Progress Toward Poliomyelitis Eradication — Afghanistan, January 2019–July 2020
Maureen Martinez, Irfan Elahi Akbar, Mufti Zubair Wadood, Hemant Shukla, Jaume Jorba, Derek Ehrhardt
Abstract
Wild poliovirus type 1 (WPV1) transmission is ongoing only in Afghanistan and Pakistan (1). Following a decline in case numbers during 2013-2016, the number of cases in Afghanistan has increased each year during 2017-2020. This report describes polio eradication activities and progress toward polio eradication in Afghanistan during January 2019-July 2020 and updates previous reports (2,3). Since April 2018, insurgent groups have imposed bans on house-to-house vaccination. In September 2019, vaccination campaigns in areas under insurgency control were restarted only at health facilities. In addition, during March-June 2020, all campaigns were paused because of the coronavirus disease 2019 (COVID-19) pandemic. The number of WPV1 cases reported in Afghanistan increased from 21 in 2018 to 29 in 2019. During January-July 2020, 41 WPV1 cases were reported as of August 29, 2020 (compared with 15 during January-July 2019); in addition, 69 cases of circulating vaccine-derived poliovirus type 2 (cVDPV2), and one case of ambiguous vaccine-derived poliovirus type 2 (aVDPV2) (isolates with no evidence of person-to-person transmission or from persons with no known immunodeficiency) were detected. Dialogue with insurgency leaders through nongovernmental and international organizations is ