Polio Bulletin - 2018, Issue no. 14 (Week 27)

Chart 1. Non-polio AFP rate (per 100 000 persons < 15 years of age), 2016–2018* Chart 2. Adequate specimen collection rate, 2016–2018 Outbreak of circulating vaccine-derived poliovirus type 1 in Papua New Guinea On 22 June 2018, the National Department of Health (NDOH) of Papua New Guinea and WHO confirmed a polio outbreak affecting Morobe province. One child was paralyzed by vaccine associated poliovirus, and the same virus was also isolated from two healthy children in the same community. On 25 June 2018, the NDOH of Papua New Guinea announced that the outbreak constitutes a ‘national public health emergency’. “We are deeply concerned that polio has re-emerged in Papua New Guinea, and the fact that the virus is circulating,” said Pascoe Kase, Secretary of the National Department of Health (NDOH). “Our immediate priority is to respond and prevent more children from being infected and paralyzed.” Under the auspices of the national public health authority, a wide-scale outbreak response, supported by WHO, UNICEF and other Global Polio Eradication Initiative partners, has been launched. The first out of four planned immunization campaigns will be implemented from 16 to 29 July in Morobe, Madang and Eastern Highlands provinces, aiming to reach up to 300,000 children with polio vaccine. For more information, please visit: http://www.wpro.who.int/papuanewguinea/ mediacentre/releases/20180725 Polio Bulletin 2018 Issue No. 14 - Week 27 (as of 10 July 2018) Chart 4. Percentage of reported AFP cases with pending classification > 90 days after onset, 2018 Chart 3. Percentage of reported AFP cases by number of polio vaccination doses, 2018 Note: Priority countries were selected for the charts. Official WHO acronyms have been used for abbreviation: CHN (China), KHM (Cambodia), LAO (Lao People’s Democratic Republic), MYS (Malaysia), PHL (Philippines), PNG (Papua New Guinea), and VNM (Viet Nam). Expanded Programme on Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Phone: +63 2 5288001 Fax: +63 2 5211036, 5260279 Email: wproepidata@who.int Web: www.wpro.who.int/immunization CONTACT US HIGHLIGHTS * AFP rate annualized as of week 27 0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0 5.5 16 17 18 16 17 18 16 17 18 16 17 18 16 17 18 16 17 18 16 17 18 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% 16 17 18 16 17 18 16 17 18 16 17 18 16 17 18 16 17 18 16 17 18 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% CHN KHM LAO MYS PHL PNG VNM ≥ 3 doses 1-2 doses 0 doses Unknown 10.7% 31.3% 26.1% 18.6% 0.0% 0.0% 24.6% 0% 5% 10% 15% 20% 25% 30% 35% VNM PNG PHL MYS LAO KHM CHN Table 1A. Classification of AFP cases with onset in 2017 and key surveillance indicators Polio Bulletin 2 2016 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 62 45 60 0 0 1 58 1 1 (1.7%) 1.33 37% 97% 06-Jul-18 4 Brunei Darrusalam 1 1 1 0 0 0 1 0 0 (0.0%) 1.00 0% 100% 09-Jan-18 - Cambodia 51 45 57 0 0 0 57 0 0 (0.0%) 1.27 91% 95% 07-Feb-18 - China 5691 2256 5278 0 2 0 5276 0 