The World Health Organisation Western Pacific Region countries were declared free of polio in 2000 until a polio outbreak involving 305 cases occurred in Indonesia in 2006. It was not until 2014 that the World Health Organisation South East Asia region was officially declared polio-free again. However, in February 2019, the Global Polio Eradication Initiative announced a new circulating vaccine-derived poliovirus outbreak in the Papua province of Indonesia. To make matter worse, the outbreak responses were tardy and led to transmission among migrating communities to other cities. The pressing regional issues of polio outbreak caused by circulating vaccine-derived poliovirus and use of oral polio vaccine have not been well presented. Our letter highlighted the suboptimal outbreak responses as well as the necessity of cross-border vaccination to curb continued poliovirus transmission.
Despite the efforts of national and international organizations, polio has not been eradicated from Pakistan. The prevalence of polio in Pakistan is exceptional in global context. Quetta and Peshawar divisions are amongst the most affected regions hit by polio in Pakistan. This study was carried out to assess the knowledge, attitudes and perceptions towards polio immunization among residents of Quetta and Peshawar divisions in Pakistan.
Introduction: Poliomyelitis is an incapacitating and highly infectious disease which effect mostly young children. It is caused by one of the three serotypes of polioviruses (PV) and transmitted through faecal-oral route hence making the disease quite pertinent to the lower and middle class society or under-immunized population. This surveillance is one of the strategy included by WHO in the “Eradication, Integration and Certification: The Endgame Strategy 2019-2023” as a supplement to AFP surveillance by which it could be more sensitive to detect low circulation of WPV and circulating vaccine derived poliovirus (cVDPV). Methods: Routine collection and testing of representative environmental surveillance are carried out in the National Polio Laboratory. The specimens are collected from designated locations draining target populations at increased risk of poliovirus transmission using the grab method once a month and processed according to WHO standard protocol. Polioviruses were identified by real time reverse transcriptase polymerase chain reaction (rRT-PCR) for intratypic differentiation (ITD) and vaccine derived poliovirus (VDPV) whereas non-polio enteroviruses (NPEVs) were identified by PCR and sequencing. Results: From 2012 to 2019, results showed various isolation of PVs and NPEVs. A total of 12 sewage disposal plants located in urban highly populated areas in Kuala Lumpur (3), Selangor (5), Sabah (3 ) and Negeri Sembilan (1) were investigated. A total of 22 Sabin-like PVs were isolated consisting of 3 PV1, 8 PV2 and 11 PV3 thus indicated that in Malaysia even though PVs were existed in environment, but all of them were Sabin-Like viruses and no evidence of imported WPV or VDPV in the sampling sites. Conclusion: Even though Malaysia has been declared as WPV free country in 2000, Environmental Surveillance is very important and crucial in detecting the introduction and silent circulation of WPV and cVDPV before the virus reaches the community.