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Polio Bulletin - 2015, Issue no. 10 (Week 21)

May 25, 2015 World Health Organization

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2015 Issue No. 10 - Week 21 (as of 25 May 2015) HIGHLIGHTS Polio Resolution at the 2015 World Health Assembly Delegates at the World Health Assembly resolved to recommit to stopping polio and to preparing for the phased withdrawal of oral polio vaccines. The meeting noted that polio eradication can be achieved through global solidarity. 3.0

Polio Bulletin

Chart 1. Non-polio AFP rate (per 100 000 persons < 15 years of age), 2013–2015* 100%

Chart 2. Adequate specimen collection rate, 2013–2015

2.5

 Ministers of health from around the world attending the 2015 World Health Assembly (WHA) in Geneva, Switzerland, adopted a landmark resolution to secure a lasting world free of all polio-disease once and for all.

80%

2.0 60%

 Ministers

1.5 40%

noted the strong progress being achieved and the impact of national emergency action plans, as more and more children in the remaining endemic countries are now fully protected from polio. Yet they warned that as long as the disease remained anywhere, children everywhere are at risk. the latest global epidemiology and impact of emergency outbreak plans, the WHA noted in particular the strong progress across Africa, with no wild poliovirus cases reported from Nigeria for more than 9 months. It appreciated the cessation of the three large multi-country outbreaks that affected three sub-regions, the Middle East, Horn of Africa and Central Africa, despite conflict and large-scale population movements affecting the region. Assembly noted the progress indicating that program in Pakistan is getting back on track. also noted the strong progress towards preparing for the phased withdrawal of oral polio vaccines (OPV), and urged all countries to ensure global readiness for the coordinated global switch from trivalent OPV to bivalent OPV in April 2016. This activity is critical to ensuring that the small risk of vaccine-associated polio paralysis can be reduced substantially and the risk of type 2 circulating vaccine-derived poliovirus outbreaks can be eliminated. This entails, notably:  ensuring sufficient global supply of inactivated polio vaccine (IPV)  a globally synchronized removal of type 2 component in the oral polio vaccine, thus replacing tOPV with bOPV in April 2016  equitable access to the global stockpile of monovalent OPV type 2 (mOPV2).

1.0 20%

0.5

 Reviewing

0.0 13 14 CHN 15 13 14 KHM 15 13 14 LAO 15 13 14 MYS 15 13 14 PHL 15 13 14 PNG 15 13 14 VNM 15

0% 13 14 CHN 15 13 14 KHM 15 13 14 LAO 15 13 14 MYS 15 13 14 PHL 15 13 14 PNG 15 13 14 VNM 15

* AFP rate annualized as of week 21

 The

 Delegates

Chart 3. Percentage of reported AFP cases by number of polio vaccination doses, 2015 100%

Chart 4. Percentage of reported AFP cases with pending classification > 90 days after onset, 2015 CHN 14.2% 36.4% 0.0% 1.9% 35.4% 11.1% 10.9% 0% 5% 10% 15% 20% 25% 30% 35% 40%

80%

KHM LAO MYS

60%

40%

PHL PNG VNM

20%

CONTACT US 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: WPR_EPIdata@wpro.who.int Web: www.wpro.who.int/immunization

0% CHN KHM LAO MYS 1-2 doses

PHL 0 doses

PNG Unknown

VNM

≥ 3 doses

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).

Table 1A. Classification of AFP cases with onset in 2014 and key surveillance indicators 2013 Classification Total reported cases Annual expected cases <15 years of age Pending Total reported cases Confirmed wild poliovirus Vaccinederived poliovirus (VDPV) Non-polio AFP rate % % with % with investigated 60-day adequate 2 days of ≤ 4 specimens 2 3 follow-up notification ≥ 80% ≥ 80% ≥ 80% Latest report date 5 Days since last report 6

2014 Indicators

Poliocompatible

Discarded (Non-polio)

Total

> 90 days 1 # (%)

≥1

≤ 30

Australia Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR Japan Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas Total 1. 2. 3. 4. 5. 6.