0 (0.0%) 2.34 93% 100% 02-May-18 - China, Hong Kong SAR 10 8 15 0 0 0 15 0 0 (0.0%) 1.88 80% 100% 01-Mar-18 - China, Macao SAR 1 1 2 0 0 0 2 0 0 (0.0%) 2.00 50% 100% 18-Jan-18 - Japan - 161 - - - - - - - - - - - - Lao People's Democratic Republic 133 21 103 0 0 0 103 0 0 (0.0%) 4.90 73% 73% 27-Feb-18 - Malaysia 143 77 154 0 0 0 154 0 0 (0.0%) 2.00 82% 90% 06-Mar-18 - Mongolia 7 9 6 0 0 0 6 0 0 (0.0%) 0.67 83% 100% 11-Jan-18 - New Zealand 12 9 13 0 0 0 13 0 0 (0.0%) 1.44 38% 100% 02-Mar-18 - Papua New Guinea 23 31 29 0 0 0 29 0 0 (0.0%) 0.94 45% 100% 24-May-18 - Philippines 417 400 462 0 0 0 462 0 0 (0.0%) 1.16 68% 97% 21-Jun-18 - Republic of Korea 70 68 68 0 0 0 68 0 0 (0.0%) 1.00 94% 100% 12-Mar-18 - Singapore 7 6 7 0 0 0 7 0 0 (0.0%) 1.17 86% 100% 07-Feb-18 - Viet Nam 382 234 385 0 0 0 385 0 0 (0.0%) 1.65 94% 89% 13-Jun-18 - Pacific island countries and areas 20 11 16 0 0 0 16 0 0 (0.0%) 1.45 63% 100% 16-May-18 - Total 7030 3383 6656 0 2 1 6652 1 1 (0.0%) 1.97 90% 98% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for o ther indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO Days since last report 5 % investigated ≤ 2 days of notification 3 Indicators Latest report date 4 Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus > 90 days 1 # (%) Vaccine- derived poliovirus (VDPV) Polio- compatible Classification Pending Discarded (Non-polio) 2017 Non-polio AFP rate Total % with adequate specimens 2 Table 1B. Classification of AFP cases with onset in 2018 and key surveillance indicators Polio Bulletin 3 2017 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 60 46 27 0 0 0 15 12 4 (14.8%) 1.13 37% 85% 06-Jul-18 4 Brunei Darrusalam 1 1 1 0 0 0 0 1 0 (0.0%) 1.93 100% 100% 07-Jul-18 3 Cambodia 57 44 28 0 0 0 23 5 0 (0.0%) 1.23 82% 89% 10-Jul-18 0 China 5278 2256 1826 0 0 0 709 1117 449 (24.6%) 1.56 91% 100% 27-Jun-18 13 China, Hong Kong SAR 15 9 5 0 0 0 4 1 0 (0.0%) 1.07 80% 100% 09-Jul-18 1 China, Macao SAR 2 1 1 0 0 0 1 0 0 (0.0%) 1.93 100% 100% 19-Jun-18 21 Japan - 161 - - - - - - - - - - - - Lao People's Democratic Republic 103 21 32 0 0 0 22 10 0 (0.0%) 2.93 91% 72% 18-Jun-18 22 Malaysia 154 77 70 0 0 0 30 40 13 (18.6%) 1.75 81% 71% 25-Jun-18 15 Mongolia 6 9 2 0 0 0 1 1 0 (0.0%) 0.43 100% 100% 04-Jul-18 6 New Zealand 13 9 4 0 0 0 0 4 2 (50.0%) 0.86 50% 100% 26-Jun-18 14 Papua New Guinea 29 34 16 0 0 0 5 11 5 (31.3%) 0.91 25% 88% 06-Jul-18 4 Philippines 462 338 115 0 0 0 76 39 30 (26.1%) 0.66 56% 96% 25-Jun-18 15 Republic of Korea 68 67 28 0 0 0 20 8 0 (0.0%) 0.80 89% 100% 10-Jul-18 0 Singapore 7 6 3 0 0 0 3 0 0 (0.0%) 0.96 67% 100% 10-Jul-18 0 Viet Nam 385 234 84 0 0 0 22 62 9 (10.7%) 0.69 99% 86% 13-Jun-18 27 Pacific island countries and areas 16 11 1 0 0 0 1 0 0 (0.0%) 0.18 0% 100% 16-May-18 55 Total 6656 3324 2243 0 0 0 932 1311 512 (22.8%) 1.30 88% 97% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Annualized non-polio AFP rate per 100 000 population under 15 years of age Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for o ther indicators 3. