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Polio: Nigeria’s ‘chronically low immunization coverage’ worries WHO as Mozambique records two wild cases

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ANOTHER case of wild polio virus has been discovered in Mozambique, close to the border of Malawi, in Southeast Africa, the World Health Organization (WHO) revealed on Friday.

The agency also deplored the “chronically low immunization coverage” in Nigeria, which it blamed for the country’s high rate of circulating vaccine-derived poliovirus (cVDPV2) which is being transmitted to neighbouring countries.

The World Health Organization (WHO) said these in a statement released on Friday after the 32nd meeting of its Emergency Committee under the International Health Regulations (2005) (IHR) on the international spread of poliovirus.


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Both cases in Mozambique indicate a single imported event from Pakistan or Afghanistan, and the importation could have occurred between July 2019 and December 2020.

With the cases, Mozambique and Malawi join two other countries with potential risks of polio international transmission – Afghanistan and Pakistan.

WHO certified Africa free of the virus, which had been a scourge on the continent for decades, in August 2020 after Nigeria – the third country in the world with wild poliovirus became free of the disease.

The outbreaks further alerted the continent and the entire globe to increase surveillance and vaccination against the virus.

However, the outbreaks do not affect the polio-free certification status of Africa because they occurred through importation into the continent, WHO stated.

But there could be more trouble for the continent: the circulating vaccine-derived poliovirus (cVDPV2) is spreading fast in 26 African nations, including Nigeria, Chad, Ghana, Benin Burkina Faso, Cameroon, Cote D’Ivoire and the Gambia.

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The cVDPV2 detected in Ghana, Togo, and Côte d’Ivoire could have resulted from a new spread from Nigeria, WHO noted.

“Despite the ongoing decline in the number of cases and lineages circulating, the risk of international spread of cVDPV2 remains high as evidenced by recent spread from Nigeria to West Africa. 

“A large amount of transmission occurring in Nigeria along with chronically low immunization coverage is now resulting in spread to multiple countries, while the detection of cVDPV2 in Eritrea of an orphan virus means that missed transmission has occurred in the Horn of Africa also,” the agency said.

Meanwhile, a multi-country response to the wild poliovirus (1) outbreak continues, with four immunization rounds ongoing in Malawi, Mozambique, Tanzania and Zambia. Zimbabwe will join the response for rounds three and four. 

The committee decried the recent outbreak of WPV1 in the North Waziristan District of Southern Khyber Pakhtunkhwa Province in Pakistan, where the wild poliovirus could have made its way to the border of Mozambique and Malawi, according to the WHO. 

Since the last meeting of the Emergency Committee in February, Pakistan has reported ten WPV1 cases from North Waziristan and two WPV1 positive environmental samples from the neighbouring district of Bannu. 

Meanwhile, the WHO has said the successful introduction of the novel vaccine OPV2 and re-introduction of tOPV (both vaccines) are expected to mitigate the risk of international spread of cVDPV2, particularly as supply issues are resolved in the second half of 2022.

“The committee noted that the rollout of wider use of novel OPV2 continues under EUL. The committee also noted the delays concerning the importance of timely, quality outbreak response with countries avoiding timely response with monovalent OPV2 or trivalent OPV, preferring to wait for novel OPV2 to become available. 

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“The committee noted that SAGE recommends that speed in the rollout of any of these three vaccines is of paramount importance and countries should avoid delays associated with waiting for novel OPV2.”

The WHO defines polio, otherwise known as poliomyelitis, as a highly infectious viral disease that largely affects children under five. The virus is transmitted by person-to-person spread mainly through the faecal-oral route or, less frequently, by a common vehicle and multiplies in the intestine, from where it can invade the nervous system and cause paralysis.

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