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Polio Bulletin - 2017, Issue no. 8 (Week 15)

April 17, 2017 World Health Organization

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Polio Bulletin 2017 Issue No. 8 - Week 15 (as of 17 April 2017) HIGHLIGHTS New vaccine-derived polioviruses type 2 (VDPV2) isolated from northern Nigeria On 7 April 2017 the WHO Headquarters received advanced notification of several new vaccine-derived polioviruses type 2 (VDPV2) isolated from northern Nigeria. The following five new VDPV2s have been isolated: One environmental sample from Gombe local government area (LGA), Gombe state was collected on 6 March. This is from a different environmental collection site than the previously isolated VDPV2 collected in Gombe on 30 January. Three environmental samples from Sokoto state. One positive sample isolated from a healthy person from South Sokoto LGA, Sokoto state, collected on 28 February. Genetic sequencing is pending on all of the newly-isolated viruses, and this process is being expedited to assess any eventual linkages to previously-detected isolates (which would potentially re-classify their status as “circulating”). The WHO Headquarters is working with the regional and country counterparts and partners in supporting the local public health authorities to conduct a field investigation and thorough risk assessment, to more clearly assess any potential risk of circulation of the identified VDPV2 strains, and to discuss needs for possible response immunization. 5.5 5.0 4.5 80%

Chart 1. Non-polio AFP rate (per 100 000 persons < 15 years of age), 2015–2017* 100%

Chart 2. Adequate specimen collection rate, 2015–2017

4.0 3.5 3.0 2.5 40% 60%

2.0

1.5 1.0 0.5 0.0 15 16 CHN 17 15 16 KHM 17 15 16 LAO 17 15 16 MYS 17 15 16 PHL 17 15 16 PNG 17 15 16 VNM 17 0% 15 16 CHN 17 15 16 KHM 17 15 16 LAO 17 15 16 MYS 17 15 16 PHL 17 15 16 PNG 17 15 16 VNM 17 20%

* AFP rate annualized as of week 15

Chart 3. Percentage of reported AFP cases by number of polio vaccination doses, 2016 100%

Chart 4. Percentage of reported AFP cases with pending classification > 90 days after onset, 2016 CHN 1.2% 0.0% 0.0% 0.0%

80%

KHM LAO MYS

60%

40%

PHL PNG

0.0% 0.0% 14.7% 0% 2% 4% 6% 8% 10% 12% 14% 16%

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: wproepidata@who.int Web: www.wpro.who.int/immunization/en

20%

VNM

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 2016 and key surveillance indicators 2015 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 investigated adequate ≤ 2 days of specimens 2 notification 3 ≥ 80% ≥ 80% Latest report date 4 Days since last report 5

2016 Indicators

Country/area

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.

53 3 84 5217 10 1 71 144 9 7 27 413 83 8 380 15 6525

45 1 45 2234 8 1 163 24 77 9 9 30 394 69 6 232 10 3357

62 1 50 5695 10 1 133 143 7 12 23 417 69 7 375 19 7024

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

0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 3 6

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

61 1 50 5627 10 1 130 143 7 12 23 417 69 7 311 15 6884

0 0 0 68 0 0 0 0 0 0 0 0 0 0 64 4 136

0 (0.0%) 0 (0.0%) 0 (0.0%) 68 (1.2%) 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%) 55 (14.7%) 4 (21.1%) 127 (1.8%) Green Yellow Red

1.38 1.00 1.11 2.55 1.25 1.00 5.42 1.86 0.78 1.33 0.77 1.06 1.00 1.17 1.62 1.90 2.09

45% 100% 90% 92% 90% 100% 74% 80% 71% 58% 43% 71% 94% 100% 95% 68% 90%

95% 100% 92% 100% 100% 100% 92% 81% 100% 83% 91% 95% 100% 100% 91% 100% 98%

20-Mar-17 11-Jan-17 16-Mar-17 05-Apr-17 09-Jan-17 12-Jan-17 13-Mar-17 06-Mar-17 13-Mar-17 13-Mar-17 10-Apr-17 10-Mar-17 27-Feb-17 06-Jan-17 16-Mar-17 03-Apr-17

12 32 14 -

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 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 Includes two cases that are 15 years old or older