62 1 73 5623 12 1 0 48 155 7 12 18 277 84 7 459 8 6847

44 1 46 2225 8 1 167 25 77 8 9 30 378 72 6 231 10 3338

60 4 72 5758 19 1 0 28 161 9 8 12 274 88 8 361 15 6878

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 2 0 0 0 0 0 0 0 1 0 0 0 0 3

2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2

58 4 72 5756 19 1 28 161 9 8 12 270 88 8 361 10 6865

0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 5 8

0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 3 (1.1%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 5 (33.3%) 8 (0.1%) Green Yellow Red

1.36 4.00 1.57 2.59 2.38 1.00 1.12 2.09 1.13 0.89 0.40 0.72 1.22 1.33 1.56 1.50 2.06

50% 75% 96% 92% 89% 0% 57% 73% 89% 38% 33% 60% 86% 75% 97% 67% 90%

83% 100% 93% 100% 100% 100% 93% 87% 100% 100% 75% 97% 98% 88% 93% 93% 99%

0% 100% 100% 96% 100% 100% 83% 100% 100% 80% 0% 6% 100% 100% 100% 80% 77%

07-Apr-15 07-Apr-15 14-May-15 13-May-15 05-Mar-15 13-Jan-15 27-Apr-15 10-Mar-15 05-Mar-15 11-Mar-15 07-Apr-15 11-May-15 16-Feb-15 07-Jan-15 14-Apr-15 23-Mar-15

14 63

Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Percentage of reported cases investigated within two days of notification Percentage of reported cases with inadequate specimens for which the 60-day follow-up evaluation has been completed Report date is fixed as soon as all cases for the year have been classified Countries are expected to submit data at least once per month to WPRO

Reached or surpassed target Nearly reached target: 0.5–0.99 for non-polio AFP rate; 60–79% for other indicators Substantially below target

Polio Bulletin

Table 1B. Classification of AFP cases with onset in 2015 and key surveillance indicators 2014 Classification Total reported cases Annual expected cases <15 years of age Pending Total reported cases Confirmed wild poliovirus Vaccinederived poliovirus (VDPV) Non-polio AFP rate 2 % % with % with investigated 60-day adequate 2 days of ≤ 5 specimens 3 4 follow-up notification ≥ 80% ≥ 80% ≥ 80% Latest report date Days since last report 6

2015 Indicators

Poliocompatible

Discarded (Non-polio)

Total

> 90 days 1 # (%)

≥1

≤ 30

60 4 72 5758 19 1 0 28 161 9 8 12 274 88 8 361 15 6878

44 1 46 2234 8 1 163 26 77 9 9 34 387 70 6 231 10 3356

13 1 11 1516 6 1 0 9 52 3 1 9 127 26 3 46 0 1824

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

6 1 0 593 5 0 6 35 1 0 6 0 23 3 2 681

7 0 11 923 1 1 3 17 2 1 3 127 3 0 44 1143

0 (0.0%) 0 (0.0%) 4 (36.4%) 215 (14.2%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 1 (1.9%) 0 (0.0%) 0 (0.0%) 1 (11.1%) 45 (35.4%) 0 (0.0%) 0 (0.0%) 5 (10.9%) 271 (14.9%) Green Yellow Red

0.73 2.48 0.59 1.68 1.86 2.48 0.86 1.67 0.83 0.28 0.66 0.81 0.92 1.24 0.49 1.35

8% 100% 100% 93% 83% 100% 78% 88% 100% 100% 56% 54% 85% 100% 96% 89%

100% 100% 100% 100% 100% 100% 89% 63% 100% 100% 78% 97% 100% 100% 96% 98%

0% 65% 100% 50% 50% 0% 7% 100% 0% 42%

19-May-15 15-Apr-15 04-May-15 21-May-15 06-May-15 15-May-15 18-May-15 18-May-15 01-May-15 28-Apr-15 07-May-15 11-May-15 19-May-15 06-May-15 14-Apr-15 11-May-15

6 40 21 4 19 10 7 7 24 27 18 14 6 19 41 14

Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Annualized non-polio AFP rate per 100 000 population under 15 years of age Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Percentage of reported cases investigated within two days of notification Percentage of reported cases with inadequate specimens for which the 60-day follow-up evaluation has been completed Countries are expected to submit data at least once per month to WPRO

Reached or surpassed target Nearly reached target: 0.5–0.99 for non-polio AFP rate; 60–79% for other indicators Substantially below target

Polio Bulletin

Table 2A. Laboratory investigation of AFP cases with onset in 2014 and key laboratory indicators Virus isolation results Country National polio laboratory Total no. of AFP L20B cases w ith positive specimens L20B positive + NPEV NPEV only Pending Negative ≤ 14 days % % results Latest Pending reported specimens report date positive > 14 2 ≤ 14 days for NPEV days ≥ 80% Intratypic differentiation/ 1 Sequencing lab No. of isolates received Type 1 W ild Sabin VDPV W ild Intratypic differentiation (ITD)/sequencing results Type 2 Type 3 Sabin VDPV W ild Sabin VDPV NPEV 3

