice of the Emergency Committee convened under the International Health Regulations (2005), the WHO Director-General extended the Temporary Recommendations to limit the international spread of poliovirus from countries affected by cVDPVs (previously, these Recommendations had been limited to countries affected by wild poliovirus) under the Public Health Emergency of International Concern (PHEIC). To comply with the Temporary Recommendations issued under the PHEIC, any country infected by cVDPV should declare the outbreak as a national public health emergency and consider vaccination of all international travellers. For the latest report on the Temporary Recommendations, see related links.
http://www.who.int/csr/don/21-december-2015-polio-myanmar/en/
