In the most recent update from the Global Polio Eradication Initiative (GPEI), they reported seven new circulating vaccine derived poliovirus type 2 (cVDPV2) cases–four from Mayadeen and three from Boukamal districts, Deir Ez-Zor governorate.

Image/ErikaWittlieb via pixabay
Image/ErikaWittlieb via pixabay

This brings the total cases to 70 this year in Syria–Mayadeen (55), Boukamal (11) and one each in Deir Ez-Zor, Tell Abyad, Thawra Tadmour–and with the most recent confirmed case by date of paralysis onset being 9 September 2017.

Two weeks ago during the fifteenth meeting of the Emergency Committee under the International Health Regulations (2005) (IHR) regarding the international spread of poliovirus, the Committee noted their concern over the size of the outbreak in the Syrian Arab Republic, and the difficulty of reaching target populations because of the conflict. As type 2 population immunity rapidly wanes, the risk of spread within the Syrian Arab Republic and beyond its borders will increase substantially, meaning urgent action is needed to stop transmission.

So what actions have been taken?

  • Since confirmation of the outbreak, World Health Organization and UNICEF has coordinated with the Government of Syria and local authorities to carry out two mass vaccination rounds in Deir Ez-Zor and Raqqa governorates, reaching resident, refugee and internally displaced children. More than 350,000 children have been reached with mOPV2 through these activities.
  • In addition to focused mOPV2 campaigns, a single dose of IPV has been offered to children aged 2-23 months in infected and high risk areas to boost immunity. Since the start of the outbreak response 317,663 children were reported vaccinated with IPV in Deir Ez-Zor, Raqqa, Aleppo, Idleb and Hama governorates.
  • IPV has been combined with the bOPV sub-national immunization days in 15 districts in Damascus, Rural Damascus, Homs, Aleppo, Raqqa governorates, accessible areas of Deir Ez-Zor city and in 5 IDPs camps in Hasakah governorate where families from outbreak zones have moved to during the outbreak response.
  • Initial data reports a total of 7,751 children aged 2-23 months were vaccinated in Damascus, representing 86 per cent of the administrative target. In addition, more than 14,000 children aged 2-23 months residing in IDP camps in Hasakah Governorate have also been reached by IPV through the campaign.
  • Since the start of the outbreak neighboring countries have utilized IPV in targeted vaccination activities, particularly in areas with high levels of population displacement and movement. More than 260,000 doses have been mobilized to reach at risk children in Lebanon and Turkey and additional IPV campaigns have taken place in Iraq.
  • Outbreak response teams continue to use IPV strategically to boost immunity and additional vaccines are being prepositioned as part of ongoing contingency planning to ensure that the programme is able to respond quickly to potential breakthrough cases in known outbreak zones or spread of virus to new areas of the country.
  • An additional sub-national campaign is taking place this week in areas of Deir Ez-Zor accessible from Hasakah governorate. 10 mobile teams from Hasakah will conduct the campaign. Outbreak response teams are supporting the mapping of populations living in previously inaccessible areas, accessible road networks for transport of vaccines, and vaccination team members residing in the area.
  • A meeting to discuss GAVI’s grant to support the provision of vaccines in Syria in 2018 and to assess cold chain capacity in Syria was held in Beirut on 24 November. The meeting was attended by the Ministry of Health, UNICEF and WHO. The meeting also discussed the progress made during the outbreak response and next steps for stopping circulation of virus. Vaccine needs for Syria were also finalized during this meeting.
  • Efforts to further improve AFP surveillance sensitivity continue across the country. WHO is supporting the strengthening of active AFP surveillance in Ein Eisa IDP camp, Raqqa governorate and Al-Arysha IDP camp in Hasakah governorate with orientation sessions on reporting of AFP cases for physicians operating in the camps. Contact sampling from all AFP cases continues and stool samples are being taken from healthy children arriving from known infected areas as well as from silent districts (districts that have not reported AFP cases in 2017).