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Substantially below target 4. Percentage of reported cases investigated within two days of notification 5. Countries are expected to submit data at least once per month to WPRO Days since last report 5 % investigated ≤ 2 days of notification 4 Indicators Latest report date Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus > 90 days 1 # (%) Vaccine- derived poliovirus (VDPV) Polio- compatible Classification Pending Discarded (Non-polio) 2018 Non-polio AFP rate 2 Total % with adequate specimens 3 Table 2A. Laboratory investigation of stool samples from AFP cases with onset in 2017 and key laboratory indicators Polio Bulletin 4 ≥ 80% ≥ 80% Australia VIDRL 44 0 0 4 40 0 0 95% 10% 08-Feb-18 VIDRL 0 - - - - - - - - - - - - - Brunei Darussalam VIDRL 0 - - - - - - - - 08-Feb-18 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 57 0 0 6 51 0 0 96% 9% 26-Jan-18 NIID 0 - - - - - - - - - - - - - China (total) 5214 47 0 343 4824 0 0 96% 6% 02-May-18 131 0 40 0 0 0 0 0 64 19 8 0 0 99% China, Anhui Prov. Lab 294 3 0 13 278 0 0 100% 4% Prov. Lab/CCDC 8 0 6 0 0 0 0 0 2 0 0 0 0 100% China, Beijing Prov. Lab 33 1 0 0 32 0 0 97% 0% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Chongqing Prov. Lab 66 0 0 2 64 0 0 91% 2% Prov. Lab/CCDC 4 0 0 0 0 0 0 0 2 0 2 0 0 100% China, Fujian Prov. Lab 179 1 0 11 167 0 0 95% 5% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Gansu Prov. Lab 90 0 0 2 88 0 0 98% 2% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 0 0 2 0 0 100% China, Guangdong Prov. Lab 399 4 0 33 362 0 0 94% 7% Prov. Lab/CCDC 12 0 6 0 0 0 0 0 6 0 0 0 0 100% China, Guangxi Prov. Lab 269 5 0 33 231 0 0 97% 11% Prov. Lab/CCDC 10 0 4 0 0 0 0 0 6 0 0 0 0 100% China, Guizhou Prov. Lab 192 0 0 15 177 0 0 97% 7% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 282 4 0 28 250 0 0 99% 8% Prov. Lab/CCDC 7 0 4 0 0 0 0 0 3 0 0 0 0 100% China, Heilongjiang Prov. Lab 106 1 0 5 100 0 0 100% 5% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Henan Prov. Lab 513 7 0 57 449 0 0 91% 9% Prov. Lab/CCDC 21 0 2 0 0 0 0 0 14 1 4 0 0 100% China, Hubei Prov. Lab 195 0 0 21 174 0 0 97% 10% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 265 1 0 18 246 0 0 99% 6% Prov. Lab/CCDC 4 0 3 0 0 0 0 0 1 0 0 0 0 100% China, Jiangsu Prov. Lab 229 4 0 3 222 0 0 100% 1% Prov. Lab/CCDC 8 0 2 0 0 0 0 0 6 0 0 0 0 100% China, Jiangxi Prov. Lab 163 1 0 16 146 0 0 95% 8% Prov. Lab/CCDC 3 0 0 0 0 0 0 0 3 0 0 0 0 100% China, Jilin Prov. Lab 60 1 0 6 53 0 0 100% 8% Prov. Lab/CCDC 4 0 2 0 0 0 0 0 2 0 0 0 0 50% China, Neimongol Prov. Lab 101 2 0 1 98 0 0 99% 0% Prov. Lab/CCDC 5 0 3 0 0 0 0 0 2 0 0 0 0 100% China, Ningxia Prov. Lab 19 0 0 2 17 0 0 95% 11% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 111 1 0 2 108 0 0 92% 2% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Shandong Prov. Lab 367 5 0 9 353 0 0 95% 2% Prov. Lab/CCDC 26 0 1 0 0 0 0 0 7 18 0 0 0 100% China, Shanghai Prov. Lab 37 0 0 0 37 0 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 157 0 0 6 151 0 0 94% 3% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Sichuan Prov. Lab 365 0 0 21 344 0 0 96% 5% Prov. Lab/CCDC 2 0 2 0 0 0 0 0 0 0 0 0 0 100% China, Tianjin Prov. Lab 30 0 0 0 30 0 0 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 140 4 0 8 128 0 0 93% 5% Prov. Lab/CCDC 8 0 5 0 0 0 0 0 3 0 0 0 0 100% China, Yunnan Prov. Lab 223 1 0 17 205 0 0 92% 6% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Zhejiang Prov. Lab 173 1 0 7 165 0 0 99% 3% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Hainan Prov. Lab 31 0 0 3 28 0 0 93% 8% CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 96 0 0 3 93 0 0 99% 2% CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 21 0 0 1 20 0 0 100% 5% CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 8 0 0 0 8 0 0 63% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 15 0 0 0 15 0 0 98% 0% 22-Jan-18 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 2 0 0 0 2 0 0 100% 0% 22-Jan-18 PHLC 0 - - - - - - - - - - - - - Japan NIID - - - - - - - - - - NIID - - - - - - - - - - - - - - Lao People's Democratic Republic NIID 144 1 1 15 127 0 0 96% 10% 29-Jan-18 NIID 4 0 0 0 0 0 0 0 2 0 2 0 0 100% Malaysia IMR 182 0 0 9 173 0 0 98% 5% 09-Feb-18 IMR 0 - - - - - - - - - - - - - Mongolia PHI 7 0 0 0 7 0 0 100% 0% 27-Feb-18 NIID 0 - - - - - - - - - - - - - New Zealand IESR 9 0 0 0 9 0 0 100% 0% 23-Jan-18 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 26 0 0 8 18 0 0 100% 22% 08-Feb-18 VIDRL 0 - - - - - - - - - - - - - Philippines RITM 483 6 0 27 450 0 0 98% 4% 26-Jun-18 RITM 15 0 4 0 0 0 0 0 11 0 0 0 0 100% Republic of Korea NIH 68 0 0 4 64 0 0 97% 4% 09-Feb-18 NIH 0 - - - - - - - - - - - - - Singapore SGH 7 0 0 0 7 0 0 100% 0% 15-Feb-18 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 177 1 0 29 147 0 0 100% 14% 25-Jan-18 NIHE 2 0 0 0 0 0 0 0 2 0 0 0 0 100% Viet Nam (South) PI 194 0 0 34 160 0 0 100% 18% 21-Feb-18 PI 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 16 0 0 5 11 0 0 100% 26% 08-Feb-18 VIDRL 0 - - - - - - - - - - - - - Total 6645 55 1 484 6105 0 0 96% 6% 152 0 44 0 0 0 0 0 79 19 10 0 0 99%6% 100% 2. NPEV growing in L20B cells L20B posit ive Pending ≤ 14 days VDPV Type 2 L20B positive + NPEV NPEV 2 VDPV Pending ITDVDPV NegativeNPEV only SabinWild 1. CCDC (Chinese Center for Disease Control and Prevention, China); IESR (Institute of Environmental Science and Research, New Zealand); IMR (Institute of Medical Research, Malaysia); NIH (National Institute of Health, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); PHI (Public Health Institute, Mongolia); PHLC (Public Health Laboratory Center, China, Hong Kong SAR); PI (Pasteur Institute, Ho Chi Minh, Viet Nam); RITM (Research Institute for Tropical Medicine, Philippines); SGH (Singapore General Hospital); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Total no. of AFP cases with specimens Results of virus isolation for AFP cases Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild Country/area % ITD results reported ≤ 7 days of receipt Type 3 Polio laboratory 1 Type 1 