Reached o r surpassed target Nearly reached target: 0.5–0.99 fo r no n-po lio A FP rate; 60–79% fo r o ther indicato rs Substantially belo w target

Polio Bulletin

Table 1B. Classification of AFP cases with onset in 2017 and key surveillance indicators 2016 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 investigated adequate ≤ 2 days of specimens 3 notification 4 ≥ 80% ≥ 80% Latest report date Days since last report 5

2017 Indicators

Country/area

Poliocompatible

Discarded (Non-polio)

Total

> 90 days 1 # (%)

≥1

≤ 30

62 1 50 5695 10 1 133 143 7 12 23 417 69 7 375 19 7024

45 1 54 2256 8 1 161 21 77 9 9 31 394 68 6 234 11 3386

10 0 0 723 0 0 21 37 2 2 6 76 7 1 30 3 918

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

4 61 15 10 1 0 2 44 7 1 0 0 145

6 662 6 27 1 2 4 32 0 0 30 3 773

0 (0.0%) 41 (5.7%) 0 (0.0%) 5 (13.5%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 1 (1.3%) 0 (0.0%) 0 (0.0%) 1 (3.3%) 0 (0.0%) 48 (5.2%) Green Yellow Red

0.77 1.11 3.47 1.67 0.77 0.77 0.67 0.67 0.36 0.58 0.44 0.95 0.94

40% 90% 90% 78% 100% 0% 67% 57% 57% 100% 87% 33% 85%

100% 99% 86% 54% 100% 100% 100% 96% 100% 100% 90% 100% 96%

13-Apr-17 10-Apr-17 21-Mar-17 05-Apr-17 03-Apr-17 12-Apr-17 12-Apr-17 12-Apr-17 05-Apr-17 13-Mar-17 10-Apr-17 31-Mar-17 27-Feb-17 07-Apr-17 16-Mar-17 03-Apr-17

4 7 27 12 14 5 5 5 12 35 7 17 49 10 32 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 Countries are expected to submit data at least once per month to WPRO

Reached o r surpassed target Nearly reached target: 0.5–0.99 fo r no n-po lio A FP rate; 60–79% fo r o ther indicato rs Substantially belo w target

Polio Bulletin

Table 2A. Laboratory investigation of stool samples from AFP cases with onset in 2016 and key laboratory indicators Results of virus isolation for AFP cases Country/area Polio laboratory Total no. of AFP cases with specimens L20B positive L20B positive + NPEV only NPEV % results % reported specimens Pending Pending Latest ≤ 14 days ≤ 14 days > 14 days positive for report date NPEV ≥ 80% Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Type 1 Wild Sabin VDPV Wild Results of intratypic differentiation (ITD)/sequencing for virus isolates Type 2 Sabin VDPV Wild Type 3 Sabin VDPV NPEV 2 1

Negative

Pending ITD

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

Australia Brunei Darussalam Cambodia China (total) China, Anhui China, Beijing China, Chongqing China, Fujian China, Gansu China, Guangdong China, Guangxi China, Guizhou China, Hebei China, Heilongjiang China, Henan China, Hubei China, Hunan China, Jiangsu China, Jiangxi China, Jilin China, Neimongol China, Ningxia China, Shaanxi China, Shandong China, Shanghai China, Shanxi China, Sichuan China, Tianjin China, Xinjiang China, Yunnan China, Zhejiang China, Hainan China, Liaoning 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

47 1 51 5615 322 44 84 183 99 406 322 223 362 119 453 200 248 239 226 89 110 21 122 397 41 158 387 42 110 251 188 44 90 30 5 10 0 201 139 7 10 24 461 67 7 208 167 16 7031

0 0 2 67 3 0 1 5 2 8 3 2 5 1 7 0 1 0 1 0 5 0 1 7 1 5 3 1 1 0 2 0 1 0 1 0 19 0 0 0 1 5 0 0 6 5 0 105

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

3 0 11 413 12 1 8 8 2 23 44 15 49 3 48 18 23 4 12 7 3 0 3 31 0 7 43 1 4 18 17 3 4 2 0 0 20 7 1 0 3 43 7 0 26 16 5 555

