M i d d l e E a s t

M i d d l e

E a s t

P o l i o Te c h n i c a l B u l l e t i n EMR: Egypt, Iraq, Jordan, Lebanon, Syria, Palestine, Iran EUR: Turkey

Data in WHO as of 18 August 2014 (Week 33) – No. 35

Situation Update As of 18 August 2014 : Syria No new WPV1 cases were reported in the past week. The most recent WPV1 case had onset of paralysis on 21 January 2014, from Salamiyah district, Hama governorate. The total number of laboratory confirmed WPV1 cases for 2014 is ONE, and 35 for 2013. The annualized non-polio AFP rate is 3.0 per 100,000 and the proportion of AFP cases with adequate specimens is 90%. Iraq: No new WPV1 cases were reported in the past week. The most recent WPV1 case had onset of paralysis on 7 April 2014 from Mada'in district, Baghdad-Resafa governorate, in a 34-months old, unvaccinated child. Genetic sequencing indicates the virus is most closely related to virus detected in February 2014 in Sha’b district, Baghdad-Resafa governorate. The total number of WPV1 cases for 2014 is TWO. August polio mass campaign was completed successfully completed in all accessible districts, preliminary data indicate high vaccination coverage in Anbar governorate.

New cases – Summary: 0

Outbreak – Summary: Total number of confirmed cases-2013: 35 Total number of confirmed cases-2014: 3 Most recent confirmed case: Mada'in , Baghdad-Resafa Iraq 7-Apr-14 Index case: Aleppo, Fardous / 14-Jul-13

Duration of outbreak: 38 weeks

Wild poliovirus and Compatible cases in Syrian Arab Republic and Iraq

SIA – Summary: Number of SIAs since Index case: 8 (8 NIDs) in Syria Number of SIAs since last case*: 5 (5 NIDs) in Syria 3 (1 NIDs, 2 SNIDs) in Iraq

Extent of outbreak:

Country

Syria

Iraq

Province No. WPV cases ALEPPO 5 DEIR_AL_ZOUR 25 EDLEB 3 HAMA 1 HASAKEH 2 BAGHDAD-RESAFA 2

*Includes SIAs within 10 days prior to onset. Note that cases are plotted randomly within the boundaries of districts.

1

Summary information As of 18 August 2014

AFP case information: 2013

Syria WPV cases Age

Compatible cases

Iraq

Egypt

Jordan

Lebanon

Palestine (OPT)

Turkey

AFP cases

AFP cases

AFP cases

AFP cases

AFP cases

AFP cases

AFP cases

% 29% 49% 11% 6% 6% 0% 0%

Nb 8 3 0 1 0 0 0 12

% 67% 25% 0% 8% 0% 0% 0%

Nb 30 41 16 32 41 16 4 180

% 17% 23% 9% 18% 23% 9% 2%

Nb 49 86 70 107 96 36 0 444

% 11% 19% 16% 24% 22% 8% 0%

Nb 114 290 179 172 190 62 0 1007

% 11% 29% 18% 17% 19% 6% 0%

Nb 6 1 3 13 7 4 1 35

% 17% 3% 9% 37% 20% 11% 3%

Nb 2 3 9 7 8 4 0 33

% 6% 9% 27% 21% 24% 12% 0%

Nb 2 8 5 8 6 9 0 38

% 5% 21% 13% 21% 16% 24% 0%

Nb 8 20 27 52 59 64 1 231

% 3% 9% 12% 23% 26% 28%

TOTAL

Nb 10 17 4 2 2 0 0 35

Zero-dose 1-3 4-6 7+ UNKNOWN TOTAL

18 16 0 0 1 35

51% 46% 0% 0% 3%

9 2 0 0 1 12

75% 17% 0% 0% 8%

34 40 82 16 8 180

19% 22% 46% 9% 4%

5 69 170 177 23 444

1% 16% 38% 40% 5%

0 30 130 843 4 1007

0% 3% 13% 84% 0%

1 1 15 16 2 35

3% 3% 43% 46% 6%

2 7 24 0 0 33

6% 21% 73% 0% 0%

0 0 29 8 1 38

0% 0% 76% 21% 3%

0 78 133 1 19 231

0% 34% 58% 0% 8%

M F

22 13 35

63% 37%

5 7 12

50% 50%

101 79 180

56% 44%

261 183 444

59% 41%

578 429 1007

57% 43%

22 13 35

63% 37%

28 5 33

85% 15%

15 23 38

39% 61%

138 93 231

60% 40%