Polio Outbreaks 2023

Polio Outbreaks June 2023

The World Health Organization (WHO) confirmed on February 2, 2023, the spread of poliovirus remained a Public Health Emergency of International Concern (PHEIC). And on May 12, 2023, the WHO published its Weekly Epidemiological Record. Additionally, the WHO's International Travel and Health recommends travelers to polio-affected areas be fully vaccinated against polio with doses of oral polio vaccine (OPV) or inactivated polio vaccine (IPV).

The Pan American Health Organization (PAHO) published Epidemiological Update - Poliomyelitis in the Region of the Americas on April 7, 2023. The PAHO/WHO reminds Member States that the risk of the emergence of a circulating vaccine-derived poliovirus type 1 (cVDPV1) or circulating vaccine-derived poliovirus type 3 (cVDPV3) has increased due to low vaccination coverage. In addition, there is a continuing risk of importation of a circulating wild poliovirus type 1 (WPV1) or vaccine-derived poliovirus (VDPV), particularly circulating vaccine-derived poliovirus type 2 (cVDPV2). And countries and territories in the Americas have conditions allowing polio transmission to be maintained, mainly due to low vaccination coverage.

Separately, the U.S. Centers for Disease Control and Prevention (CDC) published Progress Toward Poliomyelitis Eradication on May 12, 2023, confirming circulating vaccine-derived polioviruses were detected in areas where poliovirus had been eliminated, and cocirculation of more than one poliovirus type occurred in multiple countries. Furthermore, the CDC confirmed on March 22, 2023, polio continues to be an international concern and issued a Level 2 Travel Advisory.

Afghanistan Polio Outbreaks 2023

Afghanistan is affected by ongoing endemic wild poliovirus transmission. There have been 18 WPV1-positive environmental samples reported in 2023. Afghanistan detected its initial human polio case in May 2023, according to the Ministry of Health. As of June 2, 2023, local media reported four confirmed polio cases in 2023 from the province of Nangarhar. Two polio patients were confirmed in 2022, four in 2021, and 56 in 2020.

Africa Polio Outbreaks 2023

Similar to recent years, polioviruses paralyzed hundreds of African children in 2022 as countries chose to wait for the nOPV2 vaccine instead of preventing these cases using available Sabin mOPV2, wrote The Lancet on May 10, 2023.

The U.S. CDC included Africa in its Global Polio travel alert issued on March 22, 2023. Circulating poliovirus type 2 is Africa's most prevalent form of polio, with more than 400 cases reported in 14 countries in 2022. In addition, Burundi and Mozambique, and the Democratic Republic of the Congo (DRC) confirmed vaccine breakthrough cases in March 2023. On April 14, 2023, the CDC reported: Update on Wild Poliovirus Type 1 Outbreak, Southeastern Africa, 2021–2022. On March 17, 2023, the Burundi Ministry of Health declared a national public health emergency after reporting the detection of cVDPV2 from one case of AFP and five environmental samples. And the Central African Republic reported seven cVDPB2 cases in 2023 and six in 2022.

A study published on April 6, 2023, reviewed the previous cVDPV2 outbreak in the DRC since 2005. The nine cVDPV2 outbreaks detected during 2005–2012 were geographically limited and resulted in 73 paralysis cases. From January 2017–December 31, 2021, 19 cVDPV2 outbreaks were detected in DRC. Seventeen of the 19 resulted in 235 paralysis cases notified in 18 of DRC's 26 provinces. The DRC-KAS-3 cVDPV2 outbreak that circulated during 2019–2021, and resulted in 101 paralysis cases in 10 provinces, was the largest recorded in DRC.

The DRC is classified by the International Health Regulations (IHR) as a state infected with circulating vaccine-derived poliovirus type 1 (cVDPV1) with the potential risk of international spread and cVDPV2. On May 23, 2023, three cVDPV1 cases were reported; two in Haut Lomami and one in Haut Katanga, bringing the number of 2023 cases to 14 and 2022 cases to 146. And nine cVDPV2 cases were reported; four in Haut Lomami, one each in Haut Katanga, Bas Uele, and Mongala, and two in Kasai Oriental, bringing the number of 2023 cases to 30 and 363 for 2022.

In February 2023, the UN Foundation published recommendations for governments, the WHO, and UNICEF for polio transition priority countries in Africa. Since then, over 33 million children across five southern African countries have been vaccinated against the virus, with over 80 million vaccine doses administered over the past year. In 2021, the median vaccination coverage was 81.5% for the third dose of the polio vaccine. 

European Polio Conference May 2023

The European Polio Conference will be held on 25-27 May in Nancy, France. This congress, organized by Polio-France in cooperation with the European Polio Union, will not be like any other. This congress is aimed at people with polio and post-polio syndrome from all over the world and health professionals concerned with polio and post-polio syndrome management. On March 10, 2023, Member States reiterated the importance of focusing on zero-dose children and strengthening routine immunization and surveillance in countries that are polio-free and those that currently have polioviruses.

India Polio Outbreak

The Times of India reported on May 29, 2023, officials of the health department of Prayagraj launched a polio vaccination program for 8.5 lakh children. National Immunization Days are held across India twice a year, with the Government setting out to give two drops of OPV to every child under five.

