Polio spread in spotlight
The third meeting of the Emergency Committee under the 2005 International Health Regulation regarding the international spread of wild poliovirus in 2014 was convened by the World Health Organization’s (WHO) director-general near the end of last year, during which the following nations submitted an update on the implementation of the Temporary Recommendations since the Committee last met on 31 July 2014: Cameroon, Equatorial Guinea, Pakistan and the Syrian Arab Republic.
The Committee noted that the international spread of wild poliovirus has continued since July 2014, with at least three new exportations from Pakistan into neighbouring Afghanistan. There has been no other documented international spread of wild poliovirus since March 2014.
The WHO commented: “The risk of new international spread from Pakistan was assessed to have increased substantively since 31 July 2014, as cases have escalated during the current high transmission season and there has been no significant improvement in the underlying factors that are driving transmission in the country. The risk of new international spread from the other nine currently infected States appears to have declined, with only two of those States having reported new cases since 31 July: Somalia (one case) and Afghanistan (seven cases, most of which were due to imported virus).”
The Committee remains concerned that implementation of the Temporary Recommendations is still incomplete, especially as immunisation systems have continued to deteriorate in a number of the countries at greatest risk of new importations, particularly those affected by conflict. The Committee concluded that the countries identified at its second meeting as ‘States currently exporting wild poliovirus’ or ‘States infected with wild poliovirus but not currently exporting’ had not met fully the criteria for removing the recommended measures for reducing the risk of international spread of wild poliovirus. These criteria require documentation of the full application of high quality eradication activities in all infected and high-risk areas of these countries and that at least six months have passed without an exportation or, in the case of non-exporting countries, detection of wild poliovirus transmission from any source.
The Committee assessed that the event still constitutes a Public Health Emergency of International Concern and recommended the extension of the Temporary Recommendations for a further three months.