2014 Issue No. 6 - Week 11 (as of 18 March 2014) HIGHLIGHTS Middle East Polio Outbreak Update On 28 October 2013, the Ministry of Health of Syrian Arab Republic reported a polio outbreak. The last case of polio had been reported 15 years ago. To date, the total number of polio confirmed cases officially reported are 25, plus 13 additional reported from the contested areas. The latest case reported has an onset of paralysis dated 17 December 2013. This outbreak occurred in a context of large cohort of non-immune children (after interruption of many health care services) and large and complex movements of populations across and neighbouring countries. Currently, it is difficult to conclude the outbreak is completely controlled and stopped despite no cases reported. The key operational steps followed to respond to the outbreak and limit its spread to neighbouring countries in this challenging environment were: 1. Highest mobilization of regional decision-makers: All ministers of health in the Eastern Mediterranean Region have declared the polio outbreak as public health emergency and joint action. 2. Development of a polio outbreak response plan: Based on epidemiology and risk assessment analysis, several mass polio campaigns were planed targeting 22 million children under 5 years old living six countries and priority zones identified at risk. 3. Monitoring and evaluation: Quantified and timeline targets and indicators for polio campaign immunization coverage and acute flaccid paralysis surveillance performance were set up in different priorities zones. 4. Strategy used: Specific polio campaign. vaccines (mOPV1 and bOPV) for polio
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, 2013 CHN Cases with adequate specimens (%)
2.6% 0.0% 2.1% 0.6% 13.8% 0.0% 7.7% 0% 2% 4% 6% 8% 10% 12% 14% 16%
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%
* AFP rate annualized as of week 11
Chart 3. Polio immunization status of reported AFP cases, 2013 100% 100%
Chart 4. Percentage of samples received at the lab ≤ 3 days of collection, 2013
Multiple short interval campaigns in rapid succession and flexibility in their implementation (“windows of opportunities”) Polio control room set up to ensure very tight monitoring system and which generates accurate and timely programme adjustments Increase of the size of target age groups population based on epidemiological analysis Mass mobilization to generate social movement for vaccines Community specific tailored strategies to engage them in vaccination support and acceptance Involvement of civil society groups Strong and coordinated partnership efforts
80%
80%
60%
60%
54%
57% 45%
40%
40% 23% 20%
20%
0% CHN KHM ≥ 3 doses
LAO
MYS
PHL 0 doses
PNG Unknown
VNM
0% CHN
0% KHM
1% LAO MYS PHL
0% PNG VNM
1-2 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
60 1 73 5678 12 0 48 1 155 7 12 18 282 84 7 456 8 6902
0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 2 0 0 0 0 3
60 1 73 5398 12 41 1 153 5 12 18 235 79 7 377 4 6476
0 0 0 279 0 7 0 2 2 0 0 45 5 0 79 4 423
0 (0.0%) 0 (0.0%) 0 (0.0%) 150 (2.6%) 0 (0.0%) 1 (2.1%) 0 (0.0%) 1 (0.6%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 39 (13.8%) 0 (0.0%) 0 (0.0%) 35 (7.7%) 2 (25.0%) 228 (3.3%) Green Yellow Red
1.40 1.00 1.62 2.55 1.50 1.92 1.00 2.01 1.00 1.33 0.60 0.75 1.11 1.17 1.89 0.80 2.06
40% 100% 81% 92% 100% 58% 100% 83% 86% 50% 28% 67% 93% 71% 97% 63% 90%
72% 100% 96% 99% 100% 90% 100% 100% 100% 83% 83% 95% 100% 100% 99% 100% 98%
100% 100% 78% 100% 100% 98% 100% 85% 100% 83% 83% 98% 94% 86% 92% 100% 98%
0% 100% 95% 75% 100% 100% 100% 100% 47% 100% 100% 67% 0% 82%
03-Mar-14 06-Feb-14 13-Mar-14 12-Mar-14 06-Feb-14 28-Jan-14 14-Jan-14 27-Feb-14 08-Feb-14 27-Feb-14 26-Feb-14 10-Mar-14 18-Feb-14 08-Jan-14 05-Mar-14 03-Feb-14
6 49 19 38 8 28 13 43
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 adequate 60-day 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.
