2017 Issue No. 3 - Week 5 (as of 6 February 2017) HIGHLIGHTS Republic of Korea Takes Flight For Polio In January 2017 the Government of Korea announced it was giving US $4 million of those funds to UNICEF and WHO to support disease surveillance and a rapid outbreak response wherever it occurs. An innovative financing mechanism titled the ‘‘Global Disease Eradication Fund” air-ticket solidarity levy means the Government of Korea collects 1,000 South Korean Won (about US$0.85) from each international passenger departing Korea’s airports. This unique new funding agreement was made possible through the committed work of Korean R o t a r y members, who used the global stage of their R o t a r y International © UNICEF/UN026556/Parry Convention in Seoul in May to highlight the opportunity for Korea to support polio eradication. UNICEF and WHO welcomed the funding, which will be used to detect and respond to any potential outbreak of polio. UNICEF received $3 million, with WHO receiving $1 million of the funds. UNICEF Director of Polio Eradication Reza Hossaini said: “UNICEF is responsible for supply and demand in an outbreak response – the rapid supply of safe and effective vaccines, and generating the demand in the community to ensure they seek the vaccine and can quickly protect their children from the virus.” WHO’s Director of Polio Eradication, Dr Zaffran said. “Korea’s contribution is key to ensuring that we can find poliovirus anywhere it still survives through sensitive disease surveillance mechanisms.” Full story is available at: http://polioeradication.org/news-post/republic-of-korea-takes-flight -for-polio 20% 5.5 5.0 4.5 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0.0 14 15 CHN 16 14 15 KHM 16 14 15 LAO 16 14 15 MYS 16 14 15 PHL 16 14 15 PNG 16 14 15 VNM 16 0% 14 15 CHN 16 14 15 KHM 16 14 15 LAO 16 14 15 MYS 16 14 15 PHL 16 14 15 PNG 16 14 15 VNM 16 20% 40% 60% 80%
Polio Bulletin
Chart 1. Non-polio AFP rate (per 100 000 persons < 15 years of age), 2014–2016 100%
Chart 2. Adequate specimen collection rate, 2014–2016
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 5.7% 10.0% 0.0% 3.7% 3.5% 8.7% 20.9% 0% 5% 10% 15% 20% 25%
80%
KHM LAO MYS
60%
40%
PHL PNG VNM
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
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 1. 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 0 71 144 9 7 27 413 83 8 380 15 6525
45 1 45 2234 8 1 163 24 77 8 9 30 394 69 6 232 10 3356
65 1 50 5828 10 1 0 133 135 7 12 23 397 69 7 373 18 7129
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
52 1 44 4645 10 1 122 127 6 10 13 368 65 7 245 14 5730
12 0 6 1183 0 0 8 8 1 2 10 29 4 0 128 4 1395
9 (13.8%) 0 (0.0%) 5 (10.0%) 330 (5.7%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 5 (3.7%) 0 (0.0%) 1 (8.3%) 2 (8.7%) 14 (3.5%) 0 (0.0%) 0 (0.0%) 78 (20.9%) 3 (16.7%) 447 (6.3%) Green Yellow Red
1.44 1.00 1.11 2.61 1.25 1.00 5.42 1.75 0.88 1.33 0.77 1.01 1.00 1.17 1.61 1.80 2.12
45% 100% 90% 92% 90% 100% 74% 81% 71% 58% 43% 69% 94% 100% 95% 72% 90%
95% 100% 92% 100% 100% 100% 92% 81% 100% 83% 91% 95% 100% 100% 92% 100% 98%
02-Feb-17 08-Oct-16 10-Jan-17 01-Feb-17 09-Jan-17 12-Jan-17 23-Jan-17 16-Jan-17 06-Feb-17 03-Feb-17 07-Nov-16 16-Jan-17 18-Jan-17 06-Jan-17 25-Jan-17 17-Jan-17
4 27 5 14 21 0 3 91 21 19 12 20 -
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
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Polio Bulletin
