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Polio Bulletin - 2014, Issue no. 16 (Week 31)

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2014 Issue No. 16 - Week 31 (as of 4 August 2014) HIGHLIGHTS Update from the 2nd Meeting of the International Health Regulations Emergency Committee As of 3 August 2014, the WHO Director-General declared that the international spread of wild poliovirus in 2014 continued to constitute a Public Health Emergency of International Concern (PHEIC) and and extended the following Temporary Recommendations under the IHR (2005) for States currently exporting wild poliovirus: These States should:  officially declare, if not already done, at the level of head of

Polio Bulletin 90% 80% 70% 60%

Chart 1. Non-polio AFP rate and adequate specimen collection rate, 2012–2014* 3.0 2.5 100%

Chart 2. Percent cases with pending classification > 90 days after onset, 2014 CHN Cases with adequate specimens (%)

10.8% 32.0% 0.0% 10.5% 18.8% 85.7% 14.7% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

KHM LAO MYS PHL PNG VNM

Non-polio AFP rate

2.0 1.5 1.0 0.5 0.0 12 13 14 CHN 12 13 14 KHM 12 13 14 LAO 12 13 14 MYS 12 13 14 PHL 12 13 14 PNG 12 13 14 VNM

50% 40% 30% 20% 10% 0%

state or government, that the interruption of poliovirus transmission is a national public health emergency;  ensure that all residents and long-term visitors (i.e. > 4

weeks) receive a dose of OPV or inactivated poliovirus vaccine (IPV) between 4 weeks and 12 months prior to international travel; weeks), who have not received a dose of OPV or IPV in the previous 4 weeks to 12 months, receive a dose of polio vaccine at least by the time of departure as this will still provide benefit, particularly for frequent travellers; that such travellers are provided with an International Certificate of Vaccination or Prophylaxis in the form specified in Annex 6 of the International Health Regulations (2005) to record their polio vaccination and serve as proof of vaccination; been met: (i) at least 6 months have passed without new exportations and (ii) there is documentation of full application of high quality eradication activities in all infected and high risk areas; in the absence of such documentation these measures should be maintained until at least 12 months have passed without new exportations.

 ensure that those undertaking urgent travel (i.e. within 4

* AFP rate annualized as of week 31

 ensure

Chart 3. Polio immunization status of reported AFP cases, 2014 100% 100%

Chart 4. Percentage of samples received at the lab ≤ 3 days of collection, 2014

 maintain these measures until the following criteria have

80%

80% 59% 53%

60%

60%

Similar recommendations were made for residents and longterm visitors to States infected with wild poliovirus but not currently exporting. More information can be found at: http://www.who.int/mediacentre/news/statements/2014/ polio-20140803

40%

40% 29%

35%

20% 20%

0% CHN KHM LAO MYS 1-2 doses

PHL 0 doses

PNG Unknown

VNM

0% CHN

0% KHM

0% LAO MYS PHL

0% PNG VNM

≥ 3 doses

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

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 2013 and key surveillance indicators 2012 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 % with any investigated 60-day adequate 3 2 days of ≤ specimen 5 specimens 2 4 follow-up notification ≥ 80% ≥ 80% ≥ 80% Latest report date 6 Days since last report 7

2013 Indicators

Poliocompatible

Discarded (Non-polio)

Total

> 90 days 1 # (%)

≥1

Australia Brunei Darussalam Cambodia China Hong Kong (China) Japan Lao People's Democratic Republic Macao (China) Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries Total 1. 2. 3. 4. 5. 6. 7.

56 1 107 6173 14 0 55 0 141 9 8 10 403 95 10 514 4 7600

43 1 45 2225 8 167 25 1 77 7 9 30 378 76 6 241 10 3349

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

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

61 1 73 5622 12 48 1 155 7 12 18 275 84 7 459 8 6843

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

0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) Green Yellow Red

1.44 1.00 1.62 2.53 1.50 1.92 1.00 2.01 1.00 1.33 0.60 0.73 1.11 1.17 1.90 0.80 2.04

