Polio Bulletin 2013 Issue No Week 50 (as of 17 December 2013)

Transcription

1 2013 Issue No Week 50 (as of 17 December 2013) HIGHLIGHTS China moving forward in Polio End Game Strategy Plan Today, 17 December 2013, China Food and Drug Administration (CFDA) has conveyed an international workshop on scientific review of sipv vaccine developed in China. This meeting is gathering key participants from relevant departments of CFDA, National Health and Family Planning Commission (NHFPC), representatives from National Technical Advisory Group, Chinese manufacturers, World Health Organization representatives from all levels of the Organization, US CDC, as well as external regulatory experts from other countries. China had initiated the development of sipv vaccine several decades ago anticipating the global eradication era. China has its last endemic wild poliovirus (WPV) case in 1994 and was declared Polio-free as part of the Western Pacific Region in Since 1994, China has experimented on four importations, the largest and latest in 2011, a WPV type 1 importation that resulted in an outbreak that the Government successfully controlled within 3 months, reaching the lowest time ever recorded in polio history. This was possible because of a very efficient and coordinated multi-sectoral approach. Following the latest 66th World Health Assembly held in 2013, the Polio Eradication End Game Strategy Plan for was endorsed. As a result, China NHFPC and CFDA representatives have intensified their efforts to discuss with a larger audience their perspectives in upcoming IPV vaccine introduction within their routine programme. This discussion is timely and crucial in the national, regional and current global context of the vaccine switch noting that China is the most populated country in the world. CONTACT US Expanded Programme on Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Phone: Fax: , WPR_EPIdata@wpro.who.int Web: Non-polio AFP rate Chart 1. Non-polio AFP rate and adequate specimen collection rate, Chart 3. Polio immunization status of AFP, doses 1-2 doses 0 doses Unknown Cases with adequate specimens (%) Chart 2. Percent with pending classification > 90 days after onset, 2013 Chart 4. Percentage of samples received at the lab 3 days of collection, 2013 NOTES: 1. 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). 2. Non-polio AFP rate for 2013 is annualized as of polio week 50. CHN KHM LAO MYS PHL PNG VNM 4.3% % 11.1% % 24.8% 5% 1 15% 25% 3 54% 1% 58% 22% 43%

2 Table 1. Classification of AFP with onset in 2013 and key surveillance indicators 2012 Classification 2013 Indicators Annual expected <15 years of age Confirmed wild poliovirus Poliocompatible Vaccinederived poliovirus () Discarded (Non-polio) > 90 days 1 # (%) Non-polio AFP rate 2 % with adequate specimens 3 % with any specimen 4 % investigated 2 days of notification 5 % with 60-day follow-up 6 Latest report date Days since last report 7 1 Australia (0.) % 73% 09-Dec-13 8 Brunei Darussalam (0.) Aug Cambodia (6.1%) % 95% 71% 25-Nov China (6.) % 99% 85% 11-Dec-13 6 Hong Kong (China) (0.) Dec Japan Lao People's Democratic Republic (11.1%) % 86% 23% 04-Nov Macao (China) (0.) Nov Malaysia (4.3%) % 76% 59% 07-Dec Mongolia (0.) Dec-13 8 New Zealand (0.) Nov Papua New Guinea (20.) % 85% 85% 88% 10-Dec-13 7 Philippines (24.8%) % 93% 97% 45% 06-Dec Republic of Korea (35.2%) % 98% 67% 17-Sep Singapore (0.) % 86% 02-Dec Viet Nam (23.3%) % 99% 89% 29-Oct Pacific island countries (28.6%) % 09-Dec (8.) % 98% 7 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. Annualized non-polio AFP rate per population under 15 years of age Yellow Nearly reached target: for non-polio AFP rate; 60 79% for other indicators 3. Percentage of with two stool specimens collected 24 hours apart and within 14 days of onset of paralysis Red Substantially below target 4. Percentage of with at least one specimen 5. Percentage of investigated within two days of notification 6. Percentage of with inadequate specimens followed-up within 60 days of onset of paralysis 7. Countries are expected to submit data at least once per month to WPRO 2

3 Country National polio laboratory 1 no. of AFP with specimens L20B Table 2. Laboratory investigation of AFP with onset in 2013 and key laboratory indicators L20B + NPEV NPEV only Virus isolation results Negative 14 days > 14 days % results 14 days 2 % specimens for NPEV Latest report date Intratypic differentiation / Sequencing lab 1 No. of Type 1 isolates referred Wild Sabin Australia VIDRL Nov-13 VIDRL Brunei Darussalam VIDRL Nov-13 VIDRL Papua New Guinea VIDRL % 12-Nov-13 VIDRL Pacific island countries VIDRL Nov-13 VIDRL Japan NIID NIID Cambodia NIID % 23% 10-Dec-13 NIID Lao People's Democratic Republic NIID % 19% 26-Nov-13 NIID Malaysia IMR % 4% 12-Nov-13 IMR Mongolia PHI % 09-Dec-13 NIID New Zealand IESR % 02-Dec-13 IESR Philippines RITM % 1 16-Dec-13 VIDRL Republic of Korea NIH Nov-13 NIID Singapore SGH Dec-13 SGH Viet Nam, North NIHE % 14% 13-Dec-13 NIID Viet Nam, South PI % 9% 13-Dec-13 NIID China CCDC % 1% 11-Dec China, Anhui Prov. Lab % Prov. Lab China, Beijing Prov. Lab % Prov. Lab China, Fujian Prov. Lab % Prov. Lab China, Gansu Prov. Lab % 1% Prov. Lab China, Guangdong Prov. Lab % 4% Prov. Lab China, Guangxi Prov. Lab % 5% Prov. Lab China, Hebei Prov. Lab % Prov. Lab China, Heilongjiang Prov. Lab % Prov. Lab China, Henan Prov. Lab % 1% Prov. Lab China, Hunan Prov. Lab % Prov. Lab China, Jiangsu Prov. Lab % Prov. Lab China, Jiangxi Prov. Lab Prov. Lab China, Jilin Prov. Lab % Prov. Lab China, Shaanxi Prov. Lab Prov. Lab China, Shandong Prov. Lab Prov. Lab China, Shanghai Prov. Lab % Prov. Lab China, Shanxi Prov. Lab % Prov. Lab China, Sichuan Prov. Lab % 1% Prov. Lab China, Tianjin Prov. Lab % Prov. Lab China, Xinjiang Prov. Lab % Prov. Lab China, Yunnan Prov. Lab % Prov. Lab China, Zhejiang Prov. Lab Prov. Lab China, Chongqing Prov. Lab % 3% CCDC China, Guizhou Prov. Lab % CCDC China, Hainan Prov. Lab % CCDC China, Hubei Prov. Lab % CCDC China, Liaoning Prov. Lab % 2% CCDC China, Neimongol Prov. Lab % CCDC China, Ningxia Prov. Lab % CCDC China, Qinghai Prov. Lab % CCDC China, Tibet Prov. Lab % CCDC Hong Kong (China) PHLC % 14-Dec-13 PHLC Macao (China) PHLC Dec-13 PHLC % 3% 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, Hong Kong); 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. The target of 14 days for the timeliness of virus isolation will be used for all polio laboratories 3. NPEV growing in L20B cells 4. Twenty-two provincial laboratories in China perform from 2013 Wild Type 2 Sabin Intratypic differentiation () results Type 3 Wild Sabin NPEV 3 Non-EV Discordant pending sequencing % results 7 days of receipt 3

4 Country Table 3. Laboratory confirmation of polio isolates from other sources in Non-AFP Environmental samples Intratypic number number number differentiation Type 1 Type 2 Type 3 NPEV Discordant number of non-afp of non-afp tested with grown Non-EV Type 1 Type 2 Type 3 NPEV pending of samples of samples lab 2 grown Non-EV with polio for polio polio isolates Wild Sabin Wild Sabin Wild Sabin in L20B sequencing processed Wild Sabin Wild Sabin Wild Sabin in L20B isolates Australia VIDRL Japan NIID Malaysia IMR Mongolia PHI New Zealand IESR Philippines VIDRL Republic of Korea NIID Singapore SGH Viet Nam, North NIID Viet Nam, South NIID China (total) China, Anhui Prov. Lab China, Beijing Prov. Lab China, Fujian Prov. Lab China, Gansu Prov. Lab China, Guangdong Prov. Lab China, Guangxi Prov. Lab China, Hebei Prov. Lab China, Heilongjiang Prov. Lab China, Henan Prov. Lab China, Hunan Prov. Lab China, Jiangsu Prov. Lab China, Jiangxi Prov. Lab China, Jilin Prov. Lab China, Shaanxi Prov. Lab China, Shandong Prov. Lab China, Shanghai Prov. Lab China, Shanxi Prov. Lab China, Sichuan Prov. Lab China, Tianjin Prov. Lab China, Xinjiang Prov. Lab China, Yunnan Prov. Lab China, Zhejiang Prov. Lab China, Chongqing CCDC China, Guizhou CCDC China, Hainan CCDC China, Hubei CCDC China, Liaoning CCDC China, Neimongol CCDC China, Ningxia CCDC China, Qinghai CCDC China, Tibet CCDC Hong Kong (China) PHLC 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); NIID (National Institute of Infectious Diseases, Japan); PHI (Public Health Institute, Mongolia); PHLC (Public Health Laboratory Center, Hong Kong); SGH (Singapore General Hospital); VIDRL (Victorian Infectious Diseases Reference Laboratory, Australia) Discordant pending sequencing 4

5 Table 4. Vaccine-derived poliovirus, Country Cambodia c3 (1 case) c3 (1 case) China Hong Kong (China) a1 (1 case) i1 (1 case) a3 (1 case) a1 (1 case) a3 (1 case) c1 (2 )?1 (4 )?2 (1 case) i2 (1 case)?? (3 ) a1 (1 case) a1 (3 )?1 (7 )?1 (1 case) 3 (1 case) a2 (1 case) a2 (5 ) a3 (2 ) a1 (1 case) a2 (3 ) c2 (2 ) i2 (2 ) i3 (1 case) a1 (1 case) a2 (2 ) c2 (3 ) i2 (1 case) i3 (1 case) a2 (1 case) i2 (1 case) i3 (1 case) Japan?? (1 case)?3 (1 case) Lao People's Democratic Republic Mongolia?? (1 case) a2 (1 case)?? (2 ) Philippines c1 (3 ) Viet Nam a2 (2 ) 5