Pending ITD

% ITD results Discordant reported ≤ 7 pending days of sequencing receipt ≥ 80%

Australia Brunei Darussalam Cambodia China China, Anhui China, Beijing China, Fujian China, Gansu China, Guangdong China, Guangxi China, Hebei China, Heilongjiang China, Henan China, Hunan China, Jiangsu China, Jiangxi China, Jilin China, Shaanxi China, Shandong China, Shanghai China, Shanxi China, Sichuan China, Tianjin China, Xinjiang China, Yunnan China, Zhejiang China, Chongqing China, Guizhou China, Hainan China, Hubei China, Liaoning China, Neimongol China, Ningxia China, Qinghai China, Tibet China, Hong Kong SAR China, Macao SAR Japan Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam (North) Viet Nam (South) Pacific island countries and areas Total

VIDRL VIDRL NIID Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab Prov. Lab PHLC PHLC NIID NIID IMR PHI IESR VIDRL RITM NIH SGH NIHE PI VIDRL

45 2 73 5694 334 41 213 121 354 278 332 150 535 267 319 190 54 95 397 29 205 411 27 98 267 189 73 206 43 186 137 88 31 21 3 19 0 0 25 164 9 5 10 342 88 8 216 136 12 6848

0 0 5 112 20 1 2 0 4 6 11 2 4 4 18 2 1 1 5 2 4 4 0 1 11 2 0 0 0 2 1 2 2 0 0 0 1 0 0 0 0 5 0 0 0 0 0 123

0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 3

2 0 12 588 26 0 27 8 47 57 37 7 61 37 3 27 7 2 39 0 2 42 3 5 39 20 14 23 7 23 18 3 0 4 0 4 5 4 1 1 4 13 8 0 30 16 1 689

43 2 56 4993 288 40 184 113 303 215 283 141 470 226 298 161 46 92 353 27 199 365 24 92 217 167 59 183 36 161 118 83 29 17 3 15 19 160 8 4 5 324 80 8 186 120 11 6034

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

96% 50% 96% 75% 83% 82% 92% 79% 81% 64% 69% 89% 80% 90% 79% 92% 66% 89% 83% 98% 55% 42% 93% 96% 51% 69% 71% 90% 76% 60% 85% 64% 76% 93% 75% 93% 100% 100% 100% 91% 100% 88% 97% 100% 100% 93% 100% 76%

2% 0% 14% 9% 7% 0% 10% 5% 11% 17% 8% 4% 9% 13% 1% 13% 11% 2% 7% 0% 1% 9% 9% 4% 11% 8% 15% 10% 14% 12% 11% 2% 0% 17% 0% 11% 18% 2% 11% 18% 50% 3% 10% 0% 12% 11% 4% 9%

22-Jan-15 22-Jan-15 02-Feb-15 13-May-15

VIDRL VIDRL NIID Prov. Lab/CCDC Prov. Lab/CCDC Prov. Lab/CCDC Prov. Lab/CCDC Prov. Lab/CCDC Prov. Lab/CCDC Prov. Lab/CCDC Prov. Lab/CCDC Prov. Lab/CCDC Prov. Lab/CCDC Prov. Lab/CCDC Prov. Lab/CCDC Prov. Lab/CCDC Prov. Lab/CCDC Prov. Lab/CCDC Prov. Lab/CCDC Prov. Lab/CCDC Prov. Lab/CCDC Prov. Lab/CCDC Prov. Lab/CCDC Prov. Lab/CCDC Prov. Lab/CCDC CCDC CCDC CCDC CCDC CCDC CCDC CCDC CCDC CCDC

0 0 10 307 45 11 3 6 9 12 11 6 6 4 44 4 4 2 8 6 12 10 10 6 24 8 4 13 0 6 19 8 6 0 0 0 0 0 0 0 0 0 4 13 2 0 0 0 0 336

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 72 10 3 0 2 4 0 2 0 1 2 7 1 1 0 3 0 2 4 2 4 7 0 0 0 4 9 4 0 0 4 0 76

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

10 106 14 1 0 2 3 7 6 2 2 2 15 0 1 2 3 2 6 4 4 2 7 2 2 7 0 4 2 4 0 6 0 122

0 4 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 1 0 5

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 116 21 7 3 2 2 5 1 3 3 0 20 1 2 0 2 4 2 2 4 0 10 4 2 6 2 4 2 2 2 2 0 120