Table 2. 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 Latest Pending 14 days ≤ positive for report date ≤ 14 days > 14 days NPEV ≥ 80% Intratypic differentiation/ Sequencing 1 laboratory No. of isolates received Type 1 Wild Sabin VDPV Results of intratypic differentiation (ITD)/sequencing for virus isolates Type 3 Type 2 Wild Sabin VDPV Wild 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 5732 328 45 184 121 404 319 363 118 466 249 239 224 89 121 409 41 167 393 42 113 263 188 96 246 43 202 91 109 24 30 5 10 0 0 201 139 7 10 24 460 67 7 208 167 16 7147
0 0 2 67 3 0 5 3 8 3 5 1 7 1 0 1 0 1 7 1 5 3 1 1 0 2 1 1 0 0 1 5 0 0 1 0 19 0 0 0 1 5 0 0 6 5 0 105
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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
3 0 11 420 12 1 8 3 23 44 47 3 52 23 4 12 7 3 31 0 6 43 1 4 18 17 8 16 3 22 4 3 0 2 0 0 20 7 1 0 3 42 7 0 26 16 5 561
44 1 38 5156 310 44 167 113 368 267 307 109 402 223 229 210 82 114 358 40 154 346 40 108 242 169 86 224 37 174 80 97 24 28 4 10 163 132 6 10 20 409 60 7 176 146 11 6389
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 4 0 0 0 0 0 5
0 0 0 87 3 0 4 2 4 4 4 5 5 2 6 1 0 3 13 0 2 1 0 0 3 0 1 5 3 6 6 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87
94% 100% 88% 96% 100% 100% 97% 97% 87% 100% 98% 99% 87% 100% 99% 99% 100% 85% 95% 100% 97% 95% 100% 98% 94% 99% 97% 98% 90% 97% 96% 89% 96% 92% 100% 96% 97% 100% 93% 100% 100% 97% 95% 100% 99% 96% 97% 95%
5% 0% 20% 6% 3% 2% 4% 3% 4% 11% 11% 3% 9% 8% 2% 5% 6% 2% 6% 0% 3% 9% 2% 4% 6% 7% 6% 6% 6% 10% 4% 2% 0% 5% 0% 0% 8% 5% 7% 0% 12% 7% 9% 0% 11% 9% 26% 6%
27-Jan-17 27-Jan-17 30-Jan-17 01-Feb-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
0 0 0 0 0 0 0 0 0 0 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
0 0 0 0 0 0 0 0 0 0 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% 83% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 99%
14-Dec-16 14-Dec-16 30-Jan-17 12-Jan-17 29-Dec-16 16-Jan-17 27-Jan-17 02-Feb-17 18-Jan-17 02-Feb-17 06-Jan-17 24-Jan-17 27-Jan-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
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Polio Bulletin
Table 3. Laboratory confirmation of polio isolates from environmental samples in 2015–2016 1 2015 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 Wild
2016 Polio isolates Type 2 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
29 400 56 24 43 49 24 47 24 36 97 0 429
2 161 8 20 26 18 9 33 11 36 0 163
0 0 0 0 0 0 0 0 0 0 0 0
0 217 0 13 11 10 2 46 2 133 0 217
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
1 303 15 12 24 12 16 29 12 183 0 304
0 1 0 0 1 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0
1 301 1 30 7 52 2 49 7 153 0 302
0 0 0 0 0 0 0 0 0 0 0 0
26 97 17 2 16 18 5 14 8 0 17 123
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 313 48 12 48 36 45 37 22 27 38 10 323
149 9 8 35 11 18 24 17 27 0 0 149
0 0 0 0 0 0 0 0 0 0 0
156 2 5 19 0 0 25 16 89 0 156
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
174 1 5 4 4 5 15 4 136 0 174
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
423 9 11 62 28 42 33 30 208 0 423
0 0 0 0 0 0 0 0 0 0 0
183 33 3 39 23 30 33 16 0 6 6 189
2 0 2 0 0 0 0 0 0 0 0 2
2 0 2 0 0 0 0 0 0 0 0 2
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
3
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)
4
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
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Polio Bulletin