44 1 38 5126 307 43 75 170 94 374 275 206 308 115 398 180 224 235 213 82 101 21 115 359 40 146 341 40 105 232 169 41 85 28 4 10 163 132 6 10 20 413 60 7 176 146 11 6363

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 0 8 0 0 0 0 1 0 0 0 0 0 0 2 0 0 0 0 1 0 3 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8

94% 100% 88% 96% 100% 100% 96% 99% 97% 88% 100% 98% 98% 99% 87% 97% 100% 99% 99% 100% 90% 95% 84% 95% 100% 97% 95% 100% 98% 95% 99% 91% 96% 92% 100% 96% 97% 100% 93% 100% 100% 98% 95% 100% 99% 96% 97% 95%

5% 0% 20% 6% 3% 2% 7% 4% 2% 4% 11% 6% 11% 3% 9% 9% 8% 2% 5% 6% 2% 0% 2% 6% 0% 4% 9% 2% 4% 6% 7% 6% 3% 5% 0% 0% 8% 5% 7% 0% 12% 7% 9% 0% 11% 9% 26% 6%

27-Jan-17 27-Jan-17 30-Jan-17 05-Apr-17

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 Prov. Lab/CCDC Prov. Lab/CCDC Prov. Lab/CCDC Prov. Lab/CCDC Prov. Lab/CCDC CCDC CCDC CCDC CCDC

0 0 3 163 5 0 3 11 10 19 6 8 10 1 18 0 2 0 2 0 10 2 2 12 4 13 6 2 4 0 5 1 4 1 2 0 0 40 0 0 0 2 14 0 0 6 14 0 242

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 43 1 0 5 0 7 2 2 5 0 7 0 1 3 0 0 1 0 4 0 2 0 0 1 1 1 0 18 0 4 1 2 68

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 4 0 0 0 0 4

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

2 16 0 0 0 3 1 0 2 0 0 0 0 0 0 0 0 2 2 0 2 0 2 2 0 0 0 0 3 0 3 0 2 26

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 97 4 3 6 7 11 4 4 5 1 5 2 1 6 2 2 9 2 9 4 0 2 3 0 3 0 2 15 2 7 6 10 138

0 1 0 0 0 0 0 0 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 1

0 6 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6

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% 99% 100% 100% 100% 89% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%

14-Feb-17 14-Feb-17 30-Jan-17 12-Jan-17 28-Jan-17 16-Jan-17 27-Jan-17 08-Mar-17 18-Jan-17 02-Feb-17 06-Jan-17 24-Jan-17 03-Feb-17

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. NPEV growing in L20B cells

Polio Bulletin

Table 2B. Laboratory investigation of stool samples from AFP cases with onset in 2017 and key laboratory indicators Results of virus isolation for AFP cases Country/area Polio laboratory Total no. of AFP cases with specimens L20B positive L20B positive + NPEV only NPEV % results % reported specimens Pending Pending Latest ≤ 14 days ≤ 14 days > 14 days positive for report date NPEV ≥ 80% Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Type 1 Wild Sabin VDPV Wild Results of intratypic differentiation (ITD)/sequencing for virus isolates Type 2 Sabin VDPV Wild Type 3 Sabin VDPV NPEV 2 1

Negative

Pending ITD

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

6 0 3 700 35 9 14 27 9 69 33 28 50 12 69 24 13 35 19 9 7 3 14 55 8 22 35 10 17 35 22 2 11 4 0 0 0 28 23 2 2 2 116 5 1 26 26 4 944

0 0 7 0 0 1 1 0 0 1 0 1 0 1 0 0 0 1 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 7

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 0 19 0 0 1 0 0 2 3 1 0 0 1 2 0 0 1 0 1 0 1 1 0 0 4 0 0 0 0 1 0 0 3 1 0 0 2 5 0 0 2 1 2 36

4 3 632 35 7 11 26 9 66 28 24 48 12 63 19 13 33 16 9 6 3 11 53 8 21 28 10 16 24 22 1 9 1 25 22 2 2 0 95 4 1 19 19 2 830

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 0 0 0 0 0 0 0 0 16 1 0 5 6 0 29

0 0 42 0 2 1 0 0 1 1 3 1 0 4 3 0 2 1 0 0 0 2 0 0 1 3 0 1 11 0 0 2 3 0 0 0 0 0 0 0 0 0 0 0 42

