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Abstract:
Since May 1999, 86 cases of acute flaccid paralysis (AFP) have been reported in Iraq. Sixteen cases with onset during May-July have been confirmed as paralytic poliomyelitis by isolation of wild poliovirus type 1; the remaining cases are either negative, pending virus isolation (n=10), or positive for type 1 poliovirus with intratypic differentiation pending (n=nine). The first confirmed case occurred in a person residing in Ninevah governorate in the northern part of the country; subsequently, confirmed cases were reported from nine of the 18 governorates in Iraq, suggesting widespread transmission of poliovirus. Before this outbreak, the last confirmed cases of wild polioviruses occurred in Iraq during April-May 1997.
Insights
Iraq reported 86 acute flaccid paralysis cases since May 1999. Wild poliovirus type 1 was confirmed in 16 cases, indicating widespread transmission and a resurgence of polio in the region.
Area of Science:
- Epidemiology
- Virology
- Public Health
Background:
- Iraq experienced an outbreak of acute flaccid paralysis (AFP) starting in May 1999.
- The last confirmed wild poliovirus cases in Iraq were reported in April-May 1997.
Purpose of the Study:
- To report on the initial findings of the 1999 polio outbreak in Iraq.
- To identify the causative agent and assess the geographical spread of the paralysis cases.
Main Methods:
- Clinical case reporting of acute flaccid paralysis (AFP).
- Laboratory confirmation of poliovirus isolation from stool samples.
- Intratypic differentiation for poliovirus characterization.
Main Results:
- Eighty-six cases of AFP were reported by May 1999.
- Sixteen cases were confirmed as paralytic poliomyelitis due to wild poliovirus type 1.
- Confirmed cases were identified across nine of Iraq's 18 governorates, suggesting extensive transmission.
Conclusions:
- The 1999 outbreak signifies a re-emergence of wild poliovirus type 1 in Iraq.
- Widespread transmission necessitates urgent public health interventions to control the polio outbreak.