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The Wild Poliovirus Threat in East Africa: A 2004-2005 Overview of Risks and Spread

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This report examines the alarming spread of wild poliovirus (WPV) in East Africa during 2004-2005, focusing on threats to Kenya from neighboring countries like Yemen, Sudan, Uganda, and Somalia. It details the potential for WPV importation into Kenya and the risks associated with epidemic outbreaks, including the implications for public health and vaccination campaigns. The document highlights epidemiological data, recent cases in Somalia and Ethiopia, and the coordinated response efforts to mitigate further transmission.

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The Wild Poliovirus Threat in East Africa: A 2004-2005 Overview of Risks and Spread

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  1. Kenya: The Wild Poliovirus Threats

  2. The Siege: Spread of poliovirus in 2004/5 Yemen Sudan Uganda Kenya Tanzania Danger of WP imports to Kenya from Yemen, Somalia, Sudan, Ethiopia and through DRC/Uganda from Angola

  3. The Siege: Risk of Poliovirus spread Yemen Sudan Uganda Kenya Tanzania WPV in Nairobi will spread to all parts of the world

  4. Threats from Sudan

  5. The Sudan Threat: Spread follows the West African Islamic Hajj route to Mecca, Saudi Arabia

  6. The Sudan Threat: Export, Ethiopia July 2005: SUD04-2005720674 SUD-SDA-2004-028 Neyala 13Oct04… ETH-ORO-EHA-05-404 NICD EPL-05-807 E Hararghe 05Jul05 Export, Eritrea, May 2005: SUD04-2005721663 SUD-KAS-2004-016 Kassala 23Nov04… ERI-GAB-GOG-05-013 NICD 635/2005 Gogne 01May05

  7. Epidemiologic Situation / Activities • Last WPV Case – July 2005 • SIAs: The Darfour States (20 – 22 August) coordinated with SIA in Chad • The rest of Sudan (27 August to 29 August) • September 28-30 • Red Sea State/Eritrea Border not covered

  8. Threat from Yemen

  9. The Yemen Threat Exports to Somalia: YEM05-2005725542 YEM-ADN-2005-565-08 Dar Saad 13Jun05 … SOM-BAN-WDB-05-001 NICD 753/2005 Mogadishu S - Wardigley 23Jul05 … SOM-BAN-YQA-05-003 NICD 789/2005 Mogadishu S - Yaqshid 03Aug05 EMRO 23-06-05

  10. Wild polio cases in Yemen in relation to SIAs (As of 07 of September 2005) From 30 of April to 8th of June 05 Before end of April 05 Round 1 April 2005 185 cases 167 cases Round 2 30 May- 1 June 2005 Round 3 12 Jul-14 Jul 2005 From 9th of June to 22 July 05 From 23rd of July to date Last WP Case was in Almahara, Date of Onset 2nd August 2005 96 cases 8 cases EMRO 07-09-05

  11. Threat from Ethiopia

  12. Distribution of Polio Compatible and Confirmed Polio Cases, Ethiopia, 29 Sept 2005 Wild polio case Polio compatible case

  13. Epidemiology • 18 wild poliovirus cases confirmed since December 2004; (17 in 2005) • One new wild poliovirus case this week from East Harerge Zone of Oromia Region • Most recent case had symptom onset, August 12, 2005 • Sequencing of the virus from the first East Harerge cases shows closest match is with virus isolated in 2004 from Red Sea Province of Sudan. • 10 compatible cases • 9 cases with primary isolates pending ITD • Three of 11 Regions (provinces) reporting WPV cases; all P1

  14. Threat from Somalia

  15. Somalia Regions

  16. AFP/Polio cases in Mogadishu, 2005 Map 2

  17. Epidemiologic situation • Population under 15 years is 3,702,266. • Number of AFP cases(169). Their distribution is shown in table 1. • The increase is in the weeks 35-42. • 86 AFP cases were reported from Mogadishu. -12 are confirmed polio cases (all from Banadir). -8 discarded (laboratory negative). -2 pending ITD -64 still pending laboratory results. 46 (70%) of these had fever and asymmetric paralysis.

  18. Epidemiologic situation • More than 50% of cases under 2 years of age. • 50% of them did not receive any dose of OPV (zero dose). • Most of the cases are known chronic refusals. • No clusters seen in other regions.

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