Polio Bulletin 2024

Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Phone: +63 2 8528 8001 Fax: +63 2 8521 1036, 8526 0279 Email: wproepidata@who.int Web: www.who.int/westernpacific Polio Bulletin 2024 Issue No. 6 - April 2024 (as of 7 May 2024) HIGHLIGHTS Figure 1. Non-polio AFP rate (per 100 000 persons < 15 years of age), 2022–2024 Figure 2. Adequate specimen collection rate, 2022–2024 Figure 3. Percentage of reported AFP cases by number of polio vaccination doses, 2024 Figure 4. Percentage of reported AFP cases with pending classification > 90 days after onset, 2024 0.0 1.0 2.0 3.0 4.0 5.0 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% CHN KHM LAO MYS PHL PNG VNM ≥ 3 doses 1-2 doses 0 doses Unknown 3.6% 0.0% 16.7% 0.0% 0.0% 0.0% 25.3% 0% 5% 10% 15% 20% 25% 30% VNM PNG PHL MYS LAO KHM CHN 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). Global Guidance for Conducting Acute Flaccid Paralysis (AFP) Surveillance in the Context of Polio Virus Eradication, 2024 Since 1996, all WHO Regions and several countries have produced AFP guidelines based on the “Field guide for supplementary activities aimed at achieving polio eradication”. In 2024, a new Global guidance for conducting acute flaccid paralysis (AFP) surveillance in the context of poliovirus eradication has been developed, and this replaces the 1996 field guide. The new global guidance outlines well-established strategies and activities for AFP surveillance to support countries in maintaining a surveillance system sensitive enough to detect the circulation of any polioviruses including vaccine- derived poliovirus and Sabin-like viruses. In addition, it aims to increase the speed of detection of polioviruses, maintain quality of surveillance at the subnational level, highlights the importance of gender equality and integration of polio with other vaccine preventable diseases. Overall, the new guidance stresses cross-cutting issues that remain central to the success of the polio eradication program. Link: Global guidance for conducting acute flaccid paralysis (‎AFP)‎ surveillance in the context of poliovirus eradication CONTACT US 2021 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 63 48 81 0 0 0 81 0 0 (0.0%) 1.70 72% 100% 11-Apr-23 - Brunei Darussalam 2 1 2 0 0 0 2 0 0 (0.0%) 2.16 50% 100% 20-Feb-23 - Cambodia 5 48 35 0 0 0 35 0 0 (0.0%) 0.73 63% 100% 01-Feb-23 - China 4769 2362 4225 0 0 0 4225 0 0 (0.0%) 1.79 92% 99% 02-Apr-24 - China, Hong Kong SAR 9 8 6 0 0 0 6 0 0 (0.0%) 0.78 67% 100% 28-Nov-23 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.10 100% 100% 08-Mar-24 - Japan 0 148 41 0 0 0 40 1 1 (0.1%) 0.28 73% 98% 02-Jan-24 126 Lao People's Democratic Republic 20 23 28 0 0 0 28 0 0 (0.0%) 1.22 64% 68% 09-Oct-23 - Malaysia 111 80 212 0 0 0 212 0 0 (0.0%) 2.65 76% 83% 03-Apr-23 - Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 10-Nov-23 - New Zealand 9 10 23 0 0 0 23 0 0 (0.0%) 2.37 35% 100% 28-Nov-23 - Papua New Guinea 52 38 59 0 0 0 59 0 0 (0.0%) 1.53 69% 83% 10-Nov-23 - Philippines 894 327 853 0 0 0 853 0 0 (0.0%) 2.60 79% 0% 23-Nov-23 - Republic of Korea 35 60 57 0 0 0 57 0 0 (0.0%) 0.95 82% 98% 08-Mar-23 - Singapore 4 6 11 0 0 0 11 0 0 (0.0%) 1.91 82% 82% 01-Feb-23 - Viet Nam 162 250 238 0 0 0 238 0 0 (0.0%) 0.95 98% 65% 12-May-23 - Pacific island countries and areas 16 11 7 0 0 0 7 0 0 (0.0%) 0.64 71% 71% 08-Nov-22 - Total 6153 3430 5880 0 0 0 5879 1 1 (0.02%) 1.71 88% 82% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Days since last report 5 % investigated ≤  2 days of notification 3 Indicators Latest report date 4 2022 Non-polio AFP rate Total % with adequate specimens 2> 90 days 1 # (%) Vaccine- derived poliovirus (VDPV) Polio- compatible Classification Pending Table 1A. Classification of AFP cases with onset in 2022 and key surveillance indicators 2 Polio Bulletin 2022 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 81 48 82 0 0 0 82 0 0 (0.0%) 1.72 63% 100% 26-Feb-24 - Brunei Darussalam 2 1 1 0 0 0 1 0 0 (0.0%) 1.08 100% 100% 18-Jan-24 - Cambodia 35 48 47 0 0 0 47 0 0 (0.0%) 0.99 89% 98% 07-Mar-24 - China 4225 1877 5649 0 0 0 4530 1119 1,119 (19.8%) 3.01 95% 99% 06-May-24 1 China, Hong Kong SAR 6 8 16 0 0 0 16 0 0 (0.0%) 2.07 81% 100% 19-Mar-24 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.04 100% 100% 08-Apr-24 - Japan 41 144 55 0 0 0 49 6 1 (1.8%) 0.38 55% 91% 20-Feb-24 77 Lao People's Democratic Republic 28 23 39 0 0 0 24 15 0 (0.0%) 1.70 87% 90% 19-Dec-23 140 Malaysia 212 75 235 0 0 0 234 1 1 (0.4%) 3.11 84% 92% 19-Apr-24 18 Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 26-Jan-24 - New Zealand 23 10 10 0 0 0 10 0 0 (0.0%) 1.04 70% 90% 09-Apr-24 - Papua New Guinea 59 39 59 0 0 0 50 9 8 (13.6%) 1.49 59% 68% 24-Apr-24 13 Philippines 853 342 979 0 0 0 425 554 510 (52.1%) 2.86 68% 57% 11-Apr-24 26 Republic of Korea 57 57 51 0 0 0 51 0 0 (0.0%) 0.90 82% 100% 07-Mar-24 - Singapore 11 6 3 0 0 0 3 0 0 (0.0%) 0.52 100% 100% 03-Jan-24 - Viet Nam 238 222 280 0 0 0 280 0 0 (0.0%) 1.26 99% 87% 23-Apr-24 - Pacific island countries and areas 7 10 27 0 0 0 20 7 7 (25.9%) 2.63 56% 67% 06-May-24 1 Total 5880 2921 7535 0 0 0 5824 1711 1,646 (21.8%) 2.58 90% 93% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Days since last report 5 % investigated ≤ 2 days of notification 3 Indicators Latest report date4> 90 days 1 # (%) Total 2023 % with adequate specimens 2 Pending Classification Non-polio AFP rate Vaccine- derived poliovirus (VDPV) Polio- compatible Table 1B. Classification of AFP cases with onset in 2023 and key surveillance indicators 3 Polio Bulletin 2023 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 82 48 24 0 0 0 10 14 0 (0.0%) 1.45 63% 96% 06-May-24 1 Brunei Darussalam 1 1 0 - - - - - - 0.00 - - 20-Apr-24 17 Cambodia 47 48 2 0 0 0 0 2 0 (0.0%) 0.12 50% 100% 22-Apr-24 15 China 5618 1877 1155 0 0 0 129 1026 292 (25.3%) 1.78 94% 99% 29-Apr-24 8 China, Hong Kong SAR 16 8 3 0 0 0 3 0 0 (0.0%) 1.15 100% 100% 29-Apr-24 8 China, Macao SAR 1 1 1 0 0 0 0 1 0 (0.0%) 3.01 100% 100% 07-May-24 0 Japan 55 144 11 0 0 0 9 2 0 (0.0%) 0.22 64% 100% 07-May-24 0 Lao People's Democratic Republic 39 23 7 0 0 0 0 7 0 (0.0%) 0.88 100% 86% 03-May-24 4 Malaysia 234 75 61 0 0 0 46 15 0 (0.0%) 2.33 89% 62% 06-May-24 1 Mongolia 1 11 3 0 0 0 2 1 0 (0.0%) 0.80 100% 100% 06-May-24 1 New Zealand 10 10 2 0 0 0 1 1 0 (0.0%) 0.60 50% 50% 12-Apr-24 25 Papua New Guinea 57 41 8 0 0 0 0 8 0 (0.0%) 0.57 63% 38% 03-May-24 4 Philippines 890 344 180 0 0 0 0 180 30 (16.7%) 1.51 47% 98% 11-Apr-24 26 Republic of Korea 51 54 14 0 0 0 3 11 0 (0.0%) 0.75 79% 100% 03-May-24 4 Singapore 3 6 2 0 0 0 2 0 0 (0.0%) 99% 100% 100% 26-Apr-24 11 Viet Nam 280 222 28 0 0 0 13 15 1 (3.6%) 0.36 100% 96% 23-Apr-24 14 Pacific island countries and areas 26 10 0 - - - - - - 0.00 - - 06-May-24 1 Total 7411 2923 1501 0 0 0 218 1283 323 (21.5%) 1.48 87% 97% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Annualized non-polio AFP rate per 100 000 population under 15 years of age Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Substantially below target 4. Percentage of reported cases investigated within two days of notification 5. Countries are expected to submit data at least once per month to WPRO Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Days since last report 5 % investigated ≤ 2 days of notification 4 Indicators Latest report date> 90 days 1 # (%) Total 2024 % with adequate specimens 3 Pending Classification Non-polio AFP rate 2 Vaccine- derived poliovirus (VDPV) Polio- compatible Table 1C. Classification of AFP cases with onset in 2024 and key surveillance indicators 4 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 78 1 1 3 73 0 95% 3% 31-Jan-23 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 100% Brunei Darussalam VIDRL 2 0 0 0 2 0 100% 0% 16-Jan-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 35 1 0 2 32 0 97% 7% 31-Dec-22 NIID 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China (total) 4180 2 7 1 4170 0 98% 0.1% 02-Apr-24 20 0 12 0 0 0 0 0 8 0 0 0 0 100% China, Anhui Prov. Lab 268 0 0 0 268 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Beijing Prov. Lab 34 0 0 0 34 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 36 0 0 0 36 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 132 0 0 0 132 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 52 0 0 0 52 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 450 0 2 0 448 0 92% 0.2% Prov. Lab/CCDC 4 0 4 0 0 0 0 0 0 0 0 0 0 100% China, Guangxi Prov. Lab 216 0 0 1 215 0 100% 0.2% Prov. Lab/CCDC 3 0 2 0 0 0 0 0 1 0 0 0 0 100% China, Guizhou Prov. Lab 174 0 0 0 174 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hainan Prov. Lab 48 0 0 0 48 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 225 0 0 0 225 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 29 0 0 0 29 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 437 1 2 0 434 0 100% 0.2% Prov. Lab/CCDC 7 0 3 0 0 0 0 0 4 0 0 0 0 100% China, Hubei Prov. Lab 108 0 0 0 108 0 92% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 198 0 0 0 198 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 173 0 0 0 173 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 142 0 1 0 141 0 99% 0.4% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Jilin Prov. Lab 31 0 0 0 31 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 60 0 0 0 60 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 93 0 0 0 93 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ningxia Prov. Lab 12 0 0 0 12 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 6 0 0 0 6 0 67% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 71 0 0 0 71 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 243 0 0 0 243 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab 33 0 0 0 33 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 79 1 1 0 77 0 97% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Sichuan Prov. Lab 348 0 0 0 348 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tianjin Prov. Lab 11 0 0 0 11 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 88 0 1 0 87 0 100% 1% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Yunnan Prov. Lab 208 0 0 0 208 0 90% 0% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Zhejiang Prov. Lab 166 0 0 0 166 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 9 0 0 0 9 0 33% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 6 0 0 0 6 0 100% 0% 26-Jan-23 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 0 0 100% 0% 03-Jan-23 PHLC 0 - - - - - - - - - - - - - Japan NIID 36 0 0 0 36 0 97% 0% 01-May-23 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 28 0 0 2 26 0 96% 5% 10-Oct-23 NIID 0 - - - - - - - - - - - - - Malaysia IMR 219 0 0 4 215 0 91% 1% 15-Dec-23 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 06-Nov-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 15 0 0 2 12 0 100% 7% 16-Feb-23 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 57 1 1 4 51 0 81% 8% 14-Nov-23 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 100% Philippines RITM 829 5 1 63 760 0 98% 6% 05-Mar-24 RITM/NIID 19 0 8 0 0 0 0 0 11 0 0 0 0 100% Republic of Korea KDCA 57 0 0 7 50 0 82% 11% 19-Jan-23 KDCA 0 - - - - - - - - - - - - - Singapore SGH 11 0 0 0 11 0 95% 0% 11-Jan-23 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 155 0 0 26 129 0 100% 16% 15-Dec-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 79 0 0 5 74 0 100% 6% 09-Jan-23 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 7 0 0 1 6 0 85% 15% 24-Aug-22 VIDRL 0 - Total 5796 10 10 120 5654 0 97% 2% 47 0 20 0 0 0 0 0 21 0 6 0 0 100% 2. NPEV growing in L20B cells Country/area % ITD results reported ≤ 7 days of receipt Type 3 Polio laboratory 1 Type 1 Negative Results of virus isolation for AFP cases Results of intratypic differentiation (ITD)/sequencing for virus isolates L20B positive VDPV 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Total no. of AFP cases with specimens NPEV only Discordant pending sequencing NPEV 2VDPV L20B positive + NPEV Wild Sabin % specimens positive for NPEV Latest report date VDPV Sabin Pending ITDPending % results reported ≤ 14 days Wild Type 2 Table 2A. Laboratory investigation of stool samples from AFP cases with onset in 2022 and key laboratory indicators 5 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 77 0 2 2 73 0 94% 3% 05-Feb-24 VIDRL 2 0 0 0 0 0 0 0 0 0 2 0 0 100% Brunei Darussalam VIDRL 1 0 0 0 1 0 0% 0% 09-Oct-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 47 0 0 7 40 0 96% 14% 25-Dec-23 NIID 0 - - - - - - - - - - - - - China (total) 5621 0 19 0 5590 12 98% 0.2% 06-May-24 56 0 24 0 0 0 0 0 32 0 0 0 0 100% China, Anhui Prov. Lab 351 0 1 0 349 1 98% 0.1% Prov. Lab/CCDC 4 0 2 0 0 0 0 0 2 0 0 0 0 100% China, Beijing Prov. Lab 56 0 0 0 56 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 59 0 0 0 59 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 171 0 0 0 171 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 120 0 0 0 119 1 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 586 0 1 0 585 0 93% 0% Prov. Lab/CCDC 6 0 3 0 0 0 0 0 3 0 0 0 0 100% China, Guangxi Prov. Lab 252 0 3 0 249 0 99% 0.6% Prov. Lab/CCDC 8 0 2 0 0 0 0 0 6 0 0 0 0 100% China, Guizhou Prov. Lab 235 0 0 0 235 0 100% 0% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Hainan Prov. Lab 48 0 1 0 47 0 96% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Hebei Prov. Lab 334 0 0 0 334 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 69 0 0 0 69 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 688 0 6 0 680 2 100% 0.4% Prov. Lab/CCDC 14 0 8 0 0 0 0 0 6 0 0 0 0 100% China, Hubei Prov. Lab 152 0 0 0 152 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 287 0 0 0 283 4 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 217 0 0 0 217 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 182 0 0 0 182 0 91% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 43 0 0 0 43 0 100% 0% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Liaoning Prov. Lab 111 0 0 0 110 1 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 139 0 1 0 138 0 100% 0.4% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Ningxia Prov. Lab 26 0 0 0 26 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 9 0 0 0 9 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 83 0 0 0 81 2 76% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 287 0 0 0 286 1 100% 0% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Shanghai Prov. Lab 46 0 0 0 46 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 108 0 2 0 106 0 98% 1% Prov. Lab/CCDC 6 0 2 0 0 0 0 0 4 0 0 0 0 100% China, Sichuan Prov. Lab 358 0 1 0 357 0 98% 0.1% Prov. Lab/CCDC 4 0 3 0 0 0 0 0 1 0 0 0 0 100% China, Tianjin Prov. Lab 31 0 1 0 30 0 100% 2% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Xinjiang Prov. Lab 146 0 1 0 145 0 98% 0.3% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Yunnan Prov. Lab 208 0 0 0 208 0 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 198 0 1 0 197 0 99% 0.3% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Tibet Prov. Lab 21 0 0 0 21 0 95% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 15 0 0 0 15 0 97% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 40 0 0 4 36 0 91% 7% 21-Feb-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 39 0 0 1 23 15 100% 4% 19-Dec-23 NIID 0 - - - - - - - - - - - - - Malaysia IMR 254 0 0 19 235 0 88% 7% 29-Apr-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 29-Dec-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 4 0 0 1 3 0 100% 18% 19-Feb-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 59 6 0 5 48 0 97% 8% 30-Apr-24 VIDRL 27 0 7 0 0 0 0 0 20 0 0 0 0 100% Philippines RITM 894 12 0 45 836 1 97% 4% 17-Apr-24 RITM/NIID 66 0 26 0 0 0 0 0 40 0 0 0 0 100% Republic of Korea KDCA 51 0 0 6 43 2 94% 12% 02-Feb-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 3 0 0 1 2 0 100% 33% 11-Jan-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 164 0 0 27 137 0 100% 16% 11-Jan-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 113 0 0 14 99 0 100% 12% 29-Jan-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 24 0 0 3 21 0 96% 9% 22-Jan-24 VIDRL 0 - - - - - - - - - - - - - Total 7408 18 21 135 7204 30 97% 2% 151 0 57 0 0 0 0 0 92 0 2 0 0 100% 2. NPEV growing in L20B cells Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin VDPVPending % specimens positive for NPEV Latest report date SabinWild 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only Table 2B. Laboratory investigation of stool samples from AFP cases with onset in 2023 and key laboratory indicators 6 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 19 0 0 0 15 4 82% 4% 06-May-24 VIDRL 1 0 0 0 0 0 0 0 0 0 1 0 0 100% Brunei Darussalam VIDRL 0 - - - - - - - 20-Apr-24 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 2 0 0 0 1 1 100% 0% 22-Apr-24 NIID 0 - - - - - - - - - - - - - China (total) 1136 4 0 0 1078 54 97% 0.0% 29-Apr-24 12 0 4 0 0 0 0 0 8 0 0 0 0 67% China, Anhui Prov. Lab 52 0 0 0 51 1 98% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Beijing Prov. Lab 10 0 0 0 8 2 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 12 0 0 0 10 2 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 29 0 0 0 19 10 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 17 0 0 0 17 0 82% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 98 0 0 0 92 6 94% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangxi Prov. Lab 55 1 0 0 53 1 94% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guizhou Prov. Lab 45 0 0 0 42 3 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hainan Prov. Lab 8 0 0 0 8 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 43 0 0 0 40 3 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 7 0 0 0 7 0 86% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 216 1 0 0 213 2 100% 0.0% Prov. Lab/CCDC 10 0 4 0 0 0 0 0 6 0 0 0 0 60% China, Hubei Prov. Lab 29 0 0 0 29 0 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 63 1 0 0 62 0 100% 0% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Jiangsu Prov. Lab 48 0 0 0 48 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 37 0 0 0 36 1 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 9 0 0 0 8 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 19 0 0 0 19 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 11 0 0 0 3 8 67% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ningxia Prov. Lab 6 1 0 0 5 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 1 0 0 0 1 0 0% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 16 0 0 0 14 2 70% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 74 0 0 0 73 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab 8 0 0 0 8 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 22 0 0 0 20 2 90% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Sichuan Prov. Lab 74 0 0 0 73 1 95% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tianjin Prov. Lab 6 0 0 0 6 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 26 0 0 0 24 2 100% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Yunnan Prov. Lab 41 0 0 0 35 6 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 53 0 0 0 53 0 98% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 1 0 0 0 1 0 100% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 3 0 0 0 3 0 100% 0% 23-Apr-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 03-May-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 9 0 0 0 5 4 100% 0% 07-May-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 7 0 0 0 0 7 0% 0% 03-May-24 NIID 0 - - - - - - - - - - - - - Malaysia IMR 62 0 0 6 56 0 100% 7% 07-May-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 3 0 0 0 2 1 100% 0% 06-May-24 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 2 0 0 1 1 0 100% 50% 06-May-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 8 0 0 0 4 4 100% 0% 03-May-24 VIDRL 0 - - - - - - - - - - - - - Philippines RITM 213 1 1 11 183 16 98% 5% 07-May-24 RITM/NIID 0 - - - - - - - - - - - - - Republic of Korea KDCA 14 0 0 1 11 2 100% 8% 03-May-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 2 0 0 0 2 0 100% 0% 04-May-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 0 - - - - - - - 11-Jan-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 17 0 0 2 15 0 100% 12% 15-Apr-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 0 - - - - - - - 22-Jan-24 VIDRL 0 - - - - - - - - - - - - - Total 1498 5 1 21 1377 93 97% 1% 13 0 4 0 0 0 0 0 8 0 1 0 0 67% 2. NPEV growing in L20B cells Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens VDPV Pending % specimens positive for NPEV Latest report date SabinWild Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin Table 2C. Laboratory investigation of stool samples from AFP cases with onset in 2024 and key laboratory indicators 7 Polio Bulletin Table 3A. Laboratory confirmation of polio isolates from environmental samples in 20231 and key laboratory indicators 8 Polio Bulletin Table 3B. Laboratory confirmation of polio isolates from environmental samples in 20241 and key laboratory indicators 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); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); RITM (Research Institute for Tropical Medicine, Philippines); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 49 3 0 0 0 0 0 0 0 3 0 100% 0 0 Cambodia RITM 12 2 0 0 0 0 0 0 0 2 0 58% 0 0 China (total) 613 201 0 203 0 0 0 0 0 289 2 34% 1 0 China, Fujian Prov. Lab/CCDC 62 7 0 0 0 0 0 0 0 7 0 60% 1 0 China, Gansu Prov. Lab/CCDC 42 21 0 23 0 0 0 0 0 26 0 21% 0 0 China, Guangdong Prov. Lab/CCDC 48 30 0 20 0 0 0 0 0 41 0 52% 0 0 China, Guangxi Prov. Lab/CCDC 12 6 0 6 0 0 0 0 0 11 0 58% 0 0 China, Heilongjiang Prov. Lab/CCDC 24 11 0 12 0 0 0 0 0 30 0 17% 0 0 China, Jiangxi Prov. Lab/CCDC 34 9 0 6 0 0 0 0 0 6 1 65% 0 0 China, Jiangsu Prov. Lab/CCDC 124 10 0 4 0 0 0 0 0 6 0 5% 0 0 China, Liaoning Prov. Lab/CCDC 43 16 0 6 0 0 0 0 0 25 0 5% 0 0 China, Neimongol Prov. Lab/CCDC 20 8 0 15 0 0 0 0 0 13 0 0% 0 0 China, Ninxia Prov. Lab/CCDC 19 8 0 20 0 0 0 0 0 8 0 42% 0 0 China, Qinghai Prov. Lab/CCDC 14 3 0 3 0 0 0 0 0 2 0 14% 0 0 China, Shandong Prov. Lab/CCDC 34 15 0 8 0 0 0 0 0 24 0 32% 0 0 China, Shanghai Prov. Lab/CCDC 24 0 0 0 0 0 0 0 0 0 0 17% 0 0 China, Xinjiang Prov. Lab/CCDC 36 27 0 53 0 0 0 0 0 64 0 0% 0 0 China, Yunnan Prov. Lab/CCDC 37 22 0 25 0 0 0 0 0 18 0 92% 0 0 China, Zheijiang Prov. Lab/CCDC 40 8 0 2 0 0 0 0 0 8 1 70% 0 0 Lao PDR RITM 4 0 0 0 0 0 0 0 0 0 0 0% 0 0 Malaysia IMR/VIDRL 330 0 0 0 0 0 0 0 0 0 0 48% 3 0 New Zealand IESR 80 4 0 0 0 0 0 0 0 4 0 90% 0 0 Philippines RITM 616 37 0 17 0 0 0 0 0 44 0 15% 0 0 Viet Nam NIHE 124 0 0 0 0 0 0 0 0 0 0 2% 2 0 Total 1828 247 0 220 0 0 0 0 0 342 2 32% 6 0 Pending ITD Discordant pending sequencingType 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates NPEV (%) Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 15 5 0 1 0 0 0 0 0 4 0 53% 3 0 Cambodia RITM 0 - - - - - - - - - - - - - China (total) 20 15 0 26 0 0 0 0 0 23 0 35% 0 0 China, Fujian Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab/CCDC 6 3 0 5 0 0 0 0 0 7 0 0% 0 0 China, Guangdong Prov. Lab/CCDC 8 8 0 12 0 0 0 0 0 11 0 50% 0 0 China, Guangxi Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab/CCDC 3 1 0 2 0 0 0 0 0 0 0 33% 0 0 China, Neimongol Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ninxia Prov. Lab/CCDC 3 3 0 7 0 0 0 0 0 5 0 67% 0 0 China, Qinghai Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Yunnan Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zheijiang Prov. Lab/CCDC 0 - - - - - - - - - - - - - Lao PDR RITM 0 - - - - - - - - - - - - - Malaysia IMR/VIDRL 0 - - - - - - - - - - - - - New Zealand IESR 28 1 0 0 0 0 0 0 0 1 0 93% 0 0 Philippines RITM 185 12 0 5 0 0 0 0 0 20 0 41% 10 0 Viet Nam NIHE 0 - - - - - - - - - - - - - Total 248 33 0 32 0 0 0 0 0 48 0 49% 13 0 Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates NPEV (%) Pending ITD Discordant pending sequencingType 1 Type 2 Type 3 Figure 5A. China Figure 5B. Malaysia Figure 5C. Papua New Guinea Figure 5D. Philippines 1. Prefix letter refers to the VDPV category: “cVDPV” = circulating VDPV, “iVDPV” = immunodeficiency-associated VDPV, “aVDPV” = ambiguous VDPV. Suffix number refers to the poliovirus serotype (types 1, 2 or 3) 2. Community and healthy children 3. Contact of a different AFP case Vaccine-derived polio virus identified from laboratory testing, 2018–2023 0 2 4 6 8 10 12 14 16 cVDPV1 cVDPV2 cVDPV1 cVDPV2 aVDPV2 aVDPV3 2019 2020 N o. o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 45 cVDPV1 2018 N o.  o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 cVDPV1 cVDPV2 iVDPV2 aVDPV2 cVDPV2 aVDPV2 2019 2020 N o. o f c as es /s pe ci m en s 9 Polio Bulletin 0 1 2 3 4 5 cVDPV2 iVDPV3 aVDPV3 cVDPV2 aVDPV3 aVDPV1 cVDPV3 aVDPV3 aVDPV1 cVDPV3 aVDPV3 iVDPV3 aVDPV1 aVDPV1 aVDPV3 iVDPV3 2018 2019 2020 2021 2022 2023 N o . o f ca se s/ sp e ci m e n s

Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Phone: +63 2 8528 8001 Fax: +63 2 8521 1036, 8526 0279 Email: wproepidata@who.int Web: www.who.int/westernpacific Polio Bulletin 2024 Issue No. 7 - May 2024 (as of 4 June 2024) Figure 1. Non-polio AFP rate (per 100 000 persons < 15 years of age), 2022–2024 HIGHLIGHTS Figure 2. Adequate specimen collection rate, 2022–2024 Figure 3. Percentage of reported AFP cases by number of polio vaccination doses, 2024 Figure 4. Percentage of reported AFP cases with pending classification > 90 days after onset, 2024 0.0 1.0 2.0 3.0 4.0 5.0 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% CHN KHM LAO MYS PHL PNG VNM ≥ 3 doses 1-2 doses 0 doses Unknown 3.6% 0.0% 16.7% 0.0% 0.0% 0.0% 25.3% 0% 5% 10% 15% 20% 25% 30% VNM PNG PHL MYS LAO KHM CHN 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). 50 Years of Impact: how polio eradication and EPI demonstrate what is humanly possible The world immunization week was commemorated at the end of April 2024, reminding us of what humanity can achieve when efforts are made for collective health. Fifty years ago Essential Programme on Immunization (EPI) was launched in 1974 to expand national routine immunization services around the world and reduce the deaths and disabilities caused by common vaccine preventable diseases. Over the last 50 years, EPI has saved 154 million lives, reduced infant deaths by more than 40 percent, and protected millions from disability. Polio has been a part of EPI from the very beginning, and it will be essential for the polio eradication and EPI programmes to continue working together as we aim to achieve another eradication goal: ending polio once and for all. While polio eradication has very specific targets to achieve, the goals of the Global Polio Eradication Initiative (GPEI) and those linked to the EPI such as the Immunization Agenda 2030 share many similarities and ultimately depend on establishing and maintaining access to children who have not been regularly reached with any vaccines. A good example that has been critical success factor across regions, and around the world has been the exchange of workers between the polio and EPI programs. This exchange of human resources between programmes has led to a sharing of knowledge and experiences that has contributed to the achievements that we have seen in both programmes over the last half-century. For more infomation please visit: https://polioeradication.org/ CONTACT US 2021 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 63 48 81 0 0 0 81 0 0 (0.0%) 1.70 72% 100% 11-Apr-23 - Brunei Darussalam 2 1 2 0 0 0 2 0 0 (0.0%) 2.16 50% 100% 20-Feb-23 - Cambodia 5 48 35 0 0 0 35 0 0 (0.0%) 0.73 63% 100% 01-Feb-23 - China 4769 2362 4225 0 0 0 4225 0 0 (0.0%) 1.79 92% 99% 02-Apr-24 - China, Hong Kong SAR 9 8 6 0 0 0 6 0 0 (0.0%) 0.78 67% 100% 28-Nov-23 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.10 100% 100% 08-Mar-24 - Japan 0 148 41 0 0 0 40 1 0 (0.0%) 0.28 73% 98% 02-Jan-24 154 Lao People's Democratic Republic 20 23 28 0 0 0 28 0 0 (0.0%) 1.22 64% 68% 09-Oct-23 - Malaysia 111 80 212 0 0 0 212 0 0 (0.0%) 2.65 76% 83% 03-Apr-23 - Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 10-Nov-23 - New Zealand 9 10 23 0 0 0 23 0 0 (0.0%) 2.37 30% 100% 28-Nov-23 - Papua New Guinea 52 38 59 0 0 0 59 0 0 (0.0%) 1.53 69% 83% 10-Nov-23 - Philippines 894 327 853 0 0 0 853 0 0 (0.0%) 2.60 79% 0% 23-Nov-23 - Republic of Korea 35 60 57 0 0 0 57 0 0 (0.0%) 0.95 82% 98% 08-Mar-23 - Singapore 4 6 11 0 0 0 11 0 0 (0.0%) 1.91 82% 82% 01-Feb-23 - Viet Nam 162 250 238 0 0 0 238 0 0 (0.0%) 0.95 98% 65% 12-May-23 - Pacific island countries and areas 16 11 7 0 0 0 7 0 0 (0.0%) 0.64 71% 71% 08-Nov-22 - Total 6153 3430 5880 0 0 0 5879 1 0 (0.0%) 1.71 88% 82% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO > 90 days 1 # (%) Vaccine- derived poliovirus (VDPV) Polio- compatible Classification Pending Days since last report 5 % investigated ≤ 2 days of notification 3 Indicators Latest report date 4 2022 Non-polio AFP rate Total % with adequate specimens 2 Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Table 1A. Classification of AFP cases with onset in 2022 and key surveillance indicators 2 Polio Bulletin 2022 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 81 48 82 0 0 0 82 0 0 (0.0%) 1.72 63% 100% 26-Feb-24 - Brunei Darussalam 2 1 1 0 0 0 1 0 0 (0.0%) 1.08 100% 100% 18-Jan-24 - Cambodia 35 48 47 0 0 0 47 0 0 (0.0%) 0.99 89% 98% 07-Mar-24 - China 4225 1877 5649 0 0 0 4530 1119 1,119 (19.8%) 3.01 95% 99% 06-May-24 29 China, Hong Kong SAR 6 8 16 0 0 0 16 0 0 (0.0%) 2.07 81% 100% 19-Mar-24 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.04 100% 100% 08-Apr-24 - Japan 41 144 55 0 0 0 49 6 1 (1.8%) 0.38 55% 91% 20-Feb-24 105 Lao People's Democratic Republic 28 23 39 0 0 0 39 0 0 (0.0%) 1.70 87% 90% 23-May-24 - Malaysia 212 75 235 0 0 0 234 1 1 (0.4%) 3.11 84% 92% 19-Apr-24 46 Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 26-Jan-24 - New Zealand 23 10 10 0 0 0 10 0 0 (0.0%) 1.04 70% 90% 09-Apr-24 - Papua New Guinea 59 39 58 0 0 0 55 3 3 (5.2%) 1.47 60% 69% 04-Jun-24 0 Philippines 853 342 979 0 0 0 425 554 510 (52.1%) 2.86 68% 57% 11-Apr-24 54 Republic of Korea 57 57 51 0 0 0 51 0 0 (0.0%) 0.90 82% 100% 07-Mar-24 - Singapore 11 6 3 0 0 0 3 0 0 (0.0%) 0.52 100% 100% 03-Jan-24 - Viet Nam 238 222 280 0 0 0 280 0 0 (0.0%) 1.26 99% 87% 23-Apr-24 - Pacific island countries and areas 7 10 27 0 0 0 20 7 7 (25.9%) 2.59 56% 67% 06-May-24 29 Total 5880 2921 7534 0 0 0 5844 1690 1,641 (21.8%) 2.58 90% 93% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Days since last report 5 % investigated ≤ 2 days of notification 3 Indicators Latest report date4> 90 days 1 # (%) Total 2023 % with adequate specimens 2 Pending Classification Non-polio AFP rate Vaccine- derived poliovirus (VDPV) Polio- compatible Table 1B. Classification of AFP cases with onset in 2023 and key surveillance indicators 3 Polio Bulletin 2023 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 82 48 35 0 0 0 10 25 0 (0.0%) 1.73 63% 97% 03-Jun-24 1 Brunei Darussalam 1 1 0 - - - - - - 0.00 - - 20-Apr-24 45 Cambodia 47 48 11 0 0 0 0 11 0 (0.0%) 0.54 82% 100% 04-Jun-24 0 China 5649 1877 1155 0 0 0 129 1026 292 (25.3%) 1.45 94% 99% 29-Apr-24 36 China, Hong Kong SAR 16 8 4 0 0 0 3 1 0 (0.0%) 1.25 100% 100% 20-May-24 15 China, Macao SAR 1 1 1 0 0 0 0 1 0 (0.0%) 2.46 100% 100% 07-May-24 28 Japan 55 144 13 0 0 0 11 2 0 (0.0%) 0.21 69% 100% 27-May-24 8 Lao People's Democratic Republic 39 23 9 0 0 0 5 4 0 (0.0%) 0.93 89% 89% 23-May-24 12 Malaysia 235 75 82 0 0 0 68 14 0 (0.0%) 2.57 87% 49% 04-Jun-24 0 Mongolia 1 11 3 0 0 0 3 0 0 (0.0%) 0.65 100% 100% 03-Jun-24 1 New Zealand 10 10 2 0 0 0 2 0 0 (0.0%) 0.49 50% 50% 23-May-24 12 Papua New Guinea 58 41 8 0 0 0 5 3 0 (0.0%) 0.47 63% 38% 04-Jun-24 0 Philippines 979 344 180 0 0 0 0 180 30 (16.7%) 1.24 47% 98% 11-Apr-24 54 Republic of Korea 51 54 19 0 0 0 8 11 0 (0.0%) 0.83 68% 100% 04-Jun-24 0 Singapore 3 6 2 0 0 0 2 0 0 (0.0%) 81% 100% 100% 04-Jun-24 0 Viet Nam 280 222 28 0 0 0 13 15 1 (3.6%) 0.30 100% 96% 23-Apr-24 42 Pacific island countries and areas 27 11 0 - - - - - - 0.00 - - 04-Jun-24 0 Total 7534 2923 1552 0 0 0 259 1293 323 (20.8%) 1.26 86% 96% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Annualized non-polio AFP rate per 100 000 population under 15 years of age Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Substantially below target 4. Percentage of reported cases investigated within two days of notification 5. Countries are expected to submit data at least once per month to WPRO Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Days since last report 5 % investigated ≤ 2 days of notification 4 Indicators Latest report date> 90 days 1 # (%) Total 2024 % with adequate specimens 3 Pending Classification Non-polio AFP rate 2 Vaccine- derived poliovirus (VDPV) Polio- compatible Table 1C. Classification of AFP cases with onset in 2024 and key surveillance indicators 4 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 78 1 1 3 73 0 95% 3% 31-Jan-23 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 100% Brunei Darussalam VIDRL 2 0 0 0 2 0 100% 0% 16-Jan-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 35 1 0 2 32 0 97% 7% 31-Dec-22 NIID 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China (total) 4180 2 7 1 4170 0 98% 0.1% 02-Apr-24 20 0 12 0 0 0 0 0 8 0 0 0 0 100% China, Anhui Prov. Lab 268 0 0 0 268 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Beijing Prov. Lab 34 0 0 0 34 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 36 0 0 0 36 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 132 0 0 0 132 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 52 0 0 0 52 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 450 0 2 0 448 0 92% 0.2% Prov. Lab/CCDC 4 0 4 0 0 0 0 0 0 0 0 0 0 100% China, Guangxi Prov. Lab 216 0 0 1 215 0 100% 0.2% Prov. Lab/CCDC 3 0 2 0 0 0 0 0 1 0 0 0 0 100% China, Guizhou Prov. Lab 174 0 0 0 174 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hainan Prov. Lab 48 0 0 0 48 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 225 0 0 0 225 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 29 0 0 0 29 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 437 1 2 0 434 0 100% 0.2% Prov. Lab/CCDC 7 0 3 0 0 0 0 0 4 0 0 0 0 100% China, Hubei Prov. Lab 108 0 0 0 108 0 92% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 198 0 0 0 198 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 173 0 0 0 173 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 142 0 1 0 141 0 99% 0.4% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Jilin Prov. Lab 31 0 0 0 31 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 60 0 0 0 60 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 93 0 0 0 93 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ningxia Prov. Lab 12 0 0 0 12 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 6 0 0 0 6 0 67% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 71 0 0 0 71 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 243 0 0 0 243 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab 33 0 0 0 33 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 79 1 1 0 77 0 97% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Sichuan Prov. Lab 348 0 0 0 348 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tianjin Prov. Lab 11 0 0 0 11 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 88 0 1 0 87 0 100% 1% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Yunnan Prov. Lab 208 0 0 0 208 0 90% 0% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Zhejiang Prov. Lab 166 0 0 0 166 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 9 0 0 0 9 0 33% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 6 0 0 0 6 0 100% 0% 26-Jan-23 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 0 0 100% 0% 03-Jan-23 PHLC 0 - - - - - - - - - - - - - Japan NIID 36 0 0 0 36 0 97% 0% 01-May-23 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 28 0 0 2 26 0 96% 5% 10-Oct-23 NIID 0 - - - - - - - - - - - - - Malaysia IMR 219 0 0 4 215 0 91% 1% 15-Dec-23 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 06-Nov-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 15 0 0 2 12 0 100% 7% 16-Feb-23 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 57 1 1 4 51 0 81% 8% 14-Nov-23 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 100% Philippines RITM 829 5 1 63 760 0 98% 6% 05-Mar-24 RITM/NIID 19 0 8 0 0 0 0 0 11 0 0 0 0 100% Republic of Korea KDCA 57 0 0 7 50 0 82% 11% 19-Jan-23 KDCA 0 - - - - - - - - - - - - - Singapore SGH 11 0 0 0 11 0 95% 0% 11-Jan-23 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 155 0 0 26 129 0 100% 16% 15-Dec-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 79 0 0 5 74 0 100% 6% 09-Jan-23 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 7 0 0 1 6 0 85% 15% 24-Aug-22 VIDRL 0 - Total 5796 10 10 120 5654 0 97% 2% 47 0 20 0 0 0 0 0 21 0 6 0 0 100% 2. NPEV growing in L20B cells Sabin Pending ITDPending % results reported ≤ 14 days Wild Type 2 L20B positive + NPEV Wild Sabin % specimens positive for NPEV Latest report date VDPV 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Total no. of AFP cases with specimens NPEV only Discordant pending sequencing NPEV 2VDPV Country/area % ITD results reported ≤ 7 days of receipt Type 3 Polio laboratory 1 Type 1 Negative Results of virus isolation for AFP cases Results of intratypic differentiation (ITD)/sequencing for virus isolates L20B positive VDPV Table 2A. Laboratory investigation of stool samples from AFP cases with onset in 2022 and key laboratory indicators 5 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 77 0 2 2 73 0 94% 3% 05-Feb-24 VIDRL 2 0 0 0 0 0 0 0 0 0 2 0 0 100% Brunei Darussalam VIDRL 1 0 0 0 1 0 0% 0% 09-Oct-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 47 0 0 7 40 0 96% 14% 25-Dec-23 NIID 0 - - - - - - - - - - - - - China (total) 5621 0 19 0 5590 12 98% 0.2% 06-May-24 60 0 26 0 0 0 0 0 34 0 0 0 0 100% China, Anhui Prov. Lab 351 0 1 0 349 1 98% 0.1% Prov. Lab/CCDC 4 0 2 0 0 0 0 0 2 0 0 0 0 100% China, Beijing Prov. Lab 56 0 0 0 56 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 59 0 0 0 59 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 171 0 0 0 171 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 120 0 0 0 119 1 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 586 0 1 0 585 0 93% 0% Prov. Lab/CCDC 6 0 3 0 0 0 0 0 3 0 0 0 0 100% China, Guangxi Prov. Lab 252 0 3 0 249 0 99% 0.6% Prov. Lab/CCDC 8 0 2 0 0 0 0 0 6 0 0 0 0 100% China, Guizhou Prov. Lab 235 0 0 0 235 0 100% 0% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Hainan Prov. Lab 48 0 1 0 47 0 96% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Hebei Prov. Lab 334 0 0 0 334 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 69 0 0 0 69 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 688 0 6 0 680 2 100% 0.4% Prov. Lab/CCDC 18 0 10 0 0 0 0 0 8 0 0 0 0 100% China, Hubei Prov. Lab 152 0 0 0 152 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 287 0 0 0 283 4 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 217 0 0 0 217 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 182 0 0 0 182 0 91% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 43 0 0 0 43 0 100% 0% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Liaoning Prov. Lab 111 0 0 0 110 1 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 139 0 1 0 138 0 100% 0.4% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Ningxia Prov. Lab 26 0 0 0 26 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 9 0 0 0 9 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 83 0 0 0 81 2 76% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 287 0 0 0 286 1 100% 0% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Shanghai Prov. Lab 46 0 0 0 46 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 108 0 2 0 106 0 98% 1% Prov. Lab/CCDC 6 0 2 0 0 0 0 0 4 0 0 0 0 100% China, Sichuan Prov. Lab 358 0 1 0 357 0 98% 0.1% Prov. Lab/CCDC 4 0 3 0 0 0 0 0 1 0 0 0 0 100% China, Tianjin Prov. Lab 31 0 1 0 30 0 100% 2% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Xinjiang Prov. Lab 146 0 1 0 145 0 98% 0.3% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Yunnan Prov. Lab 208 0 0 0 208 0 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 198 0 1 0 197 0 99% 0.3% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Tibet Prov. Lab 21 0 0 0 21 0 95% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 14 0 0 0 14 0 97% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 40 0 0 4 36 0 92% 7% 21-Feb-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 39 0 0 1 23 15 100% 4% 21-May-24 NIID 2 0 0 0 0 0 0 0 2 0 0 0 0 100% Malaysia IMR 254 0 0 19 235 0 88% 7% 29-Apr-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 29-Dec-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 4 0 0 1 3 0 100% 18% 19-Feb-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 57 6 0 4 47 0 97% 8% 30-Apr-24 VIDRL 27 0 7 0 0 0 0 0 20 0 0 0 0 100% Philippines RITM 896 12 0 45 839 0 97% 8% 30-May-24 RITM/NIID 66 0 26 0 0 0 0 0 40 0 0 0 0 100% Republic of Korea KDCA 51 0 0 6 43 2 94% 12% 02-Feb-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 3 0 0 1 2 0 100% 33% 11-Jan-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 164 0 0 27 137 0 100% 16% 11-Jan-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 113 0 0 14 99 0 100% 12% 29-Jan-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 24 0 0 3 21 0 96% 9% 22-Jan-24 VIDRL 0 - - - - - - - - - - - - - Total 7407 18 21 134 7205 29 97% 2% 157 0 59 0 0 0 0 0 96 0 2 0 0 100% 2. NPEV growing in L20B cells Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin VDPVPending % specimens positive for NPEV Latest report date SabinWild 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only Table 2B. Laboratory investigation of stool samples from AFP cases with onset in 2023 and key laboratory indicators 6 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 30 0 1 1 21 7 84% 8% 03-Jun-24 VIDRL 1 0 0 0 0 0 0 0 0 0 1 0 0 100% Brunei Darussalam VIDRL 0 - - - - - - - 20-Apr-24 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 11 0 0 0 2 9 100% 0% 04-Jun-24 NIID 0 - - - - - - - - - - - - - China (total) 1136 4 0 0 1078 54 97% 0.0% 29-Apr-24 26 0 7 0 0 0 0 0 19 0 0 0 0 90% China, Anhui Prov. Lab 52 0 0 0 51 1 98% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Beijing Prov. Lab 10 0 0 0 8 2 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 12 0 0 0 10 2 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 29 0 0 0 19 10 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 17 0 0 0 17 0 82% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 98 0 0 0 92 6 94% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangxi Prov. Lab 55 1 0 0 53 1 94% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guizhou Prov. Lab 45 0 0 0 42 3 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hainan Prov. Lab 8 0 0 0 8 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 43 0 0 0 40 3 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 7 0 0 0 7 0 86% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 216 1 0 0 213 2 100% 0.0% Prov. Lab/CCDC 15 0 4 0 0 0 0 0 11 0 0 0 0 82% China, Hubei Prov. Lab 29 0 0 0 29 0 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 63 1 0 0 62 0 100% 0% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Jiangsu Prov. Lab 48 0 0 0 48 0 100% 0% Prov. Lab/CCDC 2 0 2 0 0 0 0 0 0 0 0 0 0 100% China, Jiangxi Prov. Lab 37 0 0 0 36 1 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 9 0 0 0 8 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 19 0 0 0 19 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 11 0 0 0 3 8 67% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ningxia Prov. Lab 6 1 0 0 5 0 100% 0% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Qinghai Prov. Lab 1 0 0 0 1 0 0% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 16 0 0 0 14 2 70% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 74 0 0 0 73 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab 8 0 0 0 8 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 22 0 0 0 20 2 90% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Sichuan Prov. Lab 74 0 0 0 73 1 95% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tianjin Prov. Lab 6 0 0 0 6 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 26 0 0 0 24 2 100% 0.0% Prov. Lab/CCDC 4 0 0 0 0 0 0 0 4 0 0 0 0 100% China, Yunnan Prov. Lab 41 0 0 0 35 6 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 53 0 0 0 53 0 98% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 1 0 0 0 1 0 100% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 4 0 0 0 4 0 100% 0% 30-May-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 30-May-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 11 0 0 0 11 0 100% 0% 22-May-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 9 0 0 1 4 4 100% 20% 23-May-24 NIID 0 - - - - - - - - - - - - - Malaysia IMR 75 0 0 7 68 0 100% 7% 03-Jun-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 3 0 0 0 3 0 100% 0% 10-May-24 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 2 0 0 1 1 0 100% 50% 04-Jun-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 8 1 2 0 5 0 100% 29% 23-May-24 VIDRL 4 0 1 0 0 0 0 0 1 0 2 0 0 67% Philippines RITM 305 3 1 19 256 26 99% 5% 04-Jun-24 RITM/NIID 0 - - - - - - - - - - - - - Republic of Korea KDCA 19 0 0 2 14 3 100% 13% 04-Jun-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 2 0 0 0 2 0 100% 0% 29-May-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 31 0 0 3 19 9 100% 14% 17-May-24 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 39 0 0 7 28 4 100% 20% 04-Jun-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 2 0 0 0 2 0 100% 0% 16-May-24 VIDRL 0 - - - - - - - - - - - - - Total 1688 8 4 41 1519 116 97% 2% 31 0 8 0 0 0 0 0 20 0 3 0 0 88% 2. NPEV growing in L20B cells Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens VDPV Pending % specimens positive for NPEV Latest report date SabinWild Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin Table 2C. Laboratory investigation of stool samples from AFP cases with onset in 2024 and key laboratory indicators 7 Polio Bulletin Table 3A. Laboratory confirmation of polio isolates from environmental samples in 20231 and key laboratory indicators 8 Polio Bulletin Table 3B. Laboratory confirmation of polio isolates from environmental samples in 20241 and key laboratory indicators 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); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); RITM (Research Institute for Tropical Medicine, Philippines); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 49 3 0 0 0 0 0 0 0 3 0 100% 0 0 Cambodia RITM 12 2 0 0 0 0 0 0 0 2 0 58% 0 0 China (total) 630 213 0 210 0 0 0 0 0 304 2 35% 0 0 China, Fujian Prov. Lab/CCDC 77 18 0 5 0 0 0 0 0 19 0 60% 0 0 China, Gansu Prov. Lab/CCDC 42 21 0 23 0 0 0 0 0 26 0 21% 0 0 China, Guangdong Prov. Lab/CCDC 48 30 0 20 0 0 0 0 0 41 0 52% 0 0 China, Guangxi Prov. Lab/CCDC 12 6 0 6 0 0 0 0 0 11 0 58% 0 0 China, Heilongjiang Prov. Lab/CCDC 24 11 0 12 0 0 0 0 0 30 0 17% 0 0 China, Jiangxi Prov. Lab/CCDC 34 9 0 6 0 0 0 0 0 6 1 65% 0 0 China, Jiangsu Prov. Lab/CCDC 124 10 0 4 0 0 0 0 0 6 0 5% 0 0 China, Liaoning Prov. Lab/CCDC 43 16 0 6 0 0 0 0 0 25 0 5% 0 0 China, Neimongol Prov. Lab/CCDC 20 8 0 15 0 0 0 0 0 13 0 0% 0 0 China, Ninxia Prov. Lab/CCDC 19 8 0 20 0 0 0 0 0 8 0 42% 0 0 China, Qinghai Prov. Lab/CCDC 14 3 0 3 0 0 0 0 0 2 0 14% 0 0 China, Shandong Prov. Lab/CCDC 36 16 0 10 0 0 0 0 0 27 0 36% 0 0 China, Shanghai Prov. Lab/CCDC 24 0 0 0 0 0 0 0 0 0 0 17% 0 0 China, Xinjiang Prov. Lab/CCDC 36 27 0 53 0 0 0 0 0 64 0 0% 0 0 China, Yunnan Prov. Lab/CCDC 37 22 0 25 0 0 0 0 0 18 0 92% 0 0 China, Zheijiang Prov. Lab/CCDC 40 8 0 2 0 0 0 0 0 8 1 70% 0 0 Lao PDR RITM 4 0 0 0 0 0 0 0 0 0 0 0% 0 0 Malaysia IMR/VIDRL 330 0 0 0 0 0 0 0 0 0 0 48% 3 0 New Zealand IESR 80 4 0 0 0 0 0 0 0 4 0 90% 0 0 Philippines RITM 616 37 0 17 0 0 0 0 0 44 0 15% 0 0 Viet Nam NIHE 124 0 0 0 0 0 0 0 0 0 0 2% 2 0 Total 1845 259 0 227 0 0 0 0 0 357 2 33% 5 0 NPEV (%) Pending ITD Discordant pending sequencingType 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 17 5 0 1 0 0 0 0 0 4 0 82% 2 0 Cambodia RITM 0 - - - - - - - - - - - - - China (total) 120 82 0 119 1 0 0 0 0 139 0 48% 2 0 China, Anui Prov. Lab/CCDC 16 16 0 33 0 0 0 0 0 26 0 100% 0 0 China, Fujian Prov. Lab/CCDC 16 7 0 3 0 0 0 0 0 4 0 44% 2 0 China, Gansu Prov. Lab/CCDC 16 8 0 9 0 0 0 0 0 14 0 50% 0 0 China, Guangdong Prov. Lab/CCDC 20 19 0 26 1 0 0 0 0 31 0 20% 0 0 China, Guangxi Prov. Lab/CCDC 4 3 0 1 0 0 0 0 0 2 0 75% 0 0 China, Heilongjiang Prov. Lab/CCDC 6 1 0 0 0 0 0 0 0 2 0 0% 0 0 China, Jiangxi Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab/CCDC 20 10 0 17 0 0 0 0 0 28 0 5% 0 0 China, Neimongol Prov. Lab/CCDC 6 6 0 0 0 0 0 0 0 14 0 100% 0 0 China, Ninxia Prov. Lab/CCDC 3 3 0 7 0 0 0 0 0 5 0 67% 0 0 China, Qinghai Prov. Lab/CCDC 4 3 0 4 0 0 0 0 0 5 0 75% 0 0 China, Shaanxi Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab/CCDC 9 6 0 13 0 0 0 0 0 8 0 67% 0 0 China, Shanghai Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Yunnan Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zheijiang Prov. Lab/CCDC 0 - - - - - - - - - - - - - Lao PDR RITM 0 - - - - - - - - - - - - - Malaysia IMR/VIDRL 0 - - - - - - - - - - - - - New Zealand IESR 28 1 0 0 0 0 0 0 0 1 0 93% 0 0 Philippines RITM 224 12 0 7 0 0 0 0 0 23 0 33% 11 0 Viet Nam NIHE 0 - - - - - - - - - - - - - Total 389 100 0 127 1 0 0 0 0 167 0 49% 13 0 NPEV (%) Pending ITD Discordant pending sequencingType 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates Figure 5A. China Figure 5B. Malaysia Figure 5C. Papua New Guinea Figure 5D. Philippines 1. Prefix letter refers to the VDPV category: “cVDPV” = circulating VDPV, “iVDPV” = immunodeficiency-associated VDPV, “aVDPV” = ambiguous VDPV. Suffix number refers to the poliovirus serotype (types 1, 2 or 3) 2. Community and healthy children 3. Contact of a different AFP case Vaccine-derived polio virus identified from laboratory testing, 2018–2023 0 2 4 6 8 10 12 14 16 cVDPV1 cVDPV2 cVDPV1 cVDPV2 aVDPV2 aVDPV3 2019 2020 N o. o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 45 cVDPV1 2018 No . of  ca ses /sp eci me ns 0 5 10 15 20 25 30 35 40 cVDPV1 cVDPV2 iVDPV2 aVDPV2 cVDPV2 aVDPV2 2019 2020 N o. o f c as es /s pe ci m en s 9 Polio Bulletin 0 1 2 3 4 5 cVDPV2 iVDPV3 aVDPV3 cVDPV2 aVDPV3 aVDPV1 cVDPV3 aVDPV3 aVDPV1 cVDPV3 aVDPV3 iVDPV3 aVDPV1 aVDPV1 aVDPV3 iVDPV3 aVDPV1 aVDPV3 2018 2019 2020 2021 2022 2023 2024 No . o f c as es /sp ec im en s

Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Phone: +63 2 8528 8001 Fax: +63 2 8521 1036, 8526 0279 Email: wproepidata@who.int Web: www.who.int/westernpacific Polio Bulletin 2024 Issue No. 8 - June 2024 (as of 2 July 2024) Figure 1. Non-polio AFP rate (per 100 000 persons < 15 years of age), 2022–2024 HIGHLIGHTS Figure 2. Adequate specimen collection rate, 2022–2024 Figure 3. Percentage of reported AFP cases by number of polio vaccination doses, 2024 Figure 4. Percentage of reported AFP cases with pending classification > 90 days after onset, 2024 0.0 1.0 2.0 3.0 4.0 5.0 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% CHN KHM LAO MYS PHL PNG VNM ≥ 3 doses 1-2 doses 0 doses Unknown 2.2% 7.7% 43.3% 0.0% 0.0% 0.0% 33.7% 0% 10% 20% 30% 40% 50% VNM PNG PHL MYS LAO KHM CHN 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). Recommencing Environmental Surveillance for poliovirus in Papua New Guinea In 2018, environmental surveillance sites were established in the cities of Port Moresby and Lae during a polio outbreak caused by cVDPV1. These surveillance sites were located in urban slum areas where population is at high risk for cVDPV transmission. Environmental sample collection was paused in mid-December 2019 but thanks to the great efforts of the National Department of Health (NDoH), Central Public Health Laboratory and other stakeholders, collection resumed in four sites in Port Moresby (Gerehu, Waigani, Joyce Bay, and Morata) in 12 June 2024. Samples collected were sent to the Research Institute for Tropical Medicine in Manila, Philippines for testing. Furthermore, NDOH also plans to resume collection in Lae, Morobe Province in second half of 2024. Resumption of environmental surveillance in Papua New Guinea will greatly contribute in maintaining the country’s polio-free status. CONTACT US 2021 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 63 48 81 0 0 0 81 0 0 (0.0%) 1.70 72% 100% 11-Apr-23 - Brunei Darussalam 2 1 2 0 0 0 2 0 0 (0.0%) 2.16 50% 100% 20-Feb-23 - Cambodia 5 48 35 0 0 0 35 0 0 (0.0%) 0.73 63% 100% 01-Feb-23 - China 4769 2362 4225 0 0 0 4225 0 0 (0.0%) 1.79 92% 99% 02-Apr-24 - China, Hong Kong SAR 9 8 6 0 0 0 6 0 0 (0.0%) 0.78 67% 100% 28-Nov-23 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.10 100% 100% 08-Mar-24 - Japan 0 148 41 0 0 0 40 1 0 (0.0%) 0.28 73% 98% 02-Jan-24 182 Lao People's Democratic Republic 20 23 28 0 0 0 28 0 0 (0.0%) 1.22 64% 68% 09-Oct-23 - Malaysia 111 80 212 0 0 0 212 0 0 (0.0%) 2.65 76% 83% 03-Apr-23 - Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 10-Nov-23 - New Zealand 9 10 23 0 0 0 23 0 0 (0.0%) 2.37 30% 100% 28-Nov-23 - Papua New Guinea 52 38 59 0 0 0 59 0 0 (0.0%) 1.53 69% 83% 10-Nov-23 - Philippines 894 327 853 0 0 0 853 0 0 (0.0%) 2.60 79% 0% 23-Nov-23 - Republic of Korea 35 60 57 0 0 0 57 0 0 (0.0%) 0.95 82% 98% 08-Mar-23 - Singapore 4 6 11 0 0 0 11 0 0 (0.0%) 1.91 82% 82% 01-Feb-23 - Viet Nam 162 250 238 0 0 0 238 0 0 (0.0%) 0.95 98% 65% 12-May-23 - Pacific island countries and areas 16 11 7 0 0 0 7 0 0 (0.0%) 0.64 71% 71% 08-Nov-22 - Total 6153 3430 5880 0 0 0 5879 1 0 (0.0%) 1.71 88% 82% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO Discarded (Non-polio) 2022 Non-polio AFP rate Total % with adequate specimens 2 Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus > 90 days 1 # (%) Vaccine- derived poliovirus (VDPV) Polio- compatible Classification Pending Days since last report 5 % investigated ≤  2 days of notification 3 Indicators Latest report date 4 Table 1A. Classification of AFP cases with onset in 2022 and key surveillance indicators 2 Polio Bulletin 2022 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 81 48 82 0 0 0 82 0 0 (0.0%) 1.72 63% 100% 26-Feb-24 - Brunei Darussalam 2 1 1 0 0 0 1 0 0 (0.0%) 1.08 100% 100% 18-Jan-24 - Cambodia 35 48 47 0 0 0 47 0 0 (0.0%) 0.99 89% 98% 07-Mar-24 - China 4225 1877 5649 0 0 0 4530 1119 1,119 (19.8%) 3.01 95% 99% 06-May-24 57 China, Hong Kong SAR 6 8 16 0 0 0 16 0 0 (0.0%) 2.07 81% 100% 19-Mar-24 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.04 100% 100% 08-Apr-24 - Japan 41 144 55 0 0 0 49 6 1 (1.8%) 0.38 55% 91% 20-Feb-24 133 Lao People's Democratic Republic 28 23 39 0 0 0 39 0 0 (0.0%) 1.70 87% 90% 23-May-24 - Malaysia 212 75 235 0 0 0 234 1 1 (0.4%) 3.11 84% 92% 19-Apr-24 74 Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 26-Jan-24 - New Zealand 23 10 10 0 0 0 10 0 0 (0.0%) 1.04 70% 90% 09-Apr-24 - Papua New Guinea 59 39 57 0 0 0 56 1 1 (1.8%) 1.44 61% 68% 20-Jun-24 12 Philippines 853 342 979 0 0 0 425 554 510 (52.1%) 2.86 68% 57% 11-Apr-24 82 Republic of Korea 57 57 51 0 0 0 51 0 0 (0.0%) 0.90 82% 100% 07-Jun-24 - Singapore 11 6 3 0 0 0 3 0 0 (0.0%) 0.52 100% 100% 03-Jan-24 - Viet Nam 238 222 280 0 0 0 280 0 0 (0.0%) 1.26 99% 87% 23-Apr-24 - Pacific island countries and areas 7 10 27 0 0 0 27 0 0 (0.0%) 2.59 56% 67% 12-Jun-24 - Total 5880 2921 7533 0 0 0 5852 1681 1,632 (21.7%) 2.58 90% 93% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO Total 2023 % with adequate specimens 2 Pending Classification Non-polio AFP rate Vaccine- derived poliovirus (VDPV) Polio- compatible Days since last report 5 % investigated ≤ 2 days of notification 3 Indicators Latest report date4> 90 days 1 # (%) Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Table 1B. Classification of AFP cases with onset in 2023 and key surveillance indicators 3 Polio Bulletin 2023 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 82 48 48 0 0 0 36 12 0 (0.0%) 1.93 52% 94% 01-Jul-24 1 Brunei Darussalam 1 1 1 0 0 0 0 1 0 (0.0%) 2.08 100% 100% 13-Jun-24 19 Cambodia 47 48 12 0 0 0 0 12 0 (0.0%) 0.48 83% 100% 24-Jun-24 8 China 5649 1877 2083 0 0 0 446 1637 702 (33.7%) 2.14 94% 99% 25-Jun-24 7 China, Hong Kong SAR 16 8 4 0 0 0 3 1 0 (0.0%) 1.02 100% 100% 20-May-24 43 China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 2.01 100% 100% 06-Jun-24 26 Japan 55 144 15 0 0 0 15 0 0 (0.0%) 0.20 73% 100% 01-Jul-24 1 Lao People's Democratic Republic 39 23 11 0 0 0 5 6 0 (0.0%) 0.93 91% 82% 27-Jun-24 5 Malaysia 235 75 82 0 0 0 68 14 0 (0.0%) 2.09 87% 49% 04-Jun-24 28 Mongolia 1 11 3 0 0 0 3 0 0 (0.0%) 0.53 100% 100% 03-Jun-24 29 New Zealand 10 10 3 0 0 0 2 1 0 (0.0%) 0.60 67% 67% 26-Jun-24 6 Papua New Guinea 58 41 13 0 0 0 8 5 1 (7.7%) 0.62 62% 31% 20-Jun-24 12 Philippines 979 344 395 0 0 0 34 361 171 (43.3%) 2.21 52% 99% 28-Jun-24 4 Republic of Korea 51 54 37 0 0 0 13 24 1 (2.7%) 1.32 73% 100% 27-Jun-24 5 Singapore 3 6 3 0 0 0 3 0 0 (0.0%) 99% 100% 100% 01-Jul-24 1 Viet Nam 280 222 93 0 0 0 37 56 2 (2.2%) 0.81 100% 65% 10-Jun-24 22 Pacific island countries and areas 27 11 6 0 0 0 0 6 1 (16.7%) 1.10 33% 83% 12-Jun-24 20 Total 7534 2923 2810 0 0 0 674 2136 878 (31.2%) 1.85 87% 96% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Annualized non-polio AFP rate per 100 000 population under 15 years of age Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Substantially below target 4. Percentage of reported cases investigated within two days of notification 5. Countries are expected to submit data at least once per month to WPRO Total 2024 % with adequate specimens 3 Pending Classification Non-polio AFP rate 2 Vaccine- derived poliovirus (VDPV) Polio- compatible Days since last report 5 % investigated ≤ 2 days of notification 4 Indicators Latest report date> 90 days 1 # (%) Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Table 1C. Classification of AFP cases with onset in 2024 and key surveillance indicators 4 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 78 1 1 3 73 0 95% 3% 31-Jan-23 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 100% Brunei Darussalam VIDRL 2 0 0 0 2 0 100% 0% 16-Jan-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 35 1 0 2 32 0 97% 7% 31-Dec-22 NIID 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China (total) 4180 2 7 1 4170 0 98% 0.1% 02-Apr-24 20 0 12 0 0 0 0 0 8 0 0 0 0 100% China, Anhui Prov. Lab 268 0 0 0 268 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Beijing Prov. Lab 34 0 0 0 34 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 36 0 0 0 36 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 132 0 0 0 132 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 52 0 0 0 52 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 450 0 2 0 448 0 92% 0.2% Prov. Lab/CCDC 4 0 4 0 0 0 0 0 0 0 0 0 0 100% China, Guangxi Prov. Lab 216 0 0 1 215 0 100% 0.2% Prov. Lab/CCDC 3 0 2 0 0 0 0 0 1 0 0 0 0 100% China, Guizhou Prov. Lab 174 0 0 0 174 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hainan Prov. Lab 48 0 0 0 48 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 225 0 0 0 225 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 29 0 0 0 29 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 437 1 2 0 434 0 100% 0.2% Prov. Lab/CCDC 7 0 3 0 0 0 0 0 4 0 0 0 0 100% China, Hubei Prov. Lab 108 0 0 0 108 0 92% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 198 0 0 0 198 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 173 0 0 0 173 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 142 0 1 0 141 0 99% 0.4% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Jilin Prov. Lab 31 0 0 0 31 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 60 0 0 0 60 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 93 0 0 0 93 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ningxia Prov. Lab 12 0 0 0 12 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 6 0 0 0 6 0 67% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 71 0 0 0 71 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 243 0 0 0 243 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab 33 0 0 0 33 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 79 1 1 0 77 0 97% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Sichuan Prov. Lab 348 0 0 0 348 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tianjin Prov. Lab 11 0 0 0 11 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 88 0 1 0 87 0 100% 1% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Yunnan Prov. Lab 208 0 0 0 208 0 90% 0% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Zhejiang Prov. Lab 166 0 0 0 166 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 9 0 0 0 9 0 33% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 6 0 0 0 6 0 100% 0% 26-Jan-23 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 0 0 100% 0% 03-Jan-23 PHLC 0 - - - - - - - - - - - - - Japan NIID 36 0 0 0 36 0 97% 0% 01-May-23 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 28 0 0 2 26 0 96% 5% 10-Oct-23 NIID 0 - - - - - - - - - - - - - Malaysia IMR 219 0 0 4 215 0 91% 1% 15-Dec-23 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 06-Nov-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 15 0 0 2 12 0 100% 7% 16-Feb-23 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 57 1 1 4 51 0 81% 8% 14-Nov-23 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 100% Philippines RITM 829 5 1 63 760 0 98% 6% 05-Mar-24 RITM/NIID 19 0 8 0 0 0 0 0 11 0 0 0 0 100% Republic of Korea KDCA 57 0 0 7 50 0 82% 11% 19-Jan-23 KDCA 0 - - - - - - - - - - - - - Singapore SGH 11 0 0 0 11 0 95% 0% 11-Jan-23 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 155 0 0 26 129 0 100% 16% 15-Dec-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 79 0 0 5 74 0 100% 6% 09-Jan-23 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 7 0 0 1 6 0 85% 15% 24-Aug-22 VIDRL 0 - Total 5796 10 10 120 5654 0 97% 2% 47 0 20 0 0 0 0 0 21 0 6 0 0 100% 2. NPEV growing in L20B cells Sabin Pending ITDPending % results reported ≤ 14 days Wild Type 2 L20B positive + NPEV Wild Sabin % specimens positive for NPEV Latest report date VDPV 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Total no. of AFP cases with specimens NPEV only Discordant pending sequencing NPEV 2VDPV Country/area % ITD results reported ≤ 7 days of receipt Type 3 Polio laboratory 1 Type 1 Negative Results of virus isolation for AFP cases Results of intratypic differentiation (ITD)/sequencing for virus isolates L20B positive VDPV Table 2A. Laboratory investigation of stool samples from AFP cases with onset in 2022 and key laboratory indicators 5 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 77 0 2 2 73 0 94% 3% 05-Feb-24 VIDRL 2 0 0 0 0 0 0 0 0 0 2 0 0 100% Brunei Darussalam VIDRL 1 0 0 0 1 0 0% 0% 09-Oct-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 47 0 0 7 40 0 96% 14% 25-Dec-23 NIID 0 - - - - - - - - - - - - - China (total) 5621 0 19 0 5590 12 98% 0.2% 06-May-24 60 0 26 0 0 0 0 0 34 0 0 0 0 100% China, Anhui Prov. Lab 351 0 1 0 349 1 98% 0.1% Prov. Lab/CCDC 4 0 2 0 0 0 0 0 2 0 0 0 0 100% China, Beijing Prov. Lab 56 0 0 0 56 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 59 0 0 0 59 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 171 0 0 0 171 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 120 0 0 0 119 1 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 586 0 1 0 585 0 93% 0% Prov. Lab/CCDC 6 0 3 0 0 0 0 0 3 0 0 0 0 100% China, Guangxi Prov. Lab 252 0 3 0 249 0 99% 0.6% Prov. Lab/CCDC 8 0 2 0 0 0 0 0 6 0 0 0 0 100% China, Guizhou Prov. Lab 235 0 0 0 235 0 100% 0% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Hainan Prov. Lab 48 0 1 0 47 0 96% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Hebei Prov. Lab 334 0 0 0 334 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 69 0 0 0 69 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 688 0 6 0 680 2 100% 0.4% Prov. Lab/CCDC 18 0 10 0 0 0 0 0 8 0 0 0 0 100% China, Hubei Prov. Lab 152 0 0 0 152 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 287 0 0 0 283 4 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 217 0 0 0 217 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 182 0 0 0 182 0 91% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 43 0 0 0 43 0 100% 0% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Liaoning Prov. Lab 111 0 0 0 110 1 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 139 0 1 0 138 0 100% 0.4% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Ningxia Prov. Lab 26 0 0 0 26 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 9 0 0 0 9 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 83 0 0 0 81 2 76% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 287 0 0 0 286 1 100% 0% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Shanghai Prov. Lab 46 0 0 0 46 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 108 0 2 0 106 0 98% 1% Prov. Lab/CCDC 6 0 2 0 0 0 0 0 4 0 0 0 0 100% China, Sichuan Prov. Lab 358 0 1 0 357 0 98% 0.1% Prov. Lab/CCDC 4 0 3 0 0 0 0 0 1 0 0 0 0 100% China, Tianjin Prov. Lab 31 0 1 0 30 0 100% 2% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Xinjiang Prov. Lab 146 0 1 0 145 0 98% 0.3% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Yunnan Prov. Lab 208 0 0 0 208 0 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 198 0 1 0 197 0 99% 0.3% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Tibet Prov. Lab 21 0 0 0 21 0 95% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 14 0 0 0 14 0 97% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 40 0 0 4 36 0 92% 7% 21-Feb-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 39 0 0 1 23 15 100% 4% 21-May-24 NIID 2 0 0 0 0 0 0 0 2 0 0 0 0 100% Malaysia IMR 254 0 0 19 235 0 88% 7% 29-Apr-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 29-Dec-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 4 0 0 1 3 0 100% 18% 19-Feb-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 57 6 0 4 47 0 97% 8% 30-Apr-24 VIDRL 27 0 7 0 0 0 0 0 20 0 0 0 0 100% Philippines RITM 892 13 0 44 834 0 97% 4% 11-Jun-24 RITM/NIID 66 0 26 0 0 0 0 0 40 0 0 0 0 100% Republic of Korea KDCA 51 0 0 6 43 2 94% 12% 07-Jun-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 3 0 0 1 2 0 100% 33% 11-Jan-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 164 0 0 27 137 0 100% 16% 11-Jan-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 113 0 0 14 99 0 100% 12% 29-Jan-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 24 0 0 3 21 0 96% 9% 22-Jan-24 VIDRL 0 - - - - - - - - - - - - - Total 7403 19 21 133 7200 29 97% 2% 157 0 59 0 0 0 0 0 96 0 2 0 0 100% 2. NPEV growing in L20B cells Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin VDPVPending % specimens positive for NPEV Latest report date SabinWild 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only Table 2B. Laboratory investigation of stool samples from AFP cases with onset in 2023 and key laboratory indicators 6 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 37 0 2 2 30 3 86% 9% 01-Jul-24 VIDRL 2 0 0 0 0 0 0 0 0 0 2 0 0 100% Brunei Darussalam VIDRL 1 0 0 0 1 0 100% 0% 12-Jun-24 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 12 0 0 0 2 10 100% 0% 24-Jun-24 NIID 0 - - - - - - - - - - - - - China (total) 2062 0 8 0 1938 116 97% 0.2% 25-Jun-24 26 0 7 0 0 0 0 0 19 0 0 0 0 81% China, Anhui Prov. Lab 104 0 0 0 104 0 98% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Beijing Prov. Lab 16 0 0 0 15 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 18 0 0 0 16 2 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 63 0 0 0 24 39 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 32 0 0 0 32 0 91% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 186 0 0 0 184 2 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangxi Prov. Lab 114 0 1 0 112 1 89% 0.4% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guizhou Prov. Lab 92 0 0 0 89 3 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hainan Prov. Lab 19 0 0 0 16 3 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 111 0 0 0 104 7 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 14 0 0 0 13 1 92% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 354 0 3 0 348 3 100% 0.4% Prov. Lab/CCDC 15 0 4 0 0 0 0 0 11 0 0 0 0 73% China, Hubei Prov. Lab 67 0 0 0 51 16 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 114 0 1 0 113 0 100% 0% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Jiangsu Prov. Lab 81 0 1 0 79 1 100% 1% Prov. Lab/CCDC 2 0 2 0 0 0 0 0 0 0 0 0 0 100% China, Jiangxi Prov. Lab 64 0 0 0 64 0 91% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 19 0 0 0 19 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 28 0 0 0 28 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 24 0 0 0 24 0 96% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ningxia Prov. Lab 10 0 1 0 9 0 100% 5% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Qinghai Prov. Lab 4 0 0 0 4 0 75% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 35 0 0 0 31 4 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 114 0 0 0 99 15 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab 10 0 0 0 10 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 35 0 0 0 33 2 94% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Sichuan Prov. Lab 114 0 0 0 113 1 96% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tianjin Prov. Lab 10 0 0 0 10 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 42 0 1 0 39 2 100% 1.3% Prov. Lab/CCDC 4 0 0 0 0 0 0 0 4 0 0 0 0 75% China, Yunnan Prov. Lab 90 0 0 0 79 11 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 74 0 0 0 72 2 99% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 4 0 0 0 4 0 100% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 4 0 0 0 4 0 100% 0% 25-Jun-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 25-Jun-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 15 0 0 0 13 2 100% 0% 01-Jul-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 11 0 0 1 4 6 100% 20% 25-Jun-24 NIID 0 - - - - - - - - - - - - - Malaysia IMR 105 0 0 10 95 0 100% 7% 28-Jun-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 3 0 0 0 3 0 100% 0% 10-Jun-24 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 3 0 0 1 1 1 100% 50% 27-Jun-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 13 1 2 0 5 5 100% 29% 07-Jun-24 VIDRL 4 0 1 0 0 0 0 0 1 0 2 0 0 50% Philippines RITM 362 4 1 25 320 11 99% 6% 01-Jul-24 RITM/NIID 0 - - - - - - - - - - - - - Republic of Korea KDCA 37 0 0 5 23 9 100% 13% 27-Jun-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 3 0 0 0 3 0 100% 0% 25-Jun-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 81 0 0 17 49 15 100% 25% 28-Jun-24 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 44 0 0 8 35 1 100% 19% 01-Jul-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 2 0 0 0 2 0 100% 0% 16-May-24 VIDRL 0 - - - - - - - - - - - - - Total 2796 5 13 69 2529 179 98% 3% 32 0 8 0 0 0 0 0 20 0 4 0 0 67% 2. NPEV growing in L20B cells Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens VDPV Pending % specimens positive for NPEV Latest report date SabinWild Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin Table 2C. Laboratory investigation of stool samples from AFP cases with onset in 2024 and key laboratory indicators 7 Polio Bulletin Table 3A. Laboratory confirmation of polio isolates from environmental samples in 20231 and key laboratory indicators 8 Polio Bulletin Table 3B. Laboratory confirmation of polio isolates from environmental samples in 20241 and key laboratory indicators 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); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); RITM (Research Institute for Tropical Medicine, Philippines); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 49 3 0 0 0 0 0 0 0 3 0 100% 0 0 Cambodia RITM 12 2 0 0 0 0 0 0 0 2 0 58% 0 0 China (total) 630 213 0 210 0 0 0 0 0 304 2 35% 0 0 China, Fujian Prov. Lab/CCDC 77 18 0 5 0 0 0 0 0 19 0 60% 0 0 China, Gansu Prov. Lab/CCDC 42 21 0 23 0 0 0 0 0 26 0 21% 0 0 China, Guangdong Prov. Lab/CCDC 48 30 0 20 0 0 0 0 0 41 0 52% 0 0 China, Guangxi Prov. Lab/CCDC 12 6 0 6 0 0 0 0 0 11 0 58% 0 0 China, Heilongjiang Prov. Lab/CCDC 24 11 0 12 0 0 0 0 0 30 0 17% 0 0 China, Jiangxi Prov. Lab/CCDC 34 9 0 6 0 0 0 0 0 6 1 65% 0 0 China, Jiangsu Prov. Lab/CCDC 124 10 0 4 0 0 0 0 0 6 0 5% 0 0 China, Liaoning Prov. Lab/CCDC 43 16 0 6 0 0 0 0 0 25 0 5% 0 0 China, Neimongol Prov. Lab/CCDC 20 8 0 15 0 0 0 0 0 13 0 0% 0 0 China, Ninxia Prov. Lab/CCDC 19 8 0 20 0 0 0 0 0 8 0 42% 0 0 China, Qinghai Prov. Lab/CCDC 14 3 0 3 0 0 0 0 0 2 0 14% 0 0 China, Shandong Prov. Lab/CCDC 36 16 0 10 0 0 0 0 0 27 0 36% 0 0 China, Shanghai Prov. Lab/CCDC 24 0 0 0 0 0 0 0 0 0 0 17% 0 0 China, Xinjiang Prov. Lab/CCDC 36 27 0 53 0 0 0 0 0 64 0 0% 0 0 China, Yunnan Prov. Lab/CCDC 37 22 0 25 0 0 0 0 0 18 0 92% 0 0 China, Zheijiang Prov. Lab/CCDC 40 8 0 2 0 0 0 0 0 8 1 70% 0 0 Lao PDR RITM 4 0 0 0 0 0 0 0 0 0 0 0% 0 0 Malaysia IMR/VIDRL 330 0 0 0 0 0 0 0 0 0 0 48% 3 0 New Zealand IESR 80 4 0 0 0 0 0 0 0 4 0 90% 0 0 Philippines RITM 616 37 0 17 0 0 0 0 0 44 0 15% 0 0 Viet Nam NIHE 124 0 0 0 0 0 0 0 0 0 0 2% 2 0 Total 1845 259 0 227 0 0 0 0 0 357 2 33% 5 0 NPEV (%) Pending ITD Discordant pending sequencingType 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 17 5 0 1 0 0 0 0 0 4 0 82% 2 0 Cambodia RITM 0 - - - - - - - - - - - - - China (total) 120 82 0 119 1 0 0 0 0 139 0 48% 2 0 China, Anui Prov. Lab/CCDC 16 16 0 33 0 0 0 0 0 26 0 100% 0 0 China, Fujian Prov. Lab/CCDC 16 7 0 3 0 0 0 0 0 4 0 44% 2 0 China, Gansu Prov. Lab/CCDC 16 8 0 9 0 0 0 0 0 14 0 50% 0 0 China, Guangdong Prov. Lab/CCDC 20 19 0 26 1 0 0 0 0 31 0 20% 0 0 China, Guangxi Prov. Lab/CCDC 4 3 0 1 0 0 0 0 0 2 0 75% 0 0 China, Heilongjiang Prov. Lab/CCDC 6 1 0 0 0 0 0 0 0 2 0 0% 0 0 China, Jiangxi Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab/CCDC 20 10 0 17 0 0 0 0 0 28 0 5% 0 0 China, Neimongol Prov. Lab/CCDC 6 6 0 0 0 0 0 0 0 14 0 100% 0 0 China, Ninxia Prov. Lab/CCDC 3 3 0 7 0 0 0 0 0 5 0 67% 0 0 China, Qinghai Prov. Lab/CCDC 4 3 0 4 0 0 0 0 0 5 0 75% 0 0 China, Shaanxi Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab/CCDC 9 6 0 13 0 0 0 0 0 8 0 67% 0 0 China, Shanghai Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Yunnan Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zheijiang Prov. Lab/CCDC 0 - - - - - - - - - - - - - Lao PDR RITM 0 - - - - - - - - - - - - - Malaysia IMR/VIDRL 0 - - - - - - - - - - - - - New Zealand IESR 28 1 0 0 0 0 0 0 0 1 0 93% 0 0 Philippines RITM 273 18 0 7 0 0 0 0 0 24 0 30% 20 0 Viet Nam NIHE 0 - - - - - - - - - - - - - Total 438 106 0 127 1 0 0 0 0 168 0 41% 24 0 Pending ITD Discordant pending sequencingType 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates NPEV (%) Figure 5A. China Figure 5B. Malaysia Figure 5C. Papua New Guinea Figure 5D. Philippines 1. Prefix letter refers to the VDPV category: “cVDPV” = circulating VDPV, “iVDPV” = immunodeficiency-associated VDPV, “aVDPV” = ambiguous VDPV. Suffix number refers to the poliovirus serotype (types 1, 2 or 3) 2. Community and healthy children 3. Contact of a different AFP case Vaccine-derived polio virus identified from laboratory testing, 2018–2023 0 2 4 6 8 10 12 14 16 cVDPV1 cVDPV2 cVDPV1 cVDPV2 aVDPV2 aVDPV3 2019 2020 N o. o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 45 cVDPV1 2018 N o.  o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 cVDPV1 cVDPV2 iVDPV2 aVDPV2 cVDPV2 aVDPV2 2019 2020 N o. o f c as es /s pe ci m en s 9 Polio Bulletin 0 1 2 3 4 5 cVDPV2 iVDPV3 aVDPV3 cVDPV2 aVDPV3 aVDPV1 cVDPV3 aVDPV3 aVDPV1 cVDPV3 aVDPV3 iVDPV3 aVDPV1 aVDPV1 aVDPV3 iVDPV3 aVDPV1 aVDPV3 2018 2019 2020 2021 2022 2023 2024 N o .  o f  ca se s/ sp e ci m e n s

Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Phone: +63 2 8528 8001 Fax: +63 2 8521 1036, 8526 0279 Email: wproepidata@who.int Web: www.who.int/westernpacific Polio Bulletin 2024 Issue No. 8 - July 2024 (as of 1 August 2024) Figure 1. Non-polio AFP rate (per 100 000 persons < 15 years of age), 2022–2024 HIGHLIGHTS Figure 2. Adequate specimen collection rate, 2022–2024 Figure 3. Percentage of reported AFP cases by number of polio vaccination doses, 2024 Figure 4. Percentage of reported AFP cases with pending classification > 90 days after onset, 2024 0.0 1.0 2.0 3.0 4.0 5.0 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% CHN KHM LAO MYS PHL PNG VNM ≥ 3 doses 1-2 doses 0 doses Unknown 5.6% 10.5% 17.6% 0.0% 0.0% 7.1% 33.7% 0% 5% 10% 15% 20% 25% 30% 35% 40% VNM PNG PHL MYS LAO KHM CHN 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). Team End Polio: One Team, One Dream On July 30, 2024, the Global Polio Eradication Initiative (GPEI) launched the inspiring “Team End Polio” campaign. This remarkable initiative brings together athletes, global leaders, and passionate advocates, all rallying to raise awareness and work tirelessly toward permanently eradicating polio. Over the past three decades, collaborative efforts have dramatically reduced polio cases by 99.9%, preventing over 20 million cases of paralysis. Despite this progress, the final push remains challenging. Team End Polio calls on supporters worldwide to unite behind a polio-free future and eradicate this disease once and for all. For more details: https://polioeradication.org/ news-post/team-end-polio-one-team-one-dream/ CONTACT US 2022 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 81 48 82 0 0 0 82 0 0 (0.0%) 1.72 63% 100% 26-Feb-24 - Brunei Darussalam 2 1 1 0 0 0 1 0 0 (0.0%) 1.08 100% 100% 18-Jan-24 - Cambodia 35 48 47 0 0 0 47 0 0 (0.0%) 0.99 89% 98% 07-Mar-24 - China 4225 1877 5606 0 0 0 5606 0 0 (0.0%) 2.99 95% 99% 21-Jul-24 - China, Hong Kong SAR 6 8 16 0 0 0 16 0 0 (0.0%) 2.07 81% 100% 19-Mar-24 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.04 100% 100% 08-Apr-24 - Japan 41 144 55 0 0 0 49 6 1 (1.8%) 0.38 55% 91% 20-Feb-24 163 Lao People's Democratic Republic 28 23 39 0 0 0 39 0 0 (0.0%) 1.70 87% 90% 23-May-24 - Malaysia 212 75 235 0 0 0 235 0 0 (0.0%) 3.11 84% 92% 22-Jul-24 - Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 26-Jan-24 - New Zealand 23 10 10 0 0 0 10 0 0 (0.0%) 1.04 70% 90% 09-Apr-24 - Papua New Guinea 59 39 57 0 0 0 56 1 1 (1.8%) 1.44 63% 70% 31-Jul-24 1 Philippines 853 342 979 0 0 0 425 554 510 (52.1%) 2.86 68% 57% 11-Apr-24 112 Republic of Korea 57 57 51 0 0 0 51 0 0 (0.0%) 0.90 82% 100% 08-Jul-24 - Singapore 11 6 3 0 0 0 3 0 0 (0.0%) 0.52 100% 100% 03-Jan-24 - Viet Nam 238 222 280 0 0 0 280 0 0 (0.0%) 1.26 99% 87% 23-Apr-24 - Pacific island countries and areas 7 10 27 0 0 0 27 0 0 (0.0%) 2.59 56% 67% 12-Jun-24 - Total 5880 2921 7490 0 0 0 6929 561 512 (6.8%) 2.56 90% 93% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Days since last report 5 % investigated ≤ 2 days of notification 3 Indicators Latest report date4> 90 days 1 # (%) Total 2023 % with adequate specimens 2 Pending Classification Non-polio AFP rate Vaccine- derived poliovirus (VDPV) Polio- compatible Table 1A. Classification of AFP cases with onset in 2023 and key surveillance indicators 3 Polio Bulletin 2023 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 82 48 58 0 0 0 36 22 0 (0.0%) 2.03 57% 95% 31-Jul-24 1 Brunei Darussalam 1 1 1 0 0 0 0 1 0 (0.0%) 1.81 100% 100% 13-Jun-24 49 Cambodia 47 48 14 0 0 0 2 12 1 (7.1%) 0.49 86% 100% 30-Jul-24 2 China 5606 1877 2083 0 0 0 446 1637 702 (33.7%) 1.86 94% 99% 25-Jun-24 37 China, Hong Kong SAR 16 8 5 0 0 0 4 1 0 (0.0%) 1.11 100% 100% 31-Jul-24 1 China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.75 100% 100% 03-Jul-24 29 Japan 55 144 19 0 0 0 17 2 0 (0.0%) 0.22 68% 100% 29-Jul-24 3 Lao People's Democratic Republic 39 23 13 0 0 0 5 8 0 (0.0%) 0.95 92% 85% 30-Jul-24 2 Malaysia 235 75 126 0 0 0 105 21 0 (0.0%) 2.80 90% 79% 22-Jul-24 10 Mongolia 1 11 3 0 0 0 3 0 0 (0.0%) 0.46 100% 100% 03-Jun-24 59 New Zealand 10 10 4 0 0 0 2 2 0 (0.0%) 0.69 50% 50% 25-Jul-24 7 Papua New Guinea 57 41 19 0 0 0 8 11 2 (10.5%) 0.79 53% 32% 31-Jul-24 1 Philippines 979 344 495 0 0 0 263 232 87 (17.6%) 2.41 50% 99% 30-Jul-24 2 Republic of Korea 51 54 44 0 0 0 15 29 1 (2.3%) 1.36 75% 100% 29-Jul-24 3 Singapore 3 6 3 0 0 0 3 0 0 (0.0%) 86% 100% 100% 01-Jul-24 31 Viet Nam 280 222 124 0 0 0 46 78 7 (5.6%) 0.94 100% 60% 09-Jul-24 23 Pacific island countries and areas 27 11 6 0 0 0 0 6 1 (16.7%) 0.96 33% 83% 12-Jun-24 50 Total 7490 2923 3018 0 0 0 956 2062 801 (26.5%) 1.73 85% 96% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Annualized non-polio AFP rate per 100 000 population under 15 years of age Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Substantially below target 4. Percentage of reported cases investigated within two days of notification 5. Countries are expected to submit data at least once per month to WPRO Total 2024 % with adequate specimens 3 Pending Classification Non-polio AFP rate 2 Vaccine- derived poliovirus (VDPV) Polio- compatible Days since last report 5 % investigated ≤ 2 days of notification 4 Indicators Latest report date> 90 days 1 # (%) Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Table 1B. Classification of AFP cases with onset in 2024 and key surveillance indicators 4 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 77 0 2 2 73 0 94% 3% 05-Feb-24 VIDRL 2 0 0 0 0 0 0 0 0 0 2 0 0 100% Brunei Darussalam VIDRL 1 0 0 0 1 0 0% 0% 09-Oct-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 47 0 0 7 40 0 96% 14% 25-Dec-23 NIID 0 - - - - - - - - - - - - - China (total) 5580 0 19 0 5561 0 98% 0.2% 21-Jul-24 60 0 26 0 0 0 0 0 34 0 0 0 0 100% China, Anhui Prov. Lab 342 0 1 0 341 0 98% 0.1% Prov. Lab/CCDC 4 0 2 0 0 0 0 0 2 0 0 0 0 100% China, Beijing Prov. Lab 56 0 0 0 56 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 59 0 0 0 59 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 171 0 0 0 171 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 111 0 0 0 111 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 586 0 1 0 585 0 93% 0% Prov. Lab/CCDC 6 0 3 0 0 0 0 0 3 0 0 0 0 100% China, Guangxi Prov. Lab 252 0 3 0 249 0 99% 0.6% Prov. Lab/CCDC 8 0 2 0 0 0 0 0 6 0 0 0 0 100% China, Guizhou Prov. Lab 235 0 0 0 235 0 100% 0% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Hainan Prov. Lab 48 0 1 0 47 0 96% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Hebei Prov. Lab 333 0 0 0 333 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 69 0 0 0 69 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 688 0 6 0 682 0 100% 0.4% Prov. Lab/CCDC 18 0 10 0 0 0 0 0 8 0 0 0 0 100% China, Hubei Prov. Lab 151 0 0 0 151 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 287 0 0 0 287 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 217 0 0 0 217 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 182 0 0 0 182 0 91% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 43 0 0 0 43 0 100% 0% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Liaoning Prov. Lab 102 0 0 0 102 0 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 139 0 1 0 138 0 100% 0.4% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Ningxia Prov. Lab 23 0 0 0 23 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 9 0 0 0 9 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 74 0 0 0 74 0 74% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 287 0 0 0 287 0 100% 0% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Shanghai Prov. Lab 46 0 0 0 46 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 108 0 2 0 106 0 98% 1% Prov. Lab/CCDC 6 0 2 0 0 0 0 0 4 0 0 0 0 100% China, Sichuan Prov. Lab 358 0 1 0 357 0 98% 0.1% Prov. Lab/CCDC 4 0 3 0 0 0 0 0 1 0 0 0 0 100% China, Tianjin Prov. Lab 31 0 1 0 30 0 100% 2% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Xinjiang Prov. Lab 146 0 1 0 145 0 98% 0.3% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Yunnan Prov. Lab 208 0 0 0 208 0 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 198 0 1 0 197 0 99% 0.3% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Tibet Prov. Lab 21 0 0 0 21 0 95% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 15 0 0 0 15 0 97% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 49 0 0 4 45 0 91% 7% 21-Feb-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 39 1 0 1 37 0 100% 3% 21-May-24 NIID 2 0 0 0 0 0 0 0 2 0 0 0 0 100% Malaysia IMR 254 0 0 19 235 0 88% 7% 29-Apr-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 29-Dec-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 7 0 0 1 6 0 100% 18% 19-Feb-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 57 6 0 3 47 1 97% 6% 24-Jul-24 VIDRL 27 0 7 0 0 0 0 0 20 0 0 0 0 100% Philippines RITM 891 13 0 44 833 1 97% 4% 11-Jun-24 RITM/NIID 66 0 26 0 0 0 0 0 40 0 0 0 0 100% Republic of Korea KDCA 51 0 0 6 43 2 99% 12% 08-Jul-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 3 0 0 1 2 0 100% 33% 11-Jan-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 164 0 0 27 137 0 100% 16% 11-Jan-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 113 0 0 14 99 0 100% 12% 29-Jan-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 24 0 0 3 21 0 96% 9% 22-Jan-24 VIDRL 0 - - - - - - - - - - - - - Total 7374 20 21 132 7197 4 97% 2% 157 0 59 0 0 0 0 0 96 0 2 0 0 100% 2. NPEV growing in L20B cells Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens VDPV Pending % specimens positive for NPEV Latest report date SabinWild Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin Table 2A. Laboratory investigation of stool samples from AFP cases with onset in 2023 and key laboratory indicators 6 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 48 0 2 3 37 6 88% 8% 31-Jul-24 VIDRL 2 0 0 0 0 0 0 0 0 0 2 0 0 100% Brunei Darussalam VIDRL 1 0 0 0 1 0 100% 0% 12-Jun-24 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 14 0 0 0 12 2 17% 0% 30-Jul-24 NIID 0 - - - - - - - - - - - - - China (total) 2062 0 8 0 1938 116 97% 0.2% 25-Jun-24 31 0 10 0 0 0 0 0 21 0 0 0 0 84% China, Anhui Prov. Lab 104 0 0 0 104 0 98% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Beijing Prov. Lab 16 0 0 0 15 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 18 0 0 0 16 2 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 63 0 0 0 24 39 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 32 0 0 0 32 0 91% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 186 0 0 0 184 2 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangxi Prov. Lab 114 0 1 0 112 1 89% 0.4% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guizhou Prov. Lab 92 0 0 0 89 3 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hainan Prov. Lab 19 0 0 0 16 3 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 111 0 0 0 104 7 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 14 0 0 0 13 1 92% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 354 0 3 0 348 3 100% 0.4% Prov. Lab/CCDC 20 0 7 0 0 0 0 0 13 0 0 0 0 73% China, Hubei Prov. Lab 67 0 0 0 51 16 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 114 0 1 0 113 0 100% 0% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Jiangsu Prov. Lab 81 0 1 0 79 1 100% 1% Prov. Lab/CCDC 2 0 2 0 0 0 0 0 0 0 0 0 0 100% China, Jiangxi Prov. Lab 64 0 0 0 64 0 91% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 19 0 0 0 19 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 28 0 0 0 28 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 24 0 0 0 24 0 96% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ningxia Prov. Lab 10 0 1 0 9 0 100% 5% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Qinghai Prov. Lab 4 0 0 0 4 0 75% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 35 0 0 0 31 4 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 114 0 0 0 99 15 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab 10 0 0 0 10 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 35 0 0 0 33 2 94% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Sichuan Prov. Lab 114 0 0 0 113 1 96% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tianjin Prov. Lab 10 0 0 0 10 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 42 0 1 0 39 2 100% 1.3% Prov. Lab/CCDC 4 0 0 0 0 0 0 0 4 0 0 0 0 75% China, Yunnan Prov. Lab 90 0 0 0 79 11 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 74 0 0 0 72 2 99% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 4 0 0 0 4 0 100% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 5 0 0 0 4 1 100% 0% 30-Jul-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 30-Jul-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 17 0 0 0 17 0 100% 0% 30-Jul-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 13 0 0 1 4 8 100% 20% 30-Jul-24 NIID 0 - - - - - - - - - - - - - Malaysia IMR 121 0 0 11 110 0 100% 7% 23-Jul-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 3 0 0 0 3 0 100% 0% 12-Jul-24 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 4 0 0 1 2 1 100% 38% 25-Jul-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 19 1 2 0 11 5 100% 15% 31-Jul-24 VIDRL 4 0 1 0 0 0 0 0 1 0 2 0 0 50% Philippines RITM 454 4 2 38 396 13 99% 8% 31-Jul-24 RITM/NIID 0 - - - - - - - - - - - - - Republic of Korea KDCA 44 0 0 8 34 2 100% 16% 29-Jul-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 3 0 0 0 3 0 100% 0% 29-Jul-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 81 0 0 17 49 15 100% 25% 28-Jun-24 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 57 0 0 8 46 3 100% 15% 30-Jul-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 4 0 0 1 3 0 100% 33% 22-Jul-24 VIDRL 0 - - - - - - - - - - - - - Total 2951 5 14 88 2671 172 97% 3% 37 0 11 0 0 0 0 0 22 0 4 0 0 78% 2. NPEV growing in L20B cells Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens VDPV Pending % specimens positive for NPEV Latest report date SabinWild Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin Table 2B. Laboratory investigation of stool samples from AFP cases with onset in 2024 and key laboratory indicators 7 Polio Bulletin Table 3A. Laboratory confirmation of polio isolates from environmental samples in 20231 and key laboratory indicators 8 Polio Bulletin Table 3B. Laboratory confirmation of polio isolates from environmental samples in 20241 and key laboratory indicators 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); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); RITM (Research Institute for Tropical Medicine, Philippines); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 49 3 0 0 0 0 0 0 0 3 0 100% 0 0 Cambodia RITM 12 2 0 0 0 0 0 0 0 2 0 58% 0 0 China (total) 630 213 0 210 0 0 0 0 0 304 2 35% 0 0 China, Fujian Prov. Lab/CCDC 77 18 0 5 0 0 0 0 0 19 0 60% 0 0 China, Gansu Prov. Lab/CCDC 42 21 0 23 0 0 0 0 0 26 0 21% 0 0 China, Guangdong Prov. Lab/CCDC 48 30 0 20 0 0 0 0 0 41 0 52% 0 0 China, Guangxi Prov. Lab/CCDC 12 6 0 6 0 0 0 0 0 11 0 58% 0 0 China, Heilongjiang Prov. Lab/CCDC 24 11 0 12 0 0 0 0 0 30 0 17% 0 0 China, Jiangxi Prov. Lab/CCDC 34 9 0 6 0 0 0 0 0 6 1 65% 0 0 China, Jiangsu Prov. Lab/CCDC 124 10 0 4 0 0 0 0 0 6 0 5% 0 0 China, Liaoning Prov. Lab/CCDC 43 16 0 6 0 0 0 0 0 25 0 5% 0 0 China, Neimongol Prov. Lab/CCDC 20 8 0 15 0 0 0 0 0 13 0 0% 0 0 China, Ninxia Prov. Lab/CCDC 19 8 0 20 0 0 0 0 0 8 0 42% 0 0 China, Qinghai Prov. Lab/CCDC 14 3 0 3 0 0 0 0 0 2 0 14% 0 0 China, Shandong Prov. Lab/CCDC 36 16 0 10 0 0 0 0 0 27 0 36% 0 0 China, Shanghai Prov. Lab/CCDC 24 0 0 0 0 0 0 0 0 0 0 17% 0 0 China, Xinjiang Prov. Lab/CCDC 36 27 0 53 0 0 0 0 0 64 0 0% 0 0 China, Yunnan Prov. Lab/CCDC 37 22 0 25 0 0 0 0 0 18 0 92% 0 0 China, Zheijiang Prov. Lab/CCDC 40 8 0 2 0 0 0 0 0 8 1 70% 0 0 Lao PDR RITM 4 0 0 0 0 0 0 0 0 0 0 0% 0 0 Malaysia IMR/VIDRL 330 0 0 0 0 0 0 0 0 0 0 48% 3 0 New Zealand IESR 80 4 0 0 0 0 0 0 0 4 0 90% 0 0 Philippines RITM 616 37 0 17 0 0 0 0 0 44 0 15% 0 0 Viet Nam NIHE 124 0 0 0 0 0 0 0 0 0 0 2% 0 0 Total 1845 259 0 227 0 0 0 0 0 357 2 33% 3 0 NPEV (%) Pending ITD Discordant pending sequencingType 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 20 6 0 1 0 0 0 0 0 5 0 85% 2 0 Cambodia RITM 5 1 0 0 0 0 0 0 0 1 0 40% 2 0 China (total) 242 126 0 146 1 0 0 0 0 219 0 48% 0 0 China, Anui Prov. Lab/CCDC 24 20 0 36 0 0 0 0 0 32 0 75% 0 0 China, Fujian Prov. Lab/CCDC 30 13 0 3 0 0 0 0 0 18 0 90% 0 0 China, Gansu Prov. Lab/CCDC 31 14 0 11 0 0 0 0 0 29 0 23% 0 0 China, Guangdong Prov. Lab/CCDC 24 22 0 26 1 0 0 0 0 41 0 67% 0 0 China, Guangxi Prov. Lab/CCDC 9 6 0 3 0 0 0 0 0 3 0 78% 0 0 China, Heilongjiang Prov. Lab/CCDC 10 2 0 0 0 0 0 0 0 3 0 0% 0 0 China, Jiangxi Prov. Lab/CCDC 21 3 0 0 0 0 0 0 0 3 0 43% 0 0 China, Jiangsu Prov. Lab/CCDC 14 5 0 6 0 0 0 0 0 3 0 7% 0 0 China, Liaoning Prov. Lab/CCDC 28 16 0 23 0 0 0 0 0 41 0 54% 0 0 China, Neimongol Prov. Lab/CCDC 10 7 0 6 0 0 0 0 0 16 0 0% 0 0 China, Ninxia Prov. Lab/CCDC 3 3 0 7 0 0 0 0 0 5 0 67% 0 0 China, Qinghai Prov. Lab/CCDC 6 5 0 8 0 0 0 0 0 14 0 17% 0 0 China, Shaanxi Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab/CCDC 16 10 0 17 0 0 0 0 0 11 0 56% 0 0 China, Shanghai Prov. Lab/CCDC 16 0 0 0 0 0 0 0 0 0 0 25% 0 0 China, Xinjiang Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Yunnan Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zheijiang Prov. Lab/CCDC 0 - - - - - - - - - - - - - Lao PDR RITM 0 - - - - - - - - - - - - - Malaysia IMR/VIDRL 0 - - - - - - - - - - - - - New Zealand IESR 28 1 0 0 0 0 0 0 0 1 0 93% 0 0 Philippines RITM 333 18 0 8 0 0 0 0 0 24 0 28% 26 0 Viet Nam NIHE 0 - - - - - - - - - - - - - Total 628 152 0 155 1 0 0 0 0 250 0 41% 30 0 628 152 0 155 1 0 0 0 0 250 0 30 NPEV (%) Pending ITD Discordant pending sequencingType 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates Figure 5A. China Figure 5B. Malaysia Figure 5C. Papua New Guinea Figure 5D. Philippines 1. Prefix letter refers to the VDPV category: “cVDPV” = circulating VDPV, “iVDPV” = immunodeficiency-associated VDPV, “aVDPV” = ambiguous VDPV. Suffix number refers to the poliovirus serotype (types 1, 2 or 3) 2. Community and healthy children 3. Contact of a different AFP case Vaccine-derived polio virus identified from laboratory testing, 2018–2024 0 2 4 6 8 10 12 14 16 cVDPV1 cVDPV2 cVDPV1 cVDPV2 aVDPV2 aVDPV3 2019 2020 N o. o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 45 cVDPV1 2018 No . of  ca ses /sp eci me ns 0 5 10 15 20 25 30 35 40 cVDPV1 cVDPV2 iVDPV2 aVDPV2 cVDPV2 aVDPV2 2019 2020 N o. o f c as es /s pe ci m en s 9 Polio Bulletin 0 1 2 3 4 5 cVDPV2 iVDPV3 aVDPV3 cVDPV2 aVDPV3 aVDPV1 cVDPV3 aVDPV3 aVDPV1 cVDPV3 aVDPV3 iVDPV3 aVDPV1 aVDPV1 aVDPV3 iVDPV3 aVDPV1 aVDPV3 2018 2019 2020 2021 2022 2023 2024 No . o f c as es /sp ec im en s

Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Phone: +63 2 8528 8001 Fax: +63 2 8521 1036, 8526 0279 Email: wproepidata@who.int Web: www.who.int/westernpacific Polio Bulletin 2024 Issue No. 1 - Week 1 (as of 2 January 2024) HIGHLIGHTS Figure 1. Non-polio AFP rate (per 100 000 persons < 15 years of age), 2021–2023 Figure 2. Adequate specimen collection rate, 2021–2023 Figure 3. Percentage of reported AFP cases by number of polio vaccination doses, 2023 Figure 4. Percentage of reported AFP cases with pending classification > 90 days after onset, 2023 0.0 1.0 2.0 3.0 4.0 5.0 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% CHN KHM LAO MYS PHL PNG VNM ≥ 3 doses 1-2 doses 0 doses Unknown 13.3% 5.7% 35.1% 0.0% 0.0% 0.0% 44.0% 0% 10% 20% 30% 40% 50% VNM PNG PHL MYS LAO KHM CHN 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). GPEI – a brief review of 2023 and full focus on 2024 The Global Polio Eradication Initiative has two goals laid out in its current strategy: to interrupt all remaining transmission of endemic wild poliovirus type 1 (WPV1) and to stop all outbreaks of variant poliovirus type 2 (cVDPV2). 2023 was a critical year for progressing on each of these, and while our urgent and diligent work to end polio must continue into 2024, the GPEI achieved incredible things in the past twelve months. Despite significant geo-political and environmental challenges in the two remaining WPV1-endemic countries, Pakistan and Afghanistan, the polio programme has continued to reach greater numbers of children with polio vaccines. Thanks to the novel oral polio vaccine type 2 (nOPV2), strong political commitment and community-based efforts to reach more children with the vaccine, the number of cases of variant poliovirus type 2 (cVDPV2) continued to decline in 2023. Most importantly, thanks to the efforts of the GPEI and its partners, health workers vaccinated more than 400 million children in 2023, preventing an estimated 650,000 cases of paralysis from polio and saving the lives of up to 60,000 children. For more information please visit: https://polioeradication.org/news-post/gpei-a-brief-review-of- 2023-and-full-focus-on-2024/ CONTACT US 2021 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 63 48 81 0 0 0 81 0 0 (0.0%) 1.70 72% 100% 11-Apr-23 - Brunei Darussalam 2 1 2 0 0 0 2 0 0 (0.0%) 2.16 50% 100% 20-Feb-23 - Cambodia 5 48 35 0 0 0 35 0 0 (0.0%) 0.73 63% 100% 01-Feb-23 - China 4769 2362 4225 0 0 0 4225 0 0 (0.0%) 1.79 92% 99% 26-May-23 - China, Hong Kong SAR 9 8 6 0 0 0 6 0 0 (0.0%) 0.78 67% 100% 28-Nov-23 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.10 100% 100% 23-Feb-23 - Japan 0 148 41 0 0 0 40 1 1 (0.1%) 0.28 73% 98% 07-Dec-23 26 Lao People's Democratic Republic 20 23 28 0 0 0 28 0 0 (0.0%) 1.22 64% 68% 09-Oct-23 - Malaysia 111 80 212 0 0 0 212 0 0 (0.0%) 2.65 76% 83% 03-Apr-23 - Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 10-Nov-23 - New Zealand 9 10 23 0 0 0 23 0 0 (0.0%) 2.37 35% 100% 28-Nov-23 - Papua New Guinea 52 38 59 0 0 0 59 0 0 (0.0%) 1.53 69% 83% 10-Nov-23 - Philippines 894 327 853 0 0 0 853 0 0 (0.0%) 2.60 79% 0% 23-Nov-23 - Republic of Korea 35 60 57 0 0 0 57 0 0 (0.0%) 0.95 82% 98% 08-Mar-23 - Singapore 4 6 11 0 0 0 11 0 0 (0.0%) 1.91 82% 82% 01-Feb-23 - Viet Nam 162 250 238 0 0 0 238 0 0 (0.0%) 0.95 98% 65% 12-May-23 - Pacific island countries and areas 16 11 7 0 0 0 7 0 0 (0.0%) 0.64 71% 71% 08-Nov-22 - Total 6153 3430 5880 0 0 0 5879 1 1 (0.02%) 1.71 88% 82% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO Days since last report 5 % investigated ≤  2 days of notification 3 Indicators Latest report date 4 Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus > 90 days 1 # (%) Vaccine- derived poliovirus (VDPV) Polio- compatible Classification Pending Discarded (Non-polio) 2022 Non-polio AFP rate Total % with adequate specimens 2 Table 1A. Classification of AFP cases with onset in 2022 and key surveillance indicators 2 Polio Bulletin 2022 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 81 48 82 0 0 0 72 10 0 (0.0%) 1.72 60% 99% 02-Jan-24 0 Brunei Darussalam 2 1 1 0 0 0 1 0 0 (0.0%) 1.08 100% 100% 16-Nov-23 47 Cambodia 35 48 46 0 0 0 39 7 0 (0.0%) 0.96 91% 98% 03-Dec-23 30 China 4225 1877 4825 0 0 0 1798 3027 2,124 (44.0%) 2.57 91% 99% 29-Dec-23 4 China, Hong Kong SAR 6 8 16 0 0 0 14 2 0 (0.0%) 2.07 88% 100% 05-Dec-23 28 China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.04 100% 100% 06-Dec-23 27 Japan 41 144 53 0 0 0 45 8 1 (1.9%) 0.37 70% 91% 26-Dec-23 7 Lao People's Democratic Republic 28 23 39 0 0 0 24 15 0 (0.0%) 1.70 87% 90% 19-Dec-23 14 Malaysia 212 75 230 0 0 0 216 14 0 (0.0%) 3.05 85% 86% 27-Dec-23 6 Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 20-Dec-23 13 New Zealand 23 10 10 0 0 0 8 2 0 (0.0%) 1.04 30% 90% 01-Dec-23 32 Papua New Guinea 59 39 53 0 0 0 45 8 3 (5.7%) 1.34 60% 70% 24-Nov-23 39 Philippines 853 342 890 0 0 0 417 473 312 (35.1%) 2.60 66% 43% 19-Dec-23 14 Republic of Korea 57 57 49 0 0 0 41 8 0 (0.0%) 0.86 84% 100% 26-Dec-23 7 Singapore 11 6 3 0 0 0 3 0 0 (0.0%) 0.52 100% 100% 04-Dec-23 29 Viet Nam 238 222 263 0 0 0 145 118 35 (13.3%) 1.18 100% 33% 18-Dec-23 15 Pacific island countries and areas 7 10 24 0 0 0 20 4 0 (0.0%) 2.34 50% 63% 28-Nov-23 35 Total 5880 2921 6586 0 0 0 2890 3696 2,475 (37.6%) 2.25 87% 88% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Annualized non-polio AFP rate per 100 000 population under 15 years of age Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Substantially below target 4. Percentage of reported cases investigated within two days of notification 5. Countries are expected to submit data at least once per month to WPRO Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Days since last report 5 % investigated ≤ 2 days of notification 4 Indicators Latest report date> 90 days 1 # (%) Total 2023 % with adequate specimens 3 Pending Classification Non-polio AFP rate 2 Vaccine- derived poliovirus (VDPV) Polio- compatible Table 1B. Classification of AFP cases with onset in 2023 and key surveillance indicators 3 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 78 1 1 3 73 0 95% 3% 31-Jan-23 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 100% Brunei Darussalam VIDRL 2 0 0 0 2 0 100% 0% 16-Jan-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 35 1 0 2 32 0 97% 7% 31-Dec-22 NIID 0 - - - - - - - - - - - - - China (total) 4182 2 7 1 4162 10 98% 0.1% 26-May-23 19 0 11 0 0 0 0 0 8 0 0 0 0 100% China, Anhui Prov. Lab 268 0 0 0 268 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Beijing Prov. Lab 34 0 0 0 33 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 36 0 0 0 36 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 132 0 0 0 132 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 52 0 0 0 50 2 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 452 0 2 0 449 1 92% 0.2% Prov. Lab/CCDC 4 0 4 0 0 0 0 0 0 0 0 0 0 100% China, Guangxi Prov. Lab 216 0 0 1 215 0 100% 0.2% Prov. Lab/CCDC 3 0 2 0 0 0 0 0 1 0 0 0 0 100% China, Guizhou Prov. Lab 175 0 0 0 173 2 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hainan Prov. Lab 48 0 0 0 48 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 225 0 0 0 225 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 29 0 0 0 29 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 437 1 2 0 432 2 100% 0.2% Prov. Lab/CCDC 7 0 3 0 0 0 0 0 4 0 0 0 0 100% China, Hubei Prov. Lab 108 0 0 0 108 0 92% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 198 0 0 0 198 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 173 0 0 0 173 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 142 0 1 0 141 0 99% 0.4% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Jilin Prov. Lab 31 0 0 0 31 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 60 0 0 0 60 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 93 0 0 0 93 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ningxia Prov. Lab 12 0 0 0 12 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 6 0 0 0 6 0 67% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 71 0 0 0 71 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 243 0 0 0 243 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab 33 0 0 0 33 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 79 1 1 0 76 1 97% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Sichuan Prov. Lab 348 0 0 0 348 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tianjin Prov. Lab 11 0 0 0 11 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 88 0 1 0 87 0 100% 1% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Yunnan Prov. Lab 207 0 0 0 206 1 90% 0% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Zhejiang Prov. Lab 166 0 0 0 166 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 9 0 0 0 9 0 33% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 6 0 0 0 6 0 100% 0% 26-Jan-23 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 0 0 100% 0% 03-Jan-23 PHLC 0 - - - - - - - - - - - - - Japan NIID 36 0 0 0 36 0 97% 0% 01-May-23 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 28 0 0 2 26 0 96% 5% 10-Oct-23 NIID 0 - - - - - - - - - - - - - Malaysia IMR 223 0 0 4 219 0 91% 1% 15-Dec-23 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 06-Nov-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 15 0 0 2 12 0 100% 7% 16-Feb-23 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 57 1 1 4 51 0 81% 8% 14-Nov-23 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 100% Philippines RITM 827 5 1 63 758 0 98% 6% 11-Sep-23 RITM/NIID 19 0 8 0 0 0 0 0 11 0 0 0 0 100% Republic of Korea KDCA 57 0 0 7 50 0 82% 11% 19-Jan-23 KDCA 0 - - - - - - - - - - - - - Singapore SGH 11 0 0 0 11 0 95% 0% 11-Jan-23 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 155 0 0 26 129 0 100% 16% 15-Dec-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 79 0 0 5 74 0 100% 6% 09-Jan-23 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 7 0 0 1 6 0 85% 15% 24-Aug-22 VIDRL 0 - Total 5800 10 10 120 5648 10 97% 2% 44 0 19 0 0 0 0 0 19 0 6 0 0 100% 2. NPEV growing in L20B cells Country/area % ITD results reported ≤ 7 days of receipt Type 3 Polio laboratory 1 Type 1 Negative Results of virus isolation for AFP cases Results of intratypic differentiation (ITD)/sequencing for virus isolates L20B positive VDPV 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Total no. of AFP cases with specimens NPEV only Discordant pending sequencing NPEV 2VDPV L20B positive + NPEV Wild Sabin % specimens positive for NPEV Latest report date VDPV Sabin Pending ITDPending % results reported ≤ 14 days Wild Type 2 Table 2A. Laboratory investigation of stool samples from AFP cases with onset in 2022 and key laboratory indicators 4 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 73 0 2 2 67 2 94% 4% 28-Dec-23 VIDRL 2 0 0 0 0 0 0 0 0 0 2 0 0 100% Brunei Darussalam VIDRL 1 0 0 0 1 0 0% 0% 09-Oct-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 46 0 0 7 39 0 96% 14% 25-Dec-23 NIID 0 - - - - - - - - - - - - - China (total) 4642 1 15 0 4209 417 98% 0.2% 29-Dec-23 45 0 18 0 0 0 0 0 27 0 0 0 0 97% China, Anhui Prov. Lab 284 0 1 0 263 20 99% 0.2% Prov. Lab/CCDC 4 0 2 0 0 0 0 0 2 0 0 0 0 100% China, Beijing Prov. Lab 48 0 0 0 43 5 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 45 0 0 0 40 5 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 126 0 0 0 117 9 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 103 0 0 0 95 8 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 441 0 0 0 405 36 94% 0% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 50% China, Guangxi Prov. Lab 205 0 3 0 163 39 98% 0.9% Prov. Lab/CCDC 8 0 2 0 0 0 0 0 6 0 0 0 0 100% China, Guizhou Prov. Lab 200 1 0 0 183 16 100% 0% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Hainan Prov. Lab 32 0 0 0 29 3 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 280 0 0 0 257 23 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 52 0 0 0 51 1 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 594 0 4 0 568 22 100% 0.3% Prov. Lab/CCDC 10 0 6 0 0 0 0 0 4 0 0 0 0 100% China, Hubei Prov. Lab 125 0 0 0 91 34 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 242 0 0 0 223 19 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 177 0 0 0 161 16 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 151 0 0 0 139 12 88% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 38 0 0 0 33 5 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 84 0 0 0 77 7 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 118 0 1 0 103 14 100% 0.5% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Ningxia Prov. Lab 19 0 0 0 17 2 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 8 0 0 0 7 1 71% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 65 0 0 0 48 17 79% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 248 0 0 0 222 26 100% 0% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Shanghai Prov. Lab 38 0 0 0 35 3 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 95 0 2 0 90 3 98% 1% Prov. Lab/CCDC 6 0 2 0 0 0 0 0 4 0 0 0 0 100% China, Sichuan Prov. Lab 335 0 1 0 310 24 98% 0.2% Prov. Lab/CCDC 2 0 2 0 0 0 0 0 0 0 0 0 0 100% China, Tianjin Prov. Lab 12 0 1 0 10 1 100% 5% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Xinjiang Prov. Lab 127 0 1 0 118 8 97% 0.4% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Yunnan Prov. Lab 175 0 0 0 157 18 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 159 0 1 0 138 20 100% 0.4% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Tibet Prov. Lab 16 0 0 0 16 0 94% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 15 0 0 0 15 0 97% 0% 14-Dec-23 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 14-Dec-23 PHLC 0 - - - - - - - - - - - - - Japan NIID 45 0 0 4 41 0 91% 8% 19-Dec-23 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 39 0 0 1 23 15 100% 4% 19-Dec-23 NIID 0 - - - - - - - - - - - - - Malaysia IMR 244 0 0 18 226 0 87% 6% 01-Jan-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 29-Dec-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 7 0 0 1 6 0 100% 18% 29-Dec-23 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 53 6 0 4 43 0 97% 7% 11-Dec-23 VIDRL 33 0 10 0 0 0 0 0 23 0 0 0 0 100% Philippines RITM 847 12 0 40 775 20 97% 4% 28-Dec-23 RITM/NIID 62 0 26 0 0 0 0 0 36 0 0 0 0 100% Republic of Korea KDCA 49 0 0 6 40 3 93% 12% 26-Dec-23 KDCA 0 - - - - - - - - - - - - - Singapore SGH 3 0 0 1 2 0 100% 33% 01-Jan-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 138 0 0 22 108 8 100% 17% 26-Nov-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 113 0 0 14 99 0 100% 12% 02-Jan-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 23 0 0 3 20 0 95% 9% 14-Nov-23 VIDRL 0 - - - - - - - - - - - - - Total 6340 19 17 123 5716 465 97% 2% 142 0 54 0 0 0 0 0 86 0 2 0 0 99% 2. NPEV growing in L20B cells Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens VDPV Pending % specimens positive for NPEV Latest report date SabinWild Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin Table 2B. Laboratory investigation of stool samples from AFP cases with onset in 2023 and key laboratory indicators 5 Polio Bulletin Table 3A. Laboratory confirmation of polio isolates from environmental samples in 20221 and key laboratory indicators 6 Polio Bulletin Table 3B. Laboratory confirmation of polio isolates from environmental samples in 20231 and key laboratory indicators 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); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); RITM (Research Institute for Tropical Medicine, Philippines); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 10 1 0 0 0 0 0 0 0 1 0 100% 0 0 China (total) 472 116 0 111 0 0 0 0 0 160 0 39% 0 0 China, Fujian Prov. Lab/CCDC 64 7 0 1 0 0 0 0 0 7 0 78% 0 0 China, Gansu Prov. Lab/CCDC 25 11 0 13 0 0 0 0 0 15 0 68% 0 0 China, Guangdong Prov. Lab/CCDC 48 25 0 8 0 0 0 0 0 25 0 33% 0 0 China, Guangxi Prov. Lab/CCDC 12 5 0 9 0 0 0 0 0 4 0 92% 0 0 China, Heilongjiang Prov. Lab/CCDC 23 5 0 0 0 0 0 0 0 5 0 39% 0 0 China, Jiangxi Prov. Lab/CCDC 11 1 0 0 0 0 0 0 0 1 0 27% 0 0 China, Jiangsu Prov. Lab/CCDC 124 0 0 0 0 0 0 0 0 0 0 4% 0 0 China, Liaoning Prov. Lab/CCDC 18 7 0 1 0 0 0 0 0 9 0 11% 0 0 China, Neimongol Prov. Lab/CCDC 12 4 0 2 0 0 0 0 0 14 0 0% 0 0 China, Qinghai Prov. Lab/CCDC 9 2 0 5 0 0 0 0 0 0 0 11% 0 0 China, Shandong Prov. Lab/CCDC 31 7 0 6 0 0 0 0 0 6 0 45% 0 0 China, Shanghai Prov. Lab/CCDC 20 0 0 0 0 0 0 0 0 0 0 20% 0 0 China, Sichuan Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab/CCDC 23 12 0 12 0 0 0 0 0 32 0 26% 0 0 China, Yunnan Prov. Lab/CCDC 52 30 0 54 0 0 0 0 0 42 0 90% 0 0 Malaysia IMR/VIDRL 469 0 0 0 0 0 0 0 0 0 0 11% 0 0 Philippines RITM 536 43 0 33 0 0 0 0 0 72 0 29% 0 0 Viet Nam NIHE 101 0 0 0 0 0 0 0 0 0 0 7% 0 0 Total 1588 160 0 144 0 0 0 0 0 233 0 26% 0 0 Country/area Intratypic differentiation lab 2 NPEV (%) Pending ITD Polio isolates Discordant pending sequencing Total number of samples processed Total number of samples with polio isolates Type 1 Type 2 Type 3 Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 49 3 0 0 0 0 0 0 0 3 0 71% 0 0 Cambodia RITM 12 1 0 0 0 0 0 0 0 1 0 42% 2 0 China (total) 418 123 0 105 0 0 0 0 0 190 0 27% 1 0 China, Fujian Prov. Lab/CCDC 62 7 0 0 0 0 0 0 0 7 0 60% 1 0 China, Gansu Prov. Lab/CCDC 27 12 0 12 0 0 0 0 0 7 0 15% 0 0 China, Guangdong Prov. Lab/CCDC 44 26 0 13 0 0 0 0 0 35 0 52% 0 0 China, Guangxi Prov. Lab/CCDC 9 4 0 3 0 0 0 0 0 9 0 67% 0 0 China, Heilongjiang Prov. Lab/CCDC 6 3 0 8 0 0 0 0 0 13 0 0% 0 0 China, Jiangxi Prov. Lab/CCDC 5 0 0 0 0 0 0 0 0 0 0 0% 0 0 China, Jiangsu Prov. Lab/CCDC 98 4 0 1 0 0 0 0 0 3 0 5% 0 0 China, Liaoning Prov. Lab/CCDC 35 14 0 3 0 0 0 0 0 24 0 6% 0 0 China, Neimongol Prov. Lab/CCDC 16 7 0 14 0 0 0 0 0 13 0 0% 0 0 China, Qinghai Prov. Lab/CCDC 10 1 0 0 0 0 0 0 0 1 0 10% 0 0 China, Shandong Prov. Lab/CCDC 8 2 0 1 0 0 0 0 0 2 0 0% 0 0 China, Shanghai Prov. Lab/CCDC 24 11 0 3 0 0 0 0 0 19 0 25% 0 0 China, Sichuan Prov. Lab/CCDC 18 0 0 0 0 0 0 0 0 0 0 17% 0 0 China, Xinjiang Prov. Lab/CCDC 24 18 0 42 0 0 0 0 0 45 0 0% 0 0 China, Yunnan Prov. Lab/CCDC 14 7 0 3 0 0 0 0 0 4 0 57% 0 0 China, Zheijiang Prov. Lab/CCDC 18 7 0 2 0 0 0 0 0 8 0 50% 0 0 Malaysia IMR 330 0 0 0 0 0 0 0 0 0 0 48% 3 0 New Zealand IESR 66 4 0 0 0 0 0 0 0 4 0 88% 0 0 Philippines RITM 602 30 0 17 0 0 0 0 0 43 0 15% 0 0 Viet Nam NIHE 57 0 0 0 0 0 0 0 0 0 0 5% 2 0 Total 1534 161 0 122 0 0 0 0 0 241 0 30% 8 0 Pending ITD Discordant pending sequencing Type 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates NPEV (%) Figure 5A. China Figure 5B. Malaysia Figure 5C. Papua New Guinea Figure 5D. Philippines 1. Prefix letter refers to the VDPV category: “cVDPV” = circulating VDPV, “iVDPV” = immunodeficiency-associated VDPV, “aVDPV” = ambiguous VDPV. Suffix number refers to the poliovirus serotype (types 1, 2 or 3) 2. Community and healthy children 3. Contact of a different AFP case Vaccine-derived polio virus identified from laboratory testing, 2018–2022 0 2 4 6 8 10 12 14 16 cVDPV1 cVDPV2 cVDPV1 cVDPV2 aVDPV2 aVDPV3 2019 2020 N o. o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 45 2018 N o . o f ca se s/ sp ec im en s 0 5 10 15 20 25 30 35 40 cVDPV1 cVDPV2 iVDPV2 aVDPV2 cVDPV2 aVDPV2 2019 2020 N o. o f c as es /s pe ci m en s 7 Polio Bulletin 0 1 2 3 4 5 cVDPV2 iVDPV3 aVDPV3 cVDPV2 aVDPV3 aVDPV1 cVDPV3 aVDPV3 aVDPV1 cVDPV3 aVDPV3 iVDPV3 aVDPV1 aVDPV1 aVDPV3 2018 2019 2020 2021 2022 2023 N o . o f  ca se s/ sp ec im en s

Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Phone: +63 2 8528 8001 Fax: +63 2 8521 1036, 8526 0279 Email: wproepidata@who.int Web: www.who.int/westernpacific Polio Bulletin 2024 Issue No. 2 - Week 3 (as of 16 January 2024) HIGHLIGHTS Figure 1. Non-polio AFP rate (per 100 000 persons < 15 years of age), 2021–2023 Figure 2. Adequate specimen collection rate, 2021–2023 Figure 3. Percentage of reported AFP cases by number of polio vaccination doses, 2023 Figure 4. Percentage of reported AFP cases with pending classification > 90 days after onset, 2023 0.0 1.0 2.0 3.0 4.0 5.0 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% CHN KHM LAO MYS PHL PNG VNM ≥ 3 doses 1-2 doses 0 doses Unknown 3.3% 5.7% 35.1% 0.0% 0.0% 0.0% 44.0% 0% 10% 20% 30% 40% 50% VNM PNG PHL MYS LAO KHM CHN 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). nOPV2 gets prequalified by WHO In late December 2023, the World Health Organization issued its first-ever prequalification approval for a vaccine being used under its Emergency Use Listing (EUL) regulatory pathway – novel oral polio vaccine type 2 (nOPV2). Since rollout of the vaccine in March 2021, the Global Polio Eradication Initiative (GPEI) has administered nearly 1 billion doses across 35 countries. Prequalification will enable additional countries to access the vaccine more easily for more sustainable response to outbreaks of type 2 variant poliovirus (cVDPV2). “This is a historic milestone for polio eradication and for public health,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Novel oral polio vaccine type 2 has blazed a trail for other new vaccines that address critical health emergencies, and its use demonstrates the utility of the EUL mechanism in helping to rapidly get new products to where they’re needed most.” For more information please visit: https://polioeradication.org/news-post/gpei-press- release-on-nopv2-prequalification/ CONTACT US 2021 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 63 48 81 0 0 0 81 0 0 (0.0%) 1.70 72% 100% 11-Apr-23 - Brunei Darussalam 2 1 2 0 0 0 2 0 0 (0.0%) 2.16 50% 100% 20-Feb-23 - Cambodia 5 48 35 0 0 0 35 0 0 (0.0%) 0.73 63% 100% 01-Feb-23 - China 4769 2362 4225 0 0 0 4225 0 0 (0.0%) 1.79 92% 99% 26-May-23 - China, Hong Kong SAR 9 8 6 0 0 0 6 0 0 (0.0%) 0.78 67% 100% 28-Nov-23 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.10 100% 100% 23-Feb-23 - Japan 0 148 41 0 0 0 40 1 1 (0.1%) 0.28 73% 98% 07-Dec-23 40 Lao People's Democratic Republic 20 23 28 0 0 0 28 0 0 (0.0%) 1.22 64% 68% 09-Oct-23 - Malaysia 111 80 212 0 0 0 212 0 0 (0.0%) 2.65 76% 83% 03-Apr-23 - Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 10-Nov-23 - New Zealand 9 10 23 0 0 0 23 0 0 (0.0%) 2.37 35% 100% 28-Nov-23 - Papua New Guinea 52 38 59 0 0 0 59 0 0 (0.0%) 1.53 69% 83% 10-Nov-23 - Philippines 894 327 853 0 0 0 853 0 0 (0.0%) 2.60 79% 0% 23-Nov-23 - Republic of Korea 35 60 57 0 0 0 57 0 0 (0.0%) 0.95 82% 98% 08-Mar-23 - Singapore 4 6 11 0 0 0 11 0 0 (0.0%) 1.91 82% 82% 01-Feb-23 - Viet Nam 162 250 238 0 0 0 238 0 0 (0.0%) 0.95 98% 65% 12-May-23 - Pacific island countries and areas 16 11 7 0 0 0 7 0 0 (0.0%) 0.64 71% 71% 08-Nov-22 - Total 6153 3430 5880 0 0 0 5879 1 1 (0.02%) 1.71 88% 82% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Days since last report 5 % investigated ≤  2 days of notification 3 Indicators Latest report date 4 2022 Non-polio AFP rate Total % with adequate specimens 2> 90 days 1 # (%) Vaccine- derived poliovirus (VDPV) Polio- compatible Classification Pending Table 1A. Classification of AFP cases with onset in 2022 and key surveillance indicators 2 Polio Bulletin 2022 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 81 48 83 0 0 0 72 11 0 (0.0%) 1.74 63% 99% 15-Jan-24 1 Brunei Darussalam 2 1 1 0 0 0 1 0 0 (0.0%) 1.08 100% 100% 16-Nov-23 61 Cambodia 35 48 46 0 0 0 39 7 0 (0.0%) 0.96 91% 98% 03-Dec-23 44 China 4225 1877 4825 0 0 0 1798 3027 2,124 (44.0%) 2.57 91% 99% 29-Dec-23 18 China, Hong Kong SAR 6 8 16 0 0 0 14 2 0 (0.0%) 2.07 81% 100% 05-Jan-24 11 China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.04 100% 100% 06-Dec-23 41 Japan 41 144 53 0 0 0 45 8 1 (1.9%) 0.37 57% 91% 26-Dec-23 21 Lao People's Democratic Republic 28 23 39 0 0 0 24 15 0 (0.0%) 1.70 87% 90% 19-Dec-23 28 Malaysia 212 75 233 0 0 0 223 10 0 (0.0%) 3.09 85% 89% 10-Jan-24 6 Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 20-Dec-23 27 New Zealand 23 10 10 0 0 0 8 2 0 (0.0%) 1.04 70% 90% 01-Dec-23 46 Papua New Guinea 59 39 53 0 0 0 45 8 3 (5.7%) 1.34 60% 70% 24-Nov-23 53 Philippines 853 342 890 0 0 0 417 473 312 (35.1%) 2.60 66% 43% 19-Dec-23 28 Republic of Korea 57 57 50 0 0 0 46 4 0 (0.0%) 0.88 84% 100% 15-Jan-24 1 Singapore 11 6 3 0 0 0 3 0 0 (0.0%) 0.52 100% 100% 03-Jan-24 13 Viet Nam 238 222 274 0 0 0 207 67 9 (3.3%) 1.23 100% 62% 16-Jan-24 0 Pacific island countries and areas 7 10 24 0 0 0 20 4 0 (0.0%) 2.34 50% 63% 28-Nov-23 49 Total 5880 2921 6602 0 0 0 2964 3638 2,449 (37.1%) 2.26 87% 89% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Annualized non-polio AFP rate per 100 000 population under 15 years of age Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Substantially below target 4. Percentage of reported cases investigated within two days of notification 5. Countries are expected to submit data at least once per month to WPRO Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Days since last report 5 % investigated ≤ 2 days of notification 4 Indicators Latest report date> 90 days 1 # (%) Total 2023 % with adequate specimens 3 Pending Classification Non-polio AFP rate 2 Vaccine- derived poliovirus (VDPV) Polio- compatible Table 1B. Classification of AFP cases with onset in 2023 and key surveillance indicators 3 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 78 1 1 3 73 0 95% 3% 31-Jan-23 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 100% Brunei Darussalam VIDRL 2 0 0 0 2 0 100% 0% 16-Jan-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 35 1 0 2 32 0 97% 7% 31-Dec-22 NIID 0 - - - - - - - - - - - - - China (total) 4182 2 7 1 4162 10 98% 0.1% 26-May-23 19 0 11 0 0 0 0 0 8 0 0 0 0 100% China, Anhui Prov. Lab 268 0 0 0 268 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Beijing Prov. Lab 34 0 0 0 33 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 36 0 0 0 36 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 132 0 0 0 132 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 52 0 0 0 50 2 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 452 0 2 0 449 1 92% 0.2% Prov. Lab/CCDC 4 0 4 0 0 0 0 0 0 0 0 0 0 100% China, Guangxi Prov. Lab 216 0 0 1 215 0 100% 0.2% Prov. Lab/CCDC 3 0 2 0 0 0 0 0 1 0 0 0 0 100% China, Guizhou Prov. Lab 175 0 0 0 173 2 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hainan Prov. Lab 48 0 0 0 48 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 225 0 0 0 225 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 29 0 0 0 29 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 437 1 2 0 432 2 100% 0.2% Prov. Lab/CCDC 7 0 3 0 0 0 0 0 4 0 0 0 0 100% China, Hubei Prov. Lab 108 0 0 0 108 0 92% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 198 0 0 0 198 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 173 0 0 0 173 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 142 0 1 0 141 0 99% 0.4% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Jilin Prov. Lab 31 0 0 0 31 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 60 0 0 0 60 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 93 0 0 0 93 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ningxia Prov. Lab 12 0 0 0 12 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 6 0 0 0 6 0 67% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 71 0 0 0 71 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 243 0 0 0 243 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab 33 0 0 0 33 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 79 1 1 0 76 1 97% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Sichuan Prov. Lab 348 0 0 0 348 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tianjin Prov. Lab 11 0 0 0 11 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 88 0 1 0 87 0 100% 1% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Yunnan Prov. Lab 207 0 0 0 206 1 90% 0% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Zhejiang Prov. Lab 166 0 0 0 166 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 9 0 0 0 9 0 33% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 6 0 0 0 6 0 100% 0% 26-Jan-23 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 0 0 100% 0% 03-Jan-23 PHLC 0 - - - - - - - - - - - - - Japan NIID 36 0 0 0 36 0 97% 0% 01-May-23 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 28 0 0 2 26 0 96% 5% 10-Oct-23 NIID 0 - - - - - - - - - - - - - Malaysia IMR 223 0 0 4 219 0 91% 1% 15-Dec-23 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 06-Nov-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 15 0 0 2 12 0 100% 7% 16-Feb-23 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 57 1 1 4 51 0 81% 8% 14-Nov-23 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 100% Philippines RITM 827 5 1 63 758 0 98% 6% 11-Sep-23 RITM/NIID 19 0 8 0 0 0 0 0 11 0 0 0 0 100% Republic of Korea KDCA 57 0 0 7 50 0 82% 11% 19-Jan-23 KDCA 0 - - - - - - - - - - - - - Singapore SGH 11 0 0 0 11 0 95% 0% 11-Jan-23 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 155 0 0 26 129 0 100% 16% 15-Dec-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 79 0 0 5 74 0 100% 6% 09-Jan-23 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 7 0 0 1 6 0 85% 15% 24-Aug-22 VIDRL 0 - Total 5800 10 10 120 5648 10 97% 2% 44 0 19 0 0 0 0 0 19 0 6 0 0 100% 2. NPEV growing in L20B cells Country/area % ITD results reported ≤ 7 days of receipt Type 3 Polio laboratory 1 Type 1 Negative Results of virus isolation for AFP cases Results of intratypic differentiation (ITD)/sequencing for virus isolates L20B positive VDPV 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Total no. of AFP cases with specimens NPEV only Discordant pending sequencing NPEV 2VDPV L20B positive + NPEV Wild Sabin % specimens positive for NPEV Latest report date VDPV Sabin Pending ITDPending % results reported ≤ 14 days Wild Type 2 Table 2A. Laboratory investigation of stool samples from AFP cases with onset in 2022 and key laboratory indicators 4 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 77 0 2 2 70 3 94% 4% 15-Jan-24 VIDRL 2 0 0 0 0 0 0 0 0 0 2 0 0 100% Brunei Darussalam VIDRL 1 0 0 0 1 0 0% 0% 09-Oct-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 46 0 0 7 39 0 96% 14% 25-Dec-23 NIID 0 - - - - - - - - - - - - - China (total) 4642 1 15 0 4209 417 98% 0.2% 29-Dec-23 45 0 18 0 0 0 0 0 27 0 0 0 0 97% China, Anhui Prov. Lab 284 0 1 0 263 20 99% 0.2% Prov. Lab/CCDC 4 0 2 0 0 0 0 0 2 0 0 0 0 100% China, Beijing Prov. Lab 48 0 0 0 43 5 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 45 0 0 0 40 5 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 126 0 0 0 117 9 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 103 0 0 0 95 8 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 441 0 0 0 405 36 94% 0% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 50% China, Guangxi Prov. Lab 205 0 3 0 163 39 98% 0.9% Prov. Lab/CCDC 8 0 2 0 0 0 0 0 6 0 0 0 0 100% China, Guizhou Prov. Lab 200 1 0 0 183 16 100% 0% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Hainan Prov. Lab 32 0 0 0 29 3 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 280 0 0 0 257 23 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 52 0 0 0 51 1 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 594 0 4 0 568 22 100% 0.3% Prov. Lab/CCDC 10 0 6 0 0 0 0 0 4 0 0 0 0 100% China, Hubei Prov. Lab 125 0 0 0 91 34 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 242 0 0 0 223 19 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 177 0 0 0 161 16 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 151 0 0 0 139 12 88% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 38 0 0 0 33 5 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 84 0 0 0 77 7 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 118 0 1 0 103 14 100% 0.5% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Ningxia Prov. Lab 19 0 0 0 17 2 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 8 0 0 0 7 1 71% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 65 0 0 0 48 17 79% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 248 0 0 0 222 26 100% 0% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Shanghai Prov. Lab 38 0 0 0 35 3 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 95 0 2 0 90 3 98% 1% Prov. Lab/CCDC 6 0 2 0 0 0 0 0 4 0 0 0 0 100% China, Sichuan Prov. Lab 335 0 1 0 310 24 98% 0.2% Prov. Lab/CCDC 2 0 2 0 0 0 0 0 0 0 0 0 0 100% China, Tianjin Prov. Lab 12 0 1 0 10 1 100% 5% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Xinjiang Prov. Lab 127 0 1 0 118 8 97% 0.4% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Yunnan Prov. Lab 175 0 0 0 157 18 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 159 0 1 0 138 20 100% 0.4% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Tibet Prov. Lab 16 0 0 0 16 0 94% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 15 0 0 0 15 0 97% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 45 0 0 4 41 0 91% 8% 19-Dec-23 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 39 0 0 1 23 15 100% 4% 19-Dec-23 NIID 0 - - - - - - - - - - - - - Malaysia IMR 248 0 0 19 229 0 88% 7% 14-Jan-23 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 29-Dec-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 7 0 0 1 6 0 100% 18% 08-Jan-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 23 0 0 3 20 0 95% 9% 14-Nov-23 VIDRL 33 0 10 0 0 0 0 0 23 0 0 0 0 100% Philippines RITM 53 6 0 4 43 0 97% 7% 11-Dec-23 RITM/NIID 66 0 26 0 0 0 0 0 40 0 0 0 0 100% Republic of Korea KDCA 868 12 0 42 801 13 97% 4% 15-Jan-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 50 0 0 6 41 3 93% 12% 09-Jan-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 3 0 0 1 2 0 100% 33% 11-Jan-24 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 164 0 0 27 137 0 100% 16% 11-Jan-23 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 113 0 0 14 99 0 100% 12% 16-Jan-24 VIDRL 0 - - - - - - - - - - - - - Total 6396 19 17 131 5778 451 97% 2% 146 0 54 0 0 0 0 0 90 0 2 0 0 99% 2. NPEV growing in L20B cells Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin VDPVPending % specimens positive for NPEV Latest report date SabinWild 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only Table 2B. Laboratory investigation of stool samples from AFP cases with onset in 2023 and key laboratory indicators 5 Polio Bulletin Table 3A. Laboratory confirmation of polio isolates from environmental samples in 20221 and key laboratory indicators 6 Polio Bulletin Table 3B. Laboratory confirmation of polio isolates from environmental samples in 20231 and key laboratory indicators 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); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); RITM (Research Institute for Tropical Medicine, Philippines); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 10 1 0 0 0 0 0 0 0 1 0 100% 0 0 China (total) 472 116 0 111 0 0 0 0 0 160 0 39% 0 0 China, Fujian Prov. Lab/CCDC 64 7 0 1 0 0 0 0 0 7 0 78% 0 0 China, Gansu Prov. Lab/CCDC 25 11 0 13 0 0 0 0 0 15 0 68% 0 0 China, Guangdong Prov. Lab/CCDC 48 25 0 8 0 0 0 0 0 25 0 33% 0 0 China, Guangxi Prov. Lab/CCDC 12 5 0 9 0 0 0 0 0 4 0 92% 0 0 China, Heilongjiang Prov. Lab/CCDC 23 5 0 0 0 0 0 0 0 5 0 39% 0 0 China, Jiangxi Prov. Lab/CCDC 11 1 0 0 0 0 0 0 0 1 0 27% 0 0 China, Jiangsu Prov. Lab/CCDC 124 0 0 0 0 0 0 0 0 0 0 4% 0 0 China, Liaoning Prov. Lab/CCDC 18 7 0 1 0 0 0 0 0 9 0 11% 0 0 China, Neimongol Prov. Lab/CCDC 12 4 0 2 0 0 0 0 0 14 0 0% 0 0 China, Qinghai Prov. Lab/CCDC 9 2 0 5 0 0 0 0 0 0 0 11% 0 0 China, Shandong Prov. Lab/CCDC 31 7 0 6 0 0 0 0 0 6 0 45% 0 0 China, Shanghai Prov. Lab/CCDC 20 0 0 0 0 0 0 0 0 0 0 20% 0 0 China, Sichuan Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab/CCDC 23 12 0 12 0 0 0 0 0 32 0 26% 0 0 China, Yunnan Prov. Lab/CCDC 52 30 0 54 0 0 0 0 0 42 0 90% 0 0 Malaysia IMR/VIDRL 469 0 0 0 0 0 0 0 0 0 0 11% 0 0 Philippines RITM 536 43 0 33 0 0 0 0 0 72 0 29% 0 0 Viet Nam NIHE 101 0 0 0 0 0 0 0 0 0 0 7% 0 0 Total 1588 160 0 144 0 0 0 0 0 233 0 26% 0 0 Country/area Intratypic differentiation lab 2 NPEV (%) Pending ITD Polio isolates Discordant pending sequencing Total number of samples processed Total number of samples with polio isolates Type 1 Type 2 Type 3 Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 49 3 0 0 0 0 0 0 0 3 0 71% 0 0 Cambodia RITM 12 1 0 0 0 0 0 0 0 1 0 42% 2 0 China (total) 418 123 0 105 0 0 0 0 0 190 0 27% 1 0 China, Fujian Prov. Lab/CCDC 62 7 0 0 0 0 0 0 0 7 0 60% 1 0 China, Gansu Prov. Lab/CCDC 27 12 0 12 0 0 0 0 0 7 0 15% 0 0 China, Guangdong Prov. Lab/CCDC 44 26 0 13 0 0 0 0 0 35 0 52% 0 0 China, Guangxi Prov. Lab/CCDC 9 4 0 3 0 0 0 0 0 9 0 67% 0 0 China, Heilongjiang Prov. Lab/CCDC 6 3 0 8 0 0 0 0 0 13 0 0% 0 0 China, Jiangxi Prov. Lab/CCDC 5 0 0 0 0 0 0 0 0 0 0 0% 0 0 China, Jiangsu Prov. Lab/CCDC 98 4 0 1 0 0 0 0 0 3 0 5% 0 0 China, Liaoning Prov. Lab/CCDC 35 14 0 3 0 0 0 0 0 24 0 6% 0 0 China, Neimongol Prov. Lab/CCDC 16 7 0 14 0 0 0 0 0 13 0 0% 0 0 China, Qinghai Prov. Lab/CCDC 10 1 0 0 0 0 0 0 0 1 0 10% 0 0 China, Shandong Prov. Lab/CCDC 8 2 0 1 0 0 0 0 0 2 0 0% 0 0 China, Shanghai Prov. Lab/CCDC 24 11 0 3 0 0 0 0 0 19 0 25% 0 0 China, Sichuan Prov. Lab/CCDC 18 0 0 0 0 0 0 0 0 0 0 17% 0 0 China, Xinjiang Prov. Lab/CCDC 24 18 0 42 0 0 0 0 0 45 0 0% 0 0 China, Yunnan Prov. Lab/CCDC 14 7 0 3 0 0 0 0 0 4 0 57% 0 0 China, Zheijiang Prov. Lab/CCDC 18 7 0 2 0 0 0 0 0 8 0 50% 0 0 Malaysia IMR 330 0 0 0 0 0 0 0 0 0 0 48% 3 0 New Zealand IESR 66 4 0 0 0 0 0 0 0 4 0 88% 0 0 Philippines RITM 610 37 0 17 0 0 0 0 0 44 0 15% 0 0 Viet Nam NIHE 123 0 0 0 0 0 0 0 0 0 0 2% 46 0 Total 1608 168 0 122 0 0 0 0 0 242 0 29% 52 0 Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates NPEV (%) Pending ITD Discordant pending sequencing Type 1 Type 2 Type 3 Figure 5A. China Figure 5B. Malaysia Figure 5C. Papua New Guinea Figure 5D. Philippines 1. Prefix letter refers to the VDPV category: “cVDPV” = circulating VDPV, “iVDPV” = immunodeficiency-associated VDPV, “aVDPV” = ambiguous VDPV. Suffix number refers to the poliovirus serotype (types 1, 2 or 3) 2. Community and healthy children 3. Contact of a different AFP case Vaccine-derived polio virus identified from laboratory testing, 2018–2022 0 2 4 6 8 10 12 14 16 cVDPV1 cVDPV2 cVDPV1 cVDPV2 aVDPV2 aVDPV3 2019 2020 N o. o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 45 2018 N o . o f ca se s/ sp ec im en s 0 5 10 15 20 25 30 35 40 cVDPV1 cVDPV2 iVDPV2 aVDPV2 cVDPV2 aVDPV2 2019 2020 N o. o f c as es /s pe ci m en s 7 Polio Bulletin 0 1 2 3 4 5 cVDPV2 iVDPV3 aVDPV3 cVDPV2 aVDPV3 aVDPV1 cVDPV3 aVDPV3 aVDPV1 cVDPV3 aVDPV3 iVDPV3 aVDPV1 aVDPV1 aVDPV3 2018 2019 2020 2021 2022 2023 N o . o f  ca se s/ sp ec im en s

Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Phone: +63 2 8528 8001 Fax: +63 2 8521 1036, 8526 0279 Email: wproepidata@who.int Web: www.who.int/westernpacific Polio Bulletin 2024 Issue No. 3 - Week 5 (as of 30 January 2024) HIGHLIGHTS Figure 1. Non-polio AFP rate (per 100 000 persons < 15 years of age), 2021–2023 Figure 2. Adequate specimen collection rate, 2021–2023 Figure 3. Percentage of reported AFP cases by number of polio vaccination doses, 2023 Figure 4. Percentage of reported AFP cases with pending classification > 90 days after onset, 2023 0.0 1.0 2.0 3.0 4.0 5.0 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% CHN KHM LAO MYS PHL PNG VNM ≥ 3 doses 1-2 doses 0 doses Unknown 3.3% 5.7% 35.1% 0.0% 0.0% 0.0% 44.0% 0% 10% 20% 30% 40% 50% VNM PNG PHL MYS LAO KHM CHN 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). Health leaders call for focused efforts in endemic and most consequential geographies Global health leaders and Ministers of Health at the 154th session of the WHO Executive Board in January 2024 reaffirmed their commitment to eradicate polio once and for all and use the polio investments to build strong, equitable and resilient health systems. Member States noted the unique opportunity to eradicate remaining wild poliovirus type 1 endemic transmission. Delegates also reiterated the importance of intensifying efforts to combat variant poliovirus outbreaks (circulating vaccine-derived polioviruses), including through strengthened outbreak response and the continued roll-out of novel oral polio vaccine type 2, which became the first vaccine used under Emergency Use Listing to be pre-qualified by WHO. For more information please visit: https://polioeradication.org/news-post/eb-eyes-success- on-polio-focus-on-areas-of-complex-emergencies/ CONTACT US 2021 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 63 48 81 0 0 0 81 0 0 (0.0%) 1.70 72% 100% 11-Apr-23 - Brunei Darussalam 2 1 2 0 0 0 2 0 0 (0.0%) 2.16 50% 100% 20-Feb-23 - Cambodia 5 48 35 0 0 0 35 0 0 (0.0%) 0.73 63% 100% 01-Feb-23 - China 4769 2362 4225 0 0 0 4225 0 0 (0.0%) 1.79 92% 99% 26-May-23 - China, Hong Kong SAR 9 8 6 0 0 0 6 0 0 (0.0%) 0.78 67% 100% 28-Nov-23 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.10 100% 100% 23-Feb-23 - Japan 0 148 41 0 0 0 40 1 1 (0.1%) 0.28 73% 98% 07-Dec-23 54 Lao People's Democratic Republic 20 23 28 0 0 0 28 0 0 (0.0%) 1.22 64% 68% 09-Oct-23 - Malaysia 111 80 212 0 0 0 212 0 0 (0.0%) 2.65 76% 83% 03-Apr-23 - Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 10-Nov-23 - New Zealand 9 10 23 0 0 0 23 0 0 (0.0%) 2.37 35% 100% 28-Nov-23 - Papua New Guinea 52 38 59 0 0 0 59 0 0 (0.0%) 1.53 69% 83% 10-Nov-23 - Philippines 894 327 853 0 0 0 853 0 0 (0.0%) 2.60 79% 0% 23-Nov-23 - Republic of Korea 35 60 57 0 0 0 57 0 0 (0.0%) 0.95 82% 98% 08-Mar-23 - Singapore 4 6 11 0 0 0 11 0 0 (0.0%) 1.91 82% 82% 01-Feb-23 - Viet Nam 162 250 238 0 0 0 238 0 0 (0.0%) 0.95 98% 65% 12-May-23 - Pacific island countries and areas 16 11 7 0 0 0 7 0 0 (0.0%) 0.64 71% 71% 08-Nov-22 - Total 6153 3430 5880 0 0 0 5879 1 1 (0.02%) 1.71 88% 82% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO > 90 days 1 # (%) Vaccine- derived poliovirus (VDPV) Polio- compatible Classification Pending Days since last report 5 % investigated ≤  2 days of notification 3 Indicators Latest report date 4 2022 Non-polio AFP rate Total % with adequate specimens 2 Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Table 1A. Classification of AFP cases with onset in 2022 and key surveillance indicators 2 Polio Bulletin 2022 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 81 48 83 0 0 0 72 11 0 (0.0%) 1.74 63% 99% 23-Jan-24 7 Brunei Darussalam 2 1 1 0 0 0 1 0 0 (0.0%) 1.08 100% 100% 18-Jan-24 12 Cambodia 35 48 46 0 0 0 46 0 0 (0.0%) 0.96 91% 98% 24-Jan-24 6 China 4225 1877 4825 0 0 0 1798 3027 2,124 (44.0%) 2.57 91% 99% 29-Dec-23 32 China, Hong Kong SAR 6 8 16 0 0 0 16 0 0 (0.0%) 2.07 81% 100% 18-Jan-24 12 China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.04 100% 100% 18-Jan-24 12 Japan 41 144 54 0 0 0 46 8 1 (1.9%) 0.38 56% 91% 30-Jan-24 0 Lao People's Democratic Republic 28 23 39 0 0 0 24 15 0 (0.0%) 1.70 87% 90% 19-Dec-23 42 Malaysia 212 75 235 0 0 0 229 6 0 (0.0%) 3.11 84% 91% 25-Jan-24 5 Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 26-Jan-24 4 New Zealand 23 10 11 0 0 0 8 3 0 (0.0%) 1.14 64% 82% 18-Jan-24 12 Papua New Guinea 59 39 53 0 0 0 45 8 3 (5.7%) 1.34 60% 70% 24-Nov-23 67 Philippines 853 342 890 0 0 0 417 473 312 (35.1%) 2.60 66% 43% 19-Dec-23 42 Republic of Korea 57 57 51 0 0 0 46 5 0 (0.0%) 0.90 82% 100% 23-Jan-24 7 Singapore 11 6 3 0 0 0 3 0 0 (0.0%) 0.52 100% 100% 03-Jan-24 27 Viet Nam 238 222 274 0 0 0 207 67 9 (3.3%) 1.23 100% 62% 16-Jan-24 14 Pacific island countries and areas 7 10 26 0 0 0 20 6 4 (15.4%) 2.53 50% 69% 29-Jan-24 1 Total 5880 2921 6609 0 0 0 2980 3629 2,453 (37.1%) 2.26 87% 89% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Annualized non-polio AFP rate per 100 000 population under 15 years of age Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Substantially below target 4. Percentage of reported cases investigated within two days of notification 5. Countries are expected to submit data at least once per month to WPRO Total 2023 % with adequate specimens 3 Pending Classification Non-polio AFP rate 2 Vaccine- derived poliovirus (VDPV) Polio- compatible Days since last report 5 % investigated ≤ 2 days of notification 4 Indicators Latest report date> 90 days 1 # (%) Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Table 1B. Classification of AFP cases with onset in 2023 and key surveillance indicators 3 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 78 1 1 3 73 0 95% 3% 31-Jan-23 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 100% Brunei Darussalam VIDRL 2 0 0 0 2 0 100% 0% 16-Jan-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 35 1 0 2 32 0 97% 7% 31-Dec-22 NIID 0 - - - - - - - - - - - - - China (total) 4182 2 7 1 4162 10 98% 0.1% 26-May-23 19 0 11 0 0 0 0 0 8 0 0 0 0 100% China, Anhui Prov. Lab 268 0 0 0 268 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Beijing Prov. Lab 34 0 0 0 33 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 36 0 0 0 36 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 132 0 0 0 132 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 52 0 0 0 50 2 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 452 0 2 0 449 1 92% 0.2% Prov. Lab/CCDC 4 0 4 0 0 0 0 0 0 0 0 0 0 100% China, Guangxi Prov. Lab 216 0 0 1 215 0 100% 0.2% Prov. Lab/CCDC 3 0 2 0 0 0 0 0 1 0 0 0 0 100% China, Guizhou Prov. Lab 175 0 0 0 173 2 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hainan Prov. Lab 48 0 0 0 48 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 225 0 0 0 225 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 29 0 0 0 29 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 437 1 2 0 432 2 100% 0.2% Prov. Lab/CCDC 7 0 3 0 0 0 0 0 4 0 0 0 0 100% China, Hubei Prov. Lab 108 0 0 0 108 0 92% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 198 0 0 0 198 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 173 0 0 0 173 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 142 0 1 0 141 0 99% 0.4% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Jilin Prov. Lab 31 0 0 0 31 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 60 0 0 0 60 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 93 0 0 0 93 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ningxia Prov. Lab 12 0 0 0 12 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 6 0 0 0 6 0 67% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 71 0 0 0 71 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 243 0 0 0 243 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab 33 0 0 0 33 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 79 1 1 0 76 1 97% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Sichuan Prov. Lab 348 0 0 0 348 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tianjin Prov. Lab 11 0 0 0 11 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 88 0 1 0 87 0 100% 1% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Yunnan Prov. Lab 207 0 0 0 206 1 90% 0% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Zhejiang Prov. Lab 166 0 0 0 166 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 9 0 0 0 9 0 33% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 6 0 0 0 6 0 100% 0% 26-Jan-23 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 0 0 100% 0% 03-Jan-23 PHLC 0 - - - - - - - - - - - - - Japan NIID 36 0 0 0 36 0 97% 0% 01-May-23 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 28 0 0 2 26 0 96% 5% 10-Oct-23 NIID 0 - - - - - - - - - - - - - Malaysia IMR 223 0 0 4 219 0 91% 1% 15-Dec-23 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 06-Nov-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 15 0 0 2 12 0 100% 7% 16-Feb-23 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 57 1 1 4 51 0 81% 8% 14-Nov-23 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 100% Philippines RITM 827 5 1 63 758 0 98% 6% 11-Sep-23 RITM/NIID 19 0 8 0 0 0 0 0 11 0 0 0 0 100% Republic of Korea KDCA 57 0 0 7 50 0 82% 11% 19-Jan-23 KDCA 0 - - - - - - - - - - - - - Singapore SGH 11 0 0 0 11 0 95% 0% 11-Jan-23 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 155 0 0 26 129 0 100% 16% 15-Dec-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 79 0 0 5 74 0 100% 6% 09-Jan-23 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 7 0 0 1 6 0 85% 15% 24-Aug-22 VIDRL 0 - Total 5800 10 10 120 5648 10 97% 2% 44 0 19 0 0 0 0 0 19 0 6 0 0 100% 2. NPEV growing in L20B cells Country/area % ITD results reported ≤ 7 days of receipt Type 3 Polio laboratory 1 Type 1 Negative Results of virus isolation for AFP cases Results of intratypic differentiation (ITD)/sequencing for virus isolates L20B positive VDPV 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Total no. of AFP cases with specimens NPEV only Discordant pending sequencing NPEV 2VDPV L20B positive + NPEV Wild Sabin % specimens positive for NPEV Latest report date VDPV Sabin Pending ITDPending % results reported ≤ 14 days Wild Type 2 Table 2A. Laboratory investigation of stool samples from AFP cases with onset in 2022 and key laboratory indicators 4 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 77 0 2 2 73 0 94% 3% 23-Jan-24 VIDRL 2 0 0 0 0 0 0 0 0 0 2 0 0 100% Brunei Darussalam VIDRL 1 0 0 0 1 0 0% 0% 09-Oct-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 46 0 0 7 39 0 96% 14% 25-Dec-23 NIID 0 - - - - - - - - - - - - - China (total) 4642 1 15 0 4209 417 98% 0.2% 29-Dec-23 52 0 22 0 0 0 0 0 30 0 0 0 0 97% China, Anhui Prov. Lab 284 0 1 0 263 20 99% 0.2% Prov. Lab/CCDC 4 0 2 0 0 0 0 0 2 0 0 0 0 100% China, Beijing Prov. Lab 48 0 0 0 43 5 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 45 0 0 0 40 5 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 126 0 0 0 117 9 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 103 0 0 0 95 8 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 441 0 0 0 405 36 94% 0% Prov. Lab/CCDC 6 0 3 0 0 0 0 0 3 0 0 0 0 75% China, Guangxi Prov. Lab 205 0 3 0 163 39 98% 0.9% Prov. Lab/CCDC 8 0 2 0 0 0 0 0 6 0 0 0 0 100% China, Guizhou Prov. Lab 200 1 0 0 183 16 100% 0% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Hainan Prov. Lab 32 0 0 0 29 3 93% 0% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Hebei Prov. Lab 280 0 0 0 257 23 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 52 0 0 0 51 1 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 594 0 4 0 568 22 100% 0.3% Prov. Lab/CCDC 10 0 6 0 0 0 0 0 4 0 0 0 0 100% China, Hubei Prov. Lab 125 0 0 0 91 34 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 242 0 0 0 223 19 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 177 0 0 0 161 16 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 151 0 0 0 139 12 88% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 38 0 0 0 33 5 100% 0% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Liaoning Prov. Lab 84 0 0 0 77 7 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 118 0 1 0 103 14 100% 0.5% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Ningxia Prov. Lab 19 0 0 0 17 2 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 8 0 0 0 7 1 71% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 65 0 0 0 48 17 79% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 248 0 0 0 222 26 100% 0% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Shanghai Prov. Lab 38 0 0 0 35 3 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 95 0 2 0 90 3 98% 1% Prov. Lab/CCDC 6 0 2 0 0 0 0 0 4 0 0 0 0 100% China, Sichuan Prov. Lab 335 0 1 0 310 24 98% 0.2% Prov. Lab/CCDC 4 0 3 0 0 0 0 0 1 0 0 0 0 100% China, Tianjin Prov. Lab 12 0 1 0 10 1 100% 5% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Xinjiang Prov. Lab 127 0 1 0 118 8 97% 0.4% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Yunnan Prov. Lab 175 0 0 0 157 18 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 159 0 1 0 138 20 100% 0.4% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Tibet Prov. Lab 16 0 0 0 16 0 94% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 15 0 0 0 15 0 97% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 46 0 0 4 41 1 91% 8% 30-Jan-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 39 0 0 1 23 15 100% 4% 19-Dec-23 NIID 0 - - - - - - - - - - - - - Malaysia IMR 249 0 0 19 230 0 88% 7% 19-Jan-23 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 29-Dec-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 8 0 0 1 6 1 100% 17% 29-Jan-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 53 6 0 4 43 0 97% 7% 17-Jan-24 VIDRL 31 0 8 0 0 0 0 0 23 0 0 0 0 100% Philippines RITM 884 12 0 42 820 10 97% 4% 29-Jan-24 RITM/NIID 66 0 26 0 0 0 0 0 40 0 0 0 0 100% Republic of Korea KDCA 51 0 0 6 42 3 94% 12% 23-Jan-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 3 0 0 1 2 0 100% 33% 11-Jan-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 164 0 0 27 137 0 100% 16% 11-Jan-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 113 0 0 14 99 0 100% 12% 29-Jan-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 24 0 0 3 21 0 96% 9% 22-Jan-24 VIDRL 0 - - - - - - - - - - - - - Total 6417 19 17 131 5803 447 97% 2% 151 0 56 0 0 0 0 0 93 0 2 0 0 99% 2. NPEV growing in L20B cells Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin VDPVPending % specimens positive for NPEV Latest report date SabinWild 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only Table 2B. Laboratory investigation of stool samples from AFP cases with onset in 2023 and key laboratory indicators 5 Polio Bulletin Table 3A. Laboratory confirmation of polio isolates from environmental samples in 20221 and key laboratory indicators 6 Polio Bulletin Table 3B. Laboratory confirmation of polio isolates from environmental samples in 20231 and key laboratory indicators 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); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); RITM (Research Institute for Tropical Medicine, Philippines); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 10 1 0 0 0 0 0 0 0 1 0 100% 0 0 China (total) 472 116 0 111 0 0 0 0 0 160 0 39% 0 0 China, Fujian Prov. Lab/CCDC 64 7 0 1 0 0 0 0 0 7 0 78% 0 0 China, Gansu Prov. Lab/CCDC 25 11 0 13 0 0 0 0 0 15 0 68% 0 0 China, Guangdong Prov. Lab/CCDC 48 25 0 8 0 0 0 0 0 25 0 33% 0 0 China, Guangxi Prov. Lab/CCDC 12 5 0 9 0 0 0 0 0 4 0 92% 0 0 China, Heilongjiang Prov. Lab/CCDC 23 5 0 0 0 0 0 0 0 5 0 39% 0 0 China, Jiangxi Prov. Lab/CCDC 11 1 0 0 0 0 0 0 0 1 0 27% 0 0 China, Jiangsu Prov. Lab/CCDC 124 0 0 0 0 0 0 0 0 0 0 4% 0 0 China, Liaoning Prov. Lab/CCDC 18 7 0 1 0 0 0 0 0 9 0 11% 0 0 China, Neimongol Prov. Lab/CCDC 12 4 0 2 0 0 0 0 0 14 0 0% 0 0 China, Qinghai Prov. Lab/CCDC 9 2 0 5 0 0 0 0 0 0 0 11% 0 0 China, Shandong Prov. Lab/CCDC 31 7 0 6 0 0 0 0 0 6 0 45% 0 0 China, Shanghai Prov. Lab/CCDC 20 0 0 0 0 0 0 0 0 0 0 20% 0 0 China, Sichuan Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab/CCDC 23 12 0 12 0 0 0 0 0 32 0 26% 0 0 China, Yunnan Prov. Lab/CCDC 52 30 0 54 0 0 0 0 0 42 0 90% 0 0 Malaysia IMR/VIDRL 469 0 0 0 0 0 0 0 0 0 0 11% 0 0 Philippines RITM 536 43 0 33 0 0 0 0 0 72 0 29% 0 0 Viet Nam NIHE 101 0 0 0 0 0 0 0 0 0 0 7% 0 0 Total 1588 160 0 144 0 0 0 0 0 233 0 26% 0 0 Country/area Intratypic differentiation lab 2 NPEV (%) Pending ITD Polio isolates Discordant pending sequencing Total number of samples processed Total number of samples with polio isolates Type 1 Type 2 Type 3 Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 49 3 0 0 0 0 0 0 0 3 0 71% 0 0 Cambodia RITM 12 2 0 0 0 0 0 0 0 2 0 58% 0 0 China (total) 530 163 0 145 0 0 0 0 0 251 0 28% 1 0 China, Fujian Prov. Lab/CCDC 62 7 0 0 0 0 0 0 0 7 0 60% 1 0 China, Gansu Prov. Lab/CCDC 37 18 0 16 0 0 0 0 0 20 0 22% 0 0 China, Guangdong Prov. Lab/CCDC 48 30 0 20 0 0 0 0 0 41 0 52% 0 0 China, Guangxi Prov. Lab/CCDC 11 5 0 6 0 0 0 0 0 9 0 64% 0 0 China, Heilongjiang Prov. Lab/CCDC 22 10 0 12 0 0 0 0 0 28 0 18% 0 0 China, Jiangxi Prov. Lab/CCDC 5 0 0 0 0 0 0 0 0 0 0 0% 0 0 China, Jiangsu Prov. Lab/CCDC 124 10 0 4 0 0 0 0 0 6 0 5% 0 0 China, Liaoning Prov. Lab/CCDC 35 14 0 3 0 0 0 0 0 24 0 6% 0 0 China, Neimongol Prov. Lab/CCDC 20 8 0 15 0 0 0 0 0 13 0 0% 0 0 China, Qinghai Prov. Lab/CCDC 10 1 0 0 0 0 0 0 0 1 0 10% 0 0 China, Shandong Prov. Lab/CCDC 14 3 0 3 0 0 0 0 0 2 0 14% 0 0 China, Shanghai Prov. Lab/CCDC 32 15 0 8 0 0 0 0 0 24 0 31% 0 0 China, Sichuan Prov. Lab/CCDC 22 0 0 0 0 0 0 0 0 0 0 18% 0 0 China, Xinjiang Prov. Lab/CCDC 36 27 0 53 0 0 0 0 0 64 0 0% 0 0 China, Yunnan Prov. Lab/CCDC 14 7 0 3 0 0 0 0 0 4 0 57% 0 0 China, Zheijiang Prov. Lab/CCDC 18 8 0 2 0 0 0 0 0 8 0 68% 0 0 Lao PDR RITM 4 0 0 0 0 0 0 0 0 0 0 0% 0 0 Malaysia IMR 330 0 0 0 0 0 0 0 0 0 0 48% 3 0 New Zealand IESR 66 4 0 0 0 0 0 0 0 4 0 88% 0 0 Philippines RITM 614 37 0 17 0 0 0 0 0 44 0 15% 2 0 Viet Nam NIHE 123 0 0 0 0 0 0 0 0 0 0 2% 46 0 Total 1724 209 0 162 0 0 0 0 0 304 0 29% 52 0 Pending ITD Discordant pending sequencing Type 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates NPEV (%) Figure 5A. China Figure 5B. Malaysia Figure 5C. Papua New Guinea Figure 5D. Philippines 1. Prefix letter refers to the VDPV category: “cVDPV” = circulating VDPV, “iVDPV” = immunodeficiency-associated VDPV, “aVDPV” = ambiguous VDPV. Suffix number refers to the poliovirus serotype (types 1, 2 or 3) 2. Community and healthy children 3. Contact of a different AFP case Vaccine-derived polio virus identified from laboratory testing, 2018–2022 0 2 4 6 8 10 12 14 16 cVDPV1 cVDPV2 cVDPV1 cVDPV2 aVDPV2 aVDPV3 2019 2020 N o. o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 45 2018 N o . o f ca se s/ sp ec im en s 0 5 10 15 20 25 30 35 40 cVDPV1 cVDPV2 iVDPV2 aVDPV2 cVDPV2 aVDPV2 2019 2020 N o. o f c as es /s pe ci m en s 7 Polio Bulletin 0 1 2 3 4 5 cVDPV2 iVDPV3 aVDPV3 cVDPV2 aVDPV3 aVDPV1 cVDPV3 aVDPV3 aVDPV1 cVDPV3 aVDPV3 iVDPV3 aVDPV1 aVDPV1 aVDPV3 iVDPV3 2018 2019 2020 2021 2022 2023 N o . o f c as es /s pe ci m en s

Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Phone: +63 2 8528 8001 Fax: +63 2 8521 1036, 8526 0279 Email: wproepidata@who.int Web: www.who.int/westernpacific Polio Bulletin 2024 Issue No. 4 - February 2024 (as of 5 March 2024) HIGHLIGHTS Figure 1. Non-polio AFP rate (per 100 000 persons < 15 years of age), 2021–2023 Figure 2. Adequate specimen collection rate, 2021–2023 Figure 3. Percentage of reported AFP cases by number of polio vaccination doses, 2023 Figure 4. Percentage of reported AFP cases with pending classification > 90 days after onset, 2023 0.0 1.0 2.0 3.0 4.0 5.0 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 21 22 23 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% CHN KHM LAO MYS PHL PNG VNM ≥ 3 doses 1-2 doses 0 doses Unknown 8.6% 5.7% 35.1% 0.4% 0.0% 0.0% 44.0% 0% 10% 20% 30% 40% 50% VNM PNG PHL MYS LAO KHM CHN 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). Ongoing circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreak in Indonesia Indonesia reported outbreak of cVDPV2 in October 2022 that continues to spread further in the country. The outbreak was first detected in Aceh province, and more recently the virus has spread to Central and East Java provinces. As of February 2024, seven cVDPV2 cases have been reported, and the date of paralysis onset of the most recent case is 06 December 2023, including several detections of the virus among healthy children, and environmental surveillance sites. The cVDPV2 virus isolates show 3-43 nucleotide differentiation from the Sabin type 2 strain. The outbreak response activities including large-scale immunization response with novel oral polio vaccine type 2 (nOPV2) continue. During the most recent nOPV2 SIA implemented in East Java, Central Java, and Sleman Yogyakarta provinces, nearly 9 million children aged upto seven years were vaccinated with nOPV2 achieving 103% coverage. For more details: https://www.who.int/indonesia/ emergencies/polio-outbreak CONTACT US 2021 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 63 48 81 0 0 0 81 0 0 (0.0%) 1.70 72% 100% 11-Apr-23 - Brunei Darussalam 2 1 2 0 0 0 2 0 0 (0.0%) 2.16 50% 100% 20-Feb-23 - Cambodia 5 48 35 0 0 0 35 0 0 (0.0%) 0.73 63% 100% 01-Feb-23 - China 4769 2362 4225 0 0 0 4225 0 0 (0.0%) 1.79 92% 99% 26-May-23 - China, Hong Kong SAR 9 8 6 0 0 0 6 0 0 (0.0%) 0.78 67% 100% 28-Nov-23 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.10 100% 100% 23-Feb-23 - Japan 0 148 41 0 0 0 40 1 1 (0.1%) 0.28 73% 98% 02-Jan-24 63 Lao People's Democratic Republic 20 23 28 0 0 0 28 0 0 (0.0%) 1.22 64% 68% 09-Oct-23 - Malaysia 111 80 212 0 0 0 212 0 0 (0.0%) 2.65 76% 83% 03-Apr-23 - Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 10-Nov-23 - New Zealand 9 10 23 0 0 0 23 0 0 (0.0%) 2.37 35% 100% 28-Nov-23 - Papua New Guinea 52 38 59 0 0 0 59 0 0 (0.0%) 1.53 69% 83% 10-Nov-23 - Philippines 894 327 853 0 0 0 853 0 0 (0.0%) 2.60 79% 4% 23-Nov-23 - Republic of Korea 35 60 57 0 0 0 57 0 0 (0.0%) 0.95 82% 98% 08-Mar-23 - Singapore 4 6 11 0 0 0 11 0 0 (0.0%) 1.91 82% 82% 01-Feb-23 - Viet Nam 162 250 238 0 0 0 238 0 0 (0.0%) 0.95 98% 65% 12-May-23 - Pacific island countries and areas 16 11 7 0 0 0 7 0 0 (0.0%) 0.64 71% 71% 08-Nov-22 - Total 6153 3430 5880 0 0 0 5879 1 1 (0.02%) 1.71 88% 82% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO 2022 Non-polio AFP rate Total % with adequate specimens 2> 90 days 1 # (%) Vaccine- derived poliovirus (VDPV) Polio- compatible Classification Pending Discarded (Non-polio) Days since last report 5 % investigated ≤ 2 days of notification 3 Indicators Latest report date 4 Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Table 1A. Classification of AFP cases with onset in 2022 and key surveillance indicators 2 Polio Bulletin 2022 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 81 48 82 0 0 0 82 0 0 (0.0%) 1.72 63% 100% 26-Feb-24 - Brunei Darussalam 2 1 1 0 0 0 1 0 0 (0.0%) 1.08 100% 100% 18-Jan-24 - Cambodia 35 48 47 0 0 0 47 0 0 (0.0%) 0.98 89% 98% 24-Jan-24 - China 4225 1877 4825 0 0 0 1798 3027 2,124 (44.0%) 2.57 91% 99% 29-Dec-23 67 China, Hong Kong SAR 6 8 16 0 0 0 16 0 0 (0.0%) 2.07 81% 100% 18-Jan-24 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.10 100% 100% 04-Mar-24 - Japan 41 144 55 0 0 0 49 6 1 (1.8%) 0.38 55% 91% 20-Feb-24 14 Lao People's Democratic Republic 28 23 39 0 0 0 24 15 0 (0.0%) 1.70 87% 90% 19-Dec-23 77 Malaysia 212 75 237 0 0 0 234 3 1 (0.4%) 3.14 84% 92% 29-Feb-24 5 Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 26-Jan-24 - New Zealand 23 10 11 0 0 0 8 3 0 (0.0%) 1.14 64% 82% 05-Mar-24 0 Papua New Guinea 59 39 53 0 0 0 45 8 3 (5.7%) 1.34 60% 70% 24-Nov-23 102 Philippines 853 342 890 0 0 0 417 473 312 (35.1%) 2.60 66% 43% 19-Dec-23 77 Republic of Korea 57 57 51 0 0 0 49 2 0 (0.0%) 0.90 82% 100% 05-Mar-24 0 Singapore 11 6 3 0 0 0 3 0 0 (0.0%) 0.52 100% 100% 03-Jan-24 - Viet Nam 238 222 280 0 0 0 250 30 0 (0.0%) 1.26 99% 64% 05-Mar-24 0 Pacific island countries and areas 7 10 26 0 0 0 19 7 4 (15.4%) 2.53 50% 69% 02-Feb-24 32 Total 5880 2921 6618 0 0 0 3044 3574 2,445 (37.0%) 2.26 87% 90% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Annualized non-polio AFP rate per 100 000 population under 15 years of age Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Substantially below target 4. Percentage of reported cases investigated within two days of notification 5. Countries are expected to submit data at least once per month to WPRO Total 2023 % with adequate specimens 3 Pending Classification Non-polio AFP rate 2 Vaccine- derived poliovirus (VDPV) Polio- compatible Days since last report 5 % investigated ≤ 2 days of notification 4 Indicators Latest report date> 90 days 1 # (%) Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Table 1B. Classification of AFP cases with onset in 2023 and key surveillance indicators 3 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 78 1 1 3 73 0 95% 3% 31-Jan-23 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 100% Brunei Darussalam VIDRL 2 0 0 0 2 0 100% 0% 16-Jan-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 35 1 0 2 32 0 97% 7% 31-Dec-22 NIID 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China (total) 4182 2 7 1 4162 10 98% 0.1% 26-May-23 20 0 12 0 0 0 0 0 8 0 0 0 0 100% China, Anhui Prov. Lab 268 0 0 0 268 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Beijing Prov. Lab 34 0 0 0 33 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 36 0 0 0 36 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 132 0 0 0 132 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 52 0 0 0 50 2 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 452 0 2 0 449 1 92% 0.2% Prov. Lab/CCDC 4 0 4 0 0 0 0 0 0 0 0 0 0 100% China, Guangxi Prov. Lab 216 0 0 1 215 0 100% 0.2% Prov. Lab/CCDC 3 0 2 0 0 0 0 0 1 0 0 0 0 100% China, Guizhou Prov. Lab 175 0 0 0 173 2 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hainan Prov. Lab 48 0 0 0 48 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 225 0 0 0 225 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 29 0 0 0 29 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 437 1 2 0 432 2 100% 0.2% Prov. Lab/CCDC 7 0 3 0 0 0 0 0 4 0 0 0 0 100% China, Hubei Prov. Lab 108 0 0 0 108 0 92% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 198 0 0 0 198 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 173 0 0 0 173 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 142 0 1 0 141 0 99% 0.4% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Jilin Prov. Lab 31 0 0 0 31 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 60 0 0 0 60 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 93 0 0 0 93 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ningxia Prov. Lab 12 0 0 0 12 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 6 0 0 0 6 0 67% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 71 0 0 0 71 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 243 0 0 0 243 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab 33 0 0 0 33 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 79 1 1 0 76 1 97% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Sichuan Prov. Lab 348 0 0 0 348 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tianjin Prov. Lab 11 0 0 0 11 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 88 0 1 0 87 0 100% 1% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Yunnan Prov. Lab 207 0 0 0 206 1 90% 0% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Zhejiang Prov. Lab 166 0 0 0 166 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 9 0 0 0 9 0 33% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 6 0 0 0 6 0 100% 0% 26-Jan-23 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 0 0 100% 0% 03-Jan-23 PHLC 0 - - - - - - - - - - - - - Japan NIID 36 0 0 0 36 0 97% 0% 01-May-23 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 28 0 0 2 26 0 96% 5% 10-Oct-23 NIID 0 - - - - - - - - - - - - - Malaysia IMR 219 0 0 4 215 0 91% 1% 15-Dec-23 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 06-Nov-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 15 0 0 2 12 0 100% 7% 16-Feb-23 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 57 1 1 4 51 0 81% 8% 14-Nov-23 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 100% Philippines RITM 829 5 1 63 759 1 98% 6% 05-Mar-24 RITM/NIID 19 0 8 0 0 0 0 0 11 0 0 0 0 100% Republic of Korea KDCA 57 0 0 7 50 0 82% 11% 19-Jan-23 KDCA 0 - - - - - - - - - - - - - Singapore SGH 11 0 0 0 11 0 95% 0% 11-Jan-23 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 155 0 0 26 129 0 100% 16% 15-Dec-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 79 0 0 5 74 0 100% 6% 09-Jan-23 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 7 0 0 1 6 0 85% 15% 24-Aug-22 VIDRL 0 - Total 5798 10 10 120 5645 11 97% 2% 47 0 20 0 0 0 0 0 21 0 6 0 0 100% 2. NPEV growing in L20B cells Country/area % ITD results reported ≤ 7 days of receipt Type 3 Polio laboratory 1 Type 1 Negative Results of virus isolation for AFP cases Results of intratypic differentiation (ITD)/sequencing for virus isolates L20B positive VDPV 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Total no. of AFP cases with specimens NPEV only Discordant pending sequencing NPEV 2VDPV L20B positive + NPEV Wild Sabin % specimens positive for NPEV Latest report date VDPV Sabin Pending ITDPending % results reported ≤ 14 days Wild Type 2 Table 2A. Laboratory investigation of stool samples from AFP cases with onset in 2022 and key laboratory indicators 4 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 77 0 2 2 73 0 94% 3% 05-Feb-24 VIDRL 2 0 0 0 0 0 0 0 0 0 2 0 0 100% Brunei Darussalam VIDRL 1 0 0 0 1 0 0% 0% 09-Oct-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 46 0 0 7 39 0 96% 14% 25-Dec-23 NIID 0 - - - - - - - - - - - - - China (total) 4642 1 15 0 4209 417 98% 0.2% 29-Dec-23 56 0 24 0 0 0 0 0 32 0 0 0 0 100% China, Anhui Prov. Lab 284 0 1 0 263 20 99% 0.2% Prov. Lab/CCDC 4 0 2 0 0 0 0 0 2 0 0 0 0 100% China, Beijing Prov. Lab 48 0 0 0 43 5 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 45 0 0 0 40 5 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 126 0 0 0 117 9 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 103 0 0 0 95 8 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 441 0 0 0 405 36 94% 0% Prov. Lab/CCDC 6 0 3 0 0 0 0 0 3 0 0 0 0 100% China, Guangxi Prov. Lab 205 0 3 0 163 39 98% 0.9% Prov. Lab/CCDC 8 0 2 0 0 0 0 0 6 0 0 0 0 100% China, Guizhou Prov. Lab 200 1 0 0 183 16 100% 0% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Hainan Prov. Lab 32 0 0 0 29 3 93% 0% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Hebei Prov. Lab 280 0 0 0 257 23 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 52 0 0 0 51 1 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 594 0 4 0 568 22 100% 0.3% Prov. Lab/CCDC 14 0 8 0 0 0 0 0 6 0 0 0 0 100% China, Hubei Prov. Lab 125 0 0 0 91 34 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 242 0 0 0 223 19 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 177 0 0 0 161 16 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 151 0 0 0 139 12 88% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 38 0 0 0 33 5 100% 0% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Liaoning Prov. Lab 84 0 0 0 77 7 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 118 0 1 0 103 14 100% 0.5% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Ningxia Prov. Lab 19 0 0 0 17 2 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 8 0 0 0 7 1 71% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 65 0 0 0 48 17 79% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 248 0 0 0 222 26 100% 0% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Shanghai Prov. Lab 38 0 0 0 35 3 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 95 0 2 0 90 3 98% 1% Prov. Lab/CCDC 6 0 2 0 0 0 0 0 4 0 0 0 0 100% China, Sichuan Prov. Lab 335 0 1 0 310 24 98% 0.2% Prov. Lab/CCDC 4 0 3 0 0 0 0 0 1 0 0 0 0 100% China, Tianjin Prov. Lab 12 0 1 0 10 1 100% 5% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Xinjiang Prov. Lab 127 0 1 0 118 8 97% 0.4% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Yunnan Prov. Lab 175 0 0 0 157 18 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 159 0 1 0 138 20 100% 0.4% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Tibet Prov. Lab 16 0 0 0 16 0 94% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 14 0 0 0 14 0 97% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 40 0 0 4 36 0 91% 7% 21-Feb-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 39 0 0 1 23 15 100% 4% 19-Dec-23 NIID 0 - - - - - - - - - - - - - Malaysia IMR 253 0 0 19 234 0 88% 7% 19-Feb-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 29-Dec-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 4 0 0 1 3 0 100% 17% 19-Feb-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 53 6 0 4 43 0 97% 7% 17-Jan-24 VIDRL 27 0 6 0 0 0 0 0 21 0 0 0 0 100% Philippines RITM 891 12 0 45 831 3 97% 4% 05-Mar-24 RITM/NIID 66 0 26 0 0 0 0 0 40 0 0 0 0 100% Republic of Korea KDCA 51 0 0 6 43 2 94% 12% 02-Feb-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 3 0 0 1 2 0 100% 33% 11-Jan-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 164 0 0 27 137 0 100% 16% 11-Jan-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 113 0 0 14 99 0 100% 12% 29-Jan-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 24 0 0 3 21 0 96% 9% 22-Jan-24 VIDRL 0 - - - - - - - - - - - - - Total 6417 19 17 134 5810 437 97% 2% 151 0 56 0 0 0 0 0 93 0 2 0 0 100% 2. NPEV growing in L20B cells Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin VDPVPending % specimens positive for NPEV Latest report date SabinWild 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only Table 2B. Laboratory investigation of stool samples from AFP cases with onset in 2023 and key laboratory indicators 5 Polio Bulletin Table 3A. Laboratory confirmation of polio isolates from environmental samples in 20221 and key laboratory indicators 6 Polio Bulletin Table 3B. Laboratory confirmation of polio isolates from environmental samples in 20231 and key laboratory indicators 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); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); RITM (Research Institute for Tropical Medicine, Philippines); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 10 1 0 0 0 0 0 0 0 1 0 100% 0 0 China (total) 472 116 0 111 0 0 0 0 0 160 0 39% 0 0 China, Fujian Prov. Lab/CCDC 64 7 0 1 0 0 0 0 0 7 0 78% 0 0 China, Gansu Prov. Lab/CCDC 25 11 0 13 0 0 0 0 0 15 0 68% 0 0 China, Guangdong Prov. Lab/CCDC 48 25 0 8 0 0 0 0 0 25 0 33% 0 0 China, Guangxi Prov. Lab/CCDC 12 5 0 9 0 0 0 0 0 4 0 92% 0 0 China, Heilongjiang Prov. Lab/CCDC 23 5 0 0 0 0 0 0 0 5 0 39% 0 0 China, Jiangxi Prov. Lab/CCDC 11 1 0 0 0 0 0 0 0 1 0 27% 0 0 China, Jiangsu Prov. Lab/CCDC 124 0 0 0 0 0 0 0 0 0 0 4% 0 0 China, Liaoning Prov. Lab/CCDC 18 7 0 1 0 0 0 0 0 9 0 11% 0 0 China, Neimongol Prov. Lab/CCDC 12 4 0 2 0 0 0 0 0 14 0 0% 0 0 China, Qinghai Prov. Lab/CCDC 9 2 0 5 0 0 0 0 0 0 0 11% 0 0 China, Shandong Prov. Lab/CCDC 31 7 0 6 0 0 0 0 0 6 0 45% 0 0 China, Shanghai Prov. Lab/CCDC 20 0 0 0 0 0 0 0 0 0 0 20% 0 0 China, Sichuan Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab/CCDC 23 12 0 12 0 0 0 0 0 32 0 26% 0 0 China, Yunnan Prov. Lab/CCDC 52 30 0 54 0 0 0 0 0 42 0 90% 0 0 Malaysia IMR/VIDRL 469 0 0 0 0 0 0 0 0 0 0 11% 0 0 Philippines RITM 536 43 0 33 0 0 0 0 0 72 0 29% 0 0 Viet Nam NIHE 101 0 0 0 0 0 0 0 0 0 0 7% 0 0 Total 1588 160 0 144 0 0 0 0 0 233 0 26% 0 0 Country/area Intratypic differentiation lab 2 NPEV (%) Pending ITD Polio isolates Discordant pending sequencing Total number of samples processed Total number of samples with polio isolates Type 1 Type 2 Type 3 Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 49 3 0 0 0 0 0 0 0 3 0 100% 0 0 Cambodia RITM 12 2 0 0 0 0 0 0 0 2 0 58% 0 0 China (total) 613 201 0 203 0 0 0 0 0 289 0 34% 1 0 China, Fujian Prov. Lab/CCDC 62 7 0 0 0 0 0 0 0 7 0 60% 1 0 China, Gansu Prov. Lab/CCDC 42 21 0 23 0 0 0 0 0 26 0 21% 0 0 China, Guangdong Prov. Lab/CCDC 48 30 0 20 0 0 0 0 0 41 0 52% 0 0 China, Guangxi Prov. Lab/CCDC 12 6 0 6 0 0 0 0 0 11 0 58% 0 0 China, Heilongjiang Prov. Lab/CCDC 24 11 0 12 0 0 0 0 0 30 0 17% 0 0 China, Jiangxi Prov. Lab/CCDC 34 9 0 6 0 0 0 0 0 6 0 65% 0 0 China, Jiangsu Prov. Lab/CCDC 124 10 0 4 0 0 0 0 0 6 0 5% 0 0 China, Liaoning Prov. Lab/CCDC 43 16 0 6 0 0 0 0 0 25 0 5% 0 0 China, Neimongol Prov. Lab/CCDC 20 8 0 15 0 0 0 0 0 13 0 0% 0 0 China, Ninxia Prov. Lab/CCDC 19 8 0 20 0 0 0 0 0 8 0 42% 0 0 China, Qinghai Prov. Lab/CCDC 14 3 0 3 0 0 0 0 0 2 0 14% 0 0 China, Shandong Prov. Lab/CCDC 34 15 0 8 0 0 0 0 0 24 0 32% 0 0 China, Shanghai Prov. Lab/CCDC 24 0 0 0 0 0 0 0 0 0 0 17% 0 0 China, Xinjiang Prov. Lab/CCDC 36 27 0 53 0 0 0 0 0 64 0 0% 0 0 China, Yunnan Prov. Lab/CCDC 37 22 0 25 0 0 0 0 0 18 0 92% 0 0 China, Zheijiang Prov. Lab/CCDC 18 8 0 2 0 0 0 0 0 8 0 70% 0 0 Lao PDR RITM 4 0 0 0 0 0 0 0 0 0 0 0% 0 0 Malaysia IMR 321 0 0 0 0 0 0 0 0 0 0 47% 3 0 New Zealand IESR 66 4 0 0 0 0 0 0 0 4 0 88% 0 0 Philippines RITM 616 37 0 17 0 0 0 0 0 44 0 15% 0 0 Viet Nam NIHE 124 0 0 0 0 0 0 0 0 0 0 2% 2 0 Total 1805 247 0 220 0 0 0 0 0 342 0 32% 6 0 NPEV (%) Pending ITD Discordant pending sequencing Type 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates Figure 5A. China Figure 5B. Malaysia Figure 5C. Papua New Guinea Figure 5D. Philippines 1. Prefix letter refers to the VDPV category: “cVDPV” = circulating VDPV, “iVDPV” = immunodeficiency-associated VDPV, “aVDPV” = ambiguous VDPV. Suffix number refers to the poliovirus serotype (types 1, 2 or 3) 2. Community and healthy children 3. Contact of a different AFP case Vaccine-derived polio virus identified from laboratory testing, 2018–2023 0 2 4 6 8 10 12 14 16 cVDPV1 cVDPV2 cVDPV1 cVDPV2 aVDPV2 aVDPV3 2019 2020 N o. o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 45 2018 N o . o f ca se s/ sp ec im en s 0 5 10 15 20 25 30 35 40 cVDPV1 cVDPV2 iVDPV2 aVDPV2 cVDPV2 aVDPV2 2019 2020 N o. o f c as es /s pe ci m en s 7 Polio Bulletin 0 1 2 3 4 5 cVDPV2 iVDPV3 aVDPV3 cVDPV2 aVDPV3 aVDPV1 cVDPV3 aVDPV3 aVDPV1 cVDPV3 aVDPV3 iVDPV3 aVDPV1 aVDPV1 aVDPV3 iVDPV3 2018 2019 2020 2021 2022 2023 N o . o f ca se s/ sp e ci m e n s

Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Phone: +63 2 8528 8001 Fax: +63 2 8521 1036, 8526 0279 Email: wproepidata@who.int Web: www.who.int/westernpacific Polio Bulletin 2024 Issue No. 5 - March 2024 (as of 2 April 2024) HIGHLIGHTS Figure 1. Non-polio AFP rate (per 100 000 persons < 15 years of age), 2022–2024 Figure 2. Adequate specimen collection rate, 2022–2024 Figure 3. Percentage of reported AFP cases by number of polio vaccination doses, 2024 Figure 4. Percentage of reported AFP cases with pending classification > 90 days after onset, 2024 0.0 1.0 2.0 3.0 4.0 5.0 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% CHN KHM LAO MYS PHL PNG VNM ≥ 3 doses 1-2 doses 0 doses Unknown 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 4.3% 0% 1% 2% 3% 4% 5% VNM PNG PHL MYS LAO KHM CHN 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). South-East Asia Region celebrates a decade of wild polio-free certification On 27 March 2014, India was officially certified wild polio-free. As the last country battling the virus in the WHO South-East Asia Region (SEAR), it paved the way for the entire Region to be certified wild polio-free. This was a huge milestone in the polio eradication efforts, equally important for other Regions like the Western Pacific, and the entire world. During celebration of the 10-year anniversary of this triumph on 27 March 2024, polio experts reflected upon the collective will and commitment that made overcoming a seemingly insurmountable health challenge possible at that time. Their reflections highlight the most critical elements that made success possible, including commitment from the governments, and strong partnerships for health. For more details: https://polioeradication.org/ news-post/experts-reflect-on-a-decade-of-wild- polio-free-certification-for-the-who-south-east- asia-region-searo/ CONTACT US 2021 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 63 48 81 0 0 0 81 0 0 (0.0%) 1.70 72% 100% 11-Apr-23 - Brunei Darussalam 2 1 2 0 0 0 2 0 0 (0.0%) 2.16 50% 100% 20-Feb-23 - Cambodia 5 48 35 0 0 0 35 0 0 (0.0%) 0.73 63% 100% 01-Feb-23 - China 4769 2362 4225 0 0 0 4225 0 0 (0.0%) 1.79 92% 99% 02-Apr-24 - China, Hong Kong SAR 9 8 6 0 0 0 6 0 0 (0.0%) 0.78 67% 100% 28-Nov-23 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.10 100% 100% 08-Mar-24 - Japan 0 148 41 0 0 0 40 1 1 (0.1%) 0.28 73% 98% 02-Jan-24 91 Lao People's Democratic Republic 20 23 28 0 0 0 28 0 0 (0.0%) 1.22 64% 68% 09-Oct-23 - Malaysia 111 80 212 0 0 0 212 0 0 (0.0%) 2.65 76% 83% 03-Apr-23 - Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 10-Nov-23 - New Zealand 9 10 23 0 0 0 23 0 0 (0.0%) 2.37 35% 100% 28-Nov-23 - Papua New Guinea 52 38 59 0 0 0 59 0 0 (0.0%) 1.53 69% 83% 10-Nov-23 - Philippines 894 327 853 0 0 0 853 0 0 (0.0%) 2.60 79% 0% 23-Nov-23 - Republic of Korea 35 60 57 0 0 0 57 0 0 (0.0%) 0.95 82% 98% 08-Mar-23 - Singapore 4 6 11 0 0 0 11 0 0 (0.0%) 1.91 82% 82% 01-Feb-23 - Viet Nam 162 250 238 0 0 0 238 0 0 (0.0%) 0.95 98% 65% 12-May-23 - Pacific island countries and areas 16 11 7 0 0 0 7 0 0 (0.0%) 0.64 71% 71% 08-Nov-22 - Total 6153 3430 5880 0 0 0 5879 1 1 (0.02%) 1.71 88% 82% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO Days since last report 5 % investigated ≤ 2 days of notification 3 Indicators Latest report date 4 Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus > 90 days 1 # (%) Vaccine- derived poliovirus (VDPV) Polio- compatible Classification Pending Discarded (Non-polio) 2022 Non-polio AFP rate Total % with adequate specimens 2 Table 1A. Classification of AFP cases with onset in 2022 and key surveillance indicators 2 Polio Bulletin 2022 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 81 48 82 0 0 0 82 0 0 (0.0%) 1.72 63% 100% 26-Feb-24 - Brunei Darussalam 2 1 1 0 0 0 1 0 0 (0.0%) 1.08 100% 100% 18-Jan-24 - Cambodia 35 48 47 0 0 0 47 0 0 (0.0%) 0.99 89% 98% 07-Mar-24 - China 4225 1877 5618 0 0 0 3963 1655 1,655 (29.5%) 2.99 95% 99% 02-Apr-24 0 China, Hong Kong SAR 6 8 16 0 0 0 16 0 0 (0.0%) 2.07 81% 100% 19-Mar-24 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.04 100% 100% 08-Mar-24 - Japan 41 144 55 0 0 0 49 6 1 (1.8%) 0.38 55% 91% 20-Feb-24 42 Lao People's Democratic Republic 28 23 39 0 0 0 24 15 0 (0.0%) 1.70 87% 90% 19-Dec-23 105 Malaysia 212 75 234 0 0 0 234 0 0 (0.0%) 3.10 85% 92% 12-Mar-24 - Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 26-Jan-24 - New Zealand 23 10 10 0 0 0 8 2 0 (0.0%) 1.04 70% 90% 23-Mar-24 10 Papua New Guinea 59 39 57 0 0 0 48 9 7 (12.3%) 1.44 56% 67% 02-Apr-24 0 Philippines 853 342 890 0 0 0 417 473 312 (35.1%) 2.60 66% 43% 19-Dec-23 105 Republic of Korea 57 57 51 0 0 0 51 0 0 (0.0%) 0.90 82% 100% 07-Mar-24 - Singapore 11 6 3 0 0 0 3 0 0 (0.0%) 0.52 100% 100% 03-Jan-24 - Viet Nam 238 222 280 0 0 0 250 30 24 (8.6%) 1.26 99% 64% 05-Mar-24 28 Pacific island countries and areas 7 10 26 0 0 0 19 7 4 (15.4%) 2.53 50% 69% 02-Feb-24 60 Total 5880 2921 7411 0 0 0 5214 2197 2,003 (27.0%) 2.54 90% 91% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Days since last report 5 % investigated ≤ 2 days of notification 3 Indicators Latest report date4> 90 days 1 # (%) Total 2023 % with adequate specimens 2 Pending Classification Non-polio AFP rate Vaccine- derived poliovirus (VDPV) Polio- compatible Table 1B. Classification of AFP cases with onset in 2023 and key surveillance indicators 3 Polio Bulletin 2023 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 82 48 13 0 0 0 0 13 0 (0.0%) 1.01 62% 92% 02-Apr-24 0 Brunei Darussalam 1 1 0 - - - - - - 0.00 - - 18-Jan-24 75 Cambodia 47 48 1 0 0 0 0 1 0 (0.0%) 0.08 0% 100% 15-Feb-24 47 China 5618 1877 696 0 0 0 49 647 30 (4.3%) 1.38 93% 99% 02-Apr-24 0 China, Hong Kong SAR 16 8 2 0 0 0 1 1 0 (0.0%) 0.98 100% 100% 26-Mar-24 7 China, Macao SAR 1 1 0 - - - - - - 0.00 - - 08-Mar-24 25 Japan 55 144 5 0 0 0 5 0 0 (0.0%) 0.13 60% 100% 25-Mar-24 8 Lao People's Democratic Republic 39 23 5 0 0 0 0 5 0 (0.0%) 0.81 100% 100% 22-Mar-24 11 Malaysia 234 75 25 0 0 0 12 13 0 (0.0%) 1.23 84% 12% 12-Mar-24 21 Mongolia 1 11 2 0 0 0 2 0 0 (0.0%) 0.68 100% 100% 02-Apr-24 0 New Zealand 10 10 1 0 0 0 0 1 0 (0.0%) 0.38 100% 0% 22-Mar-24 11 Papua New Guinea 57 41 4 0 0 0 0 4 0 (0.0%) 0.37 50% 50% 21-Mar-24 12 Philippines 890 344 0 - - - - - - 0.00 - - 19-Dec-23 105 Republic of Korea 51 54 9 0 0 0 2 7 0 (0.0%) 0.62 67% 100% 02-Apr-24 0 Singapore 3 6 0 - - - - - - 0.00 - - 04-Mar-24 29 Viet Nam 280 222 3 0 0 0 0 3 0 (0.0%) 0.05 100% 100% 05-Mar-24 28 Pacific island countries and areas 26 10 0 - - - - - - 0.00 - - 02-Feb-24 60 Total 7411 2923 766 0 0 0 71 695 30 (3.9%) 0.97 91% 96% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Annualized non-polio AFP rate per 100 000 population under 15 years of age Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Substantially below target 4. Percentage of reported cases investigated within two days of notification 5. Countries are expected to submit data at least once per month to WPRO Total 2024 % with adequate specimens 3 Pending Classification Non-polio AFP rate 2 Vaccine- derived poliovirus (VDPV) Polio- compatible Days since last report 5 % investigated ≤ 2 days of notification 4 Indicators Latest report date> 90 days 1 # (%) Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Table 1C. Classification of AFP cases with onset in 2024 and key surveillance indicators 4 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 78 1 1 3 73 0 95% 3% 31-Jan-23 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 100% Brunei Darussalam VIDRL 2 0 0 0 2 0 100% 0% 16-Jan-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 35 1 0 2 32 0 97% 7% 31-Dec-22 NIID 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China (total) 4180 2 7 1 4170 0 98% 0.1% 26-May-23 20 0 12 0 0 0 0 0 8 0 0 0 0 100% China, Anhui Prov. Lab 268 0 0 0 268 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Beijing Prov. Lab 34 0 0 0 34 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 36 0 0 0 36 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 132 0 0 0 132 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 52 0 0 0 52 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 450 0 2 0 448 0 92% 0.2% Prov. Lab/CCDC 4 0 4 0 0 0 0 0 0 0 0 0 0 100% China, Guangxi Prov. Lab 216 0 0 1 215 0 100% 0.2% Prov. Lab/CCDC 3 0 2 0 0 0 0 0 1 0 0 0 0 100% China, Guizhou Prov. Lab 174 0 0 0 174 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hainan Prov. Lab 48 0 0 0 48 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 225 0 0 0 225 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 29 0 0 0 29 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 437 1 2 0 434 0 100% 0.2% Prov. Lab/CCDC 7 0 3 0 0 0 0 0 4 0 0 0 0 100% China, Hubei Prov. Lab 108 0 0 0 108 0 92% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 198 0 0 0 198 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 173 0 0 0 173 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 142 0 1 0 141 0 99% 0.4% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Jilin Prov. Lab 31 0 0 0 31 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 60 0 0 0 60 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 93 0 0 0 93 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ningxia Prov. Lab 12 0 0 0 12 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 6 0 0 0 6 0 67% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 71 0 0 0 71 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 243 0 0 0 243 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab 33 0 0 0 33 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 79 1 1 0 77 0 97% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Sichuan Prov. Lab 348 0 0 0 348 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tianjin Prov. Lab 11 0 0 0 11 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 88 0 1 0 87 0 100% 1% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Yunnan Prov. Lab 208 0 0 0 208 0 90% 0% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Zhejiang Prov. Lab 166 0 0 0 166 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 9 0 0 0 9 0 33% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 6 0 0 0 6 0 100% 0% 26-Jan-23 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 0 0 100% 0% 03-Jan-23 PHLC 0 - - - - - - - - - - - - - Japan NIID 36 0 0 0 36 0 97% 0% 01-May-23 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 28 0 0 2 26 0 96% 5% 10-Oct-23 NIID 0 - - - - - - - - - - - - - Malaysia IMR 219 0 0 4 215 0 91% 1% 15-Dec-23 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 06-Nov-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 15 0 0 2 12 0 100% 7% 16-Feb-23 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 57 1 1 4 51 0 81% 8% 14-Nov-23 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 100% Philippines RITM 829 5 1 63 760 0 98% 6% 05-Mar-24 RITM/NIID 19 0 8 0 0 0 0 0 11 0 0 0 0 100% Republic of Korea KDCA 57 0 0 7 50 0 82% 11% 19-Jan-23 KDCA 0 - - - - - - - - - - - - - Singapore SGH 11 0 0 0 11 0 95% 0% 11-Jan-23 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 155 0 0 26 129 0 100% 16% 15-Dec-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 79 0 0 5 74 0 100% 6% 09-Jan-23 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 7 0 0 1 6 0 85% 15% 24-Aug-22 VIDRL 0 - Total 5796 10 10 120 5654 0 97% 2% 47 0 20 0 0 0 0 0 21 0 6 0 0 100% 2. NPEV growing in L20B cells Sabin Pending ITDPending % results reported ≤ 14 days Wild Type 2 L20B positive + NPEV Wild Sabin % specimens positive for NPEV Latest report date VDPV 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Total no. of AFP cases with specimens NPEV only Discordant pending sequencing NPEV 2VDPV Country/area % ITD results reported ≤ 7 days of receipt Type 3 Polio laboratory 1 Type 1 Negative Results of virus isolation for AFP cases Results of intratypic differentiation (ITD)/sequencing for virus isolates L20B positive VDPV Table 2A. Laboratory investigation of stool samples from AFP cases with onset in 2022 and key laboratory indicators 5 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 77 0 2 2 73 0 94% 3% 05-Feb-24 VIDRL 2 0 0 0 0 0 0 0 0 0 2 0 0 100% Brunei Darussalam VIDRL 1 0 0 0 1 0 0% 0% 09-Oct-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 46 0 0 7 39 0 96% 14% 25-Dec-23 NIID 0 - - - - - - - - - - - - - China (total) 4642 1 15 0 4209 417 98% 0.2% 29-Dec-23 56 0 24 0 0 0 0 0 32 0 0 0 0 100% China, Anhui Prov. Lab 284 0 1 0 263 20 99% 0.2% Prov. Lab/CCDC 4 0 2 0 0 0 0 0 2 0 0 0 0 100% China, Beijing Prov. Lab 48 0 0 0 43 5 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 45 0 0 0 40 5 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 126 0 0 0 117 9 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 103 0 0 0 95 8 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 441 0 0 0 405 36 94% 0% Prov. Lab/CCDC 6 0 3 0 0 0 0 0 3 0 0 0 0 100% China, Guangxi Prov. Lab 205 0 3 0 163 39 98% 0.9% Prov. Lab/CCDC 8 0 2 0 0 0 0 0 6 0 0 0 0 100% China, Guizhou Prov. Lab 200 1 0 0 183 16 100% 0% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Hainan Prov. Lab 32 0 0 0 29 3 93% 0% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Hebei Prov. Lab 280 0 0 0 257 23 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 52 0 0 0 51 1 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 594 0 4 0 568 22 100% 0.3% Prov. Lab/CCDC 14 0 8 0 0 0 0 0 6 0 0 0 0 100% China, Hubei Prov. Lab 125 0 0 0 91 34 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 242 0 0 0 223 19 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 177 0 0 0 161 16 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 151 0 0 0 139 12 88% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 38 0 0 0 33 5 100% 0% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Liaoning Prov. Lab 84 0 0 0 77 7 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 118 0 1 0 103 14 100% 0.5% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Ningxia Prov. Lab 19 0 0 0 17 2 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 8 0 0 0 7 1 71% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 65 0 0 0 48 17 79% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 248 0 0 0 222 26 100% 0% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Shanghai Prov. Lab 38 0 0 0 35 3 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 95 0 2 0 90 3 98% 1% Prov. Lab/CCDC 6 0 2 0 0 0 0 0 4 0 0 0 0 100% China, Sichuan Prov. Lab 335 0 1 0 310 24 98% 0.2% Prov. Lab/CCDC 4 0 3 0 0 0 0 0 1 0 0 0 0 100% China, Tianjin Prov. Lab 12 0 1 0 10 1 100% 5% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Xinjiang Prov. Lab 127 0 1 0 118 8 97% 0.4% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Yunnan Prov. Lab 175 0 0 0 157 18 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 159 0 1 0 138 20 100% 0.4% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Tibet Prov. Lab 16 0 0 0 16 0 94% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 14 0 0 0 14 0 97% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 40 0 0 4 36 0 91% 7% 21-Feb-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 39 0 0 1 23 15 100% 4% 19-Dec-23 NIID 0 - - - - - - - - - - - - - Malaysia IMR 253 0 0 19 234 0 88% 7% 19-Feb-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 29-Dec-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 4 0 0 1 3 0 100% 17% 19-Feb-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 53 6 0 4 43 0 97% 7% 17-Jan-24 VIDRL 27 0 6 0 0 0 0 0 21 0 0 0 0 100% Philippines RITM 891 12 0 45 831 3 97% 4% 05-Mar-24 RITM/NIID 66 0 26 0 0 0 0 0 40 0 0 0 0 100% Republic of Korea KDCA 51 0 0 6 43 2 94% 12% 02-Feb-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 3 0 0 1 2 0 100% 33% 11-Jan-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 164 0 0 27 137 0 100% 16% 11-Jan-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 113 0 0 14 99 0 100% 12% 29-Jan-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 24 0 0 3 21 0 96% 9% 22-Jan-24 VIDRL 0 - - - - - - - - - - - - - Total 6417 19 17 134 5810 437 97% 2% 151 0 56 0 0 0 0 0 93 0 2 0 0 100% 2. NPEV growing in L20B cells Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin VDPVPending % specimens positive for NPEV Latest report date SabinWild 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only Table 2B. Laboratory investigation of stool samples from AFP cases with onset in 2023 and key laboratory indicators 6 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 12 0 0 0 7 5 92% 0% 05-Feb-24 VIDRL 0 - - - - - - - - - - - - - Brunei Darussalam VIDRL 0 - - - - - - - 09-Oct-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 1 0 0 0 1 0 100% 0% 25-Dec-23 NIID 0 - - - - - - - - - - - - - China (total) 678 0 2 0 639 37 96% 0.2% 02-Apr-24 12 0 4 0 0 0 0 0 8 0 0 0 0 67% China, Anhui Prov. Lab 31 0 0 0 30 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Beijing Prov. Lab 8 0 0 0 8 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 7 0 0 0 6 1 92% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 19 0 0 0 16 3 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 9 0 0 0 9 0 67% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 61 0 0 0 56 5 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangxi Prov. Lab 34 0 0 0 33 1 94% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guizhou Prov. Lab 24 0 0 0 22 2 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hainan Prov. Lab 7 0 0 0 7 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 25 0 0 0 23 2 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 6 0 0 0 5 1 80% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 131 0 1 0 128 2 100% 0.4% Prov. Lab/CCDC 10 0 4 0 0 0 0 0 6 0 0 0 0 60% China, Hubei Prov. Lab 12 0 0 0 11 1 91% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 33 0 1 0 32 0 100% 2% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Jiangsu Prov. Lab 28 0 0 0 28 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 22 0 0 0 22 0 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 9 0 0 0 8 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 13 0 0 0 13 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 4 0 0 0 2 2 50% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ningxia Prov. Lab 3 0 0 0 2 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 1 0 0 0 1 0 0% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 13 0 0 0 13 0 68% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 41 0 0 0 36 5 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab 6 0 0 0 6 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 12 0 0 0 12 0 83% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Sichuan Prov. Lab 41 0 0 0 37 4 89% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tianjin Prov. Lab 4 0 0 0 4 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 17 0 0 0 16 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Yunnan Prov. Lab 19 0 0 0 15 4 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 38 0 0 0 38 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 0 - - - - - - - CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 2 0 0 0 1 1 100% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 0 - - - - - - - 08-Jan-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 5 0 0 0 5 0 100% 0% 21-Feb-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 5 0 0 0 0 5 0% 0% 19-Dec-23 NIID 0 - - - - - - - - - - - - - Malaysia IMR 33 0 0 2 31 0 100% 5% 19-Feb-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 2 0 0 0 2 0 100% 0% 29-Dec-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 1 0 0 1 0 0 100% 100% 19-Feb-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 4 0 0 0 0 4 0% 0% 21-Mar-24 VIDRL 0 - - - - - - - - - - - - - Philippines RITM 151 1 0 6 116 27 99% 3% 22-Mar-24 RITM/NIID 0 - - - - - - - - - - - - - Republic of Korea KDCA 9 0 0 0 8 1 100% 0% 02-Feb-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 0 - - - - - - - 11-Jan-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 0 - - - - - - - 11-Jan-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 14 0 0 1 12 1 100% 8% 29-Jan-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 0 - - - - - - - 22-Jan-24 VIDRL 0 - - - - - - - - - - - - - Total 917 1 2 10 822 81 97% 1% 12 0 4 0 0 0 0 0 8 0 0 0 0 67% 2. NPEV growing in L20B cells Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens VDPV Pending % specimens positive for NPEV Latest report date SabinWild Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin Table 2C. Laboratory investigation of stool samples from AFP cases with onset in 2024 and key laboratory indicators 7 Polio Bulletin Table 3A. Laboratory confirmation of polio isolates from environmental samples in 20231 and key laboratory indicators 8 Polio Bulletin Table 3B. Laboratory confirmation of polio isolates from environmental samples in 20241 and key laboratory indicators 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); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); RITM (Research Institute for Tropical Medicine, Philippines); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 49 3 0 0 0 0 0 0 0 3 0 100% 0 0 Cambodia RITM 12 2 0 0 0 0 0 0 0 2 0 58% 0 0 China (total) 613 201 0 203 0 0 0 0 0 289 2 34% 1 0 China, Fujian Prov. Lab/CCDC 62 7 0 0 0 0 0 0 0 7 0 60% 1 0 China, Gansu Prov. Lab/CCDC 42 21 0 23 0 0 0 0 0 26 0 21% 0 0 China, Guangdong Prov. Lab/CCDC 48 30 0 20 0 0 0 0 0 41 0 52% 0 0 China, Guangxi Prov. Lab/CCDC 12 6 0 6 0 0 0 0 0 11 0 58% 0 0 China, Heilongjiang Prov. Lab/CCDC 24 11 0 12 0 0 0 0 0 30 0 17% 0 0 China, Jiangxi Prov. Lab/CCDC 34 9 0 6 0 0 0 0 0 6 1 65% 0 0 China, Jiangsu Prov. Lab/CCDC 124 10 0 4 0 0 0 0 0 6 0 5% 0 0 China, Liaoning Prov. Lab/CCDC 43 16 0 6 0 0 0 0 0 25 0 5% 0 0 China, Neimongol Prov. Lab/CCDC 20 8 0 15 0 0 0 0 0 13 0 0% 0 0 China, Ninxia Prov. Lab/CCDC 19 8 0 20 0 0 0 0 0 8 0 42% 0 0 China, Qinghai Prov. Lab/CCDC 14 3 0 3 0 0 0 0 0 2 0 14% 0 0 China, Shandong Prov. Lab/CCDC 34 15 0 8 0 0 0 0 0 24 0 32% 0 0 China, Shanghai Prov. Lab/CCDC 24 0 0 0 0 0 0 0 0 0 0 17% 0 0 China, Xinjiang Prov. Lab/CCDC 36 27 0 53 0 0 0 0 0 64 0 0% 0 0 China, Yunnan Prov. Lab/CCDC 37 22 0 25 0 0 0 0 0 18 0 92% 0 0 China, Zheijiang Prov. Lab/CCDC 40 8 0 2 0 0 0 0 0 8 1 70% 0 0 Lao PDR RITM 4 0 0 0 0 0 0 0 0 0 0 0% 0 0 Malaysia IMR/VIDRL 321 0 0 0 0 0 0 0 0 0 0 47% 3 0 New Zealand IESR 80 4 0 0 0 0 0 0 0 4 0 90% 0 0 Philippines RITM 616 37 0 17 0 0 0 0 0 44 0 15% 0 0 Viet Nam NIHE 124 0 0 0 0 0 0 0 0 0 0 2% 2 0 Total 1819 247 0 220 0 0 0 0 0 342 2 32% 6 0 Pending ITD Discordant pending sequencing Type 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates NPEV (%) Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 12 3 0 1 0 0 0 0 0 2 0 58% 4 0 Cambodia RITM 0 - - - - - - - - - - - - - China (total) 20 15 0 26 0 0 0 0 0 23 0 35% 0 0 China, Fujian Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab/CCDC 6 3 0 5 0 0 0 0 0 7 0 0% 0 0 China, Guangdong Prov. Lab/CCDC 8 8 0 12 0 0 0 0 0 11 0 50% 0 0 China, Guangxi Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab/CCDC 3 1 0 2 0 0 0 0 0 0 0 33% 0 0 China, Neimongol Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ninxia Prov. Lab/CCDC 3 3 0 7 0 0 0 0 0 5 0 67% 0 0 China, Qinghai Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Yunnan Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zheijiang Prov. Lab/CCDC 0 - - - - - - - - - - - - - Lao PDR RITM 0 - - - - - - - - - - - - - Malaysia IMR/VIDRL 0 - - - - - - - - - - - - - New Zealand IESR 20 0 0 0 0 0 0 0 0 0 0 80% 4 0 Philippines RITM 128 6 0 2 0 0 0 0 17 0 34% 10 0 Viet Nam NIHE 0 - - - - - - - - - - - - - Total 180 24 0 29 0 0 0 0 0 42 0 41% 18 0 Pending ITD Discordant pending sequencing Type 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates NPEV (%) Figure 5A. China Figure 5B. Malaysia Figure 5C. Papua New Guinea Figure 5D. Philippines 1. Prefix letter refers to the VDPV category: “cVDPV” = circulating VDPV, “iVDPV” = immunodeficiency-associated VDPV, “aVDPV” = ambiguous VDPV. Suffix number refers to the poliovirus serotype (types 1, 2 or 3) 2. Community and healthy children 3. Contact of a different AFP case Vaccine-derived polio virus identified from laboratory testing, 2018–2023 0 2 4 6 8 10 12 14 16 cVDPV1 cVDPV2 cVDPV1 cVDPV2 aVDPV2 aVDPV3 2019 2020 N o. o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 45 cVDPV1 2018 N o.  o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 cVDPV1 cVDPV2 iVDPV2 aVDPV2 cVDPV2 aVDPV2 2019 2020 N o. o f c as es /s pe ci m en s 9 Polio Bulletin 0 1 2 3 4 5 cVDPV2 iVDPV3 aVDPV3 cVDPV2 aVDPV3 aVDPV1 cVDPV3 aVDPV3 aVDPV1 cVDPV3 aVDPV3 iVDPV3 aVDPV1 aVDPV1 aVDPV3 iVDPV3 2018 2019 2020 2021 2022 2023 N o . o f ca se s/ sp e ci m e n s

Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Phone: +63 2 8528 8001 Fax: +63 2 8521 1036, 8526 0279 Email: wproepidata@who.int Web: www.who.int/westernpacific Polio Bulletin 2024 Issue No. 6 - April 2024 (as of 7 May 2024) HIGHLIGHTS Figure 1. Non-polio AFP rate (per 100 000 persons < 15 years of age), 2022–2024 Figure 2. Adequate specimen collection rate, 2022–2024 Figure 3. Percentage of reported AFP cases by number of polio vaccination doses, 2024 Figure 4. Percentage of reported AFP cases with pending classification > 90 days after onset, 2024 0.0 1.0 2.0 3.0 4.0 5.0 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% CHN KHM LAO MYS PHL PNG VNM ≥ 3 doses 1-2 doses 0 doses Unknown 3.6% 0.0% 16.7% 0.0% 0.0% 0.0% 25.3% 0% 5% 10% 15% 20% 25% 30% VNM PNG PHL MYS LAO KHM CHN 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). Global Guidance for Conducting Acute Flaccid Paralysis (AFP) Surveillance in the Context of Polio Virus Eradication, 2024 Since 1996, all WHO Regions and several countries have produced AFP guidelines based on the “Field guide for supplementary activities aimed at achieving polio eradication”. In 2024, a new Global guidance for conducting acute flaccid paralysis (AFP) surveillance in the context of poliovirus eradication has been developed, and this replaces the 1996 field guide. The new global guidance outlines well-established strategies and activities for AFP surveillance to support countries in maintaining a surveillance system sensitive enough to detect the circulation of any polioviruses including vaccine- derived poliovirus and Sabin-like viruses. In addition, it aims to increase the speed of detection of polioviruses, maintain quality of surveillance at the subnational level, highlights the importance of gender equality and integration of polio with other vaccine preventable diseases. Overall, the new guidance stresses cross-cutting issues that remain central to the success of the polio eradication program. Link: Global guidance for conducting acute flaccid paralysis (‎AFP)‎ surveillance in the context of poliovirus eradication CONTACT US 2021 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 63 48 81 0 0 0 81 0 0 (0.0%) 1.70 72% 100% 11-Apr-23 - Brunei Darussalam 2 1 2 0 0 0 2 0 0 (0.0%) 2.16 50% 100% 20-Feb-23 - Cambodia 5 48 35 0 0 0 35 0 0 (0.0%) 0.73 63% 100% 01-Feb-23 - China 4769 2362 4225 0 0 0 4225 0 0 (0.0%) 1.79 92% 99% 02-Apr-24 - China, Hong Kong SAR 9 8 6 0 0 0 6 0 0 (0.0%) 0.78 67% 100% 28-Nov-23 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.10 100% 100% 08-Mar-24 - Japan 0 148 41 0 0 0 40 1 1 (0.1%) 0.28 73% 98% 02-Jan-24 126 Lao People's Democratic Republic 20 23 28 0 0 0 28 0 0 (0.0%) 1.22 64% 68% 09-Oct-23 - Malaysia 111 80 212 0 0 0 212 0 0 (0.0%) 2.65 76% 83% 03-Apr-23 - Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 10-Nov-23 - New Zealand 9 10 23 0 0 0 23 0 0 (0.0%) 2.37 35% 100% 28-Nov-23 - Papua New Guinea 52 38 59 0 0 0 59 0 0 (0.0%) 1.53 69% 83% 10-Nov-23 - Philippines 894 327 853 0 0 0 853 0 0 (0.0%) 2.60 79% 0% 23-Nov-23 - Republic of Korea 35 60 57 0 0 0 57 0 0 (0.0%) 0.95 82% 98% 08-Mar-23 - Singapore 4 6 11 0 0 0 11 0 0 (0.0%) 1.91 82% 82% 01-Feb-23 - Viet Nam 162 250 238 0 0 0 238 0 0 (0.0%) 0.95 98% 65% 12-May-23 - Pacific island countries and areas 16 11 7 0 0 0 7 0 0 (0.0%) 0.64 71% 71% 08-Nov-22 - Total 6153 3430 5880 0 0 0 5879 1 1 (0.02%) 1.71 88% 82% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Days since last report 5 % investigated ≤  2 days of notification 3 Indicators Latest report date 4 2022 Non-polio AFP rate Total % with adequate specimens 2> 90 days 1 # (%) Vaccine- derived poliovirus (VDPV) Polio- compatible Classification Pending Table 1A. Classification of AFP cases with onset in 2022 and key surveillance indicators 2 Polio Bulletin 2022 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 81 48 82 0 0 0 82 0 0 (0.0%) 1.72 63% 100% 26-Feb-24 - Brunei Darussalam 2 1 1 0 0 0 1 0 0 (0.0%) 1.08 100% 100% 18-Jan-24 - Cambodia 35 48 47 0 0 0 47 0 0 (0.0%) 0.99 89% 98% 07-Mar-24 - China 4225 1877 5649 0 0 0 4530 1119 1,119 (19.8%) 3.01 95% 99% 06-May-24 1 China, Hong Kong SAR 6 8 16 0 0 0 16 0 0 (0.0%) 2.07 81% 100% 19-Mar-24 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.04 100% 100% 08-Apr-24 - Japan 41 144 55 0 0 0 49 6 1 (1.8%) 0.38 55% 91% 20-Feb-24 77 Lao People's Democratic Republic 28 23 39 0 0 0 24 15 0 (0.0%) 1.70 87% 90% 19-Dec-23 140 Malaysia 212 75 235 0 0 0 234 1 1 (0.4%) 3.11 84% 92% 19-Apr-24 18 Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 26-Jan-24 - New Zealand 23 10 10 0 0 0 10 0 0 (0.0%) 1.04 70% 90% 09-Apr-24 - Papua New Guinea 59 39 59 0 0 0 50 9 8 (13.6%) 1.49 59% 68% 24-Apr-24 13 Philippines 853 342 979 0 0 0 425 554 510 (52.1%) 2.86 68% 57% 11-Apr-24 26 Republic of Korea 57 57 51 0 0 0 51 0 0 (0.0%) 0.90 82% 100% 07-Mar-24 - Singapore 11 6 3 0 0 0 3 0 0 (0.0%) 0.52 100% 100% 03-Jan-24 - Viet Nam 238 222 280 0 0 0 280 0 0 (0.0%) 1.26 99% 87% 23-Apr-24 - Pacific island countries and areas 7 10 27 0 0 0 20 7 7 (25.9%) 2.63 56% 67% 06-May-24 1 Total 5880 2921 7535 0 0 0 5824 1711 1,646 (21.8%) 2.58 90% 93% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Days since last report 5 % investigated ≤ 2 days of notification 3 Indicators Latest report date4> 90 days 1 # (%) Total 2023 % with adequate specimens 2 Pending Classification Non-polio AFP rate Vaccine- derived poliovirus (VDPV) Polio- compatible Table 1B. Classification of AFP cases with onset in 2023 and key surveillance indicators 3 Polio Bulletin 2023 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 82 48 24 0 0 0 10 14 0 (0.0%) 1.45 63% 96% 06-May-24 1 Brunei Darussalam 1 1 0 - - - - - - 0.00 - - 20-Apr-24 17 Cambodia 47 48 2 0 0 0 0 2 0 (0.0%) 0.12 50% 100% 22-Apr-24 15 China 5649 1877 1155 0 0 0 129 1026 292 (25.3%) 1.78 94% 99% 29-Apr-24 8 China, Hong Kong SAR 16 8 3 0 0 0 3 0 0 (0.0%) 1.15 100% 100% 29-Apr-24 8 China, Macao SAR 1 1 1 0 0 0 0 1 0 (0.0%) 3.01 100% 100% 07-May-24 0 Japan 55 144 11 0 0 0 9 2 0 (0.0%) 0.22 64% 100% 07-May-24 0 Lao People's Democratic Republic 39 23 7 0 0 0 0 7 0 (0.0%) 0.88 100% 86% 03-May-24 4 Malaysia 235 75 61 0 0 0 46 15 0 (0.0%) 2.33 89% 62% 06-May-24 1 Mongolia 1 11 3 0 0 0 2 1 0 (0.0%) 0.80 100% 100% 06-May-24 1 New Zealand 10 10 2 0 0 0 1 1 0 (0.0%) 0.60 50% 50% 12-Apr-24 25 Papua New Guinea 59 41 8 0 0 0 0 8 0 (0.0%) 0.57 63% 38% 03-May-24 4 Philippines 979 344 180 0 0 0 0 180 30 (16.7%) 1.51 47% 98% 11-Apr-24 26 Republic of Korea 51 54 14 0 0 0 3 11 0 (0.0%) 0.75 79% 100% 03-May-24 4 Singapore 3 6 2 0 0 0 2 0 0 (0.0%) 99% 100% 100% 26-Apr-24 11 Viet Nam 280 222 28 0 0 0 13 15 1 (3.6%) 0.36 100% 96% 23-Apr-24 14 Pacific island countries and areas 27 10 0 - - - - - - 0.00 - - 06-May-24 1 Total 7535 2923 1501 0 0 0 218 1283 323 (21.5%) 1.48 87% 97% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Annualized non-polio AFP rate per 100 000 population under 15 years of age Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Substantially below target 4. Percentage of reported cases investigated within two days of notification 5. Countries are expected to submit data at least once per month to WPRO Total 2024 % with adequate specimens 3 Pending Classification Non-polio AFP rate 2 Vaccine- derived poliovirus (VDPV) Polio- compatible Days since last report 5 % investigated ≤ 2 days of notification 4 Indicators Latest report date> 90 days 1 # (%) Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Table 1C. Classification of AFP cases with onset in 2024 and key surveillance indicators 4 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 78 1 1 3 73 0 95% 3% 31-Jan-23 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 100% Brunei Darussalam VIDRL 2 0 0 0 2 0 100% 0% 16-Jan-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 35 1 0 2 32 0 97% 7% 31-Dec-22 NIID 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China (total) 4180 2 7 1 4170 0 98% 0.1% 02-Apr-24 20 0 12 0 0 0 0 0 8 0 0 0 0 100% China, Anhui Prov. Lab 268 0 0 0 268 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Beijing Prov. Lab 34 0 0 0 34 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 36 0 0 0 36 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 132 0 0 0 132 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 52 0 0 0 52 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 450 0 2 0 448 0 92% 0.2% Prov. Lab/CCDC 4 0 4 0 0 0 0 0 0 0 0 0 0 100% China, Guangxi Prov. Lab 216 0 0 1 215 0 100% 0.2% Prov. Lab/CCDC 3 0 2 0 0 0 0 0 1 0 0 0 0 100% China, Guizhou Prov. Lab 174 0 0 0 174 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hainan Prov. Lab 48 0 0 0 48 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 225 0 0 0 225 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 29 0 0 0 29 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 437 1 2 0 434 0 100% 0.2% Prov. Lab/CCDC 7 0 3 0 0 0 0 0 4 0 0 0 0 100% China, Hubei Prov. Lab 108 0 0 0 108 0 92% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 198 0 0 0 198 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 173 0 0 0 173 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 142 0 1 0 141 0 99% 0.4% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Jilin Prov. Lab 31 0 0 0 31 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 60 0 0 0 60 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 93 0 0 0 93 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ningxia Prov. Lab 12 0 0 0 12 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 6 0 0 0 6 0 67% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 71 0 0 0 71 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 243 0 0 0 243 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab 33 0 0 0 33 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 79 1 1 0 77 0 97% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Sichuan Prov. Lab 348 0 0 0 348 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tianjin Prov. Lab 11 0 0 0 11 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 88 0 1 0 87 0 100% 1% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Yunnan Prov. Lab 208 0 0 0 208 0 90% 0% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Zhejiang Prov. Lab 166 0 0 0 166 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 9 0 0 0 9 0 33% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 6 0 0 0 6 0 100% 0% 26-Jan-23 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 0 0 100% 0% 03-Jan-23 PHLC 0 - - - - - - - - - - - - - Japan NIID 36 0 0 0 36 0 97% 0% 01-May-23 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 28 0 0 2 26 0 96% 5% 10-Oct-23 NIID 0 - - - - - - - - - - - - - Malaysia IMR 219 0 0 4 215 0 91% 1% 15-Dec-23 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 06-Nov-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 15 0 0 2 12 0 100% 7% 16-Feb-23 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 57 1 1 4 51 0 81% 8% 14-Nov-23 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 100% Philippines RITM 829 5 1 63 760 0 98% 6% 05-Mar-24 RITM/NIID 19 0 8 0 0 0 0 0 11 0 0 0 0 100% Republic of Korea KDCA 57 0 0 7 50 0 82% 11% 19-Jan-23 KDCA 0 - - - - - - - - - - - - - Singapore SGH 11 0 0 0 11 0 95% 0% 11-Jan-23 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 155 0 0 26 129 0 100% 16% 15-Dec-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 79 0 0 5 74 0 100% 6% 09-Jan-23 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 7 0 0 1 6 0 85% 15% 24-Aug-22 VIDRL 0 - Total 5796 10 10 120 5654 0 97% 2% 47 0 20 0 0 0 0 0 21 0 6 0 0 100% 2. NPEV growing in L20B cells Country/area % ITD results reported ≤ 7 days of receipt Type 3 Polio laboratory 1 Type 1 Negative Results of virus isolation for AFP cases Results of intratypic differentiation (ITD)/sequencing for virus isolates L20B positive VDPV 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Total no. of AFP cases with specimens NPEV only Discordant pending sequencing NPEV 2VDPV L20B positive + NPEV Wild Sabin % specimens positive for NPEV Latest report date VDPV Sabin Pending ITDPending % results reported ≤ 14 days Wild Type 2 Table 2A. Laboratory investigation of stool samples from AFP cases with onset in 2022 and key laboratory indicators 5 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 77 0 2 2 73 0 94% 3% 05-Feb-24 VIDRL 2 0 0 0 0 0 0 0 0 0 2 0 0 100% Brunei Darussalam VIDRL 1 0 0 0 1 0 0% 0% 09-Oct-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 47 0 0 7 40 0 96% 14% 25-Dec-23 NIID 0 - - - - - - - - - - - - - China (total) 5621 0 19 0 5590 12 98% 0.2% 06-May-24 56 0 24 0 0 0 0 0 32 0 0 0 0 100% China, Anhui Prov. Lab 351 0 1 0 349 1 98% 0.1% Prov. Lab/CCDC 4 0 2 0 0 0 0 0 2 0 0 0 0 100% China, Beijing Prov. Lab 56 0 0 0 56 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 59 0 0 0 59 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 171 0 0 0 171 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 120 0 0 0 119 1 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 586 0 1 0 585 0 93% 0% Prov. Lab/CCDC 6 0 3 0 0 0 0 0 3 0 0 0 0 100% China, Guangxi Prov. Lab 252 0 3 0 249 0 99% 0.6% Prov. Lab/CCDC 8 0 2 0 0 0 0 0 6 0 0 0 0 100% China, Guizhou Prov. Lab 235 0 0 0 235 0 100% 0% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Hainan Prov. Lab 48 0 1 0 47 0 96% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Hebei Prov. Lab 334 0 0 0 334 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 69 0 0 0 69 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 688 0 6 0 680 2 100% 0.4% Prov. Lab/CCDC 14 0 8 0 0 0 0 0 6 0 0 0 0 100% China, Hubei Prov. Lab 152 0 0 0 152 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 287 0 0 0 283 4 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 217 0 0 0 217 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 182 0 0 0 182 0 91% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 43 0 0 0 43 0 100% 0% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Liaoning Prov. Lab 111 0 0 0 110 1 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 139 0 1 0 138 0 100% 0.4% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Ningxia Prov. Lab 26 0 0 0 26 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 9 0 0 0 9 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 83 0 0 0 81 2 76% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 287 0 0 0 286 1 100% 0% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Shanghai Prov. Lab 46 0 0 0 46 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 108 0 2 0 106 0 98% 1% Prov. Lab/CCDC 6 0 2 0 0 0 0 0 4 0 0 0 0 100% China, Sichuan Prov. Lab 358 0 1 0 357 0 98% 0.1% Prov. Lab/CCDC 4 0 3 0 0 0 0 0 1 0 0 0 0 100% China, Tianjin Prov. Lab 31 0 1 0 30 0 100% 2% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Xinjiang Prov. Lab 146 0 1 0 145 0 98% 0.3% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Yunnan Prov. Lab 208 0 0 0 208 0 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 198 0 1 0 197 0 99% 0.3% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Tibet Prov. Lab 21 0 0 0 21 0 95% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 15 0 0 0 15 0 97% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 40 0 0 4 36 0 91% 7% 21-Feb-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 39 0 0 1 23 15 100% 4% 19-Dec-23 NIID 0 - - - - - - - - - - - - - Malaysia IMR 254 0 0 19 235 0 88% 7% 29-Apr-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 29-Dec-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 4 0 0 1 3 0 100% 18% 19-Feb-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 59 6 0 5 48 0 97% 8% 30-Apr-24 VIDRL 27 0 7 0 0 0 0 0 20 0 0 0 0 100% Philippines RITM 894 12 0 45 836 1 97% 4% 17-Apr-24 RITM/NIID 66 0 26 0 0 0 0 0 40 0 0 0 0 100% Republic of Korea KDCA 51 0 0 6 43 2 94% 12% 02-Feb-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 3 0 0 1 2 0 100% 33% 11-Jan-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 164 0 0 27 137 0 100% 16% 11-Jan-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 113 0 0 14 99 0 100% 12% 29-Jan-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 24 0 0 3 21 0 96% 9% 22-Jan-24 VIDRL 0 - - - - - - - - - - - - - Total 7408 18 21 135 7204 30 97% 2% 151 0 57 0 0 0 0 0 92 0 2 0 0 100% 2. NPEV growing in L20B cells Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin VDPVPending % specimens positive for NPEV Latest report date SabinWild 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only Table 2B. Laboratory investigation of stool samples from AFP cases with onset in 2023 and key laboratory indicators 6 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 19 0 0 0 15 4 82% 4% 06-May-24 VIDRL 1 0 0 0 0 0 0 0 0 0 1 0 0 100% Brunei Darussalam VIDRL 0 - - - - - - - 20-Apr-24 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 2 0 0 0 1 1 100% 0% 22-Apr-24 NIID 0 - - - - - - - - - - - - - China (total) 1136 4 0 0 1078 54 97% 0.0% 29-Apr-24 12 0 4 0 0 0 0 0 8 0 0 0 0 67% China, Anhui Prov. Lab 52 0 0 0 51 1 98% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Beijing Prov. Lab 10 0 0 0 8 2 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 12 0 0 0 10 2 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 29 0 0 0 19 10 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 17 0 0 0 17 0 82% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 98 0 0 0 92 6 94% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangxi Prov. Lab 55 1 0 0 53 1 94% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guizhou Prov. Lab 45 0 0 0 42 3 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hainan Prov. Lab 8 0 0 0 8 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 43 0 0 0 40 3 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 7 0 0 0 7 0 86% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 216 1 0 0 213 2 100% 0.0% Prov. Lab/CCDC 10 0 4 0 0 0 0 0 6 0 0 0 0 60% China, Hubei Prov. Lab 29 0 0 0 29 0 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 63 1 0 0 62 0 100% 0% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Jiangsu Prov. Lab 48 0 0 0 48 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 37 0 0 0 36 1 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 9 0 0 0 8 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 19 0 0 0 19 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 11 0 0 0 3 8 67% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ningxia Prov. Lab 6 1 0 0 5 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 1 0 0 0 1 0 0% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 16 0 0 0 14 2 70% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 74 0 0 0 73 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab 8 0 0 0 8 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 22 0 0 0 20 2 90% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Sichuan Prov. Lab 74 0 0 0 73 1 95% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tianjin Prov. Lab 6 0 0 0 6 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 26 0 0 0 24 2 100% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Yunnan Prov. Lab 41 0 0 0 35 6 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 53 0 0 0 53 0 98% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 1 0 0 0 1 0 100% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 3 0 0 0 3 0 100% 0% 23-Apr-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 03-May-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 9 0 0 0 5 4 100% 0% 07-May-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 7 0 0 0 0 7 0% 0% 03-May-24 NIID 0 - - - - - - - - - - - - - Malaysia IMR 62 0 0 6 56 0 100% 7% 07-May-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 3 0 0 0 2 1 100% 0% 06-May-24 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 2 0 0 1 1 0 100% 50% 06-May-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 8 0 0 0 4 4 100% 0% 03-May-24 VIDRL 0 - - - - - - - - - - - - - Philippines RITM 213 1 1 11 183 16 98% 5% 07-May-24 RITM/NIID 0 - - - - - - - - - - - - - Republic of Korea KDCA 14 0 0 1 11 2 100% 8% 03-May-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 2 0 0 0 2 0 100% 0% 04-May-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 0 - - - - - - - 11-Jan-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 17 0 0 2 15 0 100% 12% 15-Apr-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 0 - - - - - - - 22-Jan-24 VIDRL 0 - - - - - - - - - - - - - Total 1498 5 1 21 1377 93 97% 1% 13 0 4 0 0 0 0 0 8 0 1 0 0 67% 2. NPEV growing in L20B cells Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens VDPV Pending % specimens positive for NPEV Latest report date SabinWild Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin Table 2C. Laboratory investigation of stool samples from AFP cases with onset in 2024 and key laboratory indicators 7 Polio Bulletin Table 3A. Laboratory confirmation of polio isolates from environmental samples in 20231 and key laboratory indicators 8 Polio Bulletin Table 3B. Laboratory confirmation of polio isolates from environmental samples in 20241 and key laboratory indicators 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); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); RITM (Research Institute for Tropical Medicine, Philippines); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 49 3 0 0 0 0 0 0 0 3 0 100% 0 0 Cambodia RITM 12 2 0 0 0 0 0 0 0 2 0 58% 0 0 China (total) 613 201 0 203 0 0 0 0 0 289 2 34% 1 0 China, Fujian Prov. Lab/CCDC 62 7 0 0 0 0 0 0 0 7 0 60% 1 0 China, Gansu Prov. Lab/CCDC 42 21 0 23 0 0 0 0 0 26 0 21% 0 0 China, Guangdong Prov. Lab/CCDC 48 30 0 20 0 0 0 0 0 41 0 52% 0 0 China, Guangxi Prov. Lab/CCDC 12 6 0 6 0 0 0 0 0 11 0 58% 0 0 China, Heilongjiang Prov. Lab/CCDC 24 11 0 12 0 0 0 0 0 30 0 17% 0 0 China, Jiangxi Prov. Lab/CCDC 34 9 0 6 0 0 0 0 0 6 1 65% 0 0 China, Jiangsu Prov. Lab/CCDC 124 10 0 4 0 0 0 0 0 6 0 5% 0 0 China, Liaoning Prov. Lab/CCDC 43 16 0 6 0 0 0 0 0 25 0 5% 0 0 China, Neimongol Prov. Lab/CCDC 20 8 0 15 0 0 0 0 0 13 0 0% 0 0 China, Ninxia Prov. Lab/CCDC 19 8 0 20 0 0 0 0 0 8 0 42% 0 0 China, Qinghai Prov. Lab/CCDC 14 3 0 3 0 0 0 0 0 2 0 14% 0 0 China, Shandong Prov. Lab/CCDC 34 15 0 8 0 0 0 0 0 24 0 32% 0 0 China, Shanghai Prov. Lab/CCDC 24 0 0 0 0 0 0 0 0 0 0 17% 0 0 China, Xinjiang Prov. Lab/CCDC 36 27 0 53 0 0 0 0 0 64 0 0% 0 0 China, Yunnan Prov. Lab/CCDC 37 22 0 25 0 0 0 0 0 18 0 92% 0 0 China, Zheijiang Prov. Lab/CCDC 40 8 0 2 0 0 0 0 0 8 1 70% 0 0 Lao PDR RITM 4 0 0 0 0 0 0 0 0 0 0 0% 0 0 Malaysia IMR/VIDRL 330 0 0 0 0 0 0 0 0 0 0 48% 3 0 New Zealand IESR 80 4 0 0 0 0 0 0 0 4 0 90% 0 0 Philippines RITM 616 37 0 17 0 0 0 0 0 44 0 15% 0 0 Viet Nam NIHE 124 0 0 0 0 0 0 0 0 0 0 2% 2 0 Total 1828 247 0 220 0 0 0 0 0 342 2 32% 6 0 Pending ITD Discordant pending sequencingType 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates NPEV (%) Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 15 5 0 1 0 0 0 0 0 4 0 53% 3 0 Cambodia RITM 0 - - - - - - - - - - - - - China (total) 20 15 0 26 0 0 0 0 0 23 0 35% 0 0 China, Fujian Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab/CCDC 6 3 0 5 0 0 0 0 0 7 0 0% 0 0 China, Guangdong Prov. Lab/CCDC 8 8 0 12 0 0 0 0 0 11 0 50% 0 0 China, Guangxi Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab/CCDC 3 1 0 2 0 0 0 0 0 0 0 33% 0 0 China, Neimongol Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ninxia Prov. Lab/CCDC 3 3 0 7 0 0 0 0 0 5 0 67% 0 0 China, Qinghai Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Yunnan Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zheijiang Prov. Lab/CCDC 0 - - - - - - - - - - - - - Lao PDR RITM 0 - - - - - - - - - - - - - Malaysia IMR/VIDRL 0 - - - - - - - - - - - - - New Zealand IESR 28 1 0 0 0 0 0 0 0 1 0 93% 0 0 Philippines RITM 185 12 0 5 0 0 0 0 0 20 0 41% 10 0 Viet Nam NIHE 0 - - - - - - - - - - - - - Total 248 33 0 32 0 0 0 0 0 48 0 49% 13 0 Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates NPEV (%) Pending ITD Discordant pending sequencingType 1 Type 2 Type 3 Figure 5A. China Figure 5B. Malaysia Figure 5C. Papua New Guinea Figure 5D. Philippines 1. Prefix letter refers to the VDPV category: “cVDPV” = circulating VDPV, “iVDPV” = immunodeficiency-associated VDPV, “aVDPV” = ambiguous VDPV. Suffix number refers to the poliovirus serotype (types 1, 2 or 3) 2. Community and healthy children 3. Contact of a different AFP case Vaccine-derived polio virus identified from laboratory testing, 2018–2023 0 2 4 6 8 10 12 14 16 cVDPV1 cVDPV2 cVDPV1 cVDPV2 aVDPV2 aVDPV3 2019 2020 N o. o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 45 cVDPV1 2018 N o.  o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 cVDPV1 cVDPV2 iVDPV2 aVDPV2 cVDPV2 aVDPV2 2019 2020 N o. o f c as es /s pe ci m en s 9 Polio Bulletin 0 1 2 3 4 5 cVDPV2 iVDPV3 aVDPV3 cVDPV2 aVDPV3 aVDPV1 cVDPV3 aVDPV3 aVDPV1 cVDPV3 aVDPV3 iVDPV3 aVDPV1 aVDPV1 aVDPV3 iVDPV3 2018 2019 2020 2021 2022 2023 N o . o f ca se s/ sp e ci m e n s

Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Phone: +63 2 8528 8001 Fax: +63 2 8521 1036, 8526 0279 Email: wproepidata@who.int Web: www.who.int/westernpacific Polio Bulletin 2024 Issue No. 7 - May 2024 (as of 4 June 2024) Figure 1. Non-polio AFP rate (per 100 000 persons < 15 years of age), 2022–2024 HIGHLIGHTS Figure 2. Adequate specimen collection rate, 2022–2024 Figure 3. Percentage of reported AFP cases by number of polio vaccination doses, 2024 Figure 4. Percentage of reported AFP cases with pending classification > 90 days after onset, 2024 0.0 1.0 2.0 3.0 4.0 5.0 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% CHN KHM LAO MYS PHL PNG VNM ≥ 3 doses 1-2 doses 0 doses Unknown 3.6% 0.0% 16.7% 0.0% 0.0% 0.0% 25.3% 0% 5% 10% 15% 20% 25% 30% VNM PNG PHL MYS LAO KHM CHN 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). 50 Years of Impact: how polio eradication and EPI demonstrate what is humanly possible The world immunization week was commemorated at the end of April 2024, reminding us of what humanity can achieve when efforts are made for collective health. Fifty years ago Essential Programme on Immunization (EPI) was launched in 1974 to expand national routine immunization services around the world and reduce the deaths and disabilities caused by common vaccine preventable diseases. Over the last 50 years, EPI has saved 154 million lives, reduced infant deaths by more than 40 percent, and protected millions from disability. Polio has been a part of EPI from the very beginning, and it will be essential for the polio eradication and EPI programmes to continue working together as we aim to achieve another eradication goal: ending polio once and for all. While polio eradication has very specific targets to achieve, the goals of the Global Polio Eradication Initiative (GPEI) and those linked to the EPI such as the Immunization Agenda 2030 share many similarities and ultimately depend on establishing and maintaining access to children who have not been regularly reached with any vaccines. A good example that has been critical success factor across regions, and around the world has been the exchange of workers between the polio and EPI programs. This exchange of human resources between programmes has led to a sharing of knowledge and experiences that has contributed to the achievements that we have seen in both programmes over the last half-century. For more infomation please visit: https://polioeradication.org/ CONTACT US 2021 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 63 48 81 0 0 0 81 0 0 (0.0%) 1.70 72% 100% 11-Apr-23 - Brunei Darussalam 2 1 2 0 0 0 2 0 0 (0.0%) 2.16 50% 100% 20-Feb-23 - Cambodia 5 48 35 0 0 0 35 0 0 (0.0%) 0.73 63% 100% 01-Feb-23 - China 4769 2362 4225 0 0 0 4225 0 0 (0.0%) 1.79 92% 99% 02-Apr-24 - China, Hong Kong SAR 9 8 6 0 0 0 6 0 0 (0.0%) 0.78 67% 100% 28-Nov-23 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.10 100% 100% 08-Mar-24 - Japan 0 148 41 0 0 0 40 1 0 (0.0%) 0.28 73% 98% 02-Jan-24 154 Lao People's Democratic Republic 20 23 28 0 0 0 28 0 0 (0.0%) 1.22 64% 68% 09-Oct-23 - Malaysia 111 80 212 0 0 0 212 0 0 (0.0%) 2.65 76% 83% 03-Apr-23 - Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 10-Nov-23 - New Zealand 9 10 23 0 0 0 23 0 0 (0.0%) 2.37 30% 100% 28-Nov-23 - Papua New Guinea 52 38 59 0 0 0 59 0 0 (0.0%) 1.53 69% 83% 10-Nov-23 - Philippines 894 327 853 0 0 0 853 0 0 (0.0%) 2.60 79% 0% 23-Nov-23 - Republic of Korea 35 60 57 0 0 0 57 0 0 (0.0%) 0.95 82% 98% 08-Mar-23 - Singapore 4 6 11 0 0 0 11 0 0 (0.0%) 1.91 82% 82% 01-Feb-23 - Viet Nam 162 250 238 0 0 0 238 0 0 (0.0%) 0.95 98% 65% 12-May-23 - Pacific island countries and areas 16 11 7 0 0 0 7 0 0 (0.0%) 0.64 71% 71% 08-Nov-22 - Total 6153 3430 5880 0 0 0 5879 1 0 (0.0%) 1.71 88% 82% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO > 90 days 1 # (%) Vaccine- derived poliovirus (VDPV) Polio- compatible Classification Pending Days since last report 5 % investigated ≤ 2 days of notification 3 Indicators Latest report date 4 2022 Non-polio AFP rate Total % with adequate specimens 2 Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Table 1A. Classification of AFP cases with onset in 2022 and key surveillance indicators 2 Polio Bulletin 2022 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 81 48 82 0 0 0 82 0 0 (0.0%) 1.72 63% 100% 26-Feb-24 - Brunei Darussalam 2 1 1 0 0 0 1 0 0 (0.0%) 1.08 100% 100% 18-Jan-24 - Cambodia 35 48 47 0 0 0 47 0 0 (0.0%) 0.99 89% 98% 07-Mar-24 - China 4225 1877 5649 0 0 0 4530 1119 1,119 (19.8%) 3.01 95% 99% 06-May-24 29 China, Hong Kong SAR 6 8 16 0 0 0 16 0 0 (0.0%) 2.07 81% 100% 19-Mar-24 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.04 100% 100% 08-Apr-24 - Japan 41 144 55 0 0 0 49 6 1 (1.8%) 0.38 55% 91% 20-Feb-24 105 Lao People's Democratic Republic 28 23 39 0 0 0 39 0 0 (0.0%) 1.70 87% 90% 23-May-24 - Malaysia 212 75 235 0 0 0 234 1 1 (0.4%) 3.11 84% 92% 19-Apr-24 46 Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 26-Jan-24 - New Zealand 23 10 10 0 0 0 10 0 0 (0.0%) 1.04 70% 90% 09-Apr-24 - Papua New Guinea 59 39 58 0 0 0 55 3 3 (5.2%) 1.47 60% 69% 04-Jun-24 0 Philippines 853 342 979 0 0 0 425 554 510 (52.1%) 2.86 68% 57% 11-Apr-24 54 Republic of Korea 57 57 51 0 0 0 51 0 0 (0.0%) 0.90 82% 100% 07-Mar-24 - Singapore 11 6 3 0 0 0 3 0 0 (0.0%) 0.52 100% 100% 03-Jan-24 - Viet Nam 238 222 280 0 0 0 280 0 0 (0.0%) 1.26 99% 87% 23-Apr-24 - Pacific island countries and areas 7 10 27 0 0 0 20 7 7 (25.9%) 2.59 56% 67% 06-May-24 29 Total 5880 2921 7534 0 0 0 5844 1690 1,641 (21.8%) 2.58 90% 93% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Days since last report 5 % investigated ≤ 2 days of notification 3 Indicators Latest report date4> 90 days 1 # (%) Total 2023 % with adequate specimens 2 Pending Classification Non-polio AFP rate Vaccine- derived poliovirus (VDPV) Polio- compatible Table 1B. Classification of AFP cases with onset in 2023 and key surveillance indicators 3 Polio Bulletin 2023 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 82 48 35 0 0 0 10 25 0 (0.0%) 1.73 63% 97% 03-Jun-24 1 Brunei Darussalam 1 1 0 - - - - - - 0.00 - - 20-Apr-24 45 Cambodia 47 48 11 0 0 0 0 11 0 (0.0%) 0.54 82% 100% 04-Jun-24 0 China 5649 1877 1155 0 0 0 129 1026 292 (25.3%) 1.45 94% 99% 29-Apr-24 36 China, Hong Kong SAR 16 8 4 0 0 0 3 1 0 (0.0%) 1.25 100% 100% 20-May-24 15 China, Macao SAR 1 1 1 0 0 0 0 1 0 (0.0%) 2.46 100% 100% 07-May-24 28 Japan 55 144 13 0 0 0 11 2 0 (0.0%) 0.21 69% 100% 27-May-24 8 Lao People's Democratic Republic 39 23 9 0 0 0 5 4 0 (0.0%) 0.93 89% 89% 23-May-24 12 Malaysia 235 75 82 0 0 0 68 14 0 (0.0%) 2.57 87% 49% 04-Jun-24 0 Mongolia 1 11 3 0 0 0 3 0 0 (0.0%) 0.65 100% 100% 03-Jun-24 1 New Zealand 10 10 2 0 0 0 2 0 0 (0.0%) 0.49 50% 50% 23-May-24 12 Papua New Guinea 58 41 8 0 0 0 5 3 0 (0.0%) 0.47 63% 38% 04-Jun-24 0 Philippines 979 344 180 0 0 0 0 180 30 (16.7%) 1.24 47% 98% 11-Apr-24 54 Republic of Korea 51 54 19 0 0 0 8 11 0 (0.0%) 0.83 68% 100% 04-Jun-24 0 Singapore 3 6 2 0 0 0 2 0 0 (0.0%) 81% 100% 100% 04-Jun-24 0 Viet Nam 280 222 28 0 0 0 13 15 1 (3.6%) 0.30 100% 96% 23-Apr-24 42 Pacific island countries and areas 27 11 0 - - - - - - 0.00 - - 04-Jun-24 0 Total 7534 2923 1552 0 0 0 259 1293 323 (20.8%) 1.26 86% 96% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Annualized non-polio AFP rate per 100 000 population under 15 years of age Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Substantially below target 4. Percentage of reported cases investigated within two days of notification 5. Countries are expected to submit data at least once per month to WPRO Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Days since last report 5 % investigated ≤ 2 days of notification 4 Indicators Latest report date> 90 days 1 # (%) Total 2024 % with adequate specimens 3 Pending Classification Non-polio AFP rate 2 Vaccine- derived poliovirus (VDPV) Polio- compatible Table 1C. Classification of AFP cases with onset in 2024 and key surveillance indicators 4 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 78 1 1 3 73 0 95% 3% 31-Jan-23 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 100% Brunei Darussalam VIDRL 2 0 0 0 2 0 100% 0% 16-Jan-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 35 1 0 2 32 0 97% 7% 31-Dec-22 NIID 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China (total) 4180 2 7 1 4170 0 98% 0.1% 02-Apr-24 20 0 12 0 0 0 0 0 8 0 0 0 0 100% China, Anhui Prov. Lab 268 0 0 0 268 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Beijing Prov. Lab 34 0 0 0 34 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 36 0 0 0 36 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 132 0 0 0 132 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 52 0 0 0 52 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 450 0 2 0 448 0 92% 0.2% Prov. Lab/CCDC 4 0 4 0 0 0 0 0 0 0 0 0 0 100% China, Guangxi Prov. Lab 216 0 0 1 215 0 100% 0.2% Prov. Lab/CCDC 3 0 2 0 0 0 0 0 1 0 0 0 0 100% China, Guizhou Prov. Lab 174 0 0 0 174 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hainan Prov. Lab 48 0 0 0 48 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 225 0 0 0 225 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 29 0 0 0 29 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 437 1 2 0 434 0 100% 0.2% Prov. Lab/CCDC 7 0 3 0 0 0 0 0 4 0 0 0 0 100% China, Hubei Prov. Lab 108 0 0 0 108 0 92% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 198 0 0 0 198 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 173 0 0 0 173 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 142 0 1 0 141 0 99% 0.4% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Jilin Prov. Lab 31 0 0 0 31 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 60 0 0 0 60 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 93 0 0 0 93 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ningxia Prov. Lab 12 0 0 0 12 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 6 0 0 0 6 0 67% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 71 0 0 0 71 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 243 0 0 0 243 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab 33 0 0 0 33 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 79 1 1 0 77 0 97% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Sichuan Prov. Lab 348 0 0 0 348 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tianjin Prov. Lab 11 0 0 0 11 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 88 0 1 0 87 0 100% 1% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Yunnan Prov. Lab 208 0 0 0 208 0 90% 0% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Zhejiang Prov. Lab 166 0 0 0 166 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 9 0 0 0 9 0 33% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 6 0 0 0 6 0 100% 0% 26-Jan-23 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 0 0 100% 0% 03-Jan-23 PHLC 0 - - - - - - - - - - - - - Japan NIID 36 0 0 0 36 0 97% 0% 01-May-23 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 28 0 0 2 26 0 96% 5% 10-Oct-23 NIID 0 - - - - - - - - - - - - - Malaysia IMR 219 0 0 4 215 0 91% 1% 15-Dec-23 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 06-Nov-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 15 0 0 2 12 0 100% 7% 16-Feb-23 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 57 1 1 4 51 0 81% 8% 14-Nov-23 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 100% Philippines RITM 829 5 1 63 760 0 98% 6% 05-Mar-24 RITM/NIID 19 0 8 0 0 0 0 0 11 0 0 0 0 100% Republic of Korea KDCA 57 0 0 7 50 0 82% 11% 19-Jan-23 KDCA 0 - - - - - - - - - - - - - Singapore SGH 11 0 0 0 11 0 95% 0% 11-Jan-23 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 155 0 0 26 129 0 100% 16% 15-Dec-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 79 0 0 5 74 0 100% 6% 09-Jan-23 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 7 0 0 1 6 0 85% 15% 24-Aug-22 VIDRL 0 - Total 5796 10 10 120 5654 0 97% 2% 47 0 20 0 0 0 0 0 21 0 6 0 0 100% 2. NPEV growing in L20B cells Sabin Pending ITDPending % results reported ≤ 14 days Wild Type 2 L20B positive + NPEV Wild Sabin % specimens positive for NPEV Latest report date VDPV 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Total no. of AFP cases with specimens NPEV only Discordant pending sequencing NPEV 2VDPV Country/area % ITD results reported ≤ 7 days of receipt Type 3 Polio laboratory 1 Type 1 Negative Results of virus isolation for AFP cases Results of intratypic differentiation (ITD)/sequencing for virus isolates L20B positive VDPV Table 2A. Laboratory investigation of stool samples from AFP cases with onset in 2022 and key laboratory indicators 5 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 77 0 2 2 73 0 94% 3% 05-Feb-24 VIDRL 2 0 0 0 0 0 0 0 0 0 2 0 0 100% Brunei Darussalam VIDRL 1 0 0 0 1 0 0% 0% 09-Oct-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 47 0 0 7 40 0 96% 14% 25-Dec-23 NIID 0 - - - - - - - - - - - - - China (total) 5621 0 19 0 5590 12 98% 0.2% 06-May-24 60 0 26 0 0 0 0 0 34 0 0 0 0 100% China, Anhui Prov. Lab 351 0 1 0 349 1 98% 0.1% Prov. Lab/CCDC 4 0 2 0 0 0 0 0 2 0 0 0 0 100% China, Beijing Prov. Lab 56 0 0 0 56 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 59 0 0 0 59 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 171 0 0 0 171 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 120 0 0 0 119 1 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 586 0 1 0 585 0 93% 0% Prov. Lab/CCDC 6 0 3 0 0 0 0 0 3 0 0 0 0 100% China, Guangxi Prov. Lab 252 0 3 0 249 0 99% 0.6% Prov. Lab/CCDC 8 0 2 0 0 0 0 0 6 0 0 0 0 100% China, Guizhou Prov. Lab 235 0 0 0 235 0 100% 0% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Hainan Prov. Lab 48 0 1 0 47 0 96% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Hebei Prov. Lab 334 0 0 0 334 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 69 0 0 0 69 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 688 0 6 0 680 2 100% 0.4% Prov. Lab/CCDC 18 0 10 0 0 0 0 0 8 0 0 0 0 100% China, Hubei Prov. Lab 152 0 0 0 152 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 287 0 0 0 283 4 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 217 0 0 0 217 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 182 0 0 0 182 0 91% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 43 0 0 0 43 0 100% 0% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Liaoning Prov. Lab 111 0 0 0 110 1 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 139 0 1 0 138 0 100% 0.4% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Ningxia Prov. Lab 26 0 0 0 26 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 9 0 0 0 9 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 83 0 0 0 81 2 76% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 287 0 0 0 286 1 100% 0% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Shanghai Prov. Lab 46 0 0 0 46 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 108 0 2 0 106 0 98% 1% Prov. Lab/CCDC 6 0 2 0 0 0 0 0 4 0 0 0 0 100% China, Sichuan Prov. Lab 358 0 1 0 357 0 98% 0.1% Prov. Lab/CCDC 4 0 3 0 0 0 0 0 1 0 0 0 0 100% China, Tianjin Prov. Lab 31 0 1 0 30 0 100% 2% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Xinjiang Prov. Lab 146 0 1 0 145 0 98% 0.3% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Yunnan Prov. Lab 208 0 0 0 208 0 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 198 0 1 0 197 0 99% 0.3% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Tibet Prov. Lab 21 0 0 0 21 0 95% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 14 0 0 0 14 0 97% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 40 0 0 4 36 0 92% 7% 21-Feb-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 39 0 0 1 23 15 100% 4% 21-May-24 NIID 2 0 0 0 0 0 0 0 2 0 0 0 0 100% Malaysia IMR 254 0 0 19 235 0 88% 7% 29-Apr-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 29-Dec-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 4 0 0 1 3 0 100% 18% 19-Feb-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 57 6 0 4 47 0 97% 8% 30-Apr-24 VIDRL 27 0 7 0 0 0 0 0 20 0 0 0 0 100% Philippines RITM 896 12 0 45 839 0 97% 8% 30-May-24 RITM/NIID 66 0 26 0 0 0 0 0 40 0 0 0 0 100% Republic of Korea KDCA 51 0 0 6 43 2 94% 12% 02-Feb-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 3 0 0 1 2 0 100% 33% 11-Jan-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 164 0 0 27 137 0 100% 16% 11-Jan-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 113 0 0 14 99 0 100% 12% 29-Jan-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 24 0 0 3 21 0 96% 9% 22-Jan-24 VIDRL 0 - - - - - - - - - - - - - Total 7407 18 21 134 7205 29 97% 2% 157 0 59 0 0 0 0 0 96 0 2 0 0 100% 2. NPEV growing in L20B cells Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin VDPVPending % specimens positive for NPEV Latest report date SabinWild 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only Table 2B. Laboratory investigation of stool samples from AFP cases with onset in 2023 and key laboratory indicators 6 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 30 0 1 1 21 7 84% 8% 03-Jun-24 VIDRL 1 0 0 0 0 0 0 0 0 0 1 0 0 100% Brunei Darussalam VIDRL 0 - - - - - - - 20-Apr-24 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 11 0 0 0 2 9 100% 0% 04-Jun-24 NIID 0 - - - - - - - - - - - - - China (total) 1136 4 0 0 1078 54 97% 0.0% 29-Apr-24 26 0 7 0 0 0 0 0 19 0 0 0 0 90% China, Anhui Prov. Lab 52 0 0 0 51 1 98% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Beijing Prov. Lab 10 0 0 0 8 2 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 12 0 0 0 10 2 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 29 0 0 0 19 10 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 17 0 0 0 17 0 82% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 98 0 0 0 92 6 94% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangxi Prov. Lab 55 1 0 0 53 1 94% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guizhou Prov. Lab 45 0 0 0 42 3 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hainan Prov. Lab 8 0 0 0 8 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 43 0 0 0 40 3 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 7 0 0 0 7 0 86% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 216 1 0 0 213 2 100% 0.0% Prov. Lab/CCDC 15 0 4 0 0 0 0 0 11 0 0 0 0 82% China, Hubei Prov. Lab 29 0 0 0 29 0 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 63 1 0 0 62 0 100% 0% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Jiangsu Prov. Lab 48 0 0 0 48 0 100% 0% Prov. Lab/CCDC 2 0 2 0 0 0 0 0 0 0 0 0 0 100% China, Jiangxi Prov. Lab 37 0 0 0 36 1 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 9 0 0 0 8 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 19 0 0 0 19 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 11 0 0 0 3 8 67% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ningxia Prov. Lab 6 1 0 0 5 0 100% 0% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Qinghai Prov. Lab 1 0 0 0 1 0 0% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 16 0 0 0 14 2 70% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 74 0 0 0 73 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab 8 0 0 0 8 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 22 0 0 0 20 2 90% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Sichuan Prov. Lab 74 0 0 0 73 1 95% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tianjin Prov. Lab 6 0 0 0 6 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 26 0 0 0 24 2 100% 0.0% Prov. Lab/CCDC 4 0 0 0 0 0 0 0 4 0 0 0 0 100% China, Yunnan Prov. Lab 41 0 0 0 35 6 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 53 0 0 0 53 0 98% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 1 0 0 0 1 0 100% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 4 0 0 0 4 0 100% 0% 30-May-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 30-May-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 11 0 0 0 11 0 100% 0% 22-May-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 9 0 0 1 4 4 100% 20% 23-May-24 NIID 0 - - - - - - - - - - - - - Malaysia IMR 75 0 0 7 68 0 100% 7% 03-Jun-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 3 0 0 0 3 0 100% 0% 10-May-24 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 2 0 0 1 1 0 100% 50% 04-Jun-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 8 1 2 0 5 0 100% 29% 23-May-24 VIDRL 4 0 1 0 0 0 0 0 1 0 2 0 0 67% Philippines RITM 305 3 1 19 256 26 99% 5% 04-Jun-24 RITM/NIID 0 - - - - - - - - - - - - - Republic of Korea KDCA 19 0 0 2 14 3 100% 13% 04-Jun-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 2 0 0 0 2 0 100% 0% 29-May-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 31 0 0 3 19 9 100% 14% 17-May-24 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 39 0 0 7 28 4 100% 20% 04-Jun-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 2 0 0 0 2 0 100% 0% 16-May-24 VIDRL 0 - - - - - - - - - - - - - Total 1688 8 4 41 1519 116 97% 2% 31 0 8 0 0 0 0 0 20 0 3 0 0 88% 2. NPEV growing in L20B cells Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens VDPV Pending % specimens positive for NPEV Latest report date SabinWild Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin Table 2C. Laboratory investigation of stool samples from AFP cases with onset in 2024 and key laboratory indicators 7 Polio Bulletin Table 3A. Laboratory confirmation of polio isolates from environmental samples in 20231 and key laboratory indicators 8 Polio Bulletin Table 3B. Laboratory confirmation of polio isolates from environmental samples in 20241 and key laboratory indicators 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); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); RITM (Research Institute for Tropical Medicine, Philippines); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 49 3 0 0 0 0 0 0 0 3 0 100% 0 0 Cambodia RITM 12 2 0 0 0 0 0 0 0 2 0 58% 0 0 China (total) 630 213 0 210 0 0 0 0 0 304 2 35% 0 0 China, Fujian Prov. Lab/CCDC 77 18 0 5 0 0 0 0 0 19 0 60% 0 0 China, Gansu Prov. Lab/CCDC 42 21 0 23 0 0 0 0 0 26 0 21% 0 0 China, Guangdong Prov. Lab/CCDC 48 30 0 20 0 0 0 0 0 41 0 52% 0 0 China, Guangxi Prov. Lab/CCDC 12 6 0 6 0 0 0 0 0 11 0 58% 0 0 China, Heilongjiang Prov. Lab/CCDC 24 11 0 12 0 0 0 0 0 30 0 17% 0 0 China, Jiangxi Prov. Lab/CCDC 34 9 0 6 0 0 0 0 0 6 1 65% 0 0 China, Jiangsu Prov. Lab/CCDC 124 10 0 4 0 0 0 0 0 6 0 5% 0 0 China, Liaoning Prov. Lab/CCDC 43 16 0 6 0 0 0 0 0 25 0 5% 0 0 China, Neimongol Prov. Lab/CCDC 20 8 0 15 0 0 0 0 0 13 0 0% 0 0 China, Ninxia Prov. Lab/CCDC 19 8 0 20 0 0 0 0 0 8 0 42% 0 0 China, Qinghai Prov. Lab/CCDC 14 3 0 3 0 0 0 0 0 2 0 14% 0 0 China, Shandong Prov. Lab/CCDC 36 16 0 10 0 0 0 0 0 27 0 36% 0 0 China, Shanghai Prov. Lab/CCDC 24 0 0 0 0 0 0 0 0 0 0 17% 0 0 China, Xinjiang Prov. Lab/CCDC 36 27 0 53 0 0 0 0 0 64 0 0% 0 0 China, Yunnan Prov. Lab/CCDC 37 22 0 25 0 0 0 0 0 18 0 92% 0 0 China, Zheijiang Prov. Lab/CCDC 40 8 0 2 0 0 0 0 0 8 1 70% 0 0 Lao PDR RITM 4 0 0 0 0 0 0 0 0 0 0 0% 0 0 Malaysia IMR/VIDRL 330 0 0 0 0 0 0 0 0 0 0 48% 3 0 New Zealand IESR 80 4 0 0 0 0 0 0 0 4 0 90% 0 0 Philippines RITM 616 37 0 17 0 0 0 0 0 44 0 15% 0 0 Viet Nam NIHE 124 0 0 0 0 0 0 0 0 0 0 2% 2 0 Total 1845 259 0 227 0 0 0 0 0 357 2 33% 5 0 NPEV (%) Pending ITD Discordant pending sequencingType 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 17 5 0 1 0 0 0 0 0 4 0 82% 2 0 Cambodia RITM 0 - - - - - - - - - - - - - China (total) 120 82 0 119 1 0 0 0 0 139 0 48% 2 0 China, Anui Prov. Lab/CCDC 16 16 0 33 0 0 0 0 0 26 0 100% 0 0 China, Fujian Prov. Lab/CCDC 16 7 0 3 0 0 0 0 0 4 0 44% 2 0 China, Gansu Prov. Lab/CCDC 16 8 0 9 0 0 0 0 0 14 0 50% 0 0 China, Guangdong Prov. Lab/CCDC 20 19 0 26 1 0 0 0 0 31 0 20% 0 0 China, Guangxi Prov. Lab/CCDC 4 3 0 1 0 0 0 0 0 2 0 75% 0 0 China, Heilongjiang Prov. Lab/CCDC 6 1 0 0 0 0 0 0 0 2 0 0% 0 0 China, Jiangxi Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab/CCDC 20 10 0 17 0 0 0 0 0 28 0 5% 0 0 China, Neimongol Prov. Lab/CCDC 6 6 0 0 0 0 0 0 0 14 0 100% 0 0 China, Ninxia Prov. Lab/CCDC 3 3 0 7 0 0 0 0 0 5 0 67% 0 0 China, Qinghai Prov. Lab/CCDC 4 3 0 4 0 0 0 0 0 5 0 75% 0 0 China, Shaanxi Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab/CCDC 9 6 0 13 0 0 0 0 0 8 0 67% 0 0 China, Shanghai Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Yunnan Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zheijiang Prov. Lab/CCDC 0 - - - - - - - - - - - - - Lao PDR RITM 0 - - - - - - - - - - - - - Malaysia IMR/VIDRL 0 - - - - - - - - - - - - - New Zealand IESR 28 1 0 0 0 0 0 0 0 1 0 93% 0 0 Philippines RITM 224 12 0 7 0 0 0 0 0 23 0 33% 11 0 Viet Nam NIHE 0 - - - - - - - - - - - - - Total 389 100 0 127 1 0 0 0 0 167 0 49% 13 0 NPEV (%) Pending ITD Discordant pending sequencingType 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates Figure 5A. China Figure 5B. Malaysia Figure 5C. Papua New Guinea Figure 5D. Philippines 1. Prefix letter refers to the VDPV category: “cVDPV” = circulating VDPV, “iVDPV” = immunodeficiency-associated VDPV, “aVDPV” = ambiguous VDPV. Suffix number refers to the poliovirus serotype (types 1, 2 or 3) 2. Community and healthy children 3. Contact of a different AFP case Vaccine-derived polio virus identified from laboratory testing, 2018–2024 0 2 4 6 8 10 12 14 16 cVDPV1 cVDPV2 cVDPV1 cVDPV2 aVDPV2 aVDPV3 2019 2020 N o. o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 45 cVDPV1 2018 No . of  ca ses /sp eci me ns 0 5 10 15 20 25 30 35 40 cVDPV1 cVDPV2 iVDPV2 aVDPV2 cVDPV2 aVDPV2 2019 2020 N o. o f c as es /s pe ci m en s 9 Polio Bulletin 0 1 2 3 4 5 cVDPV2 iVDPV3 aVDPV3 cVDPV2 aVDPV3 aVDPV1 cVDPV3 aVDPV3 aVDPV1 cVDPV3 aVDPV3 iVDPV3 aVDPV1 aVDPV1 aVDPV3 iVDPV3 aVDPV1 aVDPV3 2018 2019 2020 2021 2022 2023 2024 No . o f c as es /sp ec im en s

Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Phone: +63 2 8528 8001 Fax: +63 2 8521 1036, 8526 0279 Email: wproepidata@who.int Web: www.who.int/westernpacific Polio Bulletin 2024 Issue No. 8 - June 2024 (as of 2 July 2024) Figure 1. Non-polio AFP rate (per 100 000 persons < 15 years of age), 2022–2024 HIGHLIGHTS Figure 2. Adequate specimen collection rate, 2022–2024 Figure 3. Percentage of reported AFP cases by number of polio vaccination doses, 2024 Figure 4. Percentage of reported AFP cases with pending classification > 90 days after onset, 2024 0.0 1.0 2.0 3.0 4.0 5.0 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% CHN KHM LAO MYS PHL PNG VNM ≥ 3 doses 1-2 doses 0 doses Unknown 2.2% 7.7% 43.3% 0.0% 0.0% 0.0% 33.7% 0% 10% 20% 30% 40% 50% VNM PNG PHL MYS LAO KHM CHN 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). Resumption of Environmental Surveillance for Poliovirus in Papua New Guinea In 2018, environmental surveillance sites were established in the cities of Port Moresby and Lae during a polio outbreak caused by cVDPV1. These surveillance sites were located in urban slum areas where population is at high risk for cVDPV transmission. Environmental sample collection was paused in mid-December 2019 but thanks to the great efforts of the National Department of Health (NDoH), Central Public Health Laboratory and other stakeholders, collection resumed in four sites in Port Moresby (Gerehu, Waigani, Joyce Bay, and Morata) in 12 June 2024. Samples collected were sent to the Research Institute for Tropical Medicine in Manila, Philippines for testing. Furthermore, NDOH also plans to resume collection in Lae, Morobe Province in second half of 2024. Resumption of environmental surveillance in Papua New Guinea will greatly contribute in maintaining the country’s polio-free status. CONTACT US 2021 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 63 48 81 0 0 0 81 0 0 (0.0%) 1.70 72% 100% 11-Apr-23 - Brunei Darussalam 2 1 2 0 0 0 2 0 0 (0.0%) 2.16 50% 100% 20-Feb-23 - Cambodia 5 48 35 0 0 0 35 0 0 (0.0%) 0.73 63% 100% 01-Feb-23 - China 4769 2362 4225 0 0 0 4225 0 0 (0.0%) 1.79 92% 99% 02-Apr-24 - China, Hong Kong SAR 9 8 6 0 0 0 6 0 0 (0.0%) 0.78 67% 100% 28-Nov-23 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.10 100% 100% 08-Mar-24 - Japan 0 148 41 0 0 0 40 1 0 (0.0%) 0.28 73% 98% 02-Jan-24 182 Lao People's Democratic Republic 20 23 28 0 0 0 28 0 0 (0.0%) 1.22 64% 68% 09-Oct-23 - Malaysia 111 80 212 0 0 0 212 0 0 (0.0%) 2.65 76% 83% 03-Apr-23 - Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 10-Nov-23 - New Zealand 9 10 23 0 0 0 23 0 0 (0.0%) 2.37 30% 100% 28-Nov-23 - Papua New Guinea 52 38 59 0 0 0 59 0 0 (0.0%) 1.53 69% 83% 10-Nov-23 - Philippines 894 327 853 0 0 0 853 0 0 (0.0%) 2.60 79% 0% 23-Nov-23 - Republic of Korea 35 60 57 0 0 0 57 0 0 (0.0%) 0.95 82% 98% 08-Mar-23 - Singapore 4 6 11 0 0 0 11 0 0 (0.0%) 1.91 82% 82% 01-Feb-23 - Viet Nam 162 250 238 0 0 0 238 0 0 (0.0%) 0.95 98% 65% 12-May-23 - Pacific island countries and areas 16 11 7 0 0 0 7 0 0 (0.0%) 0.64 71% 71% 08-Nov-22 - Total 6153 3430 5880 0 0 0 5879 1 0 (0.0%) 1.71 88% 82% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO Discarded (Non-polio) 2022 Non-polio AFP rate Total % with adequate specimens 2 Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus > 90 days 1 # (%) Vaccine- derived poliovirus (VDPV) Polio- compatible Classification Pending Days since last report 5 % investigated ≤  2 days of notification 3 Indicators Latest report date 4 Table 1A. Classification of AFP cases with onset in 2022 and key surveillance indicators 2 Polio Bulletin 2022 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 81 48 82 0 0 0 82 0 0 (0.0%) 1.72 63% 100% 26-Feb-24 - Brunei Darussalam 2 1 1 0 0 0 1 0 0 (0.0%) 1.08 100% 100% 18-Jan-24 - Cambodia 35 48 47 0 0 0 47 0 0 (0.0%) 0.99 89% 98% 07-Mar-24 - China 4225 1877 5649 0 0 0 4530 1119 1,119 (19.8%) 3.01 95% 99% 06-May-24 57 China, Hong Kong SAR 6 8 16 0 0 0 16 0 0 (0.0%) 2.07 81% 100% 19-Mar-24 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.04 100% 100% 08-Apr-24 - Japan 41 144 55 0 0 0 49 6 1 (1.8%) 0.38 55% 91% 20-Feb-24 133 Lao People's Democratic Republic 28 23 39 0 0 0 39 0 0 (0.0%) 1.70 87% 90% 23-May-24 - Malaysia 212 75 235 0 0 0 234 1 1 (0.4%) 3.11 84% 92% 19-Apr-24 74 Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 26-Jan-24 - New Zealand 23 10 10 0 0 0 10 0 0 (0.0%) 1.04 70% 90% 09-Apr-24 - Papua New Guinea 59 39 57 0 0 0 56 1 1 (1.8%) 1.44 61% 68% 20-Jun-24 12 Philippines 853 342 979 0 0 0 425 554 510 (52.1%) 2.86 68% 57% 11-Apr-24 82 Republic of Korea 57 57 51 0 0 0 51 0 0 (0.0%) 0.90 82% 100% 07-Jun-24 - Singapore 11 6 3 0 0 0 3 0 0 (0.0%) 0.52 100% 100% 03-Jan-24 - Viet Nam 238 222 280 0 0 0 280 0 0 (0.0%) 1.26 99% 87% 23-Apr-24 - Pacific island countries and areas 7 10 27 0 0 0 27 0 0 (0.0%) 2.59 56% 67% 12-Jun-24 - Total 5880 2921 7533 0 0 0 5852 1681 1,632 (21.7%) 2.58 90% 93% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Days since last report 5 % investigated ≤ 2 days of notification 3 Indicators Latest report date4> 90 days 1 # (%) Total 2023 % with adequate specimens 2 Pending Classification Non-polio AFP rate Vaccine- derived poliovirus (VDPV) Polio- compatible Table 1B. Classification of AFP cases with onset in 2023 and key surveillance indicators 3 Polio Bulletin 2023 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 82 48 48 0 0 0 36 12 0 (0.0%) 1.93 52% 94% 01-Jul-24 1 Brunei Darussalam 1 1 1 0 0 0 0 1 0 (0.0%) 2.08 100% 100% 13-Jun-24 19 Cambodia 47 48 12 0 0 0 0 12 0 (0.0%) 0.48 83% 100% 24-Jun-24 8 China 5649 1877 2083 0 0 0 446 1637 702 (33.7%) 2.14 94% 99% 25-Jun-24 7 China, Hong Kong SAR 16 8 4 0 0 0 3 1 0 (0.0%) 1.02 100% 100% 20-May-24 43 China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 2.01 100% 100% 06-Jun-24 26 Japan 55 144 15 0 0 0 15 0 0 (0.0%) 0.20 73% 100% 01-Jul-24 1 Lao People's Democratic Republic 39 23 11 0 0 0 5 6 0 (0.0%) 0.93 91% 82% 27-Jun-24 5 Malaysia 235 75 82 0 0 0 68 14 0 (0.0%) 2.09 87% 49% 04-Jun-24 28 Mongolia 1 11 3 0 0 0 3 0 0 (0.0%) 0.53 100% 100% 03-Jun-24 29 New Zealand 10 10 3 0 0 0 2 1 0 (0.0%) 0.60 67% 67% 26-Jun-24 6 Papua New Guinea 57 41 13 0 0 0 8 5 1 (7.7%) 0.62 62% 31% 20-Jun-24 12 Philippines 979 344 395 0 0 0 34 361 171 (43.3%) 2.21 52% 99% 28-Jun-24 4 Republic of Korea 51 54 37 0 0 0 13 24 1 (2.7%) 1.32 73% 100% 27-Jun-24 5 Singapore 3 6 3 0 0 0 3 0 0 (0.0%) 99% 100% 100% 01-Jul-24 1 Viet Nam 280 222 93 0 0 0 37 56 2 (2.2%) 0.81 100% 65% 10-Jun-24 22 Pacific island countries and areas 27 11 6 0 0 0 0 6 1 (16.7%) 1.10 33% 83% 12-Jun-24 20 Total 7533 2923 2810 0 0 0 674 2136 878 (31.2%) 1.85 87% 96% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Annualized non-polio AFP rate per 100 000 population under 15 years of age Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Substantially below target 4. Percentage of reported cases investigated within two days of notification 5. Countries are expected to submit data at least once per month to WPRO Total 2024 % with adequate specimens 3 Pending Classification Non-polio AFP rate 2 Vaccine- derived poliovirus (VDPV) Polio- compatible Days since last report 5 % investigated ≤ 2 days of notification 4 Indicators Latest report date> 90 days 1 # (%) Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Table 1C. Classification of AFP cases with onset in 2024 and key surveillance indicators 4 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 78 1 1 3 73 0 95% 3% 31-Jan-23 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 100% Brunei Darussalam VIDRL 2 0 0 0 2 0 100% 0% 16-Jan-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 35 1 0 2 32 0 97% 7% 31-Dec-22 NIID 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China (total) 4180 2 7 1 4170 0 98% 0.1% 02-Apr-24 20 0 12 0 0 0 0 0 8 0 0 0 0 100% China, Anhui Prov. Lab 268 0 0 0 268 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Beijing Prov. Lab 34 0 0 0 34 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 36 0 0 0 36 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 132 0 0 0 132 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 52 0 0 0 52 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 450 0 2 0 448 0 92% 0.2% Prov. Lab/CCDC 4 0 4 0 0 0 0 0 0 0 0 0 0 100% China, Guangxi Prov. Lab 216 0 0 1 215 0 100% 0.2% Prov. Lab/CCDC 3 0 2 0 0 0 0 0 1 0 0 0 0 100% China, Guizhou Prov. Lab 174 0 0 0 174 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hainan Prov. Lab 48 0 0 0 48 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 225 0 0 0 225 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 29 0 0 0 29 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 437 1 2 0 434 0 100% 0.2% Prov. Lab/CCDC 7 0 3 0 0 0 0 0 4 0 0 0 0 100% China, Hubei Prov. Lab 108 0 0 0 108 0 92% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 198 0 0 0 198 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 173 0 0 0 173 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 142 0 1 0 141 0 99% 0.4% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Jilin Prov. Lab 31 0 0 0 31 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 60 0 0 0 60 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 93 0 0 0 93 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ningxia Prov. Lab 12 0 0 0 12 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 6 0 0 0 6 0 67% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 71 0 0 0 71 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 243 0 0 0 243 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab 33 0 0 0 33 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 79 1 1 0 77 0 97% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Sichuan Prov. Lab 348 0 0 0 348 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tianjin Prov. Lab 11 0 0 0 11 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 88 0 1 0 87 0 100% 1% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Yunnan Prov. Lab 208 0 0 0 208 0 90% 0% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Zhejiang Prov. Lab 166 0 0 0 166 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 9 0 0 0 9 0 33% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 6 0 0 0 6 0 100% 0% 26-Jan-23 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 0 0 100% 0% 03-Jan-23 PHLC 0 - - - - - - - - - - - - - Japan NIID 36 0 0 0 36 0 97% 0% 01-May-23 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 28 0 0 2 26 0 96% 5% 10-Oct-23 NIID 0 - - - - - - - - - - - - - Malaysia IMR 219 0 0 4 215 0 91% 1% 15-Dec-23 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 06-Nov-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 15 0 0 2 12 0 100% 7% 16-Feb-23 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 57 1 1 4 51 0 81% 8% 14-Nov-23 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 100% Philippines RITM 829 5 1 63 760 0 98% 6% 05-Mar-24 RITM/NIID 19 0 8 0 0 0 0 0 11 0 0 0 0 100% Republic of Korea KDCA 57 0 0 7 50 0 82% 11% 19-Jan-23 KDCA 0 - - - - - - - - - - - - - Singapore SGH 11 0 0 0 11 0 95% 0% 11-Jan-23 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 155 0 0 26 129 0 100% 16% 15-Dec-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 79 0 0 5 74 0 100% 6% 09-Jan-23 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 7 0 0 1 6 0 85% 15% 24-Aug-22 VIDRL 0 - Total 5796 10 10 120 5654 0 97% 2% 47 0 20 0 0 0 0 0 21 0 6 0 0 100% 2. NPEV growing in L20B cells Sabin Pending ITDPending % results reported ≤ 14 days Wild Type 2 L20B positive + NPEV Wild Sabin % specimens positive for NPEV Latest report date VDPV 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Total no. of AFP cases with specimens NPEV only Discordant pending sequencing NPEV 2VDPV Country/area % ITD results reported ≤ 7 days of receipt Type 3 Polio laboratory 1 Type 1 Negative Results of virus isolation for AFP cases Results of intratypic differentiation (ITD)/sequencing for virus isolates L20B positive VDPV Table 2A. Laboratory investigation of stool samples from AFP cases with onset in 2022 and key laboratory indicators 5 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 77 0 2 2 73 0 94% 3% 05-Feb-24 VIDRL 2 0 0 0 0 0 0 0 0 0 2 0 0 100% Brunei Darussalam VIDRL 1 0 0 0 1 0 0% 0% 09-Oct-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 47 0 0 7 40 0 96% 14% 25-Dec-23 NIID 0 - - - - - - - - - - - - - China (total) 5621 0 19 0 5590 12 98% 0.2% 06-May-24 60 0 26 0 0 0 0 0 34 0 0 0 0 100% China, Anhui Prov. Lab 351 0 1 0 349 1 98% 0.1% Prov. Lab/CCDC 4 0 2 0 0 0 0 0 2 0 0 0 0 100% China, Beijing Prov. Lab 56 0 0 0 56 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 59 0 0 0 59 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 171 0 0 0 171 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 120 0 0 0 119 1 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 586 0 1 0 585 0 93% 0% Prov. Lab/CCDC 6 0 3 0 0 0 0 0 3 0 0 0 0 100% China, Guangxi Prov. Lab 252 0 3 0 249 0 99% 0.6% Prov. Lab/CCDC 8 0 2 0 0 0 0 0 6 0 0 0 0 100% China, Guizhou Prov. Lab 235 0 0 0 235 0 100% 0% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Hainan Prov. Lab 48 0 1 0 47 0 96% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Hebei Prov. Lab 334 0 0 0 334 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 69 0 0 0 69 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 688 0 6 0 680 2 100% 0.4% Prov. Lab/CCDC 18 0 10 0 0 0 0 0 8 0 0 0 0 100% China, Hubei Prov. Lab 152 0 0 0 152 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 287 0 0 0 283 4 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 217 0 0 0 217 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 182 0 0 0 182 0 91% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 43 0 0 0 43 0 100% 0% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Liaoning Prov. Lab 111 0 0 0 110 1 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 139 0 1 0 138 0 100% 0.4% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Ningxia Prov. Lab 26 0 0 0 26 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 9 0 0 0 9 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 83 0 0 0 81 2 76% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 287 0 0 0 286 1 100% 0% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Shanghai Prov. Lab 46 0 0 0 46 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 108 0 2 0 106 0 98% 1% Prov. Lab/CCDC 6 0 2 0 0 0 0 0 4 0 0 0 0 100% China, Sichuan Prov. Lab 358 0 1 0 357 0 98% 0.1% Prov. Lab/CCDC 4 0 3 0 0 0 0 0 1 0 0 0 0 100% China, Tianjin Prov. Lab 31 0 1 0 30 0 100% 2% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Xinjiang Prov. Lab 146 0 1 0 145 0 98% 0.3% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Yunnan Prov. Lab 208 0 0 0 208 0 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 198 0 1 0 197 0 99% 0.3% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Tibet Prov. Lab 21 0 0 0 21 0 95% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 14 0 0 0 14 0 97% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 40 0 0 4 36 0 92% 7% 21-Feb-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 39 0 0 1 23 15 100% 4% 21-May-24 NIID 2 0 0 0 0 0 0 0 2 0 0 0 0 100% Malaysia IMR 254 0 0 19 235 0 88% 7% 29-Apr-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 29-Dec-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 4 0 0 1 3 0 100% 18% 19-Feb-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 57 6 0 4 47 0 97% 8% 30-Apr-24 VIDRL 27 0 7 0 0 0 0 0 20 0 0 0 0 100% Philippines RITM 892 13 0 44 834 0 97% 4% 11-Jun-24 RITM/NIID 66 0 26 0 0 0 0 0 40 0 0 0 0 100% Republic of Korea KDCA 51 0 0 6 43 2 94% 12% 07-Jun-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 3 0 0 1 2 0 100% 33% 11-Jan-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 164 0 0 27 137 0 100% 16% 11-Jan-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 113 0 0 14 99 0 100% 12% 29-Jan-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 24 0 0 3 21 0 96% 9% 22-Jan-24 VIDRL 0 - - - - - - - - - - - - - Total 7403 19 21 133 7200 29 97% 2% 157 0 59 0 0 0 0 0 96 0 2 0 0 100% 2. NPEV growing in L20B cells Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin VDPVPending % specimens positive for NPEV Latest report date SabinWild 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only Table 2B. Laboratory investigation of stool samples from AFP cases with onset in 2023 and key laboratory indicators 6 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 37 0 2 2 30 3 86% 9% 01-Jul-24 VIDRL 2 0 0 0 0 0 0 0 0 0 2 0 0 100% Brunei Darussalam VIDRL 1 0 0 0 1 0 100% 0% 12-Jun-24 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 12 0 0 0 2 10 100% 0% 24-Jun-24 NIID 0 - - - - - - - - - - - - - China (total) 2062 0 8 0 1938 116 97% 0.2% 25-Jun-24 26 0 7 0 0 0 0 0 19 0 0 0 0 81% China, Anhui Prov. Lab 104 0 0 0 104 0 98% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Beijing Prov. Lab 16 0 0 0 15 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 18 0 0 0 16 2 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 63 0 0 0 24 39 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 32 0 0 0 32 0 91% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 186 0 0 0 184 2 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangxi Prov. Lab 114 0 1 0 112 1 89% 0.4% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guizhou Prov. Lab 92 0 0 0 89 3 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hainan Prov. Lab 19 0 0 0 16 3 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 111 0 0 0 104 7 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 14 0 0 0 13 1 92% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 354 0 3 0 348 3 100% 0.4% Prov. Lab/CCDC 15 0 4 0 0 0 0 0 11 0 0 0 0 73% China, Hubei Prov. Lab 67 0 0 0 51 16 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 114 0 1 0 113 0 100% 0% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Jiangsu Prov. Lab 81 0 1 0 79 1 100% 1% Prov. Lab/CCDC 2 0 2 0 0 0 0 0 0 0 0 0 0 100% China, Jiangxi Prov. Lab 64 0 0 0 64 0 91% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 19 0 0 0 19 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 28 0 0 0 28 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 24 0 0 0 24 0 96% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ningxia Prov. Lab 10 0 1 0 9 0 100% 5% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Qinghai Prov. Lab 4 0 0 0 4 0 75% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 35 0 0 0 31 4 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 114 0 0 0 99 15 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab 10 0 0 0 10 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 35 0 0 0 33 2 94% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Sichuan Prov. Lab 114 0 0 0 113 1 96% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tianjin Prov. Lab 10 0 0 0 10 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 42 0 1 0 39 2 100% 1.3% Prov. Lab/CCDC 4 0 0 0 0 0 0 0 4 0 0 0 0 75% China, Yunnan Prov. Lab 90 0 0 0 79 11 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 74 0 0 0 72 2 99% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 4 0 0 0 4 0 100% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 4 0 0 0 4 0 100% 0% 25-Jun-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 25-Jun-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 15 0 0 0 13 2 100% 0% 01-Jul-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 11 0 0 1 4 6 100% 20% 25-Jun-24 NIID 0 - - - - - - - - - - - - - Malaysia IMR 105 0 0 10 95 0 100% 7% 28-Jun-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 3 0 0 0 3 0 100% 0% 10-Jun-24 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 3 0 0 1 1 1 100% 50% 27-Jun-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 13 1 2 0 5 5 100% 29% 07-Jun-24 VIDRL 4 0 1 0 0 0 0 0 1 0 2 0 0 50% Philippines RITM 362 4 1 25 320 11 99% 6% 01-Jul-24 RITM/NIID 0 - - - - - - - - - - - - - Republic of Korea KDCA 37 0 0 5 23 9 100% 13% 27-Jun-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 3 0 0 0 3 0 100% 0% 25-Jun-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 81 0 0 17 49 15 100% 25% 28-Jun-24 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 44 0 0 8 35 1 100% 19% 01-Jul-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 2 0 0 0 2 0 100% 0% 16-May-24 VIDRL 0 - - - - - - - - - - - - - Total 2796 5 13 69 2529 179 98% 3% 32 0 8 0 0 0 0 0 20 0 4 0 0 67% 2. NPEV growing in L20B cells Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens VDPV Pending % specimens positive for NPEV Latest report date SabinWild Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin Table 2C. Laboratory investigation of stool samples from AFP cases with onset in 2024 and key laboratory indicators 7 Polio Bulletin Table 3A. Laboratory confirmation of polio isolates from environmental samples in 20231 and key laboratory indicators 8 Polio Bulletin Table 3B. Laboratory confirmation of polio isolates from environmental samples in 20241 and key laboratory indicators 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); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); RITM (Research Institute for Tropical Medicine, Philippines); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 49 3 0 0 0 0 0 0 0 3 0 100% 0 0 Cambodia RITM 12 2 0 0 0 0 0 0 0 2 0 58% 0 0 China (total) 630 213 0 210 0 0 0 0 0 304 2 35% 0 0 China, Fujian Prov. Lab/CCDC 77 18 0 5 0 0 0 0 0 19 0 60% 0 0 China, Gansu Prov. Lab/CCDC 42 21 0 23 0 0 0 0 0 26 0 21% 0 0 China, Guangdong Prov. Lab/CCDC 48 30 0 20 0 0 0 0 0 41 0 52% 0 0 China, Guangxi Prov. Lab/CCDC 12 6 0 6 0 0 0 0 0 11 0 58% 0 0 China, Heilongjiang Prov. Lab/CCDC 24 11 0 12 0 0 0 0 0 30 0 17% 0 0 China, Jiangxi Prov. Lab/CCDC 34 9 0 6 0 0 0 0 0 6 1 65% 0 0 China, Jiangsu Prov. Lab/CCDC 124 10 0 4 0 0 0 0 0 6 0 5% 0 0 China, Liaoning Prov. Lab/CCDC 43 16 0 6 0 0 0 0 0 25 0 5% 0 0 China, Neimongol Prov. Lab/CCDC 20 8 0 15 0 0 0 0 0 13 0 0% 0 0 China, Ninxia Prov. Lab/CCDC 19 8 0 20 0 0 0 0 0 8 0 42% 0 0 China, Qinghai Prov. Lab/CCDC 14 3 0 3 0 0 0 0 0 2 0 14% 0 0 China, Shandong Prov. Lab/CCDC 36 16 0 10 0 0 0 0 0 27 0 36% 0 0 China, Shanghai Prov. Lab/CCDC 24 0 0 0 0 0 0 0 0 0 0 17% 0 0 China, Xinjiang Prov. Lab/CCDC 36 27 0 53 0 0 0 0 0 64 0 0% 0 0 China, Yunnan Prov. Lab/CCDC 37 22 0 25 0 0 0 0 0 18 0 92% 0 0 China, Zheijiang Prov. Lab/CCDC 40 8 0 2 0 0 0 0 0 8 1 70% 0 0 Lao PDR RITM 4 0 0 0 0 0 0 0 0 0 0 0% 0 0 Malaysia IMR/VIDRL 330 0 0 0 0 0 0 0 0 0 0 48% 3 0 New Zealand IESR 80 4 0 0 0 0 0 0 0 4 0 90% 0 0 Philippines RITM 616 37 0 17 0 0 0 0 0 44 0 15% 0 0 Viet Nam NIHE 124 0 0 0 0 0 0 0 0 0 0 2% 2 0 Total 1845 259 0 227 0 0 0 0 0 357 2 33% 5 0 NPEV (%) Pending ITD Discordant pending sequencingType 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 17 5 0 1 0 0 0 0 0 4 0 82% 2 0 Cambodia RITM 0 - - - - - - - - - - - - - China (total) 120 82 0 119 1 0 0 0 0 139 0 48% 2 0 China, Anui Prov. Lab/CCDC 16 16 0 33 0 0 0 0 0 26 0 100% 0 0 China, Fujian Prov. Lab/CCDC 16 7 0 3 0 0 0 0 0 4 0 44% 2 0 China, Gansu Prov. Lab/CCDC 16 8 0 9 0 0 0 0 0 14 0 50% 0 0 China, Guangdong Prov. Lab/CCDC 20 19 0 26 1 0 0 0 0 31 0 20% 0 0 China, Guangxi Prov. Lab/CCDC 4 3 0 1 0 0 0 0 0 2 0 75% 0 0 China, Heilongjiang Prov. Lab/CCDC 6 1 0 0 0 0 0 0 0 2 0 0% 0 0 China, Jiangxi Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab/CCDC 20 10 0 17 0 0 0 0 0 28 0 5% 0 0 China, Neimongol Prov. Lab/CCDC 6 6 0 0 0 0 0 0 0 14 0 100% 0 0 China, Ninxia Prov. Lab/CCDC 3 3 0 7 0 0 0 0 0 5 0 67% 0 0 China, Qinghai Prov. Lab/CCDC 4 3 0 4 0 0 0 0 0 5 0 75% 0 0 China, Shaanxi Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab/CCDC 9 6 0 13 0 0 0 0 0 8 0 67% 0 0 China, Shanghai Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Yunnan Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zheijiang Prov. Lab/CCDC 0 - - - - - - - - - - - - - Lao PDR RITM 0 - - - - - - - - - - - - - Malaysia IMR/VIDRL 0 - - - - - - - - - - - - - New Zealand IESR 28 1 0 0 0 0 0 0 0 1 0 93% 0 0 Philippines RITM 273 18 0 7 0 0 0 0 0 24 0 30% 20 0 Viet Nam NIHE 0 - - - - - - - - - - - - - Total 438 106 0 127 1 0 0 0 0 168 0 41% 24 0 Pending ITD Discordant pending sequencingType 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates NPEV (%) Figure 5A. China Figure 5B. Malaysia Figure 5C. Papua New Guinea Figure 5D. Philippines 1. Prefix letter refers to the VDPV category: “cVDPV” = circulating VDPV, “iVDPV” = immunodeficiency-associated VDPV, “aVDPV” = ambiguous VDPV. Suffix number refers to the poliovirus serotype (types 1, 2 or 3) 2. Community and healthy children 3. Contact of a different AFP case Vaccine-derived polio virus identified from laboratory testing, 2018–2024 0 2 4 6 8 10 12 14 16 cVDPV1 cVDPV2 cVDPV1 cVDPV2 aVDPV2 aVDPV3 2019 2020 N o. o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 45 cVDPV1 2018 N o.  o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 cVDPV1 cVDPV2 iVDPV2 aVDPV2 cVDPV2 aVDPV2 2019 2020 N o. o f c as es /s pe ci m en s 9 Polio Bulletin 0 1 2 3 4 5 cVDPV2 iVDPV3 aVDPV3 cVDPV2 aVDPV3 aVDPV1 cVDPV3 aVDPV3 aVDPV1 cVDPV3 aVDPV3 iVDPV3 aVDPV1 aVDPV1 aVDPV3 iVDPV3 aVDPV1 aVDPV3 2018 2019 2020 2021 2022 2023 2024 N o .  o f  ca se s/ sp e ci m e n s

Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Phone: +63 2 8528 8001 Fax: +63 2 8521 1036, 8526 0279 Email: wproepidata@who.int Web: www.who.int/westernpacific Polio Bulletin 2024 Issue No. 9 - July 2024 (as of 1 August 2024) Figure 1. Non-polio AFP rate (per 100 000 persons < 15 years of age), 2022–2024 HIGHLIGHTS Figure 2. Adequate specimen collection rate, 2022–2024 Figure 3. Percentage of reported AFP cases by number of polio vaccination doses, 2024 Figure 4. Percentage of reported AFP cases with pending classification > 90 days after onset, 2024 0.0 1.0 2.0 3.0 4.0 5.0 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% CHN KHM LAO MYS PHL PNG VNM ≥ 3 doses 1-2 doses 0 doses Unknown 5.6% 10.5% 17.6% 0.0% 0.0% 7.1% 33.7% 0% 5% 10% 15% 20% 25% 30% 35% 40% VNM PNG PHL MYS LAO KHM CHN 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). Team End Polio: One Team, One Dream On July 30, 2024, the Global Polio Eradication Initiative (GPEI) launched the inspiring “Team End Polio” campaign. This remarkable initiative brings together athletes, global leaders, and passionate advocates, all rallying to raise awareness and work tirelessly toward permanently eradicating polio. Over the past three decades, collaborative efforts have dramatically reduced polio cases by 99.9%, preventing over 20 million cases of paralysis. Despite this progress, the final push remains challenging. Team End Polio calls on supporters worldwide to unite behind a polio-free future and eradicate this disease once and for all. For more details: https://polioeradication.org/ news-post/team-end-polio-one-team-one-dream/ CONTACT US 2022 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 81 48 82 0 0 0 82 0 0 (0.0%) 1.72 63% 100% 26-Feb-24 - Brunei Darussalam 2 1 1 0 0 0 1 0 0 (0.0%) 1.08 100% 100% 18-Jan-24 - Cambodia 35 48 47 0 0 0 47 0 0 (0.0%) 0.99 89% 98% 07-Mar-24 - China 4225 1877 5606 0 0 0 5606 0 0 (0.0%) 2.99 95% 99% 21-Jul-24 - China, Hong Kong SAR 6 8 16 0 0 0 16 0 0 (0.0%) 2.07 81% 100% 19-Mar-24 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.04 100% 100% 08-Apr-24 - Japan 41 144 55 0 0 0 49 6 1 (1.8%) 0.38 55% 91% 20-Feb-24 163 Lao People's Democratic Republic 28 23 39 0 0 0 39 0 0 (0.0%) 1.70 87% 90% 23-May-24 - Malaysia 212 75 235 0 0 0 235 0 0 (0.0%) 3.11 84% 92% 22-Jul-24 - Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 26-Jan-24 - New Zealand 23 10 10 0 0 0 10 0 0 (0.0%) 1.04 70% 90% 09-Apr-24 - Papua New Guinea 59 39 57 0 0 0 56 1 1 (1.8%) 1.44 63% 70% 31-Jul-24 1 Philippines 853 342 979 0 0 0 425 554 510 (52.1%) 2.86 68% 57% 11-Apr-24 112 Republic of Korea 57 57 51 0 0 0 51 0 0 (0.0%) 0.90 82% 100% 08-Jul-24 - Singapore 11 6 3 0 0 0 3 0 0 (0.0%) 0.52 100% 100% 03-Jan-24 - Viet Nam 238 222 280 0 0 0 280 0 0 (0.0%) 1.26 99% 87% 23-Apr-24 - Pacific island countries and areas 7 10 27 0 0 0 27 0 0 (0.0%) 2.59 56% 67% 12-Jun-24 - Total 5880 2921 7490 0 0 0 6929 561 512 (6.8%) 2.56 90% 93% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Days since last report 5 % investigated ≤ 2 days of notification 3 Indicators Latest report date4> 90 days 1 # (%) Total 2023 % with adequate specimens 2 Pending Classification Non-polio AFP rate Vaccine- derived poliovirus (VDPV) Polio- compatible Table 1A. Classification of AFP cases with onset in 2023 and key surveillance indicators 3 Polio Bulletin 2023 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 82 48 58 0 0 0 36 22 0 (0.0%) 2.03 57% 95% 31-Jul-24 1 Brunei Darussalam 1 1 1 0 0 0 0 1 0 (0.0%) 1.81 100% 100% 13-Jun-24 49 Cambodia 47 48 14 0 0 0 2 12 1 (7.1%) 0.49 86% 100% 30-Jul-24 2 China 5606 1877 2083 0 0 0 446 1637 702 (33.7%) 1.86 94% 99% 25-Jun-24 37 China, Hong Kong SAR 16 8 5 0 0 0 4 1 0 (0.0%) 1.11 100% 100% 31-Jul-24 1 China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.75 100% 100% 03-Jul-24 29 Japan 55 144 19 0 0 0 17 2 0 (0.0%) 0.22 68% 100% 29-Jul-24 3 Lao People's Democratic Republic 39 23 13 0 0 0 5 8 0 (0.0%) 0.95 92% 85% 30-Jul-24 2 Malaysia 235 75 126 0 0 0 105 21 0 (0.0%) 2.80 90% 79% 22-Jul-24 10 Mongolia 1 11 3 0 0 0 3 0 0 (0.0%) 0.46 100% 100% 03-Jun-24 59 New Zealand 10 10 4 0 0 0 2 2 0 (0.0%) 0.69 50% 50% 25-Jul-24 7 Papua New Guinea 57 41 19 0 0 0 8 11 2 (10.5%) 0.79 53% 32% 31-Jul-24 1 Philippines 979 344 495 0 0 0 263 232 87 (17.6%) 2.41 50% 99% 30-Jul-24 2 Republic of Korea 51 54 44 0 0 0 15 29 1 (2.3%) 1.36 75% 100% 29-Jul-24 3 Singapore 3 6 3 0 0 0 3 0 0 (0.0%) 86% 100% 100% 01-Jul-24 31 Viet Nam 280 222 124 0 0 0 46 78 7 (5.6%) 0.94 100% 60% 09-Jul-24 23 Pacific island countries and areas 27 11 6 0 0 0 0 6 1 (16.7%) 0.96 33% 83% 12-Jun-24 50 Total 7490 2923 3018 0 0 0 956 2062 801 (26.5%) 1.73 85% 96% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Annualized non-polio AFP rate per 100 000 population under 15 years of age Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Substantially below target 4. Percentage of reported cases investigated within two days of notification 5. Countries are expected to submit data at least once per month to WPRO Total 2024 % with adequate specimens 3 Pending Classification Non-polio AFP rate 2 Vaccine- derived poliovirus (VDPV) Polio- compatible Days since last report 5 % investigated ≤ 2 days of notification 4 Indicators Latest report date> 90 days 1 # (%) Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Table 1B. Classification of AFP cases with onset in 2024 and key surveillance indicators 4 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 77 0 2 2 73 0 94% 3% 05-Feb-24 VIDRL 2 0 0 0 0 0 0 0 0 0 2 0 0 100% Brunei Darussalam VIDRL 1 0 0 0 1 0 0% 0% 09-Oct-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 47 0 0 7 40 0 96% 14% 25-Dec-23 NIID 0 - - - - - - - - - - - - - China (total) 5580 0 19 0 5561 0 98% 0.2% 21-Jul-24 60 0 26 0 0 0 0 0 34 0 0 0 0 100% China, Anhui Prov. Lab 342 0 1 0 341 0 98% 0.1% Prov. Lab/CCDC 4 0 2 0 0 0 0 0 2 0 0 0 0 100% China, Beijing Prov. Lab 56 0 0 0 56 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 59 0 0 0 59 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 171 0 0 0 171 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 111 0 0 0 111 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 586 0 1 0 585 0 93% 0% Prov. Lab/CCDC 6 0 3 0 0 0 0 0 3 0 0 0 0 100% China, Guangxi Prov. Lab 252 0 3 0 249 0 99% 0.6% Prov. Lab/CCDC 8 0 2 0 0 0 0 0 6 0 0 0 0 100% China, Guizhou Prov. Lab 235 0 0 0 235 0 100% 0% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Hainan Prov. Lab 48 0 1 0 47 0 96% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Hebei Prov. Lab 333 0 0 0 333 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 69 0 0 0 69 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 688 0 6 0 682 0 100% 0.4% Prov. Lab/CCDC 18 0 10 0 0 0 0 0 8 0 0 0 0 100% China, Hubei Prov. Lab 151 0 0 0 151 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 287 0 0 0 287 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 217 0 0 0 217 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 182 0 0 0 182 0 91% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 43 0 0 0 43 0 100% 0% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Liaoning Prov. Lab 102 0 0 0 102 0 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 139 0 1 0 138 0 100% 0.4% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Ningxia Prov. Lab 23 0 0 0 23 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 9 0 0 0 9 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 74 0 0 0 74 0 74% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 287 0 0 0 287 0 100% 0% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Shanghai Prov. Lab 46 0 0 0 46 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 108 0 2 0 106 0 98% 1% Prov. Lab/CCDC 6 0 2 0 0 0 0 0 4 0 0 0 0 100% China, Sichuan Prov. Lab 358 0 1 0 357 0 98% 0.1% Prov. Lab/CCDC 4 0 3 0 0 0 0 0 1 0 0 0 0 100% China, Tianjin Prov. Lab 31 0 1 0 30 0 100% 2% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Xinjiang Prov. Lab 146 0 1 0 145 0 98% 0.3% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Yunnan Prov. Lab 208 0 0 0 208 0 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 198 0 1 0 197 0 99% 0.3% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Tibet Prov. Lab 21 0 0 0 21 0 95% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 15 0 0 0 15 0 97% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 49 0 0 4 45 0 91% 7% 21-Feb-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 39 1 0 1 37 0 100% 3% 21-May-24 NIID 2 0 0 0 0 0 0 0 2 0 0 0 0 100% Malaysia IMR 254 0 0 19 235 0 88% 7% 29-Apr-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 29-Dec-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 7 0 0 1 6 0 100% 18% 19-Feb-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 57 6 0 3 47 1 97% 6% 24-Jul-24 VIDRL 27 0 6 0 0 0 0 0 21 0 0 0 0 100% Philippines RITM 891 13 0 44 833 1 97% 4% 11-Jun-24 RITM/NIID 66 0 26 0 0 0 0 0 40 0 0 0 0 100% Republic of Korea KDCA 51 0 0 6 43 2 99% 12% 08-Jul-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 3 0 0 1 2 0 100% 33% 11-Jan-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 164 0 0 27 137 0 100% 16% 11-Jan-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 113 0 0 14 99 0 100% 12% 29-Jan-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 24 0 0 3 21 0 96% 9% 22-Jan-24 VIDRL 0 - - - - - - - - - - - - - Total 7374 20 21 132 7197 4 97% 2% 157 0 58 0 0 0 0 0 97 0 2 0 0 100% 2. NPEV growing in L20B cells Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin VDPVPending % specimens positive for NPEV Latest report date SabinWild 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only Table 2A. Laboratory investigation of stool samples from AFP cases with onset in 2023 and key laboratory indicators 6 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 48 0 2 3 37 6 88% 8% 31-Jul-24 VIDRL 2 0 0 0 0 0 0 0 0 0 2 0 0 100% Brunei Darussalam VIDRL 1 0 0 0 1 0 100% 0% 12-Jun-24 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 14 0 0 0 12 2 17% 0% 30-Jul-24 NIID 0 - - - - - - - - - - - - - China (total) 2062 0 8 0 1938 116 97% 0.2% 25-Jun-24 31 0 10 0 0 0 0 0 21 0 0 0 0 84% China, Anhui Prov. Lab 104 0 0 0 104 0 98% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Beijing Prov. Lab 16 0 0 0 15 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 18 0 0 0 16 2 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 63 0 0 0 24 39 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 32 0 0 0 32 0 91% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 186 0 0 0 184 2 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangxi Prov. Lab 114 0 1 0 112 1 89% 0.4% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guizhou Prov. Lab 92 0 0 0 89 3 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hainan Prov. Lab 19 0 0 0 16 3 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 111 0 0 0 104 7 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 14 0 0 0 13 1 92% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 354 0 3 0 348 3 100% 0.4% Prov. Lab/CCDC 20 0 7 0 0 0 0 0 13 0 0 0 0 73% China, Hubei Prov. Lab 67 0 0 0 51 16 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 114 0 1 0 113 0 100% 0% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Jiangsu Prov. Lab 81 0 1 0 79 1 100% 1% Prov. Lab/CCDC 2 0 2 0 0 0 0 0 0 0 0 0 0 100% China, Jiangxi Prov. Lab 64 0 0 0 64 0 91% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 19 0 0 0 19 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Liaoning Prov. Lab 28 0 0 0 28 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 24 0 0 0 24 0 96% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ningxia Prov. Lab 10 0 1 0 9 0 100% 5% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Qinghai Prov. Lab 4 0 0 0 4 0 75% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 35 0 0 0 31 4 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 114 0 0 0 99 15 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab 10 0 0 0 10 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 35 0 0 0 33 2 94% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Sichuan Prov. Lab 114 0 0 0 113 1 96% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tianjin Prov. Lab 10 0 0 0 10 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 42 0 1 0 39 2 100% 1.3% Prov. Lab/CCDC 4 0 0 0 0 0 0 0 4 0 0 0 0 75% China, Yunnan Prov. Lab 90 0 0 0 79 11 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 74 0 0 0 72 2 99% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 4 0 0 0 4 0 100% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 5 0 0 0 4 1 100% 0% 30-Jul-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 30-Jul-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 17 0 0 0 17 0 100% 0% 30-Jul-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 13 0 0 1 4 8 100% 20% 30-Jul-24 NIID 0 - - - - - - - - - - - - - Malaysia IMR 121 0 0 11 110 0 100% 7% 23-Jul-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 3 0 0 0 3 0 100% 0% 12-Jul-24 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 4 0 0 1 2 1 100% 38% 25-Jul-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 19 1 2 0 11 5 100% 15% 31-Jul-24 VIDRL 4 0 1 0 0 0 0 0 1 0 2 0 0 50% Philippines RITM 454 4 2 38 396 13 99% 8% 31-Jul-24 RITM/NIID 0 - - - - - - - - - - - - - Republic of Korea KDCA 44 0 0 8 34 2 100% 16% 29-Jul-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 3 0 0 0 3 0 100% 0% 29-Jul-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 81 0 0 17 49 15 100% 25% 28-Jun-24 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 57 0 0 8 46 3 100% 15% 30-Jul-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 4 0 0 1 3 0 100% 33% 22-Jul-24 VIDRL 0 - - - - - - - - - - - - - Total 2951 5 14 88 2671 172 97% 3% 37 0 11 0 0 0 0 0 22 0 4 0 0 78% 2. NPEV growing in L20B cells Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens VDPV Pending % specimens positive for NPEV Latest report date SabinWild Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin Table 2B. Laboratory investigation of stool samples from AFP cases with onset in 2024 and key laboratory indicators 7 Polio Bulletin Table 3A. Laboratory confirmation of polio isolates from environmental samples in 20231 and key laboratory indicators 8 Polio Bulletin Table 3B. Laboratory confirmation of polio isolates from environmental samples in 20241 and key laboratory indicators 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); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); RITM (Research Institute for Tropical Medicine, Philippines); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 49 3 0 0 0 0 0 0 0 3 0 100% 0 0 Cambodia RITM 12 2 0 0 0 0 0 0 0 2 0 58% 0 0 China (total) 630 213 0 210 0 0 0 0 0 304 2 35% 0 0 China, Fujian Prov. Lab/CCDC 77 18 0 5 0 0 0 0 0 19 0 60% 0 0 China, Gansu Prov. Lab/CCDC 42 21 0 23 0 0 0 0 0 26 0 21% 0 0 China, Guangdong Prov. Lab/CCDC 48 30 0 20 0 0 0 0 0 41 0 52% 0 0 China, Guangxi Prov. Lab/CCDC 12 6 0 6 0 0 0 0 0 11 0 58% 0 0 China, Heilongjiang Prov. Lab/CCDC 24 11 0 12 0 0 0 0 0 30 0 17% 0 0 China, Jiangxi Prov. Lab/CCDC 34 9 0 6 0 0 0 0 0 6 1 65% 0 0 China, Jiangsu Prov. Lab/CCDC 124 10 0 4 0 0 0 0 0 6 0 5% 0 0 China, Liaoning Prov. Lab/CCDC 43 16 0 6 0 0 0 0 0 25 0 5% 0 0 China, Neimongol Prov. Lab/CCDC 20 8 0 15 0 0 0 0 0 13 0 0% 0 0 China, Ninxia Prov. Lab/CCDC 19 8 0 20 0 0 0 0 0 8 0 42% 0 0 China, Qinghai Prov. Lab/CCDC 14 3 0 3 0 0 0 0 0 2 0 14% 0 0 China, Shandong Prov. Lab/CCDC 36 16 0 10 0 0 0 0 0 27 0 36% 0 0 China, Shanghai Prov. Lab/CCDC 24 0 0 0 0 0 0 0 0 0 0 17% 0 0 China, Xinjiang Prov. Lab/CCDC 36 27 0 53 0 0 0 0 0 64 0 0% 0 0 China, Yunnan Prov. Lab/CCDC 37 22 0 25 0 0 0 0 0 18 0 92% 0 0 China, Zheijiang Prov. Lab/CCDC 40 8 0 2 0 0 0 0 0 8 1 70% 0 0 Lao PDR RITM 4 0 0 0 0 0 0 0 0 0 0 0% 0 0 Malaysia IMR/VIDRL 330 0 0 0 0 0 0 0 0 0 0 48% 3 0 New Zealand IESR 80 4 0 0 0 0 0 0 0 4 0 90% 0 0 Philippines RITM 616 37 0 17 0 0 0 0 0 44 0 15% 0 0 Viet Nam NIHE 124 0 0 0 0 0 0 0 0 0 0 2% 0 0 Total 1845 259 0 227 0 0 0 0 0 357 2 33% 3 0 NPEV (%) Pending ITD Discordant pending sequencingType 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 20 6 0 1 0 0 0 0 0 5 0 85% 2 0 Cambodia RITM 5 1 0 0 0 0 0 0 0 1 0 40% 2 0 China (total) 242 126 0 146 1 0 0 0 0 219 0 48% 0 0 China, Anui Prov. Lab/CCDC 24 20 0 36 0 0 0 0 0 32 0 75% 0 0 China, Fujian Prov. Lab/CCDC 30 13 0 3 0 0 0 0 0 18 0 90% 0 0 China, Gansu Prov. Lab/CCDC 31 14 0 11 0 0 0 0 0 29 0 23% 0 0 China, Guangdong Prov. Lab/CCDC 24 22 0 26 1 0 0 0 0 41 0 67% 0 0 China, Guangxi Prov. Lab/CCDC 9 6 0 3 0 0 0 0 0 3 0 78% 0 0 China, Heilongjiang Prov. Lab/CCDC 10 2 0 0 0 0 0 0 0 3 0 0% 0 0 China, Jiangxi Prov. Lab/CCDC 21 3 0 0 0 0 0 0 0 3 0 43% 0 0 China, Jiangsu Prov. Lab/CCDC 14 5 0 6 0 0 0 0 0 3 0 7% 0 0 China, Liaoning Prov. Lab/CCDC 28 16 0 23 0 0 0 0 0 41 0 54% 0 0 China, Neimongol Prov. Lab/CCDC 10 7 0 6 0 0 0 0 0 16 0 0% 0 0 China, Ninxia Prov. Lab/CCDC 3 3 0 7 0 0 0 0 0 5 0 67% 0 0 China, Qinghai Prov. Lab/CCDC 6 5 0 8 0 0 0 0 0 14 0 17% 0 0 China, Shaanxi Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab/CCDC 16 10 0 17 0 0 0 0 0 11 0 56% 0 0 China, Shanghai Prov. Lab/CCDC 16 0 0 0 0 0 0 0 0 0 0 25% 0 0 China, Xinjiang Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Yunnan Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zheijiang Prov. Lab/CCDC 0 - - - - - - - - - - - - - Lao PDR RITM 0 - - - - - - - - - - - - - Malaysia IMR/VIDRL 0 - - - - - - - - - - - - - New Zealand IESR 28 1 0 0 0 0 0 0 0 1 0 93% 0 0 Philippines RITM 333 18 0 8 0 0 0 0 0 24 0 28% 26 0 Viet Nam NIHE 0 - - - - - - - - - - - - - Total 628 152 0 155 1 0 0 0 0 250 0 41% 30 0 628 152 0 155 1 0 0 0 0 250 0 30 NPEV (%) Pending ITD Discordant pending sequencingType 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates Figure 5A. China Figure 5B. Malaysia Figure 5C. Papua New Guinea Figure 5D. Philippines 1. Prefix letter refers to the VDPV category: “cVDPV” = circulating VDPV, “iVDPV” = immunodeficiency-associated VDPV, “aVDPV” = ambiguous VDPV. Suffix number refers to the poliovirus serotype (types 1, 2 or 3) 2. Community and healthy children 3. Contact of a different AFP case Vaccine-derived polio virus identified from laboratory testing, 2018–2024 0 2 4 6 8 10 12 14 16 cVDPV1 cVDPV2 cVDPV1 cVDPV2 aVDPV2 aVDPV3 2019 2020 N o. o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 45 cVDPV1 2018 No . of  ca ses /sp eci me ns 0 5 10 15 20 25 30 35 40 cVDPV1 cVDPV2 iVDPV2 aVDPV2 cVDPV2 aVDPV2 2019 2020 N o. o f c as es /s pe ci m en s 9 Polio Bulletin 0 1 2 3 4 5 cVDPV2 iVDPV3 aVDPV3 cVDPV2 aVDPV3 aVDPV1 cVDPV3 aVDPV3 aVDPV1 cVDPV3 aVDPV3 iVDPV3 aVDPV1 aVDPV1 aVDPV3 iVDPV3 aVDPV1 aVDPV3 2018 2019 2020 2021 2022 2023 2024 No . o f c as es /sp ec im en s

Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Phone: +63 2 8528 8001 Fax: +63 2 8521 1036, 8526 0279 Email: wproepidata@who.int Web: www.who.int/westernpacific Polio Bulletin 2024 Issue No. 10 - August 2024 (as of 3 September 2024) Figure 1. Non-polio AFP rate (per 100 000 persons < 15 years of age), 2022–2024 HIGHLIGHTS Figure 2. Adequate specimen collection rate, 2022–2024 Figure 3. Percentage of reported AFP cases by number of polio vaccination doses, 2024 Figure 4. Percentage of reported AFP cases with pending classification > 90 days after onset, 2024 0.0 1.0 2.0 3.0 4.0 5.0 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% CHN KHM LAO MYS PHL PNG VNM ≥ 3 doses 1-2 doses 0 doses Unknown 20.3% 12.5% 18.3% 0.0% 0.0% 4.3% 29.6% 0% 5% 10% 15% 20% 25% 30% 35% VNM PNG PHL MYS LAO KHM CHN 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). Tragic passing of WHO Polio Eradication Programme Director, Aidan O’Leary The Director for WHO Polio Eradication Program, Mr Aidan O’Leary passed away on the evening of Tuesday 6 August, while he was on holiday with his family. He was currently leading the global effort to eradicate polio and had already been working tirelessly for the betterment of humanity. Aidan had a wealth of emergencies and public health experience, serving as Head of Office in Yemen for the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), a role he had also previously held in Afghanistan and Iraq, as well as Head of OCHA’s Regional Office for the Syria Crisis. Aidan also demonstrated his deep commitment to supporting some of the world’s most vulnerable people in other emergency settings. This included serving as Deputy Director of Operations for UN Relief and Works Agency for Palestinian Refugees in the Near East (UNRWA) based in Gaza, and Chief of Polio Eradication for UNICEF working in Pakistan and Afghanistan. On a personal level, Aidan was an extremely personable, open and gentle friend and colleague. He will be missed deeply both on a professional and on a personal level. More details here: https://polioeradication.org/news/ tragic-passing-of-gpei-director-aidan-oleary/ CONTACT US 2022 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 81 48 82 0 0 0 82 0 0 (0.0%) 1.72 63% 100% 26-Feb-24 - Brunei Darussalam 2 1 1 0 0 0 1 0 0 (0.0%) 1.08 100% 100% 18-Jan-24 - Cambodia 35 48 47 0 0 0 47 0 0 (0.0%) 0.99 89% 98% 07-Mar-24 - China 4225 1877 5606 0 0 0 5606 0 0 (0.0%) 2.99 95% 99% 21-Jul-24 - China, Hong Kong SAR 6 8 16 0 0 0 16 0 0 (0.0%) 2.07 81% 100% 19-Mar-24 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.04 100% 100% 08-Apr-24 - Japan 41 144 55 0 0 0 49 6 2 (3.6%) 0.38 55% 93% 22-Aug-24 12 Lao People's Democratic Republic 28 23 39 0 0 0 39 0 0 (0.0%) 1.70 87% 90% 23-May-24 - Malaysia 212 75 235 0 0 0 235 0 0 (0.0%) 3.11 84% 92% 22-Jul-24 - Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 26-Jan-24 - New Zealand 23 10 10 0 0 0 10 0 0 (0.0%) 1.04 70% 90% 09-Apr-24 - Papua New Guinea 59 39 57 0 0 0 56 1 1 (1.8%) 1.44 63% 70% 09-Aug-24 25 Philippines 853 342 979 0 0 0 425 554 510 (52.1%) 2.86 68% 57% 11-Apr-24 145 Republic of Korea 57 57 51 0 0 0 51 0 0 (0.0%) 0.90 82% 100% 08-Jul-24 - Singapore 11 6 3 0 0 0 3 0 0 (0.0%) 0.52 100% 100% 03-Jan-24 - Viet Nam 238 222 280 0 0 0 280 0 0 (0.0%) 1.26 99% 87% 23-Apr-24 - Pacific island countries and areas 7 10 27 0 0 0 27 0 0 (0.0%) 2.59 56% 67% 12-Jun-24 - Total 5880 2921 7490 0 0 0 6929 561 513 (6.8%) 2.56 90% 93% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO Total 2023 % with adequate specimens 2 Pending Classification Non-polio AFP rate Vaccine- derived poliovirus (VDPV) Polio- compatible Days since last report 5 % investigated ≤ 2 days of notification 3 Indicators Latest report date4> 90 days 1 # (%) Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Table 1A. Classification of AFP cases with onset in 2023 and key surveillance indicators 3 Polio Bulletin 2023 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 82 48 66 0 0 0 56 10 0 (0.0%) 2.05 59% 98% 02-Sep-24 1 Brunei Darussalam 1 1 1 0 0 0 1 0 0 (0.0%) 1.61 100% 100% 03-Sep-24 0 Cambodia 47 48 23 0 0 0 2 21 1 (4.3%) 0.71 91% 100% 02-Sep-24 1 China 5606 1877 3085 0 0 0 1246 1839 912 (29.6%) 2.44 94% 99% 26-Aug-24 8 China, Hong Kong SAR 16 8 6 0 0 0 5 1 0 (0.0%) 1.18 100% 100% 20-Aug-24 14 China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.55 100% 100% 15-Aug-24 19 Japan 55 144 26 0 0 0 20 6 0 (0.0%) 0.27 58% 100% 20-Aug-24 14 Lao People's Democratic Republic 39 23 14 0 0 0 5 9 0 (0.0%) 0.91 93% 79% 31-Aug-24 3 Malaysia 235 75 165 0 0 0 161 4 0 (0.0%) 3.25 93% 81% 02-Sep-24 1 Mongolia 1 11 3 0 0 0 3 0 0 (0.0%) 0.41 100% 100% 12-Aug-24 22 New Zealand 10 10 5 0 0 0 1 4 1 (20.0%) 0.77 60% 60% 14-Aug-24 20 Papua New Guinea 57 41 24 0 0 0 13 11 3 (12.5%) 0.88 50% 38% 02-Sep-24 1 Philippines 979 344 524 0 0 0 304 220 96 (18.3%) 2.26 53% 100% 27-Aug-24 7 Republic of Korea 51 54 53 0 0 0 32 21 0 (0.0%) 1.46 79% 100% 26-Aug-24 8 Singapore 3 6 4 0 0 0 3 1 0 (0.0%) 102% 100% 100% 02-Sep-24 1 Viet Nam 280 222 158 0 0 0 80 78 32 (20.3%) 1.06 100% 56% 22-Aug-24 12 Pacific island countries and areas 27 11 10 0 0 0 0 10 6 (60.0%) 1.41 20% 100% 30-Aug-24 4 Total 7490 2923 4168 0 0 0 1933 2235 1,051 (25.2%) 2.12 88% 97% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Annualized non-polio AFP rate per 100 000 population under 15 years of age Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Substantially below target 4. Percentage of reported cases investigated within two days of notification 5. Countries are expected to submit data at least once per month to WPRO Total 2024 % with adequate specimens 3 Pending Classification Non-polio AFP rate 2 Vaccine- derived poliovirus (VDPV) Polio- compatible Days since last report 5 % investigated ≤ 2 days of notification 4 Indicators Latest report date> 90 days 1 # (%) Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Table 1B. Classification of AFP cases with onset in 2024 and key surveillance indicators 4 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 77 0 2 2 73 0 94% 3% 05-Feb-24 VIDRL 2 0 0 0 0 0 0 0 0 0 2 0 0 100% Brunei Darussalam VIDRL 1 0 0 0 1 0 0% 0% 09-Oct-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 47 0 0 7 40 0 96% 14% 25-Dec-23 NIID 0 - - - - - - - - - - - - - China (total) 5580 0 19 0 5561 0 98% 0.2% 21-Jul-24 60 0 26 0 0 0 0 0 34 0 0 0 0 100% China, Anhui Prov. Lab 342 0 1 0 341 0 98% 0.1% Prov. Lab/CCDC 4 0 2 0 0 0 0 0 2 0 0 0 0 100% China, Beijing Prov. Lab 56 0 0 0 56 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 59 0 0 0 59 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 171 0 0 0 171 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 111 0 0 0 111 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 586 0 1 0 585 0 93% 0% Prov. Lab/CCDC 6 0 3 0 0 0 0 0 3 0 0 0 0 100% China, Guangxi Prov. Lab 252 0 3 0 249 0 99% 0.6% Prov. Lab/CCDC 8 0 2 0 0 0 0 0 6 0 0 0 0 100% China, Guizhou Prov. Lab 235 0 0 0 235 0 100% 0% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Hainan Prov. Lab 48 0 1 0 47 0 96% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Hebei Prov. Lab 333 0 0 0 333 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 69 0 0 0 69 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 688 0 6 0 682 0 100% 0.4% Prov. Lab/CCDC 18 0 10 0 0 0 0 0 8 0 0 0 0 100% China, Hubei Prov. Lab 151 0 0 0 151 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 287 0 0 0 287 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 217 0 0 0 217 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 182 0 0 0 182 0 91% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 43 0 0 0 43 0 100% 0% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Liaoning Prov. Lab 102 0 0 0 102 0 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 139 0 1 0 138 0 100% 0.4% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Ningxia Prov. Lab 23 0 0 0 23 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 9 0 0 0 9 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 74 0 0 0 74 0 74% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 287 0 0 0 287 0 100% 0% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Shanghai Prov. Lab 46 0 0 0 46 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 108 0 2 0 106 0 98% 1% Prov. Lab/CCDC 6 0 2 0 0 0 0 0 4 0 0 0 0 100% China, Sichuan Prov. Lab 358 0 1 0 357 0 98% 0.1% Prov. Lab/CCDC 4 0 3 0 0 0 0 0 1 0 0 0 0 100% China, Tianjin Prov. Lab 31 0 1 0 30 0 100% 2% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Xinjiang Prov. Lab 146 0 1 0 145 0 98% 0.3% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Yunnan Prov. Lab 208 0 0 0 208 0 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 198 0 1 0 197 0 99% 0.3% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Tibet Prov. Lab 21 0 0 0 21 0 95% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 15 0 0 0 15 0 97% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 49 0 0 4 45 0 91% 7% 21-Feb-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 39 1 0 1 37 0 100% 3% 21-May-24 NIID 2 0 0 0 0 0 0 0 2 0 0 0 0 100% Malaysia IMR 254 0 0 19 235 0 88% 7% 29-Apr-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 29-Dec-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 7 0 0 1 6 0 100% 18% 19-Feb-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 57 6 0 3 48 0 97% 6% 27-Aug-24 VIDRL 27 0 6 0 0 0 0 0 21 0 0 0 0 100% Philippines RITM 892 13 0 44 833 2 97% 4% 21-Aug-24 RITM/NIID 66 0 26 0 0 0 0 0 40 0 0 0 0 100% Republic of Korea KDCA 51 0 0 6 45 0 99% 11% 06-Aug-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 3 0 0 1 2 0 100% 33% 11-Jan-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 164 0 0 27 137 0 100% 16% 11-Jan-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 113 0 0 14 99 0 100% 12% 29-Jan-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 24 0 0 3 21 0 96% 9% 22-Jan-24 VIDRL 0 - - - - - - - - - - - - - Total 7375 20 21 132 7200 2 97% 2% 157 0 58 0 0 0 0 0 97 0 2 0 0 100% 2. NPEV growing in L20B cells Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin VDPVPending % specimens positive for NPEV Latest report date SabinWild 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only Table 2A. Laboratory investigation of stool samples from AFP cases with onset in 2023 and key laboratory indicators 6 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 58 0 2 4 50 2 86% 7% 02-Sep-24 VIDRL 2 0 0 0 0 0 0 0 0 0 2 0 0 100% Brunei Darussalam VIDRL 1 0 0 0 1 0 100% 0% 12-Jun-24 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 23 0 0 0 19 4 47% 0% 02-Sep-24 NIID 0 - - - - - - - - - - - - - China (total) 3064 0 9 0 3008 47 97% 0.1% 26-Aug-24 33 0 10 0 0 0 0 0 23 0 0 0 0 85% China, Anhui Prov. Lab 165 0 0 0 165 0 98% 0.0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Beijing Prov. Lab 23 0 0 0 23 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Chongqing Prov. Lab 27 0 0 0 25 2 98% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Fujian Prov. Lab 113 0 0 0 106 7 97% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Gansu Prov. Lab 51 0 0 0 50 1 94% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Guangdong Prov. Lab 307 0 0 0 302 5 91% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Guangxi Prov. Lab 142 0 0 0 141 1 91% 0.0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Guizhou Prov. Lab 145 0 0 0 142 3 98% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Hainan Prov. Lab 31 0 0 0 29 2 97% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Hebei Prov. Lab 165 0 0 0 164 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Heilongjiang Prov. Lab 21 0 0 0 21 0 95% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Henan Prov. Lab 460 0 3 0 455 2 100% 0.3% Prov. Lab/CCDC 20 0 7 0 0 0 0 0 13 0 0 0 0 80% China, Hubei Prov. Lab 102 0 0 0 99 3 97% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Hunan Prov. Lab 181 0 1 0 180 0 100% 0% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Jiangsu Prov. Lab 120 0 1 0 119 0 100% 0% Prov. Lab/CCDC 2 0 2 0 0 0 0 0 0 0 0 0 0 100% China, Jiangxi Prov. Lab 99 0 0 0 98 1 94% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Jilin Prov. Lab 22 0 0 0 22 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Liaoning Prov. Lab 47 0 1 0 43 3 100% 1% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Neimongol Prov. Lab 50 0 0 0 48 2 98% 0.0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Ningxia Prov. Lab 16 0 1 0 13 2 100% 4% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Qinghai Prov. Lab 8 0 0 0 8 0 88% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Shaanxi Prov. Lab 54 0 0 0 52 2 96% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Shandong Prov. Lab 161 0 0 0 160 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Shanghai Prov. Lab 16 0 0 0 16 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Shanxi Prov. Lab 51 0 1 0 49 1 96% 1% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Sichuan Prov. Lab 180 0 0 0 178 2 98% 0.0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Tianjin Prov. Lab 12 0 0 0 12 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Xinjiang Prov. Lab 57 0 1 0 51 5 98% 1.0% Prov. Lab/CCDC 4 0 0 0 0 0 0 0 4 0 0 0 0 75% China, Yunnan Prov. Lab 134 0 0 0 133 1 92% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Zhejiang Prov. Lab 96 0 0 0 96 0 99% 0.0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Tibet Prov. Lab 8 0 0 0 8 0 100% 0% CCDC 0 - - - - - - - 0 - - - - - China, Hong Kong SAR PHLC 6 0 0 0 6 0 100% 0% 29-Aug-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 20-Aug-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 20 0 0 0 20 0 100% 0% 21-Aug-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 14 0 0 4 8 2 43% 30% 31-Aug-24 NIID 0 - - - - - - - - - - - - - Malaysia IMR 165 0 0 17 148 0 100% 8% 29-Aug-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 3 0 0 0 3 0 100% 0% 02-Sep-24 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 5 0 0 1 4 0 100% 21% 27-Aug-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 24 1 2 1 16 4 100% 13% 26-Aug-24 VIDRL 4 0 1 0 0 0 0 0 1 0 2 0 0 50% Philippines RITM 530 4 2 47 457 19 99% 8% 02-Sep-24 RITM/NIID 0 - - - - - - - - - - - - - Republic of Korea KDCA 53 0 0 11 40 2 100% 17% 26-Aug-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 4 0 0 0 3 1 100% 0% 02-Sep-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 81 0 0 17 49 15 100% 25% 28-Jun-24 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 68 0 0 11 54 3 100% 17% 26-Aug-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 6 0 0 1 5 0 100% 17% 26-Aug-24 VIDRL 0 - - - - - - - - - - - - - Total 4126 5 15 114 3892 99 97% 3% 39 0 11 0 0 0 0 0 24 0 4 0 0 78% 2. NPEV growing in L20B cells Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens VDPV Pending % specimens positive for NPEV Latest report date SabinWild Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin Table 2B. Laboratory investigation of stool samples from AFP cases with onset in 2024 and key laboratory indicators 7 Polio Bulletin Table 3A. Laboratory confirmation of polio isolates from environmental samples in 20231 and key laboratory indicators 8 Polio Bulletin Table 3B. Laboratory confirmation of polio isolates from environmental samples in 20241 and key laboratory indicators 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); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); RITM (Research Institute for Tropical Medicine, Philippines); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 49 3 0 0 0 0 0 0 0 3 0 100% 0 0 Cambodia RITM 12 2 0 0 0 0 0 0 0 2 0 58% 0 0 China (total) 630 213 0 210 0 0 0 0 0 304 2 35% 0 0 China, Fujian Prov. Lab/CCDC 77 18 0 5 0 0 0 0 0 19 0 60% 0 0 China, Gansu Prov. Lab/CCDC 42 21 0 23 0 0 0 0 0 26 0 21% 0 0 China, Guangdong Prov. Lab/CCDC 48 30 0 20 0 0 0 0 0 41 0 52% 0 0 China, Guangxi Prov. Lab/CCDC 12 6 0 6 0 0 0 0 0 11 0 58% 0 0 China, Heilongjiang Prov. Lab/CCDC 24 11 0 12 0 0 0 0 0 30 0 17% 0 0 China, Jiangxi Prov. Lab/CCDC 34 9 0 6 0 0 0 0 0 6 1 65% 0 0 China, Jiangsu Prov. Lab/CCDC 124 10 0 4 0 0 0 0 0 6 0 5% 0 0 China, Liaoning Prov. Lab/CCDC 43 16 0 6 0 0 0 0 0 25 0 5% 0 0 China, Neimongol Prov. Lab/CCDC 20 8 0 15 0 0 0 0 0 13 0 0% 0 0 China, Ninxia Prov. Lab/CCDC 19 8 0 20 0 0 0 0 0 8 0 42% 0 0 China, Qinghai Prov. Lab/CCDC 14 3 0 3 0 0 0 0 0 2 0 14% 0 0 China, Shandong Prov. Lab/CCDC 36 16 0 10 0 0 0 0 0 27 0 36% 0 0 China, Shanghai Prov. Lab/CCDC 24 0 0 0 0 0 0 0 0 0 0 17% 0 0 China, Xinjiang Prov. Lab/CCDC 36 27 0 53 0 0 0 0 0 64 0 0% 0 0 China, Yunnan Prov. Lab/CCDC 37 22 0 25 0 0 0 0 0 18 0 92% 0 0 China, Zheijiang Prov. Lab/CCDC 40 8 0 2 0 0 0 0 0 8 1 70% 0 0 Lao PDR RITM 4 0 0 0 0 0 0 0 0 0 0 0% 0 0 Malaysia IMR/VIDRL 330 0 0 0 0 0 0 0 0 0 0 48% 3 0 New Zealand IESR 80 4 0 0 0 0 0 0 0 4 0 90% 0 0 Philippines RITM 616 37 0 17 0 0 0 0 0 44 0 15% 0 0 Viet Nam NIHE 124 0 0 0 0 0 0 0 0 0 0 2% 0 0 Total 1845 259 0 227 0 0 0 0 0 357 2 33% 3 0 NPEV (%) Pending ITD Discordant pending sequencingType 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 25 6 0 1 0 0 0 0 0 5 0 88% 2 0 Cambodia RITM 10 1 0 0 0 0 0 0 0 1 0 30% 5 0 China (total) 300 154 0 185 1 0 0 0 0 273 0 53% 0 0 China, Anui Prov. Lab/CCDC 24 20 0 36 0 0 0 0 0 32 0 75% 0 0 China, Fujian Prov. Lab/CCDC 30 13 0 3 0 0 0 0 0 18 0 90% 0 0 China, Gansu Prov. Lab/CCDC 36 16 0 12 0 0 0 0 0 30 0 25% 0 0 China, Guangdong Prov. Lab/CCDC 28 26 0 30 1 0 0 0 0 51 0 71% 0 0 China, Guangxi Prov. Lab/CCDC 9 6 0 3 0 0 0 0 0 3 0 78% 0 0 China, Heilongjiang Prov. Lab/CCDC 12 2 0 0 0 0 0 0 0 3 0 0% 0 0 China, Jiangxi Prov. Lab/CCDC 21 3 0 0 0 0 0 0 0 3 0 43% 0 0 China, Jiangsu Prov. Lab/CCDC 14 5 0 6 0 0 0 0 0 3 0 7% 0 0 China, Liaoning Prov. Lab/CCDC 28 16 0 23 0 0 0 0 0 41 0 54% 0 0 China, Neimongol Prov. Lab/CCDC 10 7 0 6 0 0 0 0 0 16 0 0% 0 0 China, Ninxia Prov. Lab/CCDC 18 13 0 36 0 0 0 0 0 31 0 89% 0 0 China, Qinghai Prov. Lab/CCDC 7 6 0 9 0 0 0 0 0 16 0 29% 0 0 China, Shaanxi Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab/CCDC 16 10 0 17 0 0 0 0 0 11 0 56% 0 0 China, Shanghai Prov. Lab/CCDC 18 0 0 0 0 0 0 0 0 0 0 28% 0 0 China, Xinjiang Prov. Lab/CCDC 12 9 0 4 0 0 0 0 0 15 0 42% 0 0 China, Yunnan Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zheijiang Prov. Lab/CCDC 17 2 - - - - - - - - - - - - Lao PDR RITM 8 0 0 0 0 0 0 0 0 0 0 0% 0 0 Malaysia IMR/VIDRL 0 - - - - - - - - - - - - - New Zealand IESR 52 1 0 0 0 0 0 0 0 1 0 94% 0 0 Papua New Guinea RITM 9 0 0 0 0 0 0 0 0 0 0 67% 0 0 Philippines RITM 394 22 0 8 0 0 0 0 0 25 0 27% 17 0 Viet Nam NIHE 0 - - - - - - - - - - - - - Total 798 184 0 194 1 0 0 0 0 305 0 43% 24 0 Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates NPEV (%) Pending ITD Discordant pending sequencingType 1 Type 2 Type 3 Figure 5A. China Figure 5B. Malaysia Figure 5C. Papua New Guinea Figure 5D. Philippines 1. Prefix letter refers to the VDPV category: “cVDPV” = circulating VDPV, “iVDPV” = immunodeficiency-associated VDPV, “aVDPV” = ambiguous VDPV. Suffix number refers to the poliovirus serotype (types 1, 2 or 3) 2. Community and healthy children 3. Contact of a different AFP case Vaccine-derived polio virus identified from laboratory testing, 2018–2024 0 2 4 6 8 10 12 14 16 cVDPV1 cVDPV2 cVDPV1 cVDPV2 aVDPV2 aVDPV3 2019 2020 N o. o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 45 cVDPV1 2018 No . of  ca ses /sp eci me ns 0 5 10 15 20 25 30 35 40 cVDPV1 cVDPV2 iVDPV2 aVDPV2 cVDPV2 aVDPV2 2019 2020 N o. o f c as es /s pe ci m en s 9 Polio Bulletin 0 1 2 3 4 5 cVDPV2 iVDPV3 aVDPV3 cVDPV2 aVDPV3 aVDPV1 cVDPV3 aVDPV3 aVDPV1 cVDPV3 aVDPV3 iVDPV3 aVDPV1 aVDPV1 aVDPV3 iVDPV3 aVDPV1 aVDPV3 2018 2019 2020 2021 2022 2023 2024 No . o f c as es /sp ec im en s

Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Phone: +63 2 8528 8001 Fax: +63 2 8521 1036, 8526 0279 Email: wproepidata@who.int Web: www.who.int/westernpacific Polio Bulletin 2024 Issue No. 11 - September 2024 (as of 2 October 2024) Figure 1. Non-polio AFP rate (per 100 000 persons < 15 years of age), 2022–2024 HIGHLIGHTS Figure 2. Adequate specimen collection rate, 2022–2024 Figure 3. Percentage of reported AFP cases by number of polio vaccination doses, 2024 Figure 4. Percentage of reported AFP cases with pending classification > 90 days after onset, 2024 0.0 1.0 2.0 3.0 4.0 5.0 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% CHN KHM LAO MYS PHL PNG VNM ≥ 3 doses 1-2 doses 0 doses Unknown 29.7% 3.4% 1.0% 0.0% 0.0% 4.2% 29.6% 0% 5% 10% 15% 20% 25% 30% 35% VNM PNG PHL MYS LAO KHM CHN 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). 23rd Annual Report from the Independent Monitoring Board The 23rd report by the Independent Monitoring Board (IMB) which provides independent assessment of the Global Polio Eradication Initiative (GPEI) has been published. It presents analysis of the eradication efforts and suggests actions to help accelerate progress toward interruption of wild poliovirus type 1 (WPV1) and stop outbreaks of circulating vaccine-derived polioviruses (VDPV). It notes the decline in VDPV1 and 2 cases globally, realizing that the progress is fragile and variable across geographies; and that the resurgence of WPV1 in Pakistan and Afghanistan remains a critical concern. The GPEI has extended its timeline for certifying the eradication of WPV1 to 2027 and elimination of VDPV2 to 2029. Strategic shifts include enhancing accountability, integrating polio activities with other health services, and improving coordination with immunization programs. The program agrees with the IMB assessment and commits to working closely with the polio-affected countries and partners to optimize the polio program’s work, improve vaccination campaigns and disease surveillance, strengthen broader health systems and ultimately ensure no child is paralyzed by polio again. More details here: 23rd Report of the Independent CONTACT US 2022 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 81 48 82 0 0 0 82 0 0 (0.0%) 1.72 63% 100% 26-Feb-24 - Brunei Darussalam 2 1 1 0 0 0 1 0 0 (0.0%) 1.08 100% 100% 18-Jan-24 - Cambodia 35 48 47 0 0 0 47 0 0 (0.0%) 0.99 89% 98% 07-Mar-24 - China 4225 1877 5597 0 0 0 5597 0 0 (0.0%) 2.98 95% 99% 21-Jul-24 - China, Hong Kong SAR 6 8 16 0 0 0 16 0 0 (0.0%) 2.07 81% 100% 19-Mar-24 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.04 100% 100% 08-Apr-24 - Japan 41 144 55 0 0 0 49 6 2 (3.6%) 0.38 55% 93% 22-Aug-24 41 Lao People's Democratic Republic 28 23 39 0 0 0 39 0 0 (0.0%) 1.70 87% 90% 05-Aug-24 - Malaysia 212 75 235 0 0 0 235 0 0 (0.0%) 3.11 84% 92% 22-Jul-24 - Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 26-Jan-24 - New Zealand 23 10 10 0 0 0 10 0 0 (0.0%) 1.04 70% 90% 09-Apr-24 - Papua New Guinea 59 39 57 0 0 0 57 0 0 (0.0%) 1.44 63% 70% 17-Sep-24 - Philippines 853 342 907 0 0 0 898 9 9 (1.0%) 2.65 73% 61% 30-Sep-24 2 Republic of Korea 57 57 51 0 0 0 51 0 0 (0.0%) 0.90 82% 100% 06-Aug-24 - Singapore 11 6 3 0 0 0 3 0 0 (0.0%) 0.52 100% 100% 03-Jan-24 - Viet Nam 238 222 280 0 0 0 280 0 0 (0.0%) 1.26 99% 87% 23-Apr-24 - Pacific island countries and areas 7 10 27 0 0 0 27 0 0 (0.0%) 2.59 56% 67% 12-Jun-24 - Total 5880 2921 7409 0 0 0 7394 15 512 (6.8%) 2.53 91% 94% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Days since last report 5 % investigated ≤ 2 days of notification 3 Indicators Latest report date4> 90 days 1 # (%) Total 2023 % with adequate specimens 2 Pending Classification Non-polio AFP rate Vaccine- derived poliovirus (VDPV) Polio- compatible Table 1A. Classification of AFP cases with onset in 2023 and key surveillance indicators 3 Polio Bulletin 2023 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 82 48 74 0 0 0 56 18 0 (0.0%) 2.01 58% 99% 01-Oct-24 1 Brunei Darussalam 1 1 1 0 0 0 1 0 0 (0.0%) 1.41 100% 100% 03-Sep-24 29 Cambodia 47 48 24 0 0 0 2 22 1 (4.2%) 0.64 92% 96% 20-Sep-24 12 China 5597 1877 3085 0 0 0 1246 1839 912 (29.6%) 2.14 94% 99% 26-Aug-24 37 China, Hong Kong SAR 16 8 6 0 0 0 5 1 0 (0.0%) 1.03 100% 100% 20-Aug-24 43 China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.35 100% 100% 10-Sep-24 22 Japan 55 144 32 0 0 0 25 7 0 (0.0%) 0.29 53% 100% 30-Sep-24 2 Lao People's Democratic Republic 39 23 17 0 0 0 12 5 0 (0.0%) 0.97 94% 88% 20-Sep-24 12 Malaysia 235 75 183 0 0 0 172 11 0 (0.0%) 3.15 92% 82% 25-Sep-24 7 Mongolia 1 11 3 0 0 0 3 0 0 (0.0%) 0.36 100% 100% 11-Sep-24 21 New Zealand 10 10 5 0 0 0 5 0 0 (0.0%) 0.67 60% 60% 27-Sep-24 5 Papua New Guinea 57 41 29 0 0 0 20 9 1 (3.4%) 0.93 48% 41% 24-Sep-24 8 Philippines 907 344 590 0 0 0 348 242 144 (24.0%) 2.27 54% 83% 30-Sep-24 2 Republic of Korea 51 54 66 0 0 0 44 22 0 (0.0%) 1.59 80% 100% 24-Sep-24 8 Singapore 3 6 4 0 0 0 4 0 0 (0.0%) 89% 100% 100% 11-Sep-24 21 Viet Nam 280 222 158 0 0 0 80 78 47 (29.7%) 0.93 100% 56% 11-Sep-24 21 Pacific island countries and areas 27 11 10 0 0 0 0 10 6 (60.0%) 1.23 20% 100% 30-Aug-24 33 Total 7409 2923 4288 0 0 0 2024 2264 976 (21.2%) 1.91 87% 89% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Annualized non-polio AFP rate per 100 000 population under 15 years of age Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Substantially below target 4. Percentage of reported cases investigated within two days of notification 5. Countries are expected to submit data at least once per month to WPRO Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Days since last report 5 % investigated ≤ 2 days of notification 4 Indicators Latest report date> 90 days 1 # (%) Total 2024 % with adequate specimens 3 Pending Classification Non-polio AFP rate 2 Vaccine- derived poliovirus (VDPV) Polio- compatible Table 1B. Classification of AFP cases with onset in 2024 and key surveillance indicators 4 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 77 0 2 2 73 0 94% 3% 05-Feb-24 VIDRL 2 0 0 0 0 0 0 0 0 0 2 0 0 100% Brunei Darussalam VIDRL 1 0 0 0 1 0 0% 0% 09-Oct-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 47 0 0 7 40 0 96% 14% 25-Dec-23 NIID 0 - - - - - - - - - - - - - China (total) 5580 0 19 0 5561 0 98% 0.2% 21-Jul-24 60 0 26 0 0 0 0 0 34 0 0 0 0 100% China, Anhui Prov. Lab 342 0 1 0 341 0 98% 0.1% Prov. Lab/CCDC 4 0 2 0 0 0 0 0 2 0 0 0 0 100% China, Beijing Prov. Lab 56 0 0 0 56 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 59 0 0 0 59 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 171 0 0 0 171 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 111 0 0 0 111 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 586 0 1 0 585 0 93% 0% Prov. Lab/CCDC 6 0 3 0 0 0 0 0 3 0 0 0 0 100% China, Guangxi Prov. Lab 252 0 3 0 249 0 99% 0.6% Prov. Lab/CCDC 8 0 2 0 0 0 0 0 6 0 0 0 0 100% China, Guizhou Prov. Lab 235 0 0 0 235 0 100% 0% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Hainan Prov. Lab 48 0 1 0 47 0 96% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Hebei Prov. Lab 333 0 0 0 333 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 69 0 0 0 69 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 688 0 6 0 682 0 100% 0.4% Prov. Lab/CCDC 18 0 10 0 0 0 0 0 8 0 0 0 0 100% China, Hubei Prov. Lab 151 0 0 0 151 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 287 0 0 0 287 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 217 0 0 0 217 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 182 0 0 0 182 0 91% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 43 0 0 0 43 0 100% 0% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Liaoning Prov. Lab 102 0 0 0 102 0 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 139 0 1 0 138 0 100% 0.4% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Ningxia Prov. Lab 23 0 0 0 23 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 9 0 0 0 9 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 74 0 0 0 74 0 74% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 287 0 0 0 287 0 100% 0% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Shanghai Prov. Lab 46 0 0 0 46 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 108 0 2 0 106 0 98% 1% Prov. Lab/CCDC 6 0 2 0 0 0 0 0 4 0 0 0 0 100% China, Sichuan Prov. Lab 358 0 1 0 357 0 98% 0.1% Prov. Lab/CCDC 4 0 3 0 0 0 0 0 1 0 0 0 0 100% China, Tianjin Prov. Lab 31 0 1 0 30 0 100% 2% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Xinjiang Prov. Lab 146 0 1 0 145 0 98% 0.3% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Yunnan Prov. Lab 208 0 0 0 208 0 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 198 0 1 0 197 0 99% 0.3% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Tibet Prov. Lab 21 0 0 0 21 0 95% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 15 0 0 0 15 0 97% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 49 0 0 4 45 0 91% 7% 21-Feb-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 39 1 0 1 37 0 100% 3% 21-May-24 NIID 2 0 0 0 0 0 0 0 2 0 0 0 0 100% Malaysia IMR 254 0 0 19 235 0 88% 7% 29-Apr-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 29-Dec-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 7 0 0 1 6 0 100% 18% 19-Feb-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 57 6 0 3 48 0 97% 6% 27-Aug-24 VIDRL 27 0 6 0 0 0 0 0 21 0 0 0 0 100% Philippines RITM 892 13 0 44 834 1 97% 4% 04-Sep-24 RITM/NIID 66 0 26 0 0 0 0 0 40 0 0 0 0 100% Republic of Korea KDCA 51 0 0 6 45 0 99% 11% 06-Aug-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 3 0 0 1 2 0 100% 33% 11-Jan-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 164 0 0 27 137 0 100% 16% 11-Jan-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 113 0 0 14 99 0 100% 12% 29-Jan-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 24 0 0 3 21 0 96% 9% 22-Jan-24 VIDRL 0 - - - - - - - - - - - - - Total 7375 20 21 132 7201 1 97% 2% 157 0 58 0 0 0 0 0 97 0 2 0 0 100% 2. NPEV growing in L20B cells Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin VDPVPending % specimens positive for NPEV Latest report date SabinWild 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only Table 2A. Laboratory investigation of stool samples from AFP cases with onset in 2023 and key laboratory indicators 6 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 64 0 3 4 51 6 87% 8% 26-Sep-24 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 67% Brunei Darussalam VIDRL 1 0 0 0 1 0 100% 0% 12-Jun-24 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 24 0 0 0 23 1 52% 0% 24-Sep-24 NIID 0 - - - - - - - - - - - - - China (total) 3064 0 9 0 3008 47 97% 0.1% 26-Aug-24 33 0 10 0 0 0 0 0 23 0 0 0 0 85% China, Anhui Prov. Lab 165 0 0 0 165 0 98% 0.0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Beijing Prov. Lab 23 0 0 0 23 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Chongqing Prov. Lab 27 0 0 0 25 2 98% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Fujian Prov. Lab 113 0 0 0 106 7 97% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Gansu Prov. Lab 51 0 0 0 50 1 94% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Guangdong Prov. Lab 307 0 0 0 302 5 91% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Guangxi Prov. Lab 142 0 0 0 141 1 91% 0.0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Guizhou Prov. Lab 145 0 0 0 142 3 98% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Hainan Prov. Lab 31 0 0 0 29 2 97% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Hebei Prov. Lab 165 0 0 0 164 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Heilongjiang Prov. Lab 21 0 0 0 21 0 95% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Henan Prov. Lab 460 0 3 0 455 2 100% 0.3% Prov. Lab/CCDC 20 0 7 0 0 0 0 0 13 0 0 0 0 80% China, Hubei Prov. Lab 102 0 0 0 99 3 97% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Hunan Prov. Lab 181 0 1 0 180 0 100% 0% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Jiangsu Prov. Lab 120 0 1 0 119 0 100% 0% Prov. Lab/CCDC 2 0 2 0 0 0 0 0 0 0 0 0 0 100% China, Jiangxi Prov. Lab 99 0 0 0 98 1 94% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Jilin Prov. Lab 22 0 0 0 22 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Liaoning Prov. Lab 47 0 1 0 43 3 100% 1% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Neimongol Prov. Lab 50 0 0 0 48 2 98% 0.0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Ningxia Prov. Lab 16 0 1 0 13 2 100% 4% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Qinghai Prov. Lab 8 0 0 0 8 0 88% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Shaanxi Prov. Lab 54 0 0 0 52 2 96% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Shandong Prov. Lab 161 0 0 0 160 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Shanghai Prov. Lab 16 0 0 0 16 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Shanxi Prov. Lab 51 0 1 0 49 1 96% 1% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Sichuan Prov. Lab 180 0 0 0 178 2 98% 0.0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Tianjin Prov. Lab 12 0 0 0 12 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Xinjiang Prov. Lab 57 0 1 0 51 5 98% 1.0% Prov. Lab/CCDC 4 0 0 0 0 0 0 0 4 0 0 0 0 75% China, Yunnan Prov. Lab 134 0 0 0 133 1 92% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Zhejiang Prov. Lab 96 0 0 0 96 0 99% 0.0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Tibet Prov. Lab 8 0 0 0 8 0 100% 0% CCDC 0 - - - - - - - 0 - - - - - China, Hong Kong SAR PHLC 6 0 0 0 6 0 100% 0% 30-Sep-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 30-Sep-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 25 0 0 0 25 0 100% 0% 01-Oct-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 17 0 0 4 8 5 43% 30% 15-Sep-24 NIID 0 - - - - - - - - - - - - - Malaysia IMR 191 0 0 17 174 0 100% 7% 30-Sep-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 3 0 0 0 3 0 100% 0% 30-Sep-24 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 5 0 0 1 4 0 100% 20% 30-Sep-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 29 1 3 1 18 6 100% 18% 24-Sep-24 VIDRL 4 0 1 0 0 0 0 0 1 0 2 0 0 50% Philippines RITM 589 5 2 48 521 12 99% 7% 27-Sep-24 RITM/NIID 0 - - - - - - - - - - - - - Republic of Korea KDCA 66 0 0 15 48 3 100% 19% 24-Sep-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 4 0 0 0 3 0 100% 0% 01-Oct-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 121 0 0 20 95 6 100% 17% 07-Sep-24 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 80 1 0 11 66 2 100% 14% 30-Sep-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 8 0 0 1 7 0 100% 13% 17-Sep-24 VIDRL 0 - - - - - - - - - - - - - Total 4298 7 17 122 4062 88 97% 3% 40 0 11 0 0 0 0 0 24 0 5 0 0 67% 2. NPEV growing in L20B cells Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin VDPVPending % specimens positive for NPEV Latest report date SabinWild 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only Table 2B. Laboratory investigation of stool samples from AFP cases with onset in 2024 and key laboratory indicators 7 Polio Bulletin Table 3A. Laboratory confirmation of polio isolates from environmental samples in 20231 and key laboratory indicators 8 Polio Bulletin Table 3B. Laboratory confirmation of polio isolates from environmental samples in 20241 and key laboratory indicators 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); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); RITM (Research Institute for Tropical Medicine, Philippines); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 49 3 0 0 0 0 0 0 0 3 0 100% 0 0 Cambodia RITM 12 2 0 0 0 0 0 0 0 2 0 58% 0 0 China (total) 630 213 0 210 0 0 0 0 0 304 2 35% 0 0 China, Fujian Prov. Lab/CCDC 77 18 0 5 0 0 0 0 0 19 0 60% 0 0 China, Gansu Prov. Lab/CCDC 42 21 0 23 0 0 0 0 0 26 0 21% 0 0 China, Guangdong Prov. Lab/CCDC 48 30 0 20 0 0 0 0 0 41 0 52% 0 0 China, Guangxi Prov. Lab/CCDC 12 6 0 6 0 0 0 0 0 11 0 58% 0 0 China, Heilongjiang Prov. Lab/CCDC 24 11 0 12 0 0 0 0 0 30 0 17% 0 0 China, Jiangxi Prov. Lab/CCDC 34 9 0 6 0 0 0 0 0 6 1 65% 0 0 China, Jiangsu Prov. Lab/CCDC 124 10 0 4 0 0 0 0 0 6 0 5% 0 0 China, Liaoning Prov. Lab/CCDC 43 16 0 6 0 0 0 0 0 25 0 5% 0 0 China, Neimongol Prov. Lab/CCDC 20 8 0 15 0 0 0 0 0 13 0 0% 0 0 China, Ninxia Prov. Lab/CCDC 19 8 0 20 0 0 0 0 0 8 0 42% 0 0 China, Qinghai Prov. Lab/CCDC 14 3 0 3 0 0 0 0 0 2 0 14% 0 0 China, Shandong Prov. Lab/CCDC 36 16 0 10 0 0 0 0 0 27 0 36% 0 0 China, Shanghai Prov. Lab/CCDC 24 0 0 0 0 0 0 0 0 0 0 17% 0 0 China, Xinjiang Prov. Lab/CCDC 36 27 0 53 0 0 0 0 0 64 0 0% 0 0 China, Yunnan Prov. Lab/CCDC 37 22 0 25 0 0 0 0 0 18 0 92% 0 0 China, Zheijiang Prov. Lab/CCDC 40 8 0 2 0 0 0 0 0 8 1 70% 0 0 Lao PDR RITM 4 0 0 0 0 0 0 0 0 0 0 0% 0 0 Malaysia IMR/VIDRL 330 0 0 0 0 0 0 0 0 0 0 48% 3 0 New Zealand IESR 80 4 0 0 0 0 0 0 0 4 0 90% 0 0 Philippines RITM 616 37 0 17 0 0 0 0 0 44 0 15% 0 0 Viet Nam NIHE 124 0 0 0 0 0 0 0 0 0 0 2% 0 0 Total 1845 259 0 227 0 0 0 0 0 357 2 33% 3 0 NPEV (%) Pending ITD Discordant pending sequencingType 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 28 6 0 1 0 0 0 0 0 5 0 89% 2 0 Cambodia RITM 10 1 0 0 0 0 0 0 0 1 0 80% 0 0 China (total) 300 154 0 185 1 0 0 0 0 275 0 53% 0 0 China, Anui Prov. Lab/CCDC 24 20 0 36 0 0 0 0 0 32 0 75% 0 0 China, Fujian Prov. Lab/CCDC 30 13 0 3 0 0 0 0 0 18 0 90% 0 0 China, Gansu Prov. Lab/CCDC 36 16 0 12 0 0 0 0 0 30 0 25% 0 0 China, Guangdong Prov. Lab/CCDC 28 26 0 30 1 0 0 0 0 51 0 71% 0 0 China, Guangxi Prov. Lab/CCDC 9 6 0 3 0 0 0 0 0 3 0 78% 0 0 China, Heilongjiang Prov. Lab/CCDC 12 2 0 0 0 0 0 0 0 3 0 0% 0 0 China, Jiangxi Prov. Lab/CCDC 21 3 0 0 0 0 0 0 0 3 0 43% 0 0 China, Jiangsu Prov. Lab/CCDC 14 5 0 6 0 0 0 0 0 3 0 7% 0 0 China, Liaoning Prov. Lab/CCDC 28 16 0 23 0 0 0 0 0 41 0 54% 0 0 China, Neimongol Prov. Lab/CCDC 10 7 0 6 0 0 0 0 0 16 0 0% 0 0 China, Ninxia Prov. Lab/CCDC 18 13 0 36 0 0 0 0 0 31 0 89% 0 0 China, Qinghai Prov. Lab/CCDC 7 6 0 9 0 0 0 0 0 16 0 29% 0 0 China, Shaanxi Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab/CCDC 16 10 0 17 0 0 0 0 0 11 0 56% 0 0 China, Shanghai Prov. Lab/CCDC 18 0 0 0 0 0 0 0 0 0 0 28% 0 0 China, Xinjiang Prov. Lab/CCDC 12 9 0 4 0 0 0 0 0 15 0 42% 0 0 China, Yunnan Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zheijiang Prov. Lab/CCDC 17 2 0 0 0 0 0 0 0 2 0 0% 0 0 Lao PDR RITM 8 0 0 0 0 0 0 0 0 0 0 0% 0 0 Malaysia IMR/VIDRL 0 - - - - - - - - - - - - - New Zealand IESR 52 1 0 0 0 0 0 0 0 1 0 94% 0 0 Papua New Guinea RITM 11 1 0 0 0 0 0 0 0 1 0 73% 0 0 Philippines RITM 402 22 0 8 0 0 0 0 0 24 0 28% 5 0 Viet Nam NIHE 0 - - - - - - - - - - - - - Total 811 185 0 194 1 0 0 0 0 305 0 45% 7 0 NPEV (%) Pending ITD Discordant pending sequencingType 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates Figure 5A. China Figure 5B. Malaysia Figure 5C. Papua New Guinea Figure 5D. Philippines 1. Prefix letter refers to the VDPV category: “cVDPV” = circulating VDPV, “iVDPV” = immunodeficiency-associated VDPV, “aVDPV” = ambiguous VDPV. Suffix number refers to the poliovirus serotype (types 1, 2 or 3) 2. Community and healthy children 3. Contact of a different AFP case Vaccine-derived polio1 virus1 identified from laboratory testing, 2018–2024 0 2 4 6 8 10 12 14 16 cVDPV1 cVDPV2 cVDPV1 cVDPV2 aVDPV2 aVDPV3 2019 2020 N o. o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 45 cVDPV1 2018 N o.  o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 cVDPV1 cVDPV2 iVDPV2 aVDPV2 cVDPV2 aVDPV2 2019 2020 N o. o f c as es /s pe ci m en s 9 Polio Bulletin 0 1 2 3 4 5 cVDPV2 iVDPV3 aVDPV3 cVDPV2 aVDPV3 aVDPV1 cVDPV3 aVDPV3 aVDPV1 cVDPV3 aVDPV3 iVDPV3 aVDPV1 aVDPV1 aVDPV3 iVDPV3 aVDPV1 aVDPV3 2018 2019 2020 2021 2022 2023 2024 N o . o f c a se s/ sp e c im e n s

Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Phone: +63 2 8528 8001 Fax: +63 2 8521 1036, 8526 0279 Email: wproepidata@who.int Web: www.who.int/westernpacific Polio Bulletin 2024 Issue No. 12 - October 2024 (as of 5 November 2024) Figure 1. Non-polio AFP rate (per 100 000 persons < 15 years of age), 2022–2024 HIGHLIGHTS Figure 2. Adequate specimen collection rate, 2022–2024 Figure 3. Percentage of reported AFP cases by number of polio vaccination doses, 2024 Figure 4. Percentage of reported AFP cases with pending classification > 90 days after onset, 2024 0.0 1.0 2.0 3.0 4.0 5.0 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% CHN KHM LAO MYS PHL PNG VNM ≥ 3 doses 1-2 doses 0 doses Unknown 11.8% 9.1% 6.9% 0.5% 0.0% 0.0% 27.6% 0% 5% 10% 15% 20% 25% 30% VNM PNG PHL MYS LAO KHM CHN 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). Western Pacific Region launches new system to improve integrated VPD surveillance data reporting In October 2024, Western Pacific Region (WPR) launched the Integrated Vaccine-Preventable Diseases (VPD) Surveillance System (IVSS). This innovative system integrates country-level epidemiological and laboratory data reporting of VPDs to WHO, replacing older vertical systems for individual VPD reporting system like the Polio/ AFP Surveillance Reporting System (PASRS) for collecting polio data. The IVSS, starting with its polio module, features a user- friendly dashboard with options to report data on AFP, non-AFP and environmental surveillance, and to generate reports. This system enables real-time reporting and tracking of polio cases, which is crucial for timely interventions and responses. By integrating various data sources, it provides a comprehensive view of the polio situation including surveillance performance indicators. This digital upgrade supports WPR’s efforts to maintain the Region’s polio-free status and quickly address potential outbreaks. Cambodia and Philippines have started reporting polio cases into the IVSS. All WPR countries are highly encouraged to adopt the IVSS system and technical support is available to facilitate its use. Source: https://ivss.wpro.who.int/ CONTACT US 2022 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 81 48 82 0 0 0 82 0 0 (0.0%) 1.72 63% 100% 26-Feb-24 - Brunei Darussalam 2 1 1 0 0 0 1 0 0 (0.0%) 1.08 100% 100% 18-Jan-24 - Cambodia 35 48 47 0 0 0 47 0 0 (0.0%) 0.99 89% 98% 07-Mar-24 - China 4225 1877 5597 0 0 0 5597 0 0 (0.0%) 2.98 95% 99% 21-Jul-24 - China, Hong Kong SAR 6 8 16 0 0 0 16 0 0 (0.0%) 2.07 81% 100% 19-Mar-24 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.04 100% 100% 08-Apr-24 - Japan 41 144 55 0 0 0 49 6 2 (3.6%) 0.38 55% 93% 22-Aug-24 75 Lao People's Democratic Republic 28 23 39 0 0 0 39 0 0 (0.0%) 1.70 87% 90% 05-Aug-24 - Malaysia 212 75 235 0 0 0 235 0 0 (0.0%) 3.11 84% 92% 22-Jul-24 - Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 26-Jan-24 - New Zealand 23 10 10 0 0 0 10 0 0 (0.0%) 1.04 70% 90% 09-Apr-24 - Papua New Guinea 59 39 57 0 0 0 57 0 0 (0.0%) 1.44 63% 70% 17-Sep-24 - Philippines 853 342 907 0 0 0 907 0 0 (0.0%) 2.65 73% 61% 07-Oct-24 - Republic of Korea 57 57 51 0 0 0 51 0 0 (0.0%) 0.90 82% 100% 06-Aug-24 - Singapore 11 6 3 0 0 0 3 0 0 (0.0%) 0.52 100% 100% 03-Jan-24 - Viet Nam 238 222 280 0 0 0 280 0 0 (0.0%) 1.26 99% 87% 23-Apr-24 - Pacific island countries and areas 7 10 27 0 0 0 27 0 0 (0.0%) 2.59 56% 67% 12-Jun-24 - Total 5880 2921 7409 0 0 0 7403 6 2 (0.03%) 2.54 91% 94% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO Total 2023 % with adequate specimens 2 Pending Classification Non-polio AFP rate Vaccine- derived poliovirus (VDPV) Polio- compatible Days since last report 5 % investigated ≤ 2 days of notification 3 Indicators Latest report date4> 90 days 1 # (%) Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Table 1A. Classification of AFP cases with onset in 2023 and key surveillance indicators 3 Polio Bulletin 2023 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 82 48 85 0 0 0 71 14 0 (0.0%) 2.05 59% 99% 04-Nov-24 1 Brunei Darussalam 1 1 1 0 0 0 1 0 0 (0.0%) 1.25 100% 100% 07-Oct-24 29 Cambodia 47 48 25 0 0 0 24 1 0 (0.0%) 0.60 92% 96% 25-Oct-24 11 China 5597 1877 3978 0 0 0 1923 2055 1097 (27.6%) 2.45 94% 99% 17-Oct-24 19 China, Hong Kong SAR 16 8 8 0 0 0 6 2 0 (0.0%) 1.22 88% 100% 29-Oct-24 7 China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.20 100% 100% 07-Oct-24 29 Japan 55 144 36 0 0 0 32 4 0 (0.0%) 0.29 58% 100% 24-Oct-24 12 Lao People's Democratic Republic 39 23 19 0 0 0 12 7 0 (0.0%) 0.96 89% 84% 28-Oct-24 8 Malaysia 235 75 197 0 0 0 187 10 1 (0.5%) 3.02 93% 82% 25-Oct-24 11 Mongolia 1 11 3 0 0 0 3 0 0 (0.0%) 0.32 100% 100% 14-Oct-24 22 New Zealand 10 10 7 0 0 0 5 2 0 (0.0%) 0.84 43% 57% 31-Oct-24 5 Papua New Guinea 57 41 33 0 0 0 24 9 3 (9.1%) 0.94 52% 36% 29-Oct-24 7 Philippines 907 344 691 0 0 0 535 156 48 (6.9%) 2.32 59% 100% 30-Oct-24 6 Republic of Korea 51 54 79 0 0 0 53 26 0 (0.0%) 1.69 82% 100% 31-Oct-24 5 Singapore 3 6 4 0 0 0 4 0 0 (0.0%) 0.79 100% 100% 01-Nov-24 4 Viet Nam 280 222 221 0 0 0 154 67 26 (11.8%) 1.15 100% 58% 16-Oct-24 20 Pacific island countries and areas 27 11 12 0 0 0 12 0 0 (0.0%) 1.32 33% 100% 24-Oct-24 12 Total 7409 2923 5400 0 0 0 3047 2353 1175 (21.8%) 2.13 88% 97% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Annualized non-polio AFP rate per 100 000 population under 15 years of age Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Substantially below target 4. Percentage of reported cases investigated within two days of notification 5. Countries are expected to submit data at least once per month to WPRO Total 2024 % with adequate specimens 3 Pending Classification Non-polio AFP rate 2 Vaccine- derived poliovirus (VDPV) Polio- compatible Days since last report 5 % investigated ≤ 2 days of notification 4 Indicators Latest report date> 90 days 1 # (%) Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Table 1B. Classification of AFP cases with onset in 2024 and key surveillance indicators 4 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 77 0 2 2 73 0 94% 3% 05-Feb-24 VIDRL 2 0 0 0 0 0 0 0 0 0 2 0 0 100% Brunei Darussalam VIDRL 1 0 0 0 1 0 0% 0% 09-Oct-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 47 0 0 7 40 0 96% 14% 25-Dec-23 NIID 0 - - - - - - - - - - - - - China (total) 5580 0 19 0 5561 0 98% 0.2% 21-Jul-24 60 0 26 0 0 0 0 0 34 0 0 0 0 100% China, Anhui Prov. Lab 342 0 1 0 341 0 98% 0.1% Prov. Lab/CCDC 4 0 2 0 0 0 0 0 2 0 0 0 0 100% China, Beijing Prov. Lab 56 0 0 0 56 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 59 0 0 0 59 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 171 0 0 0 171 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 111 0 0 0 111 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 586 0 1 0 585 0 93% 0% Prov. Lab/CCDC 6 0 3 0 0 0 0 0 3 0 0 0 0 100% China, Guangxi Prov. Lab 252 0 3 0 249 0 99% 0.6% Prov. Lab/CCDC 8 0 2 0 0 0 0 0 6 0 0 0 0 100% China, Guizhou Prov. Lab 235 0 0 0 235 0 100% 0% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Hainan Prov. Lab 48 0 1 0 47 0 96% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Hebei Prov. Lab 333 0 0 0 333 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 69 0 0 0 69 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 688 0 6 0 682 0 100% 0.4% Prov. Lab/CCDC 18 0 10 0 0 0 0 0 8 0 0 0 0 100% China, Hubei Prov. Lab 151 0 0 0 151 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 287 0 0 0 287 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 217 0 0 0 217 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 182 0 0 0 182 0 91% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 43 0 0 0 43 0 100% 0% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Liaoning Prov. Lab 102 0 0 0 102 0 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 139 0 1 0 138 0 100% 0.4% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Ningxia Prov. Lab 23 0 0 0 23 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 9 0 0 0 9 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 74 0 0 0 74 0 74% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 287 0 0 0 287 0 100% 0% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Shanghai Prov. Lab 46 0 0 0 46 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 108 0 2 0 106 0 98% 1% Prov. Lab/CCDC 6 0 2 0 0 0 0 0 4 0 0 0 0 100% China, Sichuan Prov. Lab 358 0 1 0 357 0 98% 0.1% Prov. Lab/CCDC 4 0 3 0 0 0 0 0 1 0 0 0 0 100% China, Tianjin Prov. Lab 31 0 1 0 30 0 100% 2% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Xinjiang Prov. Lab 146 0 1 0 145 0 98% 0.3% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Yunnan Prov. Lab 208 0 0 0 208 0 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 198 0 1 0 197 0 99% 0.3% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Tibet Prov. Lab 21 0 0 0 21 0 95% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 15 0 0 0 15 0 97% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 49 0 0 4 45 0 91% 7% 21-Feb-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 39 1 0 1 37 0 100% 3% 21-May-24 NIID 2 0 0 0 0 0 0 0 2 0 0 0 0 100% Malaysia IMR 254 0 0 19 235 0 88% 7% 29-Apr-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 29-Dec-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 7 0 0 1 6 0 100% 18% 19-Feb-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 57 6 0 3 48 0 97% 6% 27-Aug-24 VIDRL 27 0 6 0 0 0 0 0 21 0 0 0 0 100% Philippines RITM 892 13 0 44 834 1 97% 4% 04-Sep-24 RITM/NIID 66 0 26 0 0 0 0 0 40 0 0 0 0 100% Republic of Korea KDCA 51 0 0 6 45 0 99% 11% 06-Aug-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 3 0 0 1 2 0 100% 33% 11-Jan-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 164 0 0 27 137 0 100% 16% 11-Jan-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 113 0 0 14 99 0 100% 12% 29-Jan-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 24 0 0 3 21 0 96% 9% 22-Jan-24 VIDRL 0 - - - - - - - - - - - - - Total 7375 20 21 132 7201 1 97% 2% 157 0 58 0 0 0 0 0 97 0 2 0 0 100% 2. NPEV growing in L20B cells Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin VDPVPending % specimens positive for NPEV Latest report date SabinWild 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only Table 2A. Laboratory investigation of stool samples from AFP cases with onset in 2023 and key laboratory indicators 6 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 77 0 3 5 67 2 90% 7% 04-Nov-24 VIDRL 4 0 0 0 0 0 0 0 0 0 4 0 0 67% Brunei Darussalam VIDRL 1 0 0 0 1 0 100% 0% 12-Jun-24 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 25 0 0 0 24 1 54% 0% 25-Oct-24 NIID 0 - - - - - - - - - - - - - China (total) 3949 2 9 1 3800 137 97% 0.1% 17-Oct-24 46 0 11 6 0 0 0 0 27 2 0 0 0 85% China, Anhui Prov. Lab 205 0 0 0 202 3 98% 0.0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Beijing Prov. Lab 36 0 0 0 35 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Chongqing Prov. Lab 41 0 0 0 37 4 99% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Fujian Prov. Lab 139 0 0 0 133 6 97% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Gansu Prov. Lab 65 0 0 0 64 1 95% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Guangdong Prov. Lab 392 1 0 0 383 8 92% 0% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Guangxi Prov. Lab 178 0 0 0 177 1 90% 0.0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Guizhou Prov. Lab 205 0 0 0 189 16 98% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Hainan Prov. Lab 37 0 0 0 36 1 97% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Hebei Prov. Lab 213 0 0 0 204 9 100% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Heilongjiang Prov. Lab 30 0 0 0 30 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Henan Prov. Lab 571 0 3 0 560 8 100% 0.3% Prov. Lab/CCDC 20 0 7 0 0 0 0 0 13 0 0 0 0 80% China, Hubei Prov. Lab 126 0 0 0 115 11 98% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Hunan Prov. Lab 217 0 1 0 216 0 100% 0% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Jiangsu Prov. Lab 161 0 1 0 159 1 100% 0% Prov. Lab/CCDC 2 0 2 0 0 0 0 0 0 0 0 0 0 100% China, Jiangxi Prov. Lab 131 0 0 0 127 4 95% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Jilin Prov. Lab 31 0 0 0 30 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Liaoning Prov. Lab 64 0 1 0 63 0 98% 1% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Neimongol Prov. Lab 79 0 0 0 64 15 98% 0.0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Ningxia Prov. Lab 23 0 1 0 22 0 100% 2% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Qinghai Prov. Lab 8 0 0 0 8 0 88% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Shaanxi Prov. Lab 73 0 0 0 68 5 97% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Shandong Prov. Lab 221 0 0 0 211 10 100% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Shanghai Prov. Lab 22 0 0 0 22 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Shanxi Prov. Lab 69 0 1 0 66 2 97% 1% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Sichuan Prov. Lab 225 0 0 1 210 14 98% 0.2% Prov. Lab/CCDC 6 0 0 6 0 0 0 0 0 0 0 0 0 100% China, Tianjin Prov. Lab 15 0 0 0 15 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Xinjiang Prov. Lab 75 1 1 0 67 6 96% 0.7% Prov. Lab/CCDC 5 0 0 0 0 0 0 0 5 0 0 0 0 80% China, Yunnan Prov. Lab 160 0 0 0 151 9 93% 0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Zhejiang Prov. Lab 127 0 0 0 126 1 99% 0.0% Prov. Lab/CCDC 0 - - - - - - - 0 - - - - - China, Tibet Prov. Lab 10 0 0 0 10 0 100% 0% CCDC 2 0 0 0 0 0 0 0 0 2 0 0 0 100% China, Hong Kong SAR PHLC 8 0 0 0 8 0 100% 0% 04-Nov-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 28-Oct-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 32 0 0 1 31 0 100% 2% 25-Oct-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 19 0 0 4 8 7 43% 30% 28-Oct-24 NIID 0 - - - - - - - - - - - - - Malaysia IMR 206 0 0 17 189 0 100% 7% 04-Nov-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 3 0 0 0 3 0 100% 0% 02-Nov-24 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 7 0 0 1 5 1 100% 17% 04-Nov-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 33 2 3 1 22 5 81% 15% 15-Oct-24 VIDRL 6 0 1 0 0 0 0 0 1 0 4 0 0 33% Philippines RITM 674 5 2 52 596 18 99% 7% 31-Oct-24 RITM/NIID 0 - - - - - - - - - - - - - Republic of Korea KDCA 79 0 0 19 57 3 100% 21% 31-Oct-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 4 0 0 0 3 0 100% 0% 30-Oct-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 121 0 0 20 95 6 100% 17% 07-Sep-24 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 86 1 0 11 72 2 100% 13% 21-Oct-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 9 0 0 1 8 0 100% 11% 11-Oct-24 VIDRL 0 - - - - - - - - - - - - - Total 5334 10 17 133 4990 182 97% 2% 56 0 12 6 0 0 0 0 28 2 8 0 0 75% 2. NPEV growing in L20B cells Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens VDPV Pending % specimens positive for NPEV Latest report date SabinWild Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin Table 2B. Laboratory investigation of stool samples from AFP cases with onset in 2024 and key laboratory indicators 7 Polio Bulletin Table 3A. Laboratory confirmation of polio isolates from environmental samples in 20231 and key laboratory indicators 8 Polio Bulletin Table 3B. Laboratory confirmation of polio isolates from environmental samples in 20241 and key laboratory indicators 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); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); RITM (Research Institute for Tropical Medicine, Philippines); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 49 3 0 0 0 0 0 0 0 3 0 100% 0 0 Cambodia RITM 12 2 0 0 0 0 0 0 0 2 0 58% 0 0 China (total) 630 213 0 210 0 0 0 0 0 304 2 35% 0 0 China, Fujian Prov. Lab/CCDC 77 18 0 5 0 0 0 0 0 19 0 60% 0 0 China, Gansu Prov. Lab/CCDC 42 21 0 23 0 0 0 0 0 26 0 21% 0 0 China, Guangdong Prov. Lab/CCDC 48 30 0 20 0 0 0 0 0 41 0 52% 0 0 China, Guangxi Prov. Lab/CCDC 12 6 0 6 0 0 0 0 0 11 0 58% 0 0 China, Heilongjiang Prov. Lab/CCDC 24 11 0 12 0 0 0 0 0 30 0 17% 0 0 China, Jiangxi Prov. Lab/CCDC 34 9 0 6 0 0 0 0 0 6 1 65% 0 0 China, Jiangsu Prov. Lab/CCDC 124 10 0 4 0 0 0 0 0 6 0 5% 0 0 China, Liaoning Prov. Lab/CCDC 43 16 0 6 0 0 0 0 0 25 0 5% 0 0 China, Neimongol Prov. Lab/CCDC 20 8 0 15 0 0 0 0 0 13 0 0% 0 0 China, Ninxia Prov. Lab/CCDC 19 8 0 20 0 0 0 0 0 8 0 42% 0 0 China, Qinghai Prov. Lab/CCDC 14 3 0 3 0 0 0 0 0 2 0 14% 0 0 China, Shandong Prov. Lab/CCDC 36 16 0 10 0 0 0 0 0 27 0 36% 0 0 China, Shanghai Prov. Lab/CCDC 24 0 0 0 0 0 0 0 0 0 0 17% 0 0 China, Xinjiang Prov. Lab/CCDC 36 27 0 53 0 0 0 0 0 64 0 0% 0 0 China, Yunnan Prov. Lab/CCDC 37 22 0 25 0 0 0 0 0 18 0 92% 0 0 China, Zheijiang Prov. Lab/CCDC 40 8 0 2 0 0 0 0 0 8 1 70% 0 0 Lao PDR RITM 6 0 0 0 0 0 0 0 0 0 0 0% 0 0 Malaysia IMR/VIDRL 330 0 0 0 0 0 0 0 0 0 0 48% 3 0 Mongolia NCPH 2 0 0 0 0 0 0 0 0 0 0 0% 0 0 New Zealand IESR 80 4 0 0 0 0 0 0 0 4 0 90% 0 0 Philippines RITM 616 37 0 17 0 0 0 0 0 44 0 15% 0 0 Viet Nam NIHE 124 0 0 0 0 0 0 0 0 0 0 2% 0 0 Total 1849 259 0 227 0 0 0 0 0 357 2 33% 3 0 NPEV (%) Pending ITD Discordant pending sequencingType 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 30 7 0 1 0 0 0 0 0 6 0 93% 1 0 Cambodia RITM 15 0 0 0 0 0 0 0 0 0 0 53% 0 0 China (total) 411 197 0 219 1 0 0 0 0 332 0 60% 2 0 China, Anui Prov. Lab/CCDC 36 28 0 46 0 0 0 0 0 45 0 81% 0 0 China, Fujian Prov. Lab/CCDC 42 14 0 3 0 0 0 0 0 19 0 81% 2 0 China, Gansu Prov. Lab/CCDC 46 19 0 11 0 0 0 0 0 44 0 26% 0 0 China, Guangdong Prov. Lab/CCDC 40 33 0 36 1 0 0 0 0 59 0 80% 0 0 China, Guangxi Prov. Lab/CCDC 28 9 0 5 0 0 0 0 0 4 0 82% 0 0 China, Heilongjiang Prov. Lab/CCDC 12 2 0 0 0 0 0 0 0 3 0 0% 0 0 China, Jiangxi Prov. Lab/CCDC 21 3 0 0 0 0 0 0 0 3 0 43% 0 0 China, Jiangsu Prov. Lab/CCDC 14 5 0 6 0 0 0 0 0 3 0 7% 0 0 China, Liaoning Prov. Lab/CCDC 40 21 0 28 0 0 0 0 0 44 0 63% 0 0 China, Neimongol Prov. Lab/CCDC 10 7 0 6 0 0 0 0 0 16 0 0% 0 0 China, Ninxia Prov. Lab/CCDC 18 13 0 36 0 0 0 0 0 31 0 89% 0 0 China, Qinghai Prov. Lab/CCDC 9 6 0 9 0 0 0 0 0 16 0 44% 0 0 China, Shaanxi Prov. Lab/CCDC 0 - - - - - - - - - - - China, Shandong Prov. Lab/CCDC 24 15 0 24 0 0 0 0 0 16 0 63% 0 0 China, Shanghai Prov. Lab/CCDC 18 0 0 0 0 0 0 0 0 0 0 28% 0 0 China, Xinjiang Prov. Lab/CCDC 12 9 0 4 0 0 0 0 0 15 0 42% 0 0 China, Yunnan Prov. Lab/CCDC 18 9 0 5 0 0 0 0 0 10 0 83% 0 0 China, Zheijiang Prov. Lab/CCDC 23 4 0 0 0 0 0 0 0 4 0 96% 0 0 Lao PDR RITM 14 0 0 0 0 0 0 0 0 0 0 0% 0 0 Malaysia IMR/VIDRL 237 0 0 0 0 0 0 0 0 0 0 57% 14 0 Mongolia NCPH 16 0 0 0 0 0 0 0 0 0 0 38% 3 0 New Zealand IESR 52 1 0 0 0 0 0 0 0 1 0 94% 0 0 Papua New Guinea RITM 17 1 0 0 0 0 0 0 0 1 0 88% 0 0 Philippines RITM 481 22 0 8 0 0 0 0 0 25 0 31% 1 0 Viet Nam NIHE 0 - - - - - - - - - - - - - Total 1257 234 0 228 1 0 0 0 0 366 0 50% 18 0 Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates NPEV (%) Pending ITD Discordant pending sequencingType 1 Type 2 Type 3 Figure 5A. China Figure 5B. Malaysia Figure 5C. Papua New Guinea Figure 5D. Philippines 1. Prefix letter refers to the VDPV category: “cVDPV” = circulating VDPV, “iVDPV” = immunodeficiency-associated VDPV, “aVDPV” = ambiguous VDPV. Suffix number refers to the poliovirus serotype (types 1, 2 or 3) 2. Community and healthy children 3. Contact of a different AFP case Vaccine-derived polio virus1 identified from laboratory testing, 2018–2024 0 2 4 6 8 10 12 14 16 cVDPV1 cVDPV2 cVDPV1 cVDPV2 aVDPV2 aVDPV3 2019 2020 N o. o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 45 cVDPV1 2018 N o.  o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 cVDPV1 cVDPV2 iVDPV2 aVDPV2 cVDPV2 aVDPV2 2019 2020 N o. o f c as es /s pe ci m en s 9 Polio Bulletin 0 1 2 3 4 5 cVDPV2 iVDPV3 aVDPV3 cVDPV2 aVDPV3 aVDPV1 cVDPV3 aVDPV3 aVDPV1 cVDPV3 aVDPV3 iVDPV3 aVDPV1 aVDPV1 aVDPV3 iVDPV3 aVDPV1 aVDPV3 2018 2019 2020 2021 2022 2023 2024 N o . o f c a se s/ sp e c im e n s

Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Phone: +63 2 8528 8001 Fax: +63 2 8521 1036, 8526 0279 Email: wproepidata@who.int Web: www.who.int/westernpacific Polio Bulletin 2024 Issue No. 13 - November 2024 (as of 4 December 2024) Figure 1. Non-polio AFP rate (per 100 000 persons < 15 years of age), 2022–2024 HIGHLIGHTS Figure 2. Adequate specimen collection rate, 2022–2024 Figure 3. Percentage of reported AFP cases by number of polio vaccination doses, 2024 Figure 4. Percentage of reported AFP cases with pending classification > 90 days after onset, 2024 0.0 1.0 2.0 3.0 4.0 5.0 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% CHN KHM LAO MYS PHL PNG VNM ≥ 3 doses 1-2 doses 0 doses Unknown 11.8% 7.1% 8.2% 0.5% 0.0% 0.0% 27.6% 0% 5% 10% 15% 20% 25% 30% VNM PNG PHL MYS LAO KHM CHN 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). 30th Meeting of the Regional Commission for the Certification of Polio Eradication in the Western Pacific Region The 30th meeting of the Regional Commission for Certification (RCC) of Poliomyelitis Eradication in the Western Pacific was held from 12 to 14 November 2024 in Vientiane, Lao People’s Democratic Republic. The objectives of the meeting were: • to evaluate 2024 National Certification Commission (NCC) annual progress reports, including polio eradication activities and implementation status of the 29th RCC 2023 recommendations, and to formulate country- specific recommendations for Member States and WHO to sustain polio-free status and implement polio endgame strategies; • to reaffirm certification of wild poliovirus elimination in the Western Pacific Region; and • to produce a draft annual progress report on maintaining polio-free status in the Western Pacific Region, which will be submitted to the Global Commission for the Certification (GCC) of Poliomyelitis Eradication Based on the information submitted by the NCC, the RCC concluded that the Western Pacific Region remained free of indigenous and imported wild poliovirus transmission. The RCC also noted the apparent absence of circulating vaccine-derived poliovirus (cVDPV) transmission in the Region. CONTACT US 2022 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 81 48 82 0 0 0 82 0 0 (0.0%) 1.72 63% 100% 26-Feb-24 - Brunei Darussalam 2 1 1 0 0 0 1 0 0 (0.0%) 1.08 100% 100% 18-Jan-24 - Cambodia 35 48 47 0 0 0 47 0 0 (0.0%) 0.99 89% 98% 07-Mar-24 - China 4225 1877 5597 0 0 0 5597 0 0 (0.0%) 2.98 95% 99% 21-Jul-24 - China, Hong Kong SAR 6 8 16 0 0 0 16 0 0 (0.0%) 2.07 81% 100% 19-Mar-24 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.04 100% 100% 08-Apr-24 - Japan 41 144 54 0 0 0 48 6 2 (3.7%) 0.38 56% 93% 22-Aug-24 104 Lao People's Democratic Republic 28 23 39 0 0 0 39 0 0 (0.0%) 1.70 87% 90% 05-Aug-24 - Malaysia 212 75 235 0 0 0 235 0 0 (0.0%) 3.11 84% 92% 22-Jul-24 - Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 26-Jan-24 - New Zealand 23 10 10 0 0 0 10 0 0 (0.0%) 1.04 70% 90% 09-Apr-24 - Papua New Guinea 59 39 57 0 0 0 57 0 0 (0.0%) 1.44 63% 70% 17-Sep-24 - Philippines 853 342 907 0 0 0 907 0 0 (0.0%) 2.65 73% 61% 07-Oct-24 - Republic of Korea 57 57 51 0 0 0 51 0 0 (0.0%) 0.90 82% 100% 06-Aug-24 - Singapore 11 6 3 0 0 0 3 0 0 (0.0%) 0.52 100% 100% 03-Jan-24 - Viet Nam 238 222 280 0 0 0 280 0 0 (0.0%) 1.26 99% 87% 23-Apr-24 - Pacific island countries and areas 7 10 27 0 0 0 27 0 0 (0.0%) 2.59 56% 67% 12-Jun-24 - Total 5880 2921 7408 0 0 0 7402 6 2 (0.03%) 2.54 91% 94% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO Total 2023 % with adequate specimens 2 Pending Classification Non-polio AFP rate Vaccine- derived poliovirus (VDPV) Polio- compatible Days since last report 5 % investigated ≤ 2 days of notification 3 Indicators Latest report date4> 90 days 1 # (%) Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Table 1A. Classification of AFP cases with onset in 2023 and key surveillance indicators 3 Polio Bulletin 2023 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 82 48 90 0 0 0 71 19 0 (0.0%) 2.04 58% 99% 03-Dec-24 1 Brunei Darussalam 1 1 3 0 0 0 1 2 0 (0.0%) 3.51 33% 100% 30-Nov-24 4 Cambodia 47 48 27 0 0 0 24 3 0 (0.0%) 0.60 93% 96% 08-Nov-24 26 China 5597 1877 4470 0 0 0 2238 2232 1,234 (27.6%) 2.58 94% 99% 21-Nov-24 13 China, Hong Kong SAR 16 8 12 0 0 0 9 3 0 (0.0%) 1.72 67% 100% 03-Dec-24 1 China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.13 100% 100% 13-Nov-24 21 Japan 54 144 42 0 0 0 37 5 1 (2.4%) 0.32 55% 100% 29-Nov-24 5 Lao People's Democratic Republic 39 23 27 0 0 0 12 15 0 (0.0%) 1.28 89% 85% 20-Nov-24 14 Malaysia 235 75 216 0 0 0 202 14 1 (0.5%) 3.10 91% 82% 22-Nov-24 12 Mongolia 1 11 3 0 0 0 3 0 0 (0.0%) 0.30 100% 100% 18-Nov-24 16 New Zealand 10 10 7 0 0 0 5 2 0 (0.0%) 0.78 43% 57% 18-Nov-24 16 Papua New Guinea 57 41 42 0 0 0 29 13 3 (7.1%) 1.12 55% 36% 29-Nov-24 5 Philippines 907 344 797 0 0 0 593 204 65 (8.2%) 2.51 60% 100% 04-Dec-24 0 Republic of Korea 51 54 89 0 0 0 66 23 0 (0.0%) 1.78 84% 100% 02-Dec-24 2 Singapore 3 6 5 0 0 0 4 1 0 (0.0%) 0.93 100% 100% 18-Nov-24 16 Viet Nam 280 222 221 0 0 0 154 67 26 (11.8%) 1.08 100% 58% 16-Oct-24 49 Pacific island countries and areas 27 11 12 0 0 0 12 0 0 (0.0%) 1.23 33% 100% 24-Oct-24 41 Total 7408 2923 6064 0 0 0 3461 2603 1,330 (21.9%) 2.25 88% 97% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Annualized non-polio AFP rate per 100 000 population under 15 years of age Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Substantially below target 4. Percentage of reported cases investigated within two days of notification 5. Countries are expected to submit data at least once per month to WPRO Total 2024 % with adequate specimens 3 Pending Classification Non-polio AFP rate 2 Vaccine- derived poliovirus (VDPV) Polio- compatible Days since last report 5 % investigated ≤ 2 days of notification 4 Indicators Latest report date> 90 days 1 # (%) Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Table 1B. Classification of AFP cases with onset in 2024 and key surveillance indicators 4 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 77 0 2 2 73 0 94% 3% 05-Feb-24 VIDRL 2 0 0 0 0 0 0 0 0 0 2 0 0 100% Brunei Darussalam VIDRL 1 0 0 0 1 0 0% 0% 09-Oct-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 47 0 0 7 40 0 96% 14% 25-Dec-23 NIID 0 - - - - - - - - - - - - - China (total) 5580 0 19 0 5561 0 98% 0.2% 21-Jul-24 60 0 26 0 0 0 0 0 34 0 0 0 0 100% China, Anhui Prov. Lab 342 0 1 0 341 0 98% 0.1% Prov. Lab/CCDC 4 0 2 0 0 0 0 0 2 0 0 0 0 100% China, Beijing Prov. Lab 56 0 0 0 56 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 59 0 0 0 59 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 171 0 0 0 171 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 111 0 0 0 111 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 586 0 1 0 585 0 93% 0% Prov. Lab/CCDC 6 0 3 0 0 0 0 0 3 0 0 0 0 100% China, Guangxi Prov. Lab 252 0 3 0 249 0 99% 0.6% Prov. Lab/CCDC 8 0 2 0 0 0 0 0 6 0 0 0 0 100% China, Guizhou Prov. Lab 235 0 0 0 235 0 100% 0% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Hainan Prov. Lab 48 0 1 0 47 0 96% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Hebei Prov. Lab 333 0 0 0 333 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 69 0 0 0 69 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 688 0 6 0 682 0 100% 0.4% Prov. Lab/CCDC 18 0 10 0 0 0 0 0 8 0 0 0 0 100% China, Hubei Prov. Lab 151 0 0 0 151 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 287 0 0 0 287 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 217 0 0 0 217 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 182 0 0 0 182 0 91% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 43 0 0 0 43 0 100% 0% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Liaoning Prov. Lab 102 0 0 0 102 0 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 139 0 1 0 138 0 100% 0.4% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Ningxia Prov. Lab 23 0 0 0 23 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 9 0 0 0 9 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 74 0 0 0 74 0 74% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 287 0 0 0 287 0 100% 0% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Shanghai Prov. Lab 46 0 0 0 46 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 108 0 2 0 106 0 98% 1% Prov. Lab/CCDC 6 0 2 0 0 0 0 0 4 0 0 0 0 100% China, Sichuan Prov. Lab 358 0 1 0 357 0 98% 0.1% Prov. Lab/CCDC 4 0 3 0 0 0 0 0 1 0 0 0 0 100% China, Tianjin Prov. Lab 31 0 1 0 30 0 100% 2% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Xinjiang Prov. Lab 146 0 1 0 145 0 98% 0.3% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Yunnan Prov. Lab 208 0 0 0 208 0 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 198 0 1 0 197 0 99% 0.3% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Tibet Prov. Lab 21 0 0 0 21 0 95% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 15 0 0 0 15 0 97% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 49 0 0 4 45 0 91% 7% 21-Feb-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 39 1 0 1 37 0 100% 3% 21-May-24 NIID 2 0 0 0 0 0 0 0 2 0 0 0 0 100% Malaysia IMR 254 0 0 19 235 0 88% 7% 29-Apr-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 29-Dec-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 7 0 0 1 6 0 100% 18% 19-Feb-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 57 6 0 3 48 0 97% 6% 27-Aug-24 VIDRL 27 0 6 0 0 0 0 0 21 0 0 0 0 100% Philippines RITM 892 13 0 44 834 1 97% 4% 04-Sep-24 RITM/NIID 66 0 26 0 0 0 0 0 40 0 0 0 0 100% Republic of Korea KDCA 51 0 0 6 45 0 99% 11% 06-Aug-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 3 0 0 1 2 0 100% 33% 11-Jan-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 164 0 0 27 137 0 100% 16% 11-Jan-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 113 0 0 14 99 0 100% 12% 29-Jan-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 24 0 0 3 21 0 96% 9% 22-Jan-24 VIDRL 0 - - - - - - - - - - - - - Total 7375 20 21 132 7201 1 97% 2% 157 0 58 0 0 0 0 0 97 0 2 0 0 100% 2. NPEV growing in L20B cells Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin VDPVPending % specimens positive for NPEV Latest report date SabinWild 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only Table 2A. Laboratory investigation of stool samples from AFP cases with onset in 2023 and key laboratory indicators 6 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 80 0 3 5 69 3 90% 7% 02-Dec-24 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 67% Brunei Darussalam VIDRL 3 0 0 0 3 0 67% 0% 27-Nov-24 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 27 0 0 0 27 0 59% 0% 02-Dec-24 NIID 0 - - - - - - - - - - - - - China (total) 4441 2 8 1 4331 99 97% 0.1% 21-Nov-24 46 0 11 6 0 0 0 0 27 2 0 0 0 89% China, Anhui Prov. Lab 225 0 0 0 224 1 98% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Beijing Prov. Lab 40 0 0 0 39 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 46 0 0 0 46 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 154 0 0 0 144 10 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 79 0 0 0 77 2 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 432 1 0 0 425 6 92% 0% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Guangxi Prov. Lab 197 0 0 0 197 0 91% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guizhou Prov. Lab 225 0 0 0 224 1 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hainan Prov. Lab 41 0 0 0 39 2 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 236 0 0 0 235 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 37 0 0 0 37 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 617 0 3 0 612 2 100% 0.2% Prov. Lab/CCDC 20 0 7 0 0 0 0 0 13 0 0 0 0 80% China, Hubei Prov. Lab 148 0 0 0 147 1 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 239 0 1 0 238 0 100% 0% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Jiangsu Prov. Lab 179 0 1 0 174 4 100% 0% Prov. Lab/CCDC 2 0 2 0 0 0 0 0 0 0 0 0 0 100% China, Jiangxi Prov. Lab 156 0 0 0 153 3 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 37 0 0 0 36 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - China, Liaoning Prov. Lab 76 0 0 0 75 1 99% 0% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Neimongol Prov. Lab 97 0 0 0 85 12 99% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ningxia Prov. Lab 25 0 1 0 24 0 100% 2% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Qinghai Prov. Lab 9 0 0 0 9 0 89% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 80 0 0 0 77 3 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 260 0 0 0 234 26 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab 32 0 0 0 32 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 75 0 1 0 73 1 96% 1% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Sichuan Prov. Lab 261 0 0 1 249 11 98% 0.2% Prov. Lab/CCDC 6 0 0 6 0 0 0 0 0 0 0 0 0 100% China, Tianjin Prov. Lab 16 0 0 0 16 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 86 1 1 0 83 1 96% 0.6% Prov. Lab/CCDC 5 0 0 0 0 0 0 0 5 0 0 0 0 80% China, Yunnan Prov. Lab 179 0 0 0 171 8 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 145 0 0 0 144 1 99% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 12 0 0 0 12 0 100% 0% CCDC 2 0 0 0 0 0 0 0 0 2 0 0 0 100% China, Hong Kong SAR PHLC 12 0 0 0 11 1 100% 0% 03-Dec-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 29-Nov-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 38 0 0 2 36 0 97% 3% 19-Nov-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 27 0 0 4 8 15 43% 30% 20-Nov-24 NIID 0 - - - - - - - - - - - - - Malaysia IMR 236 0 0 19 217 0 100% 6% 02-Dec-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 3 0 0 0 3 0 100% 0% 14-Nov-24 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 7 0 0 1 5 1 100% 15% 02-Dec-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 42 2 4 1 27 8 85% 15% 29-Nov-24 VIDRL 7 0 1 0 0 0 0 0 1 0 5 0 0 43% Philippines RITM 737 5 2 57 670 3 99% 7% 02-Dec-24 RITM/NIID 30 0 16 0 0 0 0 0 13 0 1 0 0 100% Republic of Korea KDCA 89 0 0 20 65 4 100% 19% 02-Dec-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 5 0 0 0 5 0 100% 0% 02-Dec-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 121 0 0 20 95 6 100% 17% 07-Sep-24 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 99 2 0 12 84 1 100% 12% 02-Dec-24 PI/NIID 2 0 0 0 0 0 0 0 2 0 0 0 0 100% Pacific island countries and areas VIDRL 9 0 0 1 8 0 100% 11% 11-Oct-24 VIDRL 0 - - - - - - - - - - - - - Total 5977 11 17 143 5665 141 97% 2% 88 0 28 6 0 0 0 0 43 2 9 0 0 85% 2. NPEV growing in L20B cells Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens VDPV Pending % specimens positive for NPEV Latest report date SabinWild Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin Table 2B. Laboratory investigation of stool samples from AFP cases with onset in 2024 and key laboratory indicators 7 Polio Bulletin Table 3A. Laboratory confirmation of polio isolates from environmental samples in 20231 and key laboratory indicators 8 Polio Bulletin Table 3B. Laboratory confirmation of polio isolates from environmental samples in 20241 and key laboratory indicators 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); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); RITM (Research Institute for Tropical Medicine, Philippines); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 49 3 0 0 0 0 0 0 0 3 0 100% 0 0 Cambodia RITM 12 2 0 0 0 0 0 0 0 2 0 58% 0 0 China (total) 630 213 0 210 0 0 0 0 0 304 2 35% 0 0 China, Fujian Prov. Lab/CCDC 77 18 0 5 0 0 0 0 0 19 0 60% 0 0 China, Gansu Prov. Lab/CCDC 42 21 0 23 0 0 0 0 0 26 0 21% 0 0 China, Guangdong Prov. Lab/CCDC 48 30 0 20 0 0 0 0 0 41 0 52% 0 0 China, Guangxi Prov. Lab/CCDC 12 6 0 6 0 0 0 0 0 11 0 58% 0 0 China, Heilongjiang Prov. Lab/CCDC 24 11 0 12 0 0 0 0 0 30 0 17% 0 0 China, Jiangxi Prov. Lab/CCDC 34 9 0 6 0 0 0 0 0 6 1 65% 0 0 China, Jiangsu Prov. Lab/CCDC 124 10 0 4 0 0 0 0 0 6 0 5% 0 0 China, Liaoning Prov. Lab/CCDC 43 16 0 6 0 0 0 0 0 25 0 5% 0 0 China, Neimongol Prov. Lab/CCDC 20 8 0 15 0 0 0 0 0 13 0 0% 0 0 China, Ninxia Prov. Lab/CCDC 19 8 0 20 0 0 0 0 0 8 0 42% 0 0 China, Qinghai Prov. Lab/CCDC 14 3 0 3 0 0 0 0 0 2 0 14% 0 0 China, Shandong Prov. Lab/CCDC 36 16 0 10 0 0 0 0 0 27 0 36% 0 0 China, Shanghai Prov. Lab/CCDC 24 0 0 0 0 0 0 0 0 0 0 17% 0 0 China, Xinjiang Prov. Lab/CCDC 36 27 0 53 0 0 0 0 0 64 0 0% 0 0 China, Yunnan Prov. Lab/CCDC 37 22 0 25 0 0 0 0 0 18 0 92% 0 0 China, Zheijiang Prov. Lab/CCDC 40 8 0 2 0 0 0 0 0 8 1 70% 0 0 Lao PDR RITM 6 0 0 0 0 0 0 0 0 0 0 0% 0 0 Malaysia IMR/VIDRL 330 0 0 0 0 0 0 0 0 0 0 48% 3 0 Mongolia NCPH 2 0 0 0 0 0 0 0 0 0 0 0% 0 0 New Zealand IESR 80 4 0 0 0 0 0 0 0 4 0 90% 0 0 Philippines RITM 616 37 0 17 0 0 0 0 0 44 0 15% 0 0 Viet Nam NIHE 124 0 0 0 0 0 0 0 0 0 0 2% 0 0 Total 1849 259 0 227 0 0 0 0 0 357 2 33% 3 0 NPEV (%) Pending ITD Discordant pending sequencingType 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 35 7 0 1 0 0 0 0 0 6 0 89% 3 0 Cambodia RITM 32 2 0 0 0 0 0 0 0 2 0 47% 0 0 China (total) 411 197 0 219 1 0 0 0 0 332 0 60% 2 0 China, Anui Prov. Lab/CCDC 36 28 0 46 0 0 0 0 0 45 0 81% 0 0 China, Fujian Prov. Lab/CCDC 42 14 0 3 0 0 0 0 0 19 0 81% 2 0 China, Gansu Prov. Lab/CCDC 46 19 0 11 0 0 0 0 0 44 0 26% 0 0 China, Guangdong Prov. Lab/CCDC 40 33 0 36 1 0 0 0 0 59 0 80% 0 0 China, Guangxi Prov. Lab/CCDC 28 9 0 5 0 0 0 0 0 4 0 82% 0 0 China, Heilongjiang Prov. Lab/CCDC 12 2 0 0 0 0 0 0 0 3 0 0% 0 0 China, Jiangxi Prov. Lab/CCDC 21 3 0 0 0 0 0 0 0 3 0 43% 0 0 China, Jiangsu Prov. Lab/CCDC 14 5 0 6 0 0 0 0 0 3 0 7% 0 0 China, Liaoning Prov. Lab/CCDC 40 21 0 28 0 0 0 0 0 44 0 63% 0 0 China, Neimongol Prov. Lab/CCDC 10 7 0 6 0 0 0 0 0 16 0 0% 0 0 China, Ninxia Prov. Lab/CCDC 18 13 0 36 0 0 0 0 0 31 0 89% 0 0 China, Qinghai Prov. Lab/CCDC 9 6 0 9 0 0 0 0 0 16 0 44% 0 0 China, Shaanxi Prov. Lab/CCDC 0 - - - - - - - - - - - China, Shandong Prov. Lab/CCDC 24 15 0 24 0 0 0 0 0 16 0 63% 0 0 China, Shanghai Prov. Lab/CCDC 18 0 0 0 0 0 0 0 0 0 0 28% 0 0 China, Xinjiang Prov. Lab/CCDC 12 9 0 4 0 0 0 0 0 15 0 42% 0 0 China, Yunnan Prov. Lab/CCDC 18 9 0 5 0 0 0 0 0 10 0 83% 0 0 China, Zheijiang Prov. Lab/CCDC 23 4 0 0 0 0 0 0 0 4 0 96% 0 0 Lao PDR RITM 14 0 0 0 0 0 0 0 0 0 0 0% 0 0 Malaysia IMR/VIDRL 237 0 0 0 0 0 0 0 0 0 0 57% 14 0 Mongolia NCPH 16 0 0 0 0 0 0 0 0 0 0 29% 3 0 New Zealand IESR 52 1 0 0 0 0 0 0 0 1 0 94% 0 0 Papua New Guinea RITM 18 1 0 0 0 0 0 0 0 1 0 83% 0 0 Philippines RITM 537 34 0 8 0 0 0 0 0 28 0 26% 9 0 Viet Nam NIHE 0 - - - - - - - - - - - - - Total 1352 242 0 228 1 0 0 0 0 370 0 47% 31 0 Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates NPEV (%) Pending ITD Discordant pending sequencingType 1 Type 2 Type 3 Figure 5A. China Figure 5B. Malaysia Figure 5C. Papua New Guinea Figure 5D. Philippines 1. Prefix letter refers to the VDPV category: “cVDPV” = circulating VDPV, “iVDPV” = immunodeficiency-associated VDPV, “aVDPV” = ambiguous VDPV. Suffix number refers to the poliovirus serotype (types 1, 2 or 3) 2. Community and healthy children 3. Contact of a different AFP case Vaccine-derived polio virus1 identified from laboratory testing, 2018–2024 0 2 4 6 8 10 12 14 16 cVDPV1 cVDPV2 cVDPV1 cVDPV2 aVDPV2 aVDPV3 2019 2020 N o. o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 45 cVDPV1 2018 N o.  o f c as es /s pe ci m en s 0 5 10 15 20 25 30 35 40 cVDPV1 cVDPV2 iVDPV2 aVDPV2 cVDPV2 aVDPV2 2019 2020 N o. o f c as es /s pe ci m en s 9 Polio Bulletin 0 1 2 3 4 5 cVDPV2 iVDPV3 aVDPV3 cVDPV2 aVDPV3 aVDPV1 cVDPV3 aVDPV3 aVDPV1 cVDPV3 aVDPV3 iVDPV3 aVDPV1 aVDPV1 aVDPV3 iVDPV3 aVDPV1 aVDPV3 2018 2019 2020 2021 2022 2023 2024 N o . o f c a se s/ sp e c im e n s

Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Phone: +63 2 8528 8001 Fax: +63 2 8521 1036, 8526 0279 Email: wproepidata@who.int Web: www.who.int/westernpacific Polio Bulletin 2024 Issue No. 14 - December 2024 (as of 8 January 2025) Figure 1. Non-polio AFP rate (per 100 000 persons < 15 years of age), 2022–2024 HIGHLIGHTS Figure 2. Adequate specimen collection rate, 2022–2024 Figure 3. Percentage of reported AFP cases by number of polio vaccination doses, 2024 Figure 4. Percentage of reported AFP cases with pending classification > 90 days after onset, 2024 0.0 1.0 2.0 3.0 4.0 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 22 23 24 CHN KHM LAO MYS PHL PNG VNM 0% 20% 40% 60% 80% 100% CHN KHM LAO MYS PHL PNG VNM ≥ 3 doses 1-2 doses 0 doses Unknown 11.8% 0.0% 0.0% 0.4% 0.0% 0.0% 27.6% 0% 5% 10% 15% 20% 25% 30% VNM PNG PHL MYS LAO KHM CHN 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). Detection of vaccine-derived poliovirus type 2 in Australia On 19th December 2024, the Victorian Infectious Diseases Reference Laboratory (VIDRL) in Australia reported the detection of vaccine-derived poliovirus type 2 (VDPV2) through environmental surveillance. The sewage water specimen was collected from the Western Treatment Plant in Melbourne on 2nd December 2024. Genetic sequencing results show that the VDPV2 isolate has 124 nucleotide substitutions compared to Sabin virus type 2 (13.7% divergence). It shows genetic linkage to the VDPV2 isolate that was detected in 2017 from the same wastewater source of environmental surveillance in Australia. The genetic signatures are compatible with immunodeficiency-related VDPV2 (iVDPV2) but do not match with any sequences from known chronic immunodeficiency related VDPV2 excretors, and hence the VDPV2 cannot be classified as iVDPV2 as the source is unknown. The virus is classified as ambiguous VDPV2 (aVDPV2), as described in Guidelines for Classification and Reporting of Vaccine-derived Polioviruses. The ongoing public health response in the country is in accordance with the guidance from Global Poliomyelitis Eradication Initiative (GPEI), including efforts to identify any VDPV2 excretor(s) through poliovirus surveillance among patients with known primary immunodeficiency disorders. Source: Poliovirus Environmental Surveillance report to WHO by VIDRL, Australia, December 19, 2024. CONTACT US 2022 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 81 48 82 0 0 0 82 0 0 (0.0%) 1.72 63% 100% 26-Feb-24 - Brunei Darussalam 2 1 1 0 0 0 1 0 0 (0.0%) 1.08 100% 100% 18-Jan-24 - Cambodia 35 48 47 0 0 0 47 0 0 (0.0%) 0.99 89% 98% 07-Mar-24 - China 4225 1877 5597 0 0 0 5597 0 0 (0.0%) 2.98 95% 99% 21-Jul-24 - China, Hong Kong SAR 6 8 16 0 0 0 16 0 0 (0.0%) 2.07 81% 100% 19-Mar-24 - China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.04 100% 100% 08-Apr-24 - Japan 41 144 54 0 0 0 48 6 2 (3.7%) 0.38 56% 93% 22-Aug-24 139 Lao People's Democratic Republic 28 23 39 0 0 0 39 0 0 (0.0%) 1.70 87% 90% 05-Aug-24 - Malaysia 212 75 235 0 0 0 235 0 0 (0.0%) 3.11 84% 92% 22-Jul-24 - Mongolia 1 11 1 0 0 0 1 0 0 (0.0%) 0.09 100% 100% 26-Jan-24 - New Zealand 23 10 10 0 0 0 10 0 0 (0.0%) 1.04 70% 90% 11-Nov-24 - Papua New Guinea 59 39 57 0 0 0 57 0 0 (0.0%) 1.44 63% 70% 17-Sep-24 - Philippines 853 342 907 0 0 0 907 0 0 (0.0%) 2.65 73% 61% 07-Oct-24 - Republic of Korea 57 57 51 0 0 0 51 0 0 (0.0%) 0.90 82% 100% 06-Aug-24 - Singapore 11 6 3 0 0 0 3 0 0 (0.0%) 0.52 100% 100% 03-Jan-24 - Viet Nam 238 222 280 0 0 0 280 0 0 (0.0%) 1.26 99% 87% 23-Apr-24 - Pacific island countries and areas 7 10 27 0 0 0 27 0 0 (0.0%) 2.59 56% 67% 12-Jun-24 - Total 5880 2921 7408 0 0 0 7402 6 2 (0.03%) 2.54 91% 94% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases investigated within two days of notification Substantially below target 4. Report date is fixed as soon as all cases for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Days since last report 5 % investigated ≤ 2 days of notification 3 Indicators Latest report date4> 90 days 1 # (%) Total 2023 % with adequate specimens 2 Pending Classification Non-polio AFP rate Vaccine- derived poliovirus (VDPV) Polio- compatible Table 1A. Classification of AFP cases with onset in 2023 and key surveillance indicators 3 Polio Bulletin 2023 ≥ 1 ≥ 80% ≥ 80% ≤ 30 Australia 82 48 94 0 0 0 84 10 0 (0.0%) 1.97 61% 99% 03-Jan-25 5 Brunei Darussalam 1 1 3 0 0 0 1 2 0 (0.0%) 3.24 33% 100% 30-Nov-24 39 Cambodia 47 48 27 0 0 0 24 3 0 (0.0%) 0.56 93% 96% 08-Nov-24 61 China 5597 1877 4470 0 0 0 2238 2232 1,234 (27.6%) 2.38 94% 99% 21-Nov-24 48 China, Hong Kong SAR 16 8 13 0 0 0 12 1 0 (0.0%) 1.72 85% 100% 03-Jan-25 5 China, Macao SAR 1 1 1 0 0 0 1 0 0 (0.0%) 1.04 100% 100% 07-Jan-25 1 Japan 54 144 46 0 0 0 41 5 1 (2.2%) 0.32 57% 100% 02-Jan-25 6 Lao People's Democratic Republic 39 23 28 0 0 0 12 16 0 (0.0%) 1.22 89% 82% 04-Dec-24 35 Malaysia 235 75 275 0 0 0 260 15 1 (0.4%) 3.64 92% 80% 06-Jan-25 2 Mongolia 1 11 4 0 0 0 3 1 0 (0.0%) 0.37 75% 100% 03-Jan-25 5 New Zealand 10 10 8 0 0 0 5 3 0 (0.0%) 0.83 38% 63% 07-Jan-25 1 Papua New Guinea 57 41 42 0 0 0 37 5 0 (0.0%) 1.04 55% 36% 24-Dec-24 15 Philippines 907 344 846 0 0 0 655 191 0 (0.0%) 2.46 62% 100% 08-Jan-24 366 Republic of Korea 51 54 94 0 0 0 86 8 0 (0.0%) 1.74 84% 100% 07-Jan-25 1 Singapore 3 6 5 0 0 0 5 0 0 (0.0%) 0.86 100% 100% 07-Jan-25 1 Viet Nam 280 222 221 0 0 0 154 67 26 (11.8%) 1.00 100% 58% 16-Oct-24 84 Pacific island countries and areas 27 11 14 0 0 0 12 2 0 (0.0%) 1.33 36% 100% 09-Dec-24 30 Total 7408 2923 6191 0 0 0 3630 2561 1,262 (20.4%) 2.12 89% 97% 1. Number (%) of reported cases pending classification more than 90 days from date of onset of paralysis to date of last report Reached or surpass target 2. Annualized non-polio AFP rate per 100 000 population under 15 years of age Nearly reached target 0.5-0.99 for non-polio AFP rate; 60-79% for other indicators 3. Percentage of reported cases with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Substantially below target 4. Percentage of reported cases investigated within two days of notification 5. Countries are expected to submit data at least once per month to WPRO Country/area Total reported cases Annual expected cases <15 years of age Total reported cases Confirmed wild poliovirus Discarded (Non-polio) Days since last report 5 % investigated ≤ 2 days of notification 4 Indicators Latest report date> 90 days 1 # (%) Total 2024 % with adequate specimens 3 Pending Classification Non-polio AFP rate 2 Vaccine- derived poliovirus (VDPV) Polio- compatible Table 1B. Classification of AFP cases with onset in 2024 and key surveillance indicators 4 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 77 0 2 2 73 0 94% 3% 05-Feb-24 VIDRL 2 0 0 0 0 0 0 0 0 0 2 0 0 100% Brunei Darussalam VIDRL 1 0 0 0 1 0 0% 0% 09-Oct-23 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 47 0 0 7 40 0 96% 14% 25-Dec-23 NIID 0 - - - - - - - - - - - - - China (total) 5580 0 19 0 5561 0 98% 0.2% 21-Jul-24 60 0 26 0 0 0 0 0 34 0 0 0 0 100% China, Anhui Prov. Lab 342 0 1 0 341 0 98% 0.1% Prov. Lab/CCDC 4 0 2 0 0 0 0 0 2 0 0 0 0 100% China, Beijing Prov. Lab 56 0 0 0 56 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 59 0 0 0 59 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 171 0 0 0 171 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 111 0 0 0 111 0 99% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 586 0 1 0 585 0 93% 0% Prov. Lab/CCDC 6 0 3 0 0 0 0 0 3 0 0 0 0 100% China, Guangxi Prov. Lab 252 0 3 0 249 0 99% 0.6% Prov. Lab/CCDC 8 0 2 0 0 0 0 0 6 0 0 0 0 100% China, Guizhou Prov. Lab 235 0 0 0 235 0 100% 0% Prov. Lab/CCDC 2 0 1 0 0 0 0 0 1 0 0 0 0 100% China, Hainan Prov. Lab 48 0 1 0 47 0 96% 1% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Hebei Prov. Lab 333 0 0 0 333 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 69 0 0 0 69 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 688 0 6 0 682 0 100% 0.4% Prov. Lab/CCDC 18 0 10 0 0 0 0 0 8 0 0 0 0 100% China, Hubei Prov. Lab 151 0 0 0 151 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 287 0 0 0 287 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangsu Prov. Lab 217 0 0 0 217 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jiangxi Prov. Lab 182 0 0 0 182 0 91% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Jilin Prov. Lab 43 0 0 0 43 0 100% 0% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Liaoning Prov. Lab 102 0 0 0 102 0 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Neimongol Prov. Lab 139 0 1 0 138 0 100% 0.4% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Ningxia Prov. Lab 23 0 0 0 23 0 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Qinghai Prov. Lab 9 0 0 0 9 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 74 0 0 0 74 0 74% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 287 0 0 0 287 0 100% 0% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Shanghai Prov. Lab 46 0 0 0 46 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 108 0 2 0 106 0 98% 1% Prov. Lab/CCDC 6 0 2 0 0 0 0 0 4 0 0 0 0 100% China, Sichuan Prov. Lab 358 0 1 0 357 0 98% 0.1% Prov. Lab/CCDC 4 0 3 0 0 0 0 0 1 0 0 0 0 100% China, Tianjin Prov. Lab 31 0 1 0 30 0 100% 2% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Xinjiang Prov. Lab 146 0 1 0 145 0 98% 0.3% Prov. Lab/CCDC 1 0 1 0 0 0 0 0 0 0 0 0 0 100% China, Yunnan Prov. Lab 208 0 0 0 208 0 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 198 0 1 0 197 0 99% 0.3% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Tibet Prov. Lab 21 0 0 0 21 0 95% 0% CCDC 0 - - - - - - - - - - - - - China, Hong Kong SAR PHLC 15 0 0 0 15 0 97% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 08-Jan-24 PHLC 0 - - - - - - - - - - - - - Japan NIID 43 0 0 4 39 0 91% 9% 21-Feb-24 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 39 1 0 1 37 0 100% 3% 21-May-24 NIID 2 0 0 0 0 0 0 0 2 0 0 0 0 100% Malaysia IMR 254 0 0 19 235 0 88% 7% 29-Apr-24 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 1 0 0 0 1 0 100% 0% 29-Dec-23 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 7 0 0 1 6 0 100% 18% 19-Feb-24 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 57 6 0 3 48 0 97% 6% 27-Aug-24 VIDRL 27 0 6 0 0 0 0 0 21 0 0 0 0 100% Philippines RITM 892 13 0 44 834 1 97% 4% 04-Sep-24 RITM/NIID 66 0 26 0 0 0 0 0 40 0 0 0 0 100% Republic of Korea KDCA 51 0 0 6 45 0 99% 11% 06-Aug-24 KDCA 0 - - - - - - - - - - - - - Singapore SGH 3 0 0 1 2 0 100% 33% 11-Jan-24 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 164 0 0 27 137 0 100% 16% 11-Jan-23 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 113 0 0 14 99 0 100% 12% 29-Jan-24 PI/NIID 0 - - - - - - - - - - - - - Pacific island countries and areas VIDRL 26 0 0 3 23 0 94% 8% 24-Dec-24 VIDRL 0 - - - - - - - - - - - - - Total 7371 20 21 132 7197 1 97% 2% 157 0 58 0 0 0 0 0 97 0 2 0 0 100% 2. NPEV growing in L20B cells Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens VDPV Pending % specimens positive for NPEV Latest report date SabinWild Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin Table 2A. Laboratory investigation of stool samples from AFP cases with onset in 2023 and key laboratory indicators 6 Polio Bulletin ≥ 80% ≥ 80% Australia VIDRL 86 0 3 5 77 1 90% 6% 03-Jan-25 VIDRL 3 0 0 0 0 0 0 0 0 0 3 0 0 67% Brunei Darussalam VIDRL 3 0 0 0 3 0 67% 0% 27-Nov-24 VIDRL 0 - - - - - - - - - - - - - Cambodia NIID 27 0 0 0 27 0 59% 0% 02-Dec-24 NIID 0 - - - - - - - - - - - - - China (total) 4441 2 8 1 4331 99 97% 0.1% 21-Nov-24 48 0 13 6 0 0 0 0 27 2 0 0 0 89% China, Anhui Prov. Lab 225 0 0 0 224 1 98% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Beijing Prov. Lab 40 0 0 0 39 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Chongqing Prov. Lab 46 0 0 0 46 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Fujian Prov. Lab 154 0 0 0 144 10 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Gansu Prov. Lab 79 0 0 0 77 2 96% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guangdong Prov. Lab 432 1 0 0 425 6 92% 0% Prov. Lab/CCDC 1 0 0 0 0 0 0 0 1 0 0 0 0 100% China, Guangxi Prov. Lab 197 0 0 0 197 0 91% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Guizhou Prov. Lab 225 0 0 0 224 1 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hainan Prov. Lab 41 0 0 0 39 2 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hebei Prov. Lab 236 0 0 0 235 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Heilongjiang Prov. Lab 37 0 0 0 37 0 97% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Henan Prov. Lab 617 0 3 0 612 2 100% 0.2% Prov. Lab/CCDC 20 0 7 0 0 0 0 0 13 0 0 0 0 80% China, Hubei Prov. Lab 148 0 0 0 147 1 98% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Hunan Prov. Lab 239 0 1 0 238 0 100% 0% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Jiangsu Prov. Lab 179 0 1 0 174 4 100% 0% Prov. Lab/CCDC 2 0 2 0 0 0 0 0 0 0 0 0 0 100% China, Jiangxi Prov. Lab 156 0 0 0 153 3 95% 0% Prov. Lab/CCDC 2 0 2 0 0 0 0 0 0 0 0 0 0 100% China, Jilin Prov. Lab 37 0 0 0 36 1 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - China, Liaoning Prov. Lab 76 0 0 0 75 1 99% 0% Prov. Lab/CCDC 2 0 0 0 0 0 0 0 2 0 0 0 0 100% China, Neimongol Prov. Lab 97 0 0 0 85 12 99% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Ningxia Prov. Lab 25 0 1 0 24 0 100% 2% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Qinghai Prov. Lab 9 0 0 0 9 0 89% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shaanxi Prov. Lab 80 0 0 0 77 3 95% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shandong Prov. Lab 260 0 0 0 234 26 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanghai Prov. Lab 32 0 0 0 32 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Shanxi Prov. Lab 75 0 1 0 73 1 96% 1% Prov. Lab/CCDC 3 0 1 0 0 0 0 0 2 0 0 0 0 100% China, Sichuan Prov. Lab 261 0 0 1 249 11 98% 0.2% Prov. Lab/CCDC 6 0 0 6 0 0 0 0 0 0 0 0 0 100% China, Tianjin Prov. Lab 16 0 0 0 16 0 100% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Xinjiang Prov. Lab 86 1 1 0 83 1 96% 0.6% Prov. Lab/CCDC 5 0 0 0 0 0 0 0 5 0 0 0 0 80% China, Yunnan Prov. Lab 179 0 0 0 171 8 93% 0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Zhejiang Prov. Lab 145 0 0 0 144 1 99% 0.0% Prov. Lab/CCDC 0 - - - - - - - - - - - - - China, Tibet Prov. Lab 12 0 0 0 12 0 100% 0% CCDC 2 0 0 0 0 0 0 0 0 2 0 0 0 100% China, Hong Kong SAR PHLC 13 0 0 0 13 0 100% 0% 06-Jan-25 PHLC 0 - - - - - - - - - - - - - China, Macao SAR PHLC 1 0 0 0 1 0 100% 0% 06-Jan-25 PHLC 0 - - - - - - - - - - - - - Japan NIID 38 0 0 1 36 1 97% 3% 02-Jan-25 NIID 0 - - - - - - - - - - - - - Lao People's Democratic Republic NIID 28 0 0 4 8 16 43% 30% 04-Dec-24 NIID 0 - - - - - - - - - - - - - Malaysia IMR 276 0 0 21 255 0 100% 6% 03-Jan-25 IMR/VIDRL 0 - - - - - - - - - - - - - Mongolia NCPH 3 0 0 0 3 0 100% 0% 03-Jan-25 NCPH/NIID 0 - - - - - - - - - - - - - New Zealand IESR 8 0 0 1 6 1 100% 18% 07-Jan-25 IESR 0 - - - - - - - - - - - - - Papua New Guinea VIDRL 42 2 5 1 32 2 87% 15% 25-Dec-24 VIDRL 8 0 1 0 0 0 0 0 1 0 6 0 0 50% Philippines RITM 784 8 0 63 711 2 99% 7% 07-Jan-25 RITM/NIID 31 0 16 0 0 0 0 0 14 0 1 0 0 100% Republic of Korea KDCA 94 0 0 20 72 2 100% 18% 03-Jan-25 KDCA 0 - - - - - - - - - - - - - Singapore SGH 5 0 0 0 5 0 100% 0% 07-Jan-25 SGH 0 - - - - - - - - - - - - - Viet Nam (North) NIHE 121 0 0 20 95 6 100% 17% 07-Sep-24 NIHE/NIID 0 - - - - - - - - - - - - - Viet Nam (South) PI 99 2 0 12 84 1 100% 12% 02-Dec-24 PI/NIID 2 0 0 0 0 0 0 0 2 0 0 0 0 100% Pacific island countries and areas VIDRL 14 0 0 1 13 0 93% 7% 30-Dec-24 VIDRL 0 - - - - - - - - - - - - - Total 6083 14 16 150 5772 131 97% 2% 92 0 30 6 0 0 0 0 44 2 10 0 0 86% 2. NPEV growing in L20B cells Results of virus isolation for AFP cases Negative % results reported ≤ 14 days L20B positive L20B positive + NPEV NPEV only 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); KDCA (Korea Disease Control and Prevention Agency, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); NCPH (National Center for Public Health, 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) Intratypic differentiation/ Sequencing laboratory 1 No. of isolates received Wild Sabin Polio laboratory 1 Type 1 VDPV Country/area Total no. of AFP cases with specimens VDPV Pending % specimens positive for NPEV Latest report date SabinWild Discordant pending sequencing Pending ITD Results of intratypic differentiation (ITD)/sequencing for virus isolates Wild VDPV Type 3 % ITD results reported ≤ 7 days of receiptNPEV 2 Type 2 Sabin Table 2B. Laboratory investigation of stool samples from AFP cases with onset in 2024 and key laboratory indicators 7 Polio Bulletin Table 3A. Laboratory confirmation of polio isolates from environmental samples in 20231 and key laboratory indicators 8 Polio Bulletin Table 3B. Laboratory confirmation of polio isolates from environmental samples in 20241 and key laboratory indicators 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); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); RITM (Research Institute for Tropical Medicine, Philippines); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 49 3 0 0 0 0 0 0 0 3 0 100% 0 0 Cambodia RITM 12 2 0 0 0 0 0 0 0 2 0 58% 0 0 China (total) 630 213 0 210 0 0 0 0 0 304 2 35% 0 0 China, Fujian Prov. Lab/CCDC 77 18 0 5 0 0 0 0 0 19 0 60% 0 0 China, Gansu Prov. Lab/CCDC 42 21 0 23 0 0 0 0 0 26 0 21% 0 0 China, Guangdong Prov. Lab/CCDC 48 30 0 20 0 0 0 0 0 41 0 52% 0 0 China, Guangxi Prov. Lab/CCDC 12 6 0 6 0 0 0 0 0 11 0 58% 0 0 China, Heilongjiang Prov. Lab/CCDC 24 11 0 12 0 0 0 0 0 30 0 17% 0 0 China, Jiangxi Prov. Lab/CCDC 34 9 0 6 0 0 0 0 0 6 1 65% 0 0 China, Jiangsu Prov. Lab/CCDC 124 10 0 4 0 0 0 0 0 6 0 5% 0 0 China, Liaoning Prov. Lab/CCDC 43 16 0 6 0 0 0 0 0 25 0 5% 0 0 China, Neimongol Prov. Lab/CCDC 20 8 0 15 0 0 0 0 0 13 0 0% 0 0 China, Ninxia Prov. Lab/CCDC 19 8 0 20 0 0 0 0 0 8 0 42% 0 0 China, Qinghai Prov. Lab/CCDC 14 3 0 3 0 0 0 0 0 2 0 14% 0 0 China, Shandong Prov. Lab/CCDC 36 16 0 10 0 0 0 0 0 27 0 36% 0 0 China, Shanghai Prov. Lab/CCDC 24 0 0 0 0 0 0 0 0 0 0 17% 0 0 China, Xinjiang Prov. Lab/CCDC 36 27 0 53 0 0 0 0 0 64 0 0% 0 0 China, Yunnan Prov. Lab/CCDC 37 22 0 25 0 0 0 0 0 18 0 92% 0 0 China, Zheijiang Prov. Lab/CCDC 40 8 0 2 0 0 0 0 0 8 1 70% 0 0 Lao PDR RITM 6 0 0 0 0 0 0 0 0 0 0 0% 0 0 Malaysia IMR/VIDRL 330 0 0 0 0 0 0 0 0 0 0 48% 3 0 Mongolia NCPH 2 0 0 0 0 0 0 0 0 0 0 0% 0 0 New Zealand IESR 80 4 0 0 0 0 0 0 0 4 0 90% 0 0 Philippines RITM 614 37 0 17 0 0 0 0 0 45 0 15% 0 0 Viet Nam NIHE 124 0 0 0 0 0 0 0 0 0 0 2% 0 0 Total 1847 259 0 227 0 0 0 0 0 358 2 33% 3 0 Pending ITD Discordant pending sequencingType 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates NPEV (%) Wild Sabin VDPV Wild Sabin VDPV Wild Sabin VDPV Australia VIDRL 38 10 0 1 0 0 0 1 0 8 0 87% 3 0 Cambodia RITM 32 2 0 0 0 0 0 0 0 2 0 47% 0 0 China (total) 411 197 0 219 1 0 0 0 0 332 0 60% 2 0 China, Anui Prov. Lab/CCDC 36 28 0 46 0 0 0 0 0 45 0 81% 0 0 China, Fujian Prov. Lab/CCDC 42 14 0 3 0 0 0 0 0 19 0 81% 2 0 China, Gansu Prov. Lab/CCDC 46 19 0 11 0 0 0 0 0 44 0 26% 0 0 China, Guangdong Prov. Lab/CCDC 40 33 0 36 1 0 0 0 0 59 0 80% 0 0 China, Guangxi Prov. Lab/CCDC 28 9 0 5 0 0 0 0 0 4 0 82% 0 0 China, Heilongjiang Prov. Lab/CCDC 12 2 0 0 0 0 0 0 0 3 0 0% 0 0 China, Jiangxi Prov. Lab/CCDC 21 3 0 0 0 0 0 0 0 3 0 43% 0 0 China, Jiangsu Prov. Lab/CCDC 14 5 0 6 0 0 0 0 0 3 0 7% 0 0 China, Liaoning Prov. Lab/CCDC 40 21 0 28 0 0 0 0 0 44 0 63% 0 0 China, Neimongol Prov. Lab/CCDC 10 7 0 6 0 0 0 0 0 16 0 0% 0 0 China, Ninxia Prov. Lab/CCDC 18 13 0 36 0 0 0 0 0 31 0 89% 0 0 China, Qinghai Prov. Lab/CCDC 9 6 0 9 0 0 0 0 0 16 0 44% 0 0 China, Shaanxi Prov. Lab/CCDC 0 - - - - - - - - - - - China, Shandong Prov. Lab/CCDC 24 15 0 24 0 0 0 0 0 16 0 63% 0 0 China, Shanghai Prov. Lab/CCDC 18 0 0 0 0 0 0 0 0 0 0 28% 0 0 China, Xinjiang Prov. Lab/CCDC 12 9 0 4 0 0 0 0 0 15 0 42% 0 0 China, Yunnan Prov. Lab/CCDC 18 9 0 5 0 0 0 0 0 10 0 83% 0 0 China, Zheijiang Prov. Lab/CCDC 23 4 0 0 0 0 0 0 0 4 0 96% 0 0 Lao PDR RITM 26 0 0 0 0 0 0 0 0 0 0 0% 12 0 Malaysia IMR/VIDRL 292 0 0 0 0 0 0 0 0 0 0 55% 19 0 Mongolia NCPH 16 0 0 0 0 0 0 0 0 0 0 29% 3 0 New Zealand IESR 52 1 0 0 0 0 0 0 0 1 0 94% 0 0 Papua New Guinea RITM 27 2 0 0 0 0 0 0 0 2 0 89% 0 0 Philippines RITM 573 20 0 8 0 0 0 0 0 32 0 27% 2 0 Viet Nam NIHE 0 - - - - - - - - - - - - - Total 1467 232 0 228 1 0 0 1 0 377 0 47% 41 0 Pending ITD Discordant pending sequencingType 1 Type 2 Type 3Country/area Intratypic differentiation lab 2 Total number of samples processed Total number of samples with polio isolates Polio isolates NPEV (%) Figure 5B. China Figure 5C. Malaysia Figure 5D. Papua New Guinea Figure 5E. Philippines 1. Prefix letter refers to the VDPV category: “cVDPV” = circulating VDPV, “iVDPV” = immunodeficiency-associated VDPV, “aVDPV” = ambiguous VDPV. Suffix number refers to the poliovirus serotype (types 1, 2 or 3) 2. Community and healthy children 3. Contact of a different AFP case Vaccine-derived polio virus1 identified from laboratory testing, 2018–2024 0 2 4 6 8 10 12 14 16 cVDPV1 cVDPV2 cVDPV1 cVDPV2 aVDPV2 aVDPV3 2019 2020 N o . o f ca se s/ sp e ci m e n s 0 5 10 15 20 25 30 35 40 45 cVDPV1 2018 No . o f c ase s/s pe cim en s 0 5 10 15 20 25 30 35 40 cVDPV1 cVDPV2 iVDPV2 aVDPV2 cVDPV2 aVDPV2 2019 2020 N o . o f c a se s/ sp e c im e n s 9 Polio Bulletin 0 1 2 3 4 5 cVDPV2 iVDPV3 aVDPV3 cVDPV2 aVDPV3 aVDPV1 cVDPV3 aVDPV3 aVDPV1 cVDPV3 aVDPV3 iVDPV3 aVDPV1 aVDPV1 aVDPV3 iVDPV3 aVDPV1 aVDPV3 2018 2019 2020 2021 2022 2023 2024 N o . o f ca se s/ sp e ci m e n s Figure 5A. Australia 0 1 2 3 aVDPV2 2024 N o . o f ca se s/ sp e ci m e n s