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Somalia

Somalia Weekly Polio Update: Week 47, 2019

Attachments

• The Somalia Polio Programme has not confirmed any new cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) in children with acute flaccid paralysis (AFP) since 8 May 2019.

• The last case of circulating vaccine-derived poliovirus type 3 (cVDPV3) in a child with AFP was detected and confirmed on 7 September 2018.

• A total of three cVDPV2 cases have been reported in Somalia across 2019.

• In total, 15 children with polio have been detected in Somalia since the onset of the ongoing concurrent cVDPV2 and cVDPV3 outbreaks in 2017.

• During the week of 47, one PV2 isolate (SOM-TOG-ANB-19-002) was reported from Ainabo district in Togdher region. The stool sample of this case has been sent to lab for further investigation.

Latest activities

Integrated measles and polio campaign

An integrated measles and polio campaign was conducted from 24 to 28 November in the federal states of Banaadir, Galguduud, Hirshabelle, Jubaland and South West State in Somalia. The preliminary data from the five-day campaign shows that a total number of 751 811 children received bOPV vaccine, 671 381 children were vaccinated against measles, 481 332 children received deworming treatment and 666 182 children received vitamin A supplement. Post campaign data has been collected and will be shared during the next weekly update.
In many of the selected districts, there are large numbers of Internally Displaced Persons (IDP) and nomadic communities, with children who may have been missed by previous campaigns.

During week 47, a total of 125 new suspected measles cases were reported across Somalia.
This brings the number of suspected measles cases reported since January 2019 to 3 981.
Of these cases, 78% are among children under the age of five.

Surveillance

Surveillance for Acute Flaccid Paralysis

• As of week 47, a total of 321 children with acute flaccid paralysis (AFP) have been reported by Somalia’s surveillance network during 2019. Of these, 300 children have tested negative for polioviruses, three children have been confirmed positive for the cVDPV2 virus, and 14 stool samples from children with AFP are still undergoing laboratory testing.

• From the 300 stool samples that tested negative for poliovirus, 91 had enteroviruses (EV) present and 19 have tested positive for sabin-like (SL) virus isolation.

• Analysis of reported vaccination history of the 233 children aged 6 – 59 months presenting with non-polio AFP shows that 21% (48) of these children were underimmunized, having received less than three doses of OPV from National Immunization Days and routine EPI combined. Thirty- six (75%) out of 48 under-immunized children are from the access-compromised regions of South and Central zones of Somalia.

• Of the 36 children presenting with AFP who are reported as never having received a polio vaccine, 23 of these children are within the 6 – 59 month age group. Twenty two of these 23 children come from from the access-compromised regions of South and Central zones of Somalia where traditional polio campaign activities are not conducted. This highlights that there are still children with absent or low protection against polio and underlines the need to ensure campaigns reach every child and routine immunization services are invigorated.

Environmental Surveillance

In 2019 to date, 51 sewage samples have been collected from four sites in Mogadishu and sent to the laboratory for testing. Of these, 26 samples have tested negative for polioviruses, 15 samples are confirmed to contain EV; one sample is confirmed to hold an ambiguous strain of vaccine-derived poliovirus (aVDPV); five samples are confirmed to contain Sabin-Like virus (SL3) and four are in the lab. Environmental Surveillance (ES) sampling frequency shifted from once every month to bi-weekly beginning of October 2019.