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On May 23, 2019, through the Polio Laboratory Network (GPLN), the WHO received notification of the detection of circulating poliovirus derived from type 2 vaccine (cVDPV2) from the United States. A sample of the environment taken on April 20, 2019 from a hospital in northern Cameroon, on the border with Borno State in Nigeria and Chad. In this region, immunization coverage against inactivated poliomyelitis vaccine (IPV1) and oral polio vaccine (OPV3) was 73% and 72%, respectively. The virus has only been detected in an environmental sample – no case of badociated paralysis has been detected so far.
Genetic sequencing confirms that the isolate is badociated with the current outbreak of cVDPV2 in neighboring Nigeria, which originated in the state of Jigawa and has spread to others. regions of Nigeria, as well as internationally at the Republic of Niger in 2018.
Public health response
The Ministry of Health and local health authorities participated in the response to the VLPV2 epidemic in Nigeria and in the Lake Chad subregion (Cameroon, Niger, Nigeria and Chad) by providing an oral polio vaccine of monovalent type 2 (OPVm2). An in-depth investigation into the incident is underway with support from partners of the Global Polio Eradication Initiative. This includes badessing the extent of circulation of this strain, identifying gaps in immunity, and supporting efforts to strengthen surveillance at the sub-national level.
WHO risk badessment
This event highlights the risk of further international spread of cVDPV2 from Nigeria and the rest of the Lake Chad region, given the large-scale population movement; subnational immunity and surveillance gaps in the Lake Chad region. Detection of this strain of cVDPV2 emphasizes the importance of maintaining routine polio immunization coverage at all levels, to minimize the risks and consequences of any poliovirus circulation.
WHO will continue to support ongoing investigations and risk badessment by national authorities.
Council of the WHO
It is important that all countries, especially those reporting frequent trips to polio-affected countries and areas, strengthen surveillance of acute flaccid paralysis (AFP) in order to quickly detect imported cases and facilitate rapid response. . All countries should maintain high routine immunization coverage at the district level to minimize the impact of the introduction of the new virus.
WHO, International Travel and Health, recommends that all travelers to polio-affected areas be fully immunized against poliomyelitis. Residents (and visitors over 4 weeks old) of infected areas must receive an additional dose of OPV or IPV within 4 weeks to 12 months of travel.
In accordance with the opinion of the Emergency Committee convened under the International Health Regulations (2005), efforts to limit the international spread of poliovirus remain a public health emergency of international concern (PHEIC). Countries affected by poliovirus transmission are subject to temporary recommendations issued under the PHEIC, which states that a poliovirus outbreak must be declared as a national public health emergency and that all international travelers must be vaccinated. Similarly, countries at risk of poliovirus export should ensure vaccination of all international travelers before departure.
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