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Why Nigeria may record more cases of polio

By Chukwuma Muanya, Assistant Editor (Lagos) and Emeka Anuforo (Abuja)
25 August 2016   |   2:38 am
According to the Global Polio Eradication Initiative (GPEI), the World Health Organisation (WHO) and the United Nation Children’s Fund (UNICEF), a case of polio means that at least 200 other children must have been exposed to the virus.
Polio immunisation

Polio immunisation

• Begins emergency response plan with five extra immunisation activities from Aug. 27 to Nov. 22

It is feared that Nigerian will confirm more cases of Acute Flaccid Paralysis (AFP) caused by the two new cases of Wild Polio Virus (WPV) detected penultimate week in Borno.

Reason: According to the Global Polio Eradication Initiative (GPEI), the World Health Organisation (WHO) and the United Nation Children’s Fund (UNICEF), a case of polio means that at least 200 other children must have been exposed to the virus.

Also, it is believed that as more communities are liberated from insurgency, the country expects that more cases could be reported.

The type one WPV (WPV1) detected from Borno state was isolated in two local government areas (LGA); in Gwoza, in a child with AFP, onset of paralysis on July 13 and close healthy contacts of that child; and in Jere from a close healthy contact of a child who had developed AFP symptoms on July 6.

These were the first WPV1 detected in Nigeria since July 2014. Genetic sequencing of the isolated viruses suggests they are most closely linked to WPV1 last detected in Borno in 2011, indicating the strain has been circulating without detection since that time.

However, an outbreak response plan has begun, focusing on both Nigeria and the Lake Chad sub-region more broadly (specifically parts of Chad, northern Cameroon, southern Niger and Central African Republic).

The GPEI in the latest edition of its Weekly Polio Update, said that an outbreak response plan has begun under the guidance of the Emergency Operations Committee (EOC), led by the Federal Government and with support from WHO and GPEI partners. It noted that detailed field investigations are underway with two investigation teams constituted by the Borno State EOC and deployed to Jere and Gwoza LGAs respectively.

The GPEI noted: “Surveillance is being strengthened. A community case search ongoing, targeting a minimum of 50,000 households around each case. An external surveillance review has begun and will continue until August 26 in five states: Borno, Kano, Kaduna, Sokoto and Federal Capital Territory (FCT).

“An emergency vaccination response is underway from August 15-18. Five subsequent large-scale supplementary immunization activities (SIAs) with bivalent oral polio vaccine (bOPV) are planned, the first one scheduled for August 27-30, and subsequent rounds planned at short intervals of two to three weeks, with the SIAs due to be completed by 22 November.

To guide against the spread of the virus, the Federal Government has approved the revision of the nation’s robust WPV outbreak response plan.

This also follows the destruction of health facilities in some of the previously captured areas limited access to immunization and healthcare.

The new response plan, according to the Minister of Health, Prof. Isaac Adewole, includes five rounds of polio campaigns, three of which are focused on eighteen northern states and two to be conducted nationwide.

The Minister unveiled these plans during a multi-stakeholder briefing in
Abuja on the recent two new cases of Polio reported in Borno.

He said the campaigns would be synchronized with the affected regions and provinces in Chad, Niger, Cameroun, and the Central African

The Minister assured that funds would not be an issue, as the country had enough fund coverage for Polio.

“We have earmarked N9.8 billion for polio and by Monday the entire N9.8 billion will be released.”

Meanwhile, Nigerians going on Hajj to Saudi Arabia are to be immunized against polio ‎as one of the conditions for entering the holy land.

Adewole spoke further on the immunization plans.

His words: “For the sub-national campaigns, 31, 540, 054 children are targeted to be vaccinated each round with oral vaccines across states in the North-East, North-West and North-Central zones of the country. For the nationwide response, 56, 363, 618 children will be vaccinated between October and November 2016.

“The revised plan was informed by factors such as historical data on WPV affected areas, pattern of transmission over the last five years, population displacement due to insecurity in the North-East, likelihood of spread of the virus to other neighbouring countries and population immunity.

“Furthermore, the justification for the expansion of the initial schedule includes the fact that, given previous history of exportation to other countries and the suboptimal routine immunization coverage in several countries in the African region, the response requires that adequate protection be provided to the vulnerable children at risk of infection. Reports from the detailed investigation carried out by our team revealed that both cases came from security compromised areas of Borno State, which have limited access to any form of health services including immunization.”

Adewole noted that the case reported in Jere local government area was from a child who had arrived at an internally displaced persons camp in Maiduguri after trekking for two days following the provision of an escape corridor by the military authorities.