89% 100% 91% 97% 100% 78% 80% 100% 97% 100% 100% 99% 100% 76% 86% 100% 100% 100% 100% 100% 100% 58% 78% 100% 90% 73% 100% 100% 96% 100% 100% 100% 100% 100% 100% 100% 100% 100% 99% 100% 100% 98% 100% 100% 91%

33% 0% 2% 0% 0% 7% 0% 0% 2% 9% 4% 0% 0% 2% 10% 0% 0% 3% 0% 7% 0% 8% 1% 0% 0% 8% 0% 0% 0% 0% 25% 0% 0% 11% 5% 0% 0% 67% 4% 0% 0% 10% 5% 50% 3%

07-Apr-17 07-Apr-17 10-Apr-17 05-Apr-17

0 0 0 26 1 0 2 1 0 2 2 0 3 0 2 0 2 0 1 0 0 0 1 3 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26

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

10 0 0 0 2 2 0 0 1 0 0 1 4 10

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

16 1 2 1 0 0 3 2 1 1 1 2 2 16

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

91% 0% 100% 100% 100% 100% 100% 100% 100% 100% 0% 100% 100% 91%

10-Apr-17 10-Apr-17 04-Apr-17 13-Feb-17 10-Apr-17 10-Apr-17 07-Apr-17 11-Apr-17 27-Feb-17 13-Apr-17 12-Apr-17 05-Apr-17 07-Apr-17

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

Polio Bulletin

Table 3. Laboratory confirmation of polio isolates from environmental samples in 2016 –2017 2016 Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates Type 1 Wild Sabin VDPV Wild Type 2 Sabin VDPV Wild Type 3 Sabin VDPV NPEV Pending ITD Discordant Total number pending of samples sequencing processed Total number of samples with polio isolates Type 1 Wild Sabin VDPV

2017 Polio isolates Type 2 Wild Sabin VDPV Wild Type 3 Sabin VDPV NPEV Pending ITD Discordant pending sequencing

Australia China (total) China, Fujian China, Gansu China, Guangdong China, Guangxi China, Heilongjiang China, Shandong China, Shanghai China, Xinjiang China, Yunnan Malaysia Total

VIDRL 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 IMR

0 345 60 13 48 36 45 45 24 36 38 10 355

171 12 8 35 13 21 28 18 36 0 0 171

0 0 0 0 0 0 0 0 0 0

179 3 5 19 1 0 25 17 109 179

0 0 0 0 0 0 0 0 0 0

174 1 5 4 4 5 15 4 136 174

0 0 0 0 0 0 0 0 0 0

507 11 13 62 52 46 42 34 247 507

0 0 0 0 0 0 0 0 0 0

229 42 2 39 23 32 40 18 25 8 6 235

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

0 30 0 3 8 8 0 5 0 6 0 2 32

19 0 1 6 3 0 3 0 6 0 0 19

0 0 0 0 0 0 0

19 1 2 2 3 11 19

0 0 0 0 0 0 0

93 7 11 7 12 56 93

0 0 0 0 0 0 0

44 0 0 8 8 0 14 0 14 0 0 44

0 0 0 0 0 0 0 0 0 0 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); IMR (Institute of Medical Research, Malaysia); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia)

Table 4. Vaccine-derived poliovirus1 identified from laboratory testing2, 2000–2016 Country/area Cambodia

2000–2009 2006 - 1 Total - 2 2009 - 1 Total - 27

2010

2011

2012

2013

2014

2015

2016

China

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)

aVDPV3 (1 AFP)

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

2005 - 3 2005 - 1 Total - 2 2004 - 3 2003 - 1 2001 - 3 aVDPV2 (2 AFP) aVDPV2 (1 AFP) cVDPV1 (8 AFP + 21 contacts) cVDPV1 (3 AFP + 4 contacts)

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). 2. Source of specimens could be AFP cases, contacts, or non-AFP cases 3. Refers to year of last VDPV case, and aggregate total of VDPV cases for 2000-2009 4. Based on laboratory reporting only; not yet classified by AFP surveillance

Polio Bulletin

Key facts

Organisation World Health Organization (WHO)

Document type Technical Documents

Adoption date April 17, 2017

Source World Health Organization