Sabin Pending > 14 days % results reported ≤ 14 days % specimens positive for NPEV Latest report date Discordant pending sequencing Table 2B. Laboratory investigation of stool samples from AFP cases with onset in 2018 and key laboratory indicators Polio Bulletin 5 ≥ 80% ≥ 80% Australia VIDRL 13 0 0 0 11 0 2 100% 0% 15-Jun-18 VIDRL 0 - - - - - - - - - - - - - Brunei Darussalam VIDRL 0 - - - - - - - - 02-May-18 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 23 0 0 7 16 0 0 96% 28% 09-Jul-18 NIID 0 - - - - - - - - - - - - - China (total) 1791 7 0 97 1607 0 80 97% 5% 27-Jun-18 28 0 5 0 0 0 0 0 22 1 0 0 0 100% China, Anhui Prov. Lab 96 1 0 1 89 0 5 100% 1% Prov. Lab/CCDC 4 0 2 0 0 0 0 0 2 0 0 0 0 100% China, Beijing Prov. Lab 11 0 0 0 10 0 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 22 0 0 0 18 0 4 89% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 59 1 0 1 56 0 1 100% 2% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Gansu Prov. Lab 34 0 0 2 28 0 4 100% 7% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 142 0 0 5 136 0 1 91% 2% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Guangxi Prov. Lab 75 0 0 8 66 0 1 97% 10% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guizhou Prov. Lab 57 0 0 1 55 0 1 98% 1% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 104 0 0 13 90 0 1 100% 10% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 41 0 0 2 39 0 0 100% 5% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 197 1 0 26 168 0 2 100% 12% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Hubei Prov. Lab 59 0 0 3 55 0 1 98% 5% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 58 0 0 8 48 0 2 96% 13% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 70 1 0 2 61 0 6 100% 3% Prov. Lab/CCDC 4 0 0 0 0 0 0 0 3 1 0 0 0 100% China, Jiangxi Prov. Lab 48 0 0 0 46 0 2 95% 0% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Jilin Prov. Lab 30 1 0 2 25 0 2 100% 5% Prov. Lab/CCDC 4 0 2 0 0 0 0 0 2 0 0 0 0 100% China, Neimongol Prov. Lab 33 0 0 2 28 0 3 100% 5% Prov. Lab/CCDC 4 0 1 0 0 0 0 0 3 0 0 0 0 100% China, Ningxia Prov. Lab 10 0 0 0 10 0 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 34 0 0 0 30 0 4 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 156 1 0 1 146 0 8 100% 1% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Shanghai Prov. Lab 10 0 0 0 10 0 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 68 0 0 0 68 0 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Sichuan Prov. Lab 101 0 0 2 73 0 26 97% 2% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tianjin Prov. Lab 13 0 0 0 13 0 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 49 1 0 3 45 0 0 86% 6% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Yunnan Prov. Lab 105 0 0 12 93 0 0 89% 10% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Zhejiang Prov. Lab 53 0 0 1 51 0 1 100% 2% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Hainan Prov. Lab 17 0 0 2 15 0 0 100% 9% CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 26 0 0 0 23 0 3 100% 0% CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 11 0 0 0 11 0 0 100% 0% CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 2 0 0 0 1 0 1 100% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 4 0 0 0 4 0 0 100% 0% 28-Jun-18 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 0 100% 0% 13-Apr-18 PHLC 0 - - - - - - - - - - - - - Japan NIID - - - - - - - - - - NIID - - - - - - - - - - - - - - Lao People's Democratic Republic NIID 50 1 0 4 45 0 0 99% 5% 09-Jul-18 NIID 1 0 0 0 0 0 0 0 1 0 0 0 0 100% Malaysia IMR 87 0 0 7 80 0 0 89% 6% 09-Jul-18 IMR 0 - - - - - - - - - - - - - Mongolia PHI 3 0 0 2 1 0 0 100% 67% 06-Jul-18 NIID 0 - - - - - - - - - - - - - New Zealand IESR 4 0 0 0 4 0 0 88% 0% 10-Jul-18 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 10 1 0 1 8 0 0 100% 12% 06-Jul-18 VIDRL 2 0 0 2 0 0 0 0 0 0 0 0 0 100% Philippines RITM 189 1 1 9 169 9 0 93% 4% 09-Jul-18 RITM 6 0 2 0 0 0 0 0 4 0 0 0 0 100% Republic of Korea NIH 28 0 0 0 25 3 0 100% 0% 10-Jul-18 NIH 0 - - - - - - - - - - - - - Singapore SGH 3 0 0 1 2 0 0 100% 20% 06-Jul-18 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 87 2 0 9 58 18 0 100% 12% 05-Jul-18 NIHE 3 0 1 0 0 0 0 0 2 0 0 0 0 100% Viet Nam (South) PI 64 3 0 4 56 1 0 100% 6% 09-Jul-18 PI 6 0 0 0 0 0 0 0 6 0 0 0 0 100% Pacific island countries and areas VIDRL 1 0 0 0 1 0 0 100% 0% 02-May-18 VIDRL 0 - - - - - - - - - - - - - Total 2358 15 1 141 2088 31 82 97% 5% 46 0 8 2 0 0 0 0 35 1 0 0 0 100%6% 100% 2. NPEV growing in L20B cells L20B posit ive Pending ≤ 14 days VDPV Type 2 L20B positive + NPEV NPEV 2 VDPV Pending ITDVDPV NegativeNPEV only SabinWild 1. CCDC (Chinese Center for Disease Control and Prevention, China); IESR (Institute of Environmental Science and Research, New Zealand); IMR (Institute of Medical Research, Malaysia); NIH (National Institute of Health, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); PHI (Public Health Institute, Mongolia); PHLC (Public Health Laboratory Center, China, Hong Kong SAR); PI (Pasteur Institute, Ho Chi Minh, Viet Nam); RITM (Research Institute for Tropical Medicine, Philippines); SGH (Singapore General Hospital); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Total no. of AFP cases with specimens Results of virus isolation for AFP cases Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild Country/area % ITD results reported ≤ 7 days of receipt Type 3 Polio laboratory 1 Type 1 Sabin Pending > 14 days % results reported ≤ 14 days % specimens positive for NPEV Latest report date Discordant pending sequencing Polio Bulletin 6 Table 3. Laboratory confirmation of polio isolates from environmental samples in 2017–2018 1 Table 4. Vaccine-derived poliovirus1 identified from laboratory testing2, 2000–2018 Country/area 2000–2009 3 2010 2011 2012 2013 2014 2015 2016 2017 2018 Australia aVDPV2 (1 env) Cambodia 2006 - 1 Total - 2 China 2009 - 1 Total - 27 aVDPV2 (3 AFP + 1 contact + 1 non-AFP) aVDPV3 (1 AFP + 1 non-AFP) aVDPV1 (1 AFP) aVDPV2 (2 AFP + 1 contact) cVDPV2 (2 AFP) iVDPV2 (1 AFP + 1 non-AFP) iVDPV3 (1 AFP) aVDPV1 (1 AFP) aVDPV2 (2 AFP) cVDPV2 (2 AFP + 1 contact) iVDPV2 + iVDPV3 (1 AFP) aVDPV2 (1 non-AFP) iVDPV2 + iVDPV3 (1 AFP) aVDPV1 (1 non-AFP) aVDPV2 (2 AFP) iVDPV3 (1 AFP) aVDPV1 (1 AFP) aVDPV2 (1 AFP) iVDPV2 (1 AFP) aVDPV2 (1 env) aVDPV3 (1 AFP) aVDPV3 (1 AFP) iVDPV3 (1 AFP) 4 ?VDPV3 (1 AFP) aVDPV3 (1 env) China, Hong Kong SAR 2005 - 3 Japan 2005 - 1 Total - 2 Lao People's Democratic Republic 2004 - 3 cVDPV1 (8 AFP + 21 contacts) cVDPV1 (3 AFP + 4 contacts) Mongolia 2003 - 1 Papua New Guinea cVDPV1 (1 AFP + 2 contacts) Philippines 2001 - 3 aVDPV2 (1 AFP) Viet Nam aVDPV2 (2 AFP) 2. Source of specimens could be AFP cases, contacts, non-AFP cases or environmental 3. Refers to year of last VDPV case, and aggregate total of VDPV cases for 2000-2009 4. Continuous excretion for 4 months; potential immunodeficient person. 1. Prefix letter refers to the VDPV category: "cVDPV" = circulating VDPV, "iVDPV" = immunodeficiency-associated VDPV, "aVDPV" = ambiguous VDPV, "?VDPV" = pending. Suffix number refers to the poliovirus serotype (types 1, 2 or 3). Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 6 2 0 0 0 0 0 1 0 1 0 4 0 0 17 2 0 2 0 0 0 0 0 0 0 12 0 0 China (total) 325 188 0 213 0 0 0 0 0 650 0 1158 0 0 96 76 0 48 0 0 0 0 0 208 1 404 7 0 China, Fujian Prov. Lab/CCDC 53 22 0 8 0 0 0 0 0 42 0 331 0 0 36 29 0 6 0 0 0 0 0 66 1 252 7 0 China, Gansu Prov. Lab/CCDC 12 10 0 10 0 0 0 0 0 29 0 18 0 0 5 3 0 2 0 0 0 0 0 4 0 13 0 0 China, Guangdong Prov. Lab/CCDC 48 39 0 18 0 0 0 0 0 87 0 108 0 0 24 21 0 13 0 0 0 0 0 58 0 90 0 0 China, Guangxi Prov. Lab/CCDC 36 20 0 22 0 0 0 0 0 36 0 94 0 0 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab/CCDC 42 17 0 12 0 0 0 0 0 34 0 112 0 0 9 7 0 1 0 0 0 0 0 16 0 3 0 0 China, Shandong Prov. Lab/CCDC 48 28 0 18 0 0 0 0 0 90 0 272 0 0 11 7 0 13 0 0 0 0 0 31 0 34 0 0 China, Shanghai Prov. Lab/CCDC 22 18 0 17 0 0 0 0 0 65 0 51 0 0 5 3 0 2 0 0 0 0 0 6 0 7 0 0 China, Xinjiang Prov. Lab/CCDC 36 34 0 108 0 0 0 0 0 267 0 115 0 0 6 6 0 11 0 0 0 0 0 27 0 5 0 0 China, Yunnan Prov. Lab/CCDC 28 0 - - - - - - - - - 57 0 0 0 - - - - - - - - - - - - - Malaysia IMR 24 0 - - - - - - - - - 22 0 0 0 - - - - - - - - - - - - - Philippines RITM 40 8 0 1 0 0 0 0 0 7 0 21 0 0 33 3 0 2 0 0 0 0 0 1 0 13 0 0 Total 395 198 0 214 0 0 0 1 0 658 0 1205 0 0 146 81 0 52 0 0 0 0 0 209 1 429 7 0 1. Based on year of collection of sample, if available. Otherwise, based on year of receipt at reference laboratory. Total number of samples with polio isolates Polio isolates Pending ITD Discordant pending sequencing Polio isolates Type 3 Total number of samples processed 2. CCDC (Chinese Center for Disease Control and Prevention, China); IMR (Institute of Medical Research, Malaysia); RITM (Research Institute for Tropical Medicine, Philippines); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) Type 1 Type 2 Type 3 Type 1 NPEV Discordant pending sequencing Country/area Type 2 Intratypic differentiation lab 2 2017 2018 Total number of samples processed Total number of samples with polio isolates NPEV Pending ITD