39% 100% 81% 93% 100% 58% 100% 83% 86% 50% 28% 68% 93% 71% 97% 63% 91%

71% 100% 96% 99% 100% 90% 100% 100% 100% 83% 83% 96% 100% 100% 99% 100% 99%

100% 100% 78% 100% 100% 98% 100% 85% 100% 83% 83% 98% 94% 86% 92% 100% 98%

0% 100% 98% 100% 100% 100% 100% 100% 50% 100% 100% 100% 100% 86%

18-Jul-14 06-Feb-14 13-Mar-14 28-May-14 06-Feb-14 26-May-14 14-Jan-14 31-Mar-14 07-Mar-14 27-Feb-14 26-Feb-14 08-Apr-14 20-Mar-14 08-Jan-14 17-Apr-14 28-Jul-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 with at least one specimen Percentage of reported cases investigated within two days of notification Percentage of reported cases with inadequate specimens followed-up within 60 days of onset of paralysis 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

2

Polio Bulletin

Table 1B. 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 2 % % with % with % with any investigated 60-day adequate 4 2 days of ≤ specimen 6 specimens 3 5 follow-up notification ≥ 80% ≥ 80% ≥ 80% Latest report date Days since last report 7

2014 Indicators

Poliocompatible

Discarded (Non-polio)

Total

> 90 days 1 # (%)

≥1

Australia Brunei Darussalam Cambodia China Hong Kong (China) Japan Lao People's Democratic Republic Macao (China) Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries Total 1. 2. 3. 4. 5. 6. 7.

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

44 1 45 2225 8 167 25 1 77 8 9 30 378 76 6 241 10 3351

18 1 25 2753 10 0 11 1 76 3 2 7 144 53 5 156 7 3272

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

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

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

15 1 0 1544 9 5 1 58 1 0 0 64 43 5 65 6 1817

3 0 25 1209 1 6 0 18 2 2 7 80 10 0 91 1 1455

2 (11.1%) 0 (0.0%) 8 (32.0%) 298 (10.8%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 8 (10.5%) 0 (0.0%) 2 (100.0%) 6 (85.7%) 27 (18.8%) 0 (0.0%) 0 (0.0%) 23 (14.7%) 0 (0.0%) 374 (11.4%) Green Yellow Red

0.69 1.68 0.93 2.08 2.10 0.74 1.68 1.66 0.63 0.37 0.39 0.64 1.17 1.40 1.09 1.17 1.64

39% 100% 92% 92% 90% 55% 0% 75% 100% 50% 0% 60% 81% 80% 92% 71% 89%

72% 100% 100% 99% 100% 100% 100% 100% 100% 100% 100% 88% 100% 100% 96% 100% 98%

83% 100% 84% 100% 100% 91% 100% 55% 100% 100% 57% 97% 96% 100% 93% 100% 98%

0% 0% 78% 100% 0% 100% 32% 100% 0% 7% 80% 100% 42% 50% 57%

25-Jun-14 22-Jul-14 24-Jul-14 30-Jul-14 01-Aug-14 06-May-14 21-Jul-14 20-Jun-14 07-Jul-14 22-Jul-14 17-Jul-14 08-Jul-14 18-Jul-14 04-Aug-14 25-Jul-14 28-Jul-14

40 13 11 5 3 90 14 45 28 13 18 27 17 0 10 7

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 with at least one specimen Percentage of reported cases investigated within two days of notification Percentage of reported cases with inadequate specimens followed-up within 60 days of onset of paralysis 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

3

Polio Bulletin

Table 2A. Laboratory investigation of AFP cases with onset in 2013 and key laboratory indicators Virus isolation results Country National polio laboratory Total no. of AFP L20B cases with specimens positive L20B positive + NPEV NPEV only Pending ≤ 14 Negative days Intratypic % % results differentiation Latest Pending reported specimens / Sequencing positive report date > 14 2 ≤ 14 days for NPEV lab 1 days ≥ 80% No. of isolates referred Type 1 W ild Sabin VDPV Wild Type 2 Sabin Intratypic differentiation (ITD) results Type 3 VDPV Wild Sabin VDPV NPEV 3

1

Pending ITD

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

Australia Brunei Darussalam Papua New Guinea Pacific island countries Japan Cambodia Lao People's Democratic Republic Malaysia Mongolia New Zealand Philippines Republic of Korea Singapore Viet Nam, North Viet Nam, South 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 Hong Kong (China) Macao (China) Total

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

44 1 18 8 0 70 43 156 7 9 366 83 7 229 225 5570 268 31 161 112 377 248 387 128 576 297 289 190 64 110 389 28 212 357 23 86 255 163 82 232 41 230 109 80 19 16 10 12 0 6848

0 0 0 0 1 0 0 0 0 0 0 1 2 2 100 4 1 4 4 2 4 12 3 13 2 9 2 0 1 17 2 3 0 1 5 2 3 0 0 0 3 0 3 0 0 0 0 106

0 0 0 0 0 0 0 0 0 1 0 0 0 0 3 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 4

9 0 3 4 21 10 7 1 2 40 2 0 41 21 582 35 0 16 6 37 28 62 7 103 41 7 14 3 2 32 0 9 39 1 6 30 19 8 23 5 31 14 3 0 1 0 0 743

35 1 15 4 48 33 149 6 7 325 81 6 186 208 4885 229 30 141 102 338 216 311 118 460 254 273 174 61 107 340 26 200 318 21 75 222 141 74 209 36 196 95 74 19 15 10 12 6001

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

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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% 100% 100% 100% 94% 97% 98% 100% 94% 95% 100% 100% 95% 98% 60% 52% 77% 80% 73% 60% 20% 64% 79% 55% 90% 43% 70% 61% 91% 69% 98% 42% 32% 87% 81% 74% 37% 78% 74% 71% 40% 72% 67% 55% 63% 20% 97% 65%

20% 0% 16% 44% 24% 21% 3% 14% 22% 9% 3% 0% 15% 9% 9% 11% 0% 7% 5% 8% 9% 13% 5% 14% 13% 2% 7% 5% 2% 6% 0% 4% 10% 4% 6% 10% 9% 9% 9% 11% 13% 11% 4% 0% 3% 0% 0% 9%

29-Jan-14 29-Jan-14 29-Jan-14 29-Jan-14 12-Feb-14 02-Apr-14 25-Feb-14 11-Feb-14 17-Mar-14 08-May-14 18-Feb-14 15-Jan-14 11-Feb-14 18-Mar-14 14-May-14

VIDRL VIDRL VIDRL VIDRL NIID NIID NIID IMR NIID IESR VIDRL NIID SGH NIID 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 CCDC CCDC CCDC CCDC CCDC CCDC CCDC CCDC CCDC

0 0 0 0 0 2 0 0 0 0 3 0 2 4 4 261 12 15 8 12 10 13 18 4 27 4 11 31 0 0 31 10 6 0 2 12 5 7 0 2 1 6 7 3 4 0 0 0 0 276

0 0 0 0 0 0 0 0 0 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 0 2 71 3 6 2 1 4 3 9 1 6 0 9 0 9 4 2 0 2 1 1 0 0 3 3 0 2 74

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

0 0 0 0 0 0 0 0 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 1 2 2 0 95 4 6 3 6 4 4 3 0 14 2 1 11 11 6 2 2 7 0 2 2 0 1 2 0 2 102

0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 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 1 0 2 2 77 5 3 3 5 2 6 6 3 7 2 1 2 11 0 2 0 3 4 4 0 1 2 2 3 0 82

0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 14

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

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

0 0 0 0 0 0 0 0 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% 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% 100% 100% 100%

16-Jan-14 16-Jan-14

PHLC PHLC

1. 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, Hong Kong); 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 4. Twenty-two provincial laboratories in China perform ITD from 2013

4

Polio Bulletin

Table 2B. 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 with positive specimens L20B positive + NPEV NPEV only Pending ≤ 14 Negative days Intratypic % % results differentiation Latest Pending reported specimens / Sequencing positive report date > 14 2 ≤ 14 days for NPEV lab 1 days ≥ 80% No. of isolates referred Type 1 Wild Sabin VDPV Wild Type 2 Sabin Intratypic differentiation (ITD) results Type 3 VDPV Wild Sabin VDPV NPEV 3

1

Pending ITD

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

Australia Brunei Darussalam Papua New Guinea Pacific island countries Japan Cambodia Lao People's Democratic Republic Malaysia Mongolia New Zealand Philippines Republic of Korea Singapore Viet Nam, North Viet Nam, South 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 Hong Kong (China) Macao (China) Total

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

23 1 7 7 0 21 18 102 3 2 189 53 5 89 70 2716 121 15 103 63 184 124 142 73 249 118 141 89 31 46 199 15 122 175 10 43 144 87 43 110 16 97 72 53 20 10 1 9 0 3315