0 2 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2

0 7 0 0 0 0 0 0 0 1 0 0 0 2 0 0 0 0 0 0 0 0 0 2 0 0 0 2 0 0 2 0 2 11

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

100% 95% 91% 100% 100% 100% 78% 100% 100% 100% 75% 100% 97% 100% 100% 100% 100% 100% 90% 100% 100% 100% 93% 100% 100% 82% 100% 100% 100% 100% 100% 100% 100% 96%

13-Jan-15 13-Jan-15 22-Jan-15 10-Feb-15 16-Mar-15 12-Jan-15 22-Jan-15 11-Mar-15 16-Feb-15 14-Jan-15 11-Feb-15 21-Jan-15 22-Jan-15

PHLC PHLC NIID NIID IMR NIID IESR VIDRL RITM NIH SGH NIHE PI VIDRL

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) 2. The target of 14 days for the timeliness of virus isolation will be used for all polio laboratories 3. NPEV growing in L20B cells

Polio Bulletin

Table 2B. Laboratory investigation of AFP cases with onset in 2015 and key laboratory indicators Virus isolation results Country National polio laboratory Total no. of AFP L20B cases with positive specimens L20B positive + NPEV NPEV only Pending Negative ≤ 14 days % % results Latest Pending reported specimens report date positive > 14 2 ≤ 14 days for NPEV days ≥ 80% Intratypic differentiation/ 1 Sequencing lab No. of isolates received Type 1 W ild Sabin VDPV W ild Intratypic differentiation (ITD)/sequencing results Type 2 Sabin VDPV W ild Type 3 Sabin VDPV NPEV 3

Pending ITD

% ITD results Discordant reported ≤ 7 pending days of sequencing receipt ≥ 80%

9 1 14 1497 79 12 49 22 84 67 86 46 162 77 78 47 17 25 109 13 52 110 21 32 55 65 34 43 12 42 30 19 4 4 1 3 0 0 8 50 2 1 7 222 26 3 26 44 1 1914

0 0 0 19 0 0 1 0 4 0 0 0 4 0 1 3 0 0 0 0 0 0 1 1 0 3 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 20

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 1 65 0 0 6 1 1 6 1 0 10 8 0 1 1 0 4 0 0 5 0 0 6 3 2 5 0 5 0 0 0 0 0 0 0 3 0 0 2 18 2 0 2 5 0 98

9 1 10 1374 78 12 41 21 79 61 84 46 148 65 76 40 16 21 103 13 51 98 20 27 46 58 28 36 12 37 30 18 4 4 1 3 8 47 2 1 5 194 22 3 21 37 1 1738

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 2 0 2 2 0 16

0 0 3 39 1 0 1 0 0 0 1 0 0 4 1 3 0 4 2 0 1 7 0 4 3 1 3 2 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 43

85% 100% 100% 96% 94% 100% 98% 100% 95% 99% 100% 100% 92% 99% 97% 100% 100% 90% 100% 100% 76% 90% 100% 100% 98% 91% 100% 95% 92% 95% 100% 100% 100% 100% 100% 82% 100% 99% 75% 100% 100% 91% 100% 100% 100% 93% 100% 96%

0% 0% 9% 4% 0% 0% 11% 5% 1% 7% 1% 0% 6% 10% 0% 1% 6% 0% 2% 0% 0% 5% 0% 0% 9% 4% 3% 11% 0% 12% 0% 0% 0% 0% 0% 0% 0% 4% 0% 0% 23% 5% 8% 0% 7% 12% 0% 4%

15-May-15 15-May-15 22-May-15 21-May-15

0 0 0 48 0 2 2 0 12 0 0 0 7 0 2 4 0 0 0 0 0 0 2 6 0 6 3 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48

0 0 0 0 0 0 0 0 0 0 0 0 0

19 0 0 4 7 2 2 0 2 2 0 0 19

1 0 0 0 0 0 0 0 0 1 0 0 1

0 0 0 0 0 0 0 0 0 0 0 0 0

18 2 2 6 0 0 2 0 4 2 0 0 18

4 0 0 2 0 0 0 0 0 0 0 2 4

0 0 0 0 0 0 0 0 0 0 0 0 0

6 0 0 0 0 0 0 2 0 1 3 0 6

0 0 0 0 0 0 0 0 0 0 0 0 0

93% 0% 100% 100% 100% 100% 100% 100% 100% 100% 67% 100% 93%

25-Mar-15 25-Mar-15 18-May-15 13-May-15 30-Mar-15 07-May-15 15-May-15 22-May-15 19-May-15 16-Apr-15 13-Apr-15 12-May-15 15-May-15