60 1 73 5678 12 0 48 1 155 7 12 18 282 84 7 456 8 6902
44 1 45 2225 8 167 25 1 77 8 9 30 378 76 6 241 10 3351
5 0 2 452 4 0 4 0 8 1 1 2 33 9 2 8 2 533
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 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 0 34 3 0 1 1 0 0 1 0 2 0 0 44
3 2 418 1 4 7 0 1 2 32 9 0 8 2 489
0 (0.0%) 0 (0.0%) 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 (11.1%) 0 (0.0%) 0 (0.0%) 1 (50.0%) 2 (0.4%) Green Yellow Red
0.54 0.21 0.96 2.36 0.76 0.49 0.59 0.53 0.32 0.41 0.56 1.58 0.16 0.95 0.75
40% 100% 90% 75% 25% 88% 100% 100% 0% 70% 67% 50% 88% 0% 87%
60% 100% 97% 100% 100% 100% 100% 100% 100% 97% 100% 100% 100% 50% 97%
80% 100% 100% 100% 100% 13% 100% 100% 0% 94% 78% 100% 88% 100% 97%
0% 19% 0% 0% 0% 0% 10% 0% 100% 0% 0% 14%
04-Mar-14 05-Feb-14 12-Mar-14 06-Mar-14 12-Mar-14 12-Mar-14 19-Feb-14 07-Mar-14 04-Mar-14 10-Mar-14 10-Mar-14 18-Feb-14 07-Mar-14 05-Mar-14 03-Feb-14
14 41 6 12 6 6 27 11 14 8 8 28 11 13 43
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 positive specimens L20B positive + NPEV NPEV only Pending Negative ≤ 14 days Intratypic % % results differentiation Latest Pending reported specimens / Sequencing report date positive > 14 2 ≤ 14 days for NPEV 1 lab 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
44 1 18 8 0 70 43 156 7 9 364 83 7 229 225 5622 266 31 163 112 379 249 388 128 583 298 286 190 64 110 389 28 218 357 23 87 263 163 83 232 44 230 114 80 38 16 10 12 0 6898
0 0 0 0 1 1 0 0 0 0 0 1 2 2 99 4 0 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 9 7 1 2 39 2 0 41 21 582 35 0 16 6 37 29 62 7 103 41 7 14 3 2 27 0 9 39 1 6 29 19 9 24 5 31 14 3 3 1 0 0 741
35 1 15 4 48 33 149 6 7 322 81 6 186 195 4908 227 30 143 101 339 215 311 118 464 250 270 174 61 107 341 26 206 312 21 76 229 141 73 208 39 196 98 74 34 15 9 12 6008
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 13 30 0 1 0 1 1 1 1 0 3 5 0 0 0 0 4 0 0 6 0 0 2 0 1 0 0 0 2 0 1 0 1 0 45
100% 100% 100% 100% 94% 97% 98% 100% 94% 95% 100% 100% 95% 97% 60% 52% 77% 79% 73% 60% 20% 64% 79% 55% 90% 43% 70% 61% 91% 69% 98% 43% 32% 87% 81% 75% 37% 75% 74% 69% 41% 74% 67% 55% 63% 11% 97% 65%
20% 0% 16% 44% 24% 19% 3% 14% 22% 9% 3% 0% 15% 9% 9% 11% 0% 7% 5% 8% 10% 13% 5% 14% 13% 2% 7% 5% 2% 5% 0% 4% 10% 4% 6% 10% 9% 9% 10% 10% 13% 11% 4% 7% 3% 0% 0% 9%
29-Jan-14 29-Jan-14 29-Jan-14 29-Jan-14 12-Feb-14 19-Feb-14 25-Feb-14 11-Feb-14 17-Mar-14 30-Jan-14 18-Feb-14 15-Jan-14 11-Feb-14 10-Jan-14 12-Mar-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 2 0 0 0 3 0 2 4 4 298 12 15 8 27 11 13 20 6 27 4 11 30 0 0 35 12 6 2 4 14 5 7 0 2 2 6 7 6 6 0 0 0 0 315
0 0 0 0 0 0 0 0 0 0 0 0 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 86 3 6 2 8 4 3 11 1 6 0 9 0 11 5 2 1 1 2 1 1 0 0 3 3 0 3 89
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 1 2 2 0 106 4 6 3 10 4 4 3 0 14 2 1 12 12 6 2 0 2 9 0 2 2 1 1 2 1 3 114
0 0 0 0 0 0 3 0 0 0 0 1 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 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 1 0 2 2 92 5 3 3 9 2 6 6 5 7 2 1 5 12 1 2 1 1 3 4 4 0 1 2 2 5 0 97
0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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
0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 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
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% 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 specimens positive L20B positive + NPEV NPEV only Pending Negative ≤ 14 days Intratypic % % results differentiation Latest Pending reported specimens / Sequencing positive report date > 14 2 ≤ 14 days for NPEV 1 lab days ≥ 80% No. of isolates referred Type 1 Wild Sabin VDPV W ild 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
4 0 0 2 0 3 3 20 1 2 35 9 2 9 13 440 21 3 20 10 29 17 24 7 38 20 19 15 6 6 47 3 25 22 6 4 21 12 10 21 1 15 12 4 1 1 0 2 0 545
0 0 1 0 0 0 0 0 0 0 0 0 2 1 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 3
0 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 1
0 0 0 0 0 0 1 1 0 0 1 1 18 0 0 1 0 1 1 2 0 3 0 0 0 0 0 3 0 0 2 1 0 1 0 0 1 0 2 0 0 0 0 0 22
4 1 2 3 15 1 0 24 5 2 4 9 387 20 3 18 10 28 15 21 7 32 19 13 14 5 5 43 3 24 20 5 4 19 12 10 13 1 12 7 2 1 1 1 458
0 1 0 0 5 0 1 0 4 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 1 16
0 0 0 0 0 0 0 10 0 0 0 3 32 0 0 1 0 0 1 0 0 3 0 6 1 1 1 1 0 1 0 0 0 1 0 0 7 0 1 5 2 0 0 0 45
88% 100% 100% 100% 100% 100% 100% 94% 100% 100% 100% 80% 52% 32% 100% 84% 85% 62% 13% 48% 86% 53% 75% 69% 64% 64% 100% 54% 100% 17% 23% 100% 100% 20% 42% 55% 50% 100% 25% 86% 100% 0% 100% 75% 56%
0% 0% 0% 0% 0% 0% 67% 2% 0% 0% 20% 5% 4% 0% 0% 5% 0% 2% 6% 8% 0% 6% 0% 0% 0% 0% 0% 5% 0% 0% 9% 17% 0% 3% 0% 0% 4% 0% 14% 0% 0% 0% 0% 0% 4%
14-Mar-14 14-Mar-14 14-Mar-14 14-Mar-14 06-Mar-14 17-Mar-14 11-Mar-14 07-Mar-14 17-Mar-14 05-Mar-14 18-Feb-14 14-Mar-14 10-Mar-14 03-Mar-14 12-Mar-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 0 0 0 0 0 10 0 2 0 0 4 0 2 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 12
0 0 0 0 0 0 0
0 6 2 2 2 0 6
0 0 0 0 0 0 0
0 0 0 0 0 0 0
2 2 0 2 0 0 4
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 2 0 0 0 2 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
100% 100% 100% 100% 100% 100% 100%
20-Feb-14 20-Feb-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 for polio polio isolates 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
269 0 0 158 0 6 0 0 0 0 28 0 0 0 7 4 0 1 0 0 0 0 2 0 0 2 2 0 2 1 2 0 0 0 1 0 0 0 2 2 0 0 1 462
1 0 6 23 7 1 1 2 2 2 2 1 2 0 2 1 1 31
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 5 14 7 0 1 0 2 1 1 1 0 0 0 1 1 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
1 0 1 10 4 0 0 1 1 0 0 0 2 0 1 1 0 12
0 0 0 1 0 1 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 1 10 4 0 0 1 1 1 1 1 0 0 1 0 0 11
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 56 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 57
0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 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
10 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 19
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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. 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