Polio Bulletin 2016 Issue No Week 27 (as of 4 July 2016)

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Deborah Randall
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1 2016 Issue No Week 27 (as of 4 July 2016) HIGHLIGHTS The role of data in helping to fight eradicate polio At the heart of the work of the GPEI lie two essential tasks: finding the virus (surveillance) and protecting children against it (immunization). Data is the lifeblood of both, supporting those on the frontline and behind the scenes to do the best job they can. When the virus is isolated, more data is used to assess the numbers of vulnerable children in the affected area to help calculate the amount of vaccines needed to respond. This information is translated into action for vaccinating door to door, to protect every child and interrupt the transmission. In countries with endemic transmission and circulating vaccinederived, data is playing a vital role in defining actions. The programme and the response activities is shifting focus from the number of children reached with vaccines to the number of children missed and left unprotected. Since the end of 2014, almost half a million children who were previously missed have now been protected against polio, partially contributed by this enhanced attention on the most vulnerable. With the success of the unprecedented switch from trivalent to bivalent oral polio vaccine in 155 countries and areas, the world saw evidence of the crucial role played by data. From each and every healthcare center from cities to the most remote rural locations, data was fed up to districts, then countries, regions and finally to the global level to confirm that every vial of the trivalent vaccine had been destroyed and replaced with the bivalent vaccine. Eradicating polio will be one of the greatest achievements in human history, making a positive impact on human health for generations to come. The role of data will be the final one, confirming no single case of virus for three years with good surveillance system in place, enabling us to declare polio finished, once and for all. A video from the Bill and Melinda Gates Foundation has celebrated the role data and information play in the everyday work done by the partners of the Global Polio Eradication Initiative, countries, donors, vaccinators and surveillance officers in their tireless fight against the. Watch it here: CONTACT US Expanded Programme on Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Phone: Fax: , wproepidata@who.int Web: Chart 1. Non-polio AFP rate (per persons < 15 years of age), * * AFP rate annualized as of week CHN KHM LAO MYS PHL PNG VNM 0 Chart 3. Percentage of AFP by number of polio vaccination doses, 2016 CHN KHM LAO MYS PHL PNG VNM 3 doses 1-2 doses 0 doses Unknown Chart 2. Adequate specimen collection rate, Chart 4. Percentage of AFP with pending classification > 90 days after onset, 2016 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) CHN KHM LAO MYS PHL PNG VNM CHN KHM LAO MYS PHL PNG VNM

2 Table 1A. Classification of AFP with onset in 2015 and key surveillance indicators 2015 Classification Indicators 2014 Country/area Annual expected <15 years of age Confirmed wild Vaccinederived () Poliocompatible Discarded (Non-polio) > 90 days 1 # () Non-polio AFP rate with adequate 2 investigated 2 days of notification 3 Latest report date 4 Days since last report Australia (0.0) Feb-16 - Brunei Darussalam (0.0) Feb-16 - Cambodia (0.0) Feb-16 - China (0.0) May-16 - China, Hong Kong SAR (0.0) Feb-16 - China, Macao SAR (0.0) Jan-16 - Japan Lao People's Democratic Republic (0.0) May-16 - Malaysia (0.0) Apr-16 - Mongolia (0.0) Mar-16 - New Zealand (0.0) Apr-16 - Papua New Guinea (0.0) May-16 - Philippines (0.0) Mar-16 - Republic of Korea (0.0) Mar-16 - Singapore (0.0) Feb-16 - Viet Nam (1.3) Jun Pacific island countries and areas (28.6) Jun (0.1) Number () of pending classification more than 90 days from date of onset of paralysis to date of last report Green Reached or surpassed target 2. Percentage of with two stool collected 24 hours apart and within 14 days of onset of paralysis Yellow Nearly reached target: for non-polio AFP rate; for other indicators 3. Percentage of investigated within two days of notification Red Substantially below target 4. Report date is fixed as soon as all for the year have been classified 5. Countries are expected to submit data at least once per month to WPRO 6. Includes three that are 15 years old or older 2

