Progress Toward Poliomyelitis Eradication - Pakistan, January 2015-September 2016

Area of Science:

• Public Health
• Epidemiology
• Virology

Background:

• Wild poliovirus type 1 (WPV1) transmission persists endemically in Pakistan, Afghanistan, and Nigeria.
• Polio eradication efforts are ongoing globally, with a focus on countries with continued endemic transmission.

Purpose of the Study:

• To describe the activities, challenges, and progress toward polio eradication in Pakistan from January 2015 to September 2016.
• To update previous reports on WPV1 transmission and control in Pakistan.

Main Methods:

• Analysis of WPV1 case data reported in Pakistan for 2015 and 2016 (up to November 1).
• Review of environmental sampling data for WPV1 detection from January-September 2015 and 2016.
• Assessment of the implementation and impact of the National Emergency Action Plan (NEAP).

Main Results:

• WPV1 cases in Pakistan decreased by 82% in 2015 (54 cases) and by 61% in the first 10 months of 2016 (15 cases) compared to the same periods in prior years.
• WPV1 was detected in 9% of environmental samples in January-September 2016, down from 19% in the same period of 2015.
• The majority of 2016 WPV1 cases occurred in children under 36 months, with some having received only one dose of oral poliovirus vaccine (OPV).
• Khyber Pakhtunkhwa (KP) province reported the highest number of WPV1 cases in 2016.

Conclusions:

• The National Emergency Action Plan (NEAP) has led to a substantial reduction in WPV1 circulation in Pakistan.
• Despite progress, WPV1 detection in high-risk areas and environmental samples necessitates improved supplemental immunization activities (SIAs) and acute flaccid paralysis (AFP) surveillance.
• Continued and refined strategies, including community-based vaccination and rapid response, are essential to halt WPV1 transmission.