0 0 0 0 4 0 0 0 0 1 0 0 0 0 48 3 0 0 1 1 2 3 0 1 2 10 0 0 0 2 2 3 3 0 1 11 1 0 1 0 0 0 0 1 0 0 0 53

0 0 1 0 0 0 0 0 0 0 0 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 2

2 0 3 0 3 5 3 0 1 9 3 0 12 8 263 6 0 14 3 23 31 13 2 26 15 2 8 3 3 13 0 1 19 2 2 24 7 8 15 5 14 2 2 0 0 0 1 313

18 1 3 6 14 13 89 3 1 169 43 5 71 52 2352 112 14 89 59 160 91 123 71 210 96 127 75 28 41 178 12 117 150 8 40 109 77 31 93 11 83 67 50 19 10 1 8 2848

3 0 0 1 0 0 10 0 0 0 7 0 4 7 1 0 0 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 33

0 0 0 0 0 0 0 0 0 12 0 0 2 3 51 0 1 0 0 0 0 2 0 12 5 2 6 0 2 5 1 1 3 0 0 0 2 4 1 0 0 3 1 0 0 0 0 68

95% 0% 100% 100% 95% 100% 100% 100% 100% 91% 93% 100% 100% 93% 63% 61% 64% 91% 64% 75% 25% 57% 82% 74% 80% 53% 91% 63% 74% 70% 97% 33% 27% 90% 93% 46% 46% 68% 88% 69% 54% 84% 63% 73% 100% 0% 85% 66%

5% 0% 58% 0% 10% 25% 3% 0% 50% 4% 5% 0% 13% 12% 8% 5% 0% 10% 4% 9% 20% 7% 2% 9% 12% 1% 8% 8% 7% 5% 0% 1% 10% 15% 4% 14% 6% 15% 13% 25% 15% 1% 2% 0% 0% 0% 4% 8%

01-Aug-14 01-Aug-14 01-Aug-14 01-Aug-14 28-Jul-14 01-Aug-14 11-Jul-14 07-Jul-14 04-Jul-14 25-Jul-14 18-Jul-14 15-Jul-14 09-Jul-14 04-Jul-14 30-Jul-14

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

0 0 0 0 0 8 0 0 0 0 2 0 0 0 0 131 5 5 0 6 4 5 5 0 2 2 26 0 0 0 4 6 8 10 0 4 24 3 4 4 0 2 2 0 0 0 0 0 0 141

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

0 0 33 0 2 2 2 0 2 0 0 2 6 2 0 0 4 2 7 0 0 0 2 0 33

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

0 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 2 49 3 0 2 2 2 2 0 0 0 14 0 2 4 4 2 7 1 2 2 0 0 59

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

0 0 47 2 3 2 0 3 1 0 2 0 6 2 4 2 2 0 10 2 2 2 0 2 47

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

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

0 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% 100% 96% 100% 100% 100% 50% 100% 100% 100% 100% 100% 95% 100% 100% 100% 100% 100% 93% 100% 100% 100% 100% 100% 97%

22-Jul-14 22-Jul-14

PHLC PHLC

1. 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, Hong Kong); 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 4. Twenty-two provincial laboratories in China perform ITD from 2013

5

Polio Bulletin

Table 3A. Laboratory confirmation of polio isolates from other sources in 2013 Non-AFP cases Country Intratypic Total number Total number differentiation of non-AFP of non-AFP lab 2 cases tested cases with polio isolates for polio Type 1 Wild Sabin VDPV Wild Type 2 Sabin VDPV Wild Type 3 Sabin NPEV Discordant Total number Pending grown pending of samples ITD sequencing processed VDPV in L20B Total number of samples with polio isolates Type 1 Wild Sabin VDPV

1

Environmental samples Type 2 Wild Sabin VDPV Wild Type 3 Sabin NPEV Discordant Pending grown pending ITD sequencing VDPV in L20B

Australia Japan Malaysia Mongolia New Zealand Philippines Republic of Korea Singapore Viet Nam, North Viet Nam, South China (total) 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 Hong Kong (China) Total

VIDRL NIID IMR PHI IESR VIDRL NIID SGH NIID 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 CCDC CCDC CCDC CCDC CCDC CCDC CCDC CCDC CCDC PHLC

269 0 0 158 0 6 0 0 0 0 28 0 0 0 7 1 0 2 2 0 0 0 2 0 0 2 2 0 2 1 2 0 0 0 0 1 0 0 3 1 0 0 1 462