3 Table 1B. Classification of AFP with onset in 2016 and key surveillance indicators 2016 Classification Indicators 2015 Country/area Annual expected <15 years of age Confirmed wild Vaccinederived () Poliocompatible Discarded (Non-polio) > 90 days 1 # () Non-polio AFP rate 2 with adequate 3 investigated 2 days of notification 4 Latest report date Days since last report Australia (20.7) Jun Brunei Darussalam Jun Cambodia (10.0) Jun-16 7 China (8.8) Jun-16 5 China, Hong Kong SAR (0.0) Jun China, Macao SAR (0.0) Jun-16 4 Japan Lao People's Democratic Republic (3.8) Jun Malaysia (18.2) Jun Mongolia (0.0) Jul-16 3 New Zealand (0.0) May Papua New Guinea (0.0) Jun Philippines (7.4) Jun Republic of Korea (0.0) Jun Singapore (0.0) Jun Viet Nam (17.9) Jun Pacific island countries and areas (22.2) Jun (9.2) Number () of pending classification more than 90 days from date of onset of paralysis to date of last report Green Reached or surpassed target 2. Annualized non-polio AFP rate per population under 15 years of age Yellow Nearly reached target: for non-polio AFP rate; for other indicators 3. Percentage of with two stool collected 24 hours apart and within 14 days of onset of paralysis Red Substantially below target 4. Percentage of investigated within two days of notification 5. Countries are expected to submit data at least once per month to WPRO 6. Includes two that are 15 years old or older 3

4 Country/area Polio no. of AFP with Table 2A. Laboratory investigation of stool samples from AFP with onset in 2015 and key laboratory indicators positive positive + only Results of virus isolation for AFP Negative > 14 days results positive for Latest report date Australia VIDRL Mar-16 VIDRL Brunei Darussalam VIDRL Mar-16 VIDRL Cambodia NIID Jan-16 NIID China (total) May China, Anhui Prov. Lab Prov. Lab/CCDC China, Beijing Prov. Lab Prov. Lab/CCDC China, Fujian Prov. Lab Prov. Lab/CCDC China, Gansu Prov. Lab Prov. Lab/CCDC China, Guangdong Prov. Lab Prov. Lab/CCDC China, Guangxi Prov. Lab Prov. Lab/CCDC China, Hebei Prov. Lab Prov. Lab/CCDC China, Heilongjiang Prov. Lab Prov. Lab/CCDC China, Henan Prov. Lab Prov. Lab/CCDC China, Hunan Prov. Lab Prov. Lab/CCDC China, Jiangsu Prov. Lab Prov. Lab/CCDC China, Jiangxi Prov. Lab Prov. Lab/CCDC China, Jilin Prov. Lab Prov. Lab/CCDC China, Shaanxi Prov. Lab Prov. Lab/CCDC China, Shandong Prov. Lab Prov. Lab/CCDC China, Shanghai Prov. Lab Prov. Lab/CCDC China, Shanxi Prov. Lab Prov. Lab/CCDC China, Sichuan Prov. Lab Prov. Lab/CCDC China, Tianjin Prov. Lab Prov. Lab/CCDC China, Xinjiang Prov. Lab Prov. Lab/CCDC China, Yunnan Prov. Lab Prov. Lab/CCDC China, Zhejiang Prov. Lab Prov. Lab/CCDC China, Chongqing Prov. Lab CCDC China, Guizhou Prov. Lab CCDC China, Hainan Prov. Lab CCDC China, Hubei Prov. Lab CCDC China, Liaoning Prov. Lab CCDC China, Neimongol Prov. Lab CCDC China, Ningxia Prov. Lab CCDC China, Qinghai Prov. Lab CCDC China, Tibet Prov. Lab CCDC China, Hong Kong SAR PHLC Jan-16 PHLC China, Macao SAR PHLC Jan-16 PHLC Japan NIID NIID Lao People's Democratic Republic NIID Mar-16 NIID Malaysia IMR Feb-16 IMR Mongolia PHI Jan-16 NIID New Zealand IESR Jan-16 IESR Papua New Guinea VIDRL Feb-16 VIDRL Philippines RITM Mar-16 RITM Republic of Korea NIH Mar-16 NIH Singapore SGH Jan-16 SGH Viet Nam (North) NIHE Jan-16 NIHE Viet Nam (South) PI Feb-16 PI Pacific island countries and areas VIDRL Feb-16 VIDRL CCDC (Chinese Center for Disease Control and Prevention, China); IESR (Institute of Environmental Science and Research, New Zealand); IMR (Institute of Medical Research, Malaysia); NIH (National Institute of Health, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); PHI (Public Health Institute, Mongolia); PHLC (Public Health Laboratory Center, China, Hong Kong SAR); PI (Pasteur Institute, Ho Chi Minh, Viet Nam); RITM (Research Institute for Tropical Medicine, Philippines); SGH (Singapore General Hospital); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) 2. growing in cells Intratypic differentiation/ Sequencing No. of received W ild Results of intratypic differentiation ()/sequencing for virus Type 2 Type 3 Wild W ild 2 Discordant pending sequencing results 7 days of receipt 4