PHLC PHLC NIID NIID IMR NIID IESR VIDRL RITM NIH SGH NIHE PI VIDRL

Polio Bulletin

Table 3A. Laboratory confirmation of polio isolates from other sources in 2014 Non-AFP cases Country Intratypic differentiation lab 2 Total number Total number of non-AFP of non-AFP cases tested cases with for polio polio isolates Type 1 Wild Sabin VDPV Wild Type 2 Sabin VDPV Wild Type 3 Sabin VDPV Pending NPEV ITD Discordant Total number pending of samples sequencing processed Total number of samples with polio isolates Type 1 Wild Sabin VDPV

Environmental samples Type 2 Wild Sabin VDPV Wild Type 3 NPEV Sabin VDPV Pending ITD Discordant pending sequencing

96 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 203 0 0 3 0 0 0 0 0 305

0 3 1 2 0 3 6

0 0 0 0 0 0 0

0 3 1 2 0 1 4

0 0 0 0 0 0 0

0 0 0 0 0 1 1

0 0 0 0 0 0 0

0 1 0 1 0 1 2

0 0 0 0 0 0 0

0 0 0 0 23 0 23

0 0 0 0 0 0 0

3 0 0 167 0 0 14 0 48 0 0 18 0 0 0 0 0 0 48 12 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 191

0 167 14 48 18 48 12 27 7 174

0 0 0 0 0 0 0 0 0

79 1 21 11 13 6 27 1 80

0 0 0 0 0 0 0 0 0

129 4 22 37 16 12 38 1 130

2 0 0 1 0 0 1 0 2

0 0 0 0 0 0 0 0 0

115 0 15 47 23 10 20 5 120

0 0 0 0 0 0 0 0 0

3 0 0 0 0 0 0 0 7 10

0 0 0 0 0 0 0 0 0 0

1. Based on year of collection of sample, if available. Otherw ise, based on year of receipt at reference laboratory. 2. 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)

Polio Bulletin

Table 3B. Laboratory confirmation of polio isolates from other sources in 2015 Non-AFP cases Country Intratypic differentiation lab 2 Total number Total number of non-AFP of non-AFP cases tested cases with for polio polio isolates Type 1 Wild Sabin VDPV Wild Type 2 Sabin VDPV Wild Type 3 Sabin VDPV Pending NPEV ITD Discordant Total number pending of samples sequencing processed Total number of samples with polio isolates Type 1 Wild Sabin VDPV

Environmental samples Type 2 Wild Sabin VDPV Wild Type 3 NPEV Sabin VDPV Pending ITD Discordant pending sequencing

23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 2 0 0 0 0 0 51

0 0 2 2

0 0 0

0 1 1

0 0 0

0 1 1

0 0 0

0 2 0 2

0 0 0 0

8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8

1 1

0 0

1 1

0 0

5 5

0 0

1. Based on year of collection of sample, if available. Otherwise, based on year of receipt at reference laboratory. 2. 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)

Polio Bulletin

Table 4. Vaccine-derived poliovirus, 2000–2015 Country Cambodia

2000–2009

2010

2011

2012

2013

2014

2015

2006 (1 case) Total (2 cases) 2009 (1 case) Total (27 cases) 2005 (3 cases) 2005 (1 case) Total (2 cases) 2004 (3 cases) 2003 (1 case) 2001 (3 cases) aVDPV2 (2 cases) aVDPV2 (1 case) aVDPV2 (5 cases) aVDPV3 (2 cases) aVDPV1 (1 case) aVDPV2 (3 cases) cVDPV2 (2 cases) iVDPV2 (2 cases) iVDPV3 (1 case) aVDPV1 (1 case) aVDPV2 (2 cases) aVDPV2 (1 case) cVDPV2 (3 cases) iVDPV2 + iVDPV3 (1 case) iVDPV2 + iVDPV3 (1 case) aVDPV1 (1 case) aVDPV2 (2 cases) iVDPV3 (1 case) iVDPV2 (1 case) ?VDPV1 (1 case) ?VDPV2 (1 case)

China China, Hong Kong SAR Japan Lao People's Democratic Republic Mongolia Philippines Viet Nam

1. Prefix letter refers to the VDPV category - "cVDPV" = circulating VDPV, "iVDPV" = immunodeficiency-associated VDPV, "aVDPV" = ambiguous VDPV, "?VDPV" = unknown. Suffix number refers to the poliovirus serotype (types 1, 2 or 3). 2. Refers to year of last VDPV case, and aggregate total of VDPV cases for 2000-2009

Polio Bulletin

Key facts

Organisation World Health Organization (WHO)

Document type Technical Documents

Adoption date May 25, 2015

Source World Health Organization