Indonesia Polio Outbreak 2023

Despite Indonesia having a strong capacity to respond to poliovirus outbreaks and West Java having a moderate to strong outbreak response capacity to interrupt transmission, there is a high susceptibility of the population to poliovirus type 2 after switching from trivalent to bivalent OPV; sub-optimal IPV coverage in Aceh, West Java and several other provinces in Indonesia; high population mobility between West Java and other areas within Indonesia; and reluctance to vaccinate among at-risk populations. The ongoing polio outbreak in Indonesia poses a high risk at the national level, moderate regional risk, and low global risk as of April 17, 2023.

Israel Polio Outbreak 2023

As of March 7, 2023, there have been reports of (4) VDPV3-positive polio cases in children during 2023. On March 2, 2023, the Israel Ministry of Health (MOH) reported three additional children tested positive for poliovirus on Twitter. On February 27, 2023, the Israel MOH issued an official alert describing a local case of Acute flaccid paralysis (AFP).

In 2022, the Israeli Ministry of Health reported a vaccine-derived poliovirus type 3 (VDPV3) outbreak in sewage in the Jerusalem area and a clinical case of paralysis in a child. In addition, the International Health Regulations National Focal Point for Israel notified the WHO of the detection of the cVDPV3 virus isolated from an AFP case in the Country on March 7, 2022. In response, Isreal launched the Two-Drops OPV vaccination program in April 2022.

The Israel Pediatric Association, the umbrella organization for The Israel Ambulatory Pediatric Association and Israel Society for Clinical Pediatrics — released a position paper in March 2023 outlining what it said were the reasons for the outbreak and the steps needed to curb it. The report noted that the priority was identifying and vaccinating the 175,922 Israeli children who had not received any inactivated polio vaccine (IPV) or OPV doses. Israeli children are advised to receive 5 IPV and 2 OPV doses.

United Kingdom Poliovirus Detections

Between February and June 2022, multiple vaccine-like-type-2 poliovirus isolates were collected from the London Beckton Sewage Treatment Works. The WHO formally confirmed that the UK has a 'circulating' VDPV2 and evidence that the poliovirus detected in London is genetically linked to Israel and New York. The UKHSA National Polio Guidelines outline public health actions when a cVDPV2 is detected in environmental samples.

Pakistan Polio Outbreak 2023

As of March 2023, Pakistan's Polio Eradication Program was actively offering vaccination services. In addition, one WPV1-positive environmental sample was reported in Punjab in 2023. In 2022, there were 20 WPV1 cases reported, and about 14 million children were vaccinated with an OPV. 

Peru Polio Outbreak 2023

In the PAHO/WHO published an update on April 7, 2023, a case of acute flaccid paralysis has been identified in the town of Atahualpa in a child, which is still under investigation. On March 23, 2023, the Peru IHR National Focal Point Polio Update notified a confirmed case of vaccine-derived poliovirus type 1 (acute flaccid paralysis). The case is a 16-month-old child belonging to an indigenous community in the Manseriche district in the Datem del Marañón province of the Loreto department, with no history of vaccination or travel history before the onset of symptoms. 

Polio Vaccines

As of May 2023, various polio vaccines are available worldwide.

Polio Outbreak News 2023

May 12, 2023 - The U.S. CDC confirmed endemic transmission of wild poliovirus type 1 continues only in Afghanistan and Pakistan.

May 12, 2023 - The WHO published - Progress towards polio eradication – worldwide, January 2021–March 2023.

April 20, 2023 - The WHO published Circulating vaccine-derived poliovirus type 2 (cVDPV2) - Burundi.

April 17, 2023 - The WHO published cVDPV2 - Indonesia.

March 22, 2023 - The U.S. CDC updated the Global polio outbreak travel notice.

March 20, 2023 - Africa's polio cases linked to a new oral vaccine.

March 10, 2023 - The New York State Department of Health informed New Yorkers traveling to Israel and other countries with circulating poliovirus to ensure they are fully immunized against polio.

March 7, 2023 - The U.S. CDC reissued its global polio travel alert.

February 12, 2023 - The PolioVaccinationUG campaign in Kampala, Uganda, targeting children aged five years and below, is scheduled for mid-February 2023.

February 2, 2023 - Eurosurveillance reported researchers in The Netherlands described a WPV3 detection in November 2022 in wastewater surveillance surrounding a polio lab in Bilthoven. 

February 1, 2023 - GPEI reported Central African Republic: one cVDPV2 case; Chad: seven cVDPV2 cases and one positive environmental sample; Indonesia: one cVDPV2 case; Nigeria: one cVDPV2 case; Yemen: one cVDPV2 case.

January 25, 2023 - New reports confirmed: Afghanistan: three WPV1 positive environmental samples, Pakistan: one WPV1 positive environmental sample, Botswana: one cVDPV2 positive environmental sample, Canada: two cVDPV2 positive environmental samples, Malawi: one cVDPV1 case, Mozambique: one cVDPV1 case, and Nigeria: six cVDPV2 positive environmental samples.

January 18, 2023 - Summary of new polioviruses this week: Afghanistan: two WPV1 positive environmental samples; Algeria: one cVDPV2 positive environmental sample; Cameroon: one cVDPV2 case; Chad: two cVDPV2 cases; DR Congo: 16 cVDPV1 cases and 19 cVDPV2 cases; Nigeria: one cVDPV2 case; Somalia: one cVDPV2 case; Zambia: two cVDPV2 positive environmental samples.

January 12, 2023 - The WHO published an Outbreak at a Glance - Circulating vaccine-derived poliovirus type 2 - Sudan.