5 Country/area Polio no. of AFP with Table 2B. Laboratory investigation of stool samples from AFP with onset in 2016 and key laboratory indicators positive positive + only Results of virus isolation for AFP Negative > 14 days results positive for Latest report date Australia VIDRL Jun-16 VIDRL Brunei Darussalam VIDRL Jun-16 VIDRL Cambodia NIID May-16 NIID China (total) Jun China, Anhui Prov. Lab Prov. Lab/CCDC China, Beijing Prov. Lab Prov. Lab/CCDC China, Fujian Prov. Lab Prov. Lab/CCDC China, Gansu Prov. Lab Prov. Lab/CCDC China, Guangdong Prov. Lab Prov. Lab/CCDC China, Guangxi Prov. Lab Prov. Lab/CCDC China, Hebei Prov. Lab Prov. Lab/CCDC China, Heilongjiang Prov. Lab Prov. Lab/CCDC China, Henan Prov. Lab Prov. Lab/CCDC China, Hunan Prov. Lab Prov. Lab/CCDC China, Jiangsu Prov. Lab Prov. Lab/CCDC China, Jiangxi Prov. Lab Prov. Lab/CCDC China, Jilin Prov. Lab Prov. Lab/CCDC China, Shaanxi Prov. Lab Prov. Lab/CCDC China, Shandong Prov. Lab Prov. Lab/CCDC China, Shanghai Prov. Lab Prov. Lab/CCDC China, Shanxi Prov. Lab Prov. Lab/CCDC China, Sichuan Prov. Lab Prov. Lab/CCDC China, Tianjin Prov. Lab Prov. Lab/CCDC China, Xinjiang Prov. Lab Prov. Lab/CCDC China, Yunnan Prov. Lab Prov. Lab/CCDC China, Zhejiang Prov. Lab Prov. Lab/CCDC China, Chongqing Prov. Lab CCDC China, Guizhou Prov. Lab CCDC China, Hainan Prov. Lab CCDC China, Hubei Prov. Lab CCDC China, Liaoning Prov. Lab CCDC China, Neimongol Prov. Lab CCDC China, Ningxia Prov. Lab CCDC China, Qinghai Prov. Lab CCDC China, Tibet Prov. Lab CCDC China, Hong Kong SAR PHLC May-16 PHLC China, Macao SAR PHLC May-16 PHLC Japan NIID NIID Lao People's Democratic Republic NIID Jun-16 NIID Malaysia IMR May-16 IMR Mongolia PHI Jun-16 NIID New Zealand IESR Jun-16 IESR Papua New Guinea VIDRL Jun-16 VIDRL Philippines RITM Jun-16 RITM Republic of Korea NIH Jun-16 NIH Singapore SGH Jul-16 SGH Viet Nam (North) NIHE Jul-16 NIHE Viet Nam (South) PI Jun-16 PI Pacific island countries and areas VIDRL Jun-16 VIDRL CCDC (Chinese Center for Disease Control and Prevention, China); IESR (Institute of Environmental Science and Research, New Zealand); IMR (Institute of Medical Research, Malaysia); NIH (National Institute of Health, Republic of Korea); NIHE (National Institute of Hygiene and Epidemiology, Ha Noi, Viet Nam); NIID (National Institute of Infectious Diseases, Japan); PHI (Public Health Institute, Mongolia); PHLC (Public Health Laboratory Center, China, Hong Kong SAR); PI (Pasteur Institute, Ho Chi Minh, Viet Nam); RITM (Research Institute for Tropical Medicine, Philippines); SGH (Singapore General Hospital); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) 2. growing in cells Intratypic differentiation/ Sequencing No. of received W ild Results of intratypic differentiation ()/sequencing for virus Type 2 Type 3 Wild W ild 2 Discordant pending sequencing results 7 days of receipt 5