1 0 6 28 7 1 2 2 2 2 2 2 1 2 1 3 1 1 36

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

0 0 5 15 7 0 2 0 0 2 1 1 1 0 0 0 1 1 21

0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 11 4 0 0 0 1 1 0 0 0 2 1 1 1 0 13

0 0 0 1 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 0

0 0 1 13 4 0 0 2 1 1 1 1 1 0 0 2 0 0 14

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

0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56

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

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

0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33

4 4

0 0

1 1

0 0

0 0

2 2

0 0

0 0

1 1

0 0

27 27

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); IESR (Institute of Environmental Science and Research, New Zealand); IMR (Institute of Medical Research, Malaysia); NIID (National Institute of Infectious Diseases, Japan); PHI (Public Health Institute, Mongolia); PHLC (Public Health Laboratory Center, Hong Kong); SGH (Singapore General Hospital); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia)

6

Polio Bulletin

Table 3B. Laboratory confirmation of polio isolates from other sources in 2014 Non-AFP cases Country Intratypic Total number Total number differentiation of non-AFP of non-AFP lab 2 cases tested cases with polio isolates for polio Type 1 Wild Sabin VDPV Wild Type 2 Sabin VDPV Wild Type 3 Sabin NPEV Discordant Total number Pending grown pending of samples ITD sequencing processed VDPV in L20B Total number of samples with polio isolates Type 1 Wild Sabin VDPV

1

Environmental samples Type 2 Wild Sabin VDPV Wild Type 3 Sabin Discordant NPEV Pending pending grown ITD sequencing VDPV in L20B

Australia Japan Malaysia Mongolia New Zealand Philippines Republic of Korea Singapore Viet Nam, North Viet Nam, South China (total) 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 Hong Kong (China) Total

VIDRL NIID IMR PHI IESR VIDRL NIID SGH NIID 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 CCDC CCDC CCDC CCDC CCDC CCDC CCDC CCDC CCDC PHLC

10 0 0 132 0 0 0 0 0 1 1 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 0 0 0 144

0 0 0 1 1 1

0 0 0 0 0 0

0 0 0 1 1 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 0 0 0 0 0

0 13 0 0 0 13

0 0 0 0 0 0

0 0 0 0 0 0

0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9

6 6

0 0

1 1

0 0

0 0

0 0

0 0

0 0

5 5

0 0

4 4

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); IESR (Institute of Environmental Science and Research, New Zealand); IMR (Institute of Medical Research, Malaysia); NIID (National Institute of Infectious Diseases, Japan); PHI (Public Health Institute, Mongolia); PHLC (Public Health Laboratory Center, Hong Kong); SGH (Singapore General Hospital); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia)

7

Polio Bulletin

Table 4. Vaccine-derived poliovirus, 2000–2013 Country Cambodia iVDPV1 (1 case) aVDPV1 (1 case) aVDPV3 (1 case) aVDPV3 (1 case)

2000

2001

2002

2003

2004

2005 cVDPV3 (1 case)

2006 cVDPV3 (1 case)

2007

2008

2009

2010

2011

2012

2013

China

aVDPV1 (1 case)

cVDPV1 (2 cases) aVDPV1 (1 case) aVDPV1 (3 cases) ?VDPV1 (4 cases) iVDPV2 (1 case) ?VDPV1 (7 cases) ?VDPV1 (1 case) ?VDPV2 (1 case) VDPV3 (1 case) ?VDPV? (3 cases) ?VDPV? (1 case) aVDPV2 (1 case) ?VDPV? (2 cases) ?VDPV? (1 case) ?VDPV3 (1 case)

aVDPV2 (1 case)

aVDPV1 (1 case) aVDPV1 (1 case) aVDPV2 (3 cases) aVDPV2 (5 cases) aVDPV2 (2 cases) aVDPV2 (1 case) cVDPV2 (2 cases) aVDPV3 (2 cases) cVDPV2 (3 cases) iVDPV2 + iVDPV3 (1 case) iVDPV2 (2 cases) iVDPV2 + iVDPV3 (1 case) iVDPV3 (1 case)

Hong Kong (China) Japan Lao People's Democratic Republic Mongolia Philippines Viet Nam cVDPV1 (3 cases)

aVDPV2 (2 cases)

8

Polio Bulletin

Key facts
Document type Technical Documents
Adoption date
Source World Health Organization