Another casualty of vaccine hesitancy: Philippines declares polio outbreak - Devex
Another casualty of vaccine hesitancy: Philippines declares polio outbreak - Devex |
- Another casualty of vaccine hesitancy: Philippines declares polio outbreak - Devex
- Polio Outbreak Declared in the Philippines - Contagionlive.com
- UNICEF-WHO Philippines: Polio Outbreak Situation Report #1 (19 September 2019) - Philippines - ReliefWeb
- Circulating vaccine-derived poliovirus type 2 – Republic of Ghana - Ghana - ReliefWeb
| Another casualty of vaccine hesitancy: Philippines declares polio outbreak - Devex Posted: 19 Sep 2019 05:30 AM PDT  MANILA — The World Health Organization has raised concerns with the declaration of a polio outbreak in the Philippines. The country has been wild poliovirus-free for nearly two decades. "We are very concerned that polioviruses are now circulating in Manila, Davao, and Lanao del Sur," said Rabindra Abeyasinghe, WHO representative in the Philippines. The U.N. agency is working closely with the Philippines' Department of Health and UNICEF on surveillance and responding to the outbreak, according to a news release. The announcement came after the Department of Health confirmed that a 3-year-old girl from Lanao Del Sur, a province in Mindanao, had tested positive for the virus. The virus was also found from samples taken in Manila's sewage system, and waterways in Davao. The outbreak was confirmed to come from circulating vaccine-derived poliovirus type 2, which can cause paralysis. Type 2 was declared eradicated globally in 2015. While the oral polio vaccine has been deemed safe and effective, it contains a weakened form of the virus to help build a child's immune response. But even this low dose of the virus can spread in a community with poor sanitation and hygiene, and circulate in populations with poor and low immunization rates. WHO says that the longer the virus circulates, the more changes it undergoes, which, in "rare" instances, could lead to vaccine-derived poliovirus. The outbreak comes as the country is battling a measles and dengue outbreak. Early this year, DOH identified vaccine hesitancy as one of the reasons for the measles outbreak in some regions. Data collected at that time — from Jan. 1 to Feb. 9 — showed that of the reported 4,302 cases, 66% had no history of measles vaccination. Of the 70 who died, 79% had no history of vaccination. One of the contributors to the public's mistrust in vaccines was the controversy around the vaccine, Dengvaxia. In 2017, DOH suspended dengue vaccination programs in the country after Sanofi Pasteur, the vaccines division of global pharmaceutical company Sanofi, reported that children who received the vaccine, but did not have any previous dengue infection, could be at potential risk of acquiring the disease. Soon after, news reports started linking the deaths of children to the vaccine. This created hysteria in the country, leaving parents wary of vaccinating their children despite no confirmation of deaths linked to the vaccine to date. Vaccine hesitancy is one of the contributing factors to the current polio outbreak, WHO's Abeyasinghe told Devex. Get development's most important headlines in your inbox every day. Thanks for subscribing! "The Philippines has been at high risk for poliovirus transmission for several years due to a number of factors, one of which is vaccine hesitancy," he said. In 2017, Abeyasinghe said coverage for three doses of oral polio vaccine for children below 1-year-old was at 71%, but dropped to 66% in 2018, the lowest in the past five years — one in every three children is not completing the required three doses. WHO Philippine representative Abeyasinghe said to stop the spread of diseases, at least 95% of children need to be vaccinated in the country. Other potential contributing factors include weak surveillance system for acute flaccid paralysis, a rare but serious condition affecting the nervous system, which is key to detecting polio; poor sanitation and lack of access to safe water. Gaps in the health system could also have contributed to the situation. "Lack of human resources, challenges for certain groups to access health services, and vaccine stock outs continue to challenge the immunization programme," Abeyasinghe said. All children under 5-years-old should receive the vaccine, "even if they have had it before," he said. "Everyone, whether covered by the mass vaccination campaign or not, should ensure that children have received three doses of OPV and one dose of IPV as part of routine childhood immunization," he added. Papua New Guinea also experienced a resurgence in polio cases in 2018, after 18 years of being polio-free. Amelia Christie, CEO of RESULTS Australia, told Devex the polio resurgence in the region shows just how important it is for the health community to remain vigilant and continue to invest in polio eradication efforts. "We need to really make sure that people are getting the vaccinations they need for polio, but also for other diseases as well that are preventable. And it also shows that we still really need to invest in the … Global Polio Eradication Initiative," she said. GPEI is supporting the Philippine government's response to the outbreak, according to the joint WHO and UNICEF news release. Lisa Cornish contributed reporting to this story.  |