6 Table 3. Laboratory confirmation of polio from environmental samples in Polio Polio Intratypic number number Country/area number Discordant number differentiation lab 2 of samples of samples Type 2 Type 3 of samples pending of samples Type 2 Type 3 with polio with polio processed sequencing processed Wild Wild Wild Wild Wild Wild Discordant pending sequencing Australia VIDRL China (total) China, Fujian Prov. Lab/CCDC China, Gansu Prov. Lab/CCDC China, Guangdong Prov. Lab/CCDC China, Guangxi Prov. Lab/CCDC China, Heilongjiang Prov. Lab/CCDC China, Shandong Prov. Lab/CCDC China, Shanghai Prov. Lab/CCDC China, Xinjiang Prov. Lab/CCDC China, Yunnan Prov. Lab/CCDC Malaysia IMR Based on year of collection of sample, if available. Otherwise, based on year of receipt at reference laboratory. 2. CCDC (Chinese Center for Disease Control and Prevention, China); IMR (Institute of Medical Research, Malaysia); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) Cambodia China Table 4. Vaccine-derived identified from laboratory testing 2, Country/area China, Hong Kong SAR a2 (3 AFP + 1 contact + 1 non-afp) a3 (1 AFP + 1 non-afp) a1 (1 AFP) a2 (2 AFP + 1 contact) c2 (2 AFP) i2 (1 AFP + 1 non-afp) i3 (1 AFP) a1 (1 AFP) a2 (2 AFP) c2 (2 AFP + 1 contact) i2 + i3 (1 AFP) a2 (1 non-afp) i2 + i3 (1 AFP) a1 (1 non-afp) a2 (2 AFP) i3 (1 AFP) a1 (1 AFP) a2 (1 AFP) i2 (1 AFP) Japan Lao People's Democratic Republic c1 (8 AFP + 21 contacts) c1 (3 AFP + 4 contacts) Mongolia Philippines a2 (1 AFP) Viet Nam a2 (2 AFP) 1. Prefix letter refers to the category: "c" = circulating, "i" = immunodeficiency-associated, "a" = ambiguous, "?" = pending. Suffix number refers to the serotype (types 1, 2 or 3). 2. Source of could be AFP, contacts, or non-afp 3. Refers to year of last case, and aggregate total of for

Polio Bulletin 2018 Issue No Week 25 (as of 26 June 2018)

Polio Bulletin 2018 Issue No Week 25 (as of 26 June 2018) 2018 Issue No. 13 - Week 25 (as of 26 June 2018) HIGHLIGHTS 27th Meeting of the Technical Advisory Group on Immunization and Vaccine-preventable Diseases in the Western Pacific Region 19 22 June 2018 -