| Polio Outbreak Declared in the Philippines - Contagionlive.com Posted: 20 Sep 2019 08:06 AM PDT  The case was confirmed in a 3-year-old girl who presented with symptoms of acute flaccid paralysis on September 16. Tests confirmed that the child had vaccine-derived polio virus type 2 (VDPV2). Environmental samples from sewage in Manila and waterways in Davao were confirmed to also contain the virus. VDPV2 was isolated from 2 of the environmental samples and genetically linked to isolates from the child. As a result, VDVP2 was classified as circulating. The last known case of wild poliovirus recorded in the Philippines was in 1993. The country was declared wild polio-free in 2000 along with the rest of the World Health Organization's (WHO) Western Pacific Region. "We are very concerned that polioviruses are now circulating in Manila, Davao, and Lanao del Sur," Rabindra Abeyasinghe, a WHO representative in the Philippines, said in the statement. "WHO and UNICEF are working closely with the Department of Health to strengthen surveillance and swiftly respond to this outbreak. We urge all parents and caregivers of children under 5 years of age to have them vaccinated so that they are protected against polio for life." According to a situation report issued by the WHO and UNICEF, wild poliovirus type 2 was certified as globally eradicated in 2015. Children become susceptible to polioviruses—both vaccine-derived or wild-type—when immunization activities are not conducted properly or too few children receive all 3 required doses of the vaccine. Full immunization provides protection for both forms of the virus. Polio vaccination coverage has been steadily declining in the Philippines over the past few years. In order to half the spread of polio, at least 95% of children under the age of 5 years need to be fully vaccinated. Prior to the outbreak declaration, the DOH launched a polio immunization campaign and indicates that further mass polio vaccination rounds will be rolled out in October. In April 2016, the trivalent oral polio vaccine was withdrawn and replaced with the bivalent oral polio vaccine (bOPV) as part of the Global Polio Eradication Initiative. This change removed the type 2 component (OPV2) from immunization programs due to the continued emergence of type 2 VDPVs, despite eradication of wild polio virus type 2 in 1999. In August when environmental samples in Manila tested positive for VDVP1, a synchronized vaccination campaign was launched and immunized 53.8% of targeted children aged 0-59 months with bOPV between August 19-31. In 2018, the estimated vaccination coverage for children under 1 year with 3 doses of bOPV was 66%. Coverage for the inactivated poliovirus vaccine has been below 50% since it was first introduced in 2016 and is currently at 23% for 2019. "The outbreak calls for urgent action to protect more children from being infected. It reminds us of the importance of increasing immunization coverage to 95% of children to stop polio virus transmission in the Philippines," UNICEF Philippines representative Oyun Dendevnorov said in the statement. To stay informed on the latest in infectious disease news and developments, please sign up for our weekly newsletter.  |
| Posted: 19 Sep 2019 03:04 AM PDT   Highlights
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| Circulating vaccine-derived poliovirus type 2 – Republic of Ghana - Ghana - ReliefWeb Posted: 06 Sep 2019 12:00 AM PDT  In Nigeria and West Africa, a cVDPV2 outbreak originating from Jigawa state, Nigeria, continues to spread. In Ghana, cVDPV2 was isolated from an acute flaccid paralysis (AFP) case in Ando-Nyamanu, Chereponi district, Northern Region, bordering Togo. The case was a two-year old girl who had experienced onset of paralysis on 27 July 2019. Stool samples were taken on 27 and 28 July 2019, and sent to the National Polio Laboratory at the Noguchi Memorial Institute for Medical Research for further laboratory investigations. The sample tested positive for cVDPV2 on 17 August 2019. Sequencing of the sample from the AFP case revealed 25 nucleotide differences compared to the reference Sabin 2 and 6 nucleotides, with the closest sequencing match made with an AFP case originating from Jigsaw state, Nigeria from 2018. Earlier, a related cVDPV2 strain had been isolated from an environmental sample, collected on 11 June 2019, from Northern Region in Ghana. Both isolated viruses were linked to an outbreak originating in Jigawa, Nigeria, in 2018. In the past, this same strain had spread within Nigeria, and internationally to the Republic of Niger, Benin, and Cameroon. The last indigenous wild poliovirus was reported in 2000. This is the first ever reported cVDPV2 outbreak reported in the country. Public health response The Ministry of Health has declared detection of this virus to be a national public health emergency, in line with temporary recommendations issued by the International Health Regulations Emergency Committee regarding the international spread of poliovirus. The Ministry of Health and its Partners are working to urgently stop the outbreak and prevent further spread. An emergency meeting with key stakeholders and partners of the Global Polio Eradication Initiative (GPEI) was held on the 19 August 2019 to discuss response measures. In response to this, the Ministry of Health / Ghana Health Service has taken these immediate actions:
WHO risk assessment Given cross-border population movements with Nigeria and across West Africa, as well as subnational immunity and surveillance gaps, West Africa is considered at high-risk for further transmission and international spread of the isolated cVDPV2 across the region. WHO advice It is important that all countries, in particular those with frequent travel and contacts with polio-affected countries and areas, strengthen surveillance for AFP cases in order to rapidly detect any new virus importation and to facilitate a rapid response. Countries, territories and areas should also maintain uniformly high routine immunization coverage at the district level to minimize the consequences of any new virus introduction. WHO's International Travel and Health recommends that all travellers to polio-affected areas be fully vaccinated against polio. Residents (and visitors for more than 4 weeks) from infected areas should receive an additional dose of OPV or inactivated polio vaccine (IPV) within 4 weeks to 12 months of travel. As per the advice of the Emergency Committee convened under the International Health Regulations (2005), efforts to limit the international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC). Countries affected by poliovirus transmission is subject to Temporary Recommendations. To comply with the Temporary Recommendations issued under the PHEIC, any country infected by poliovirus should declare the outbreak as a national public health emergency and consider vaccination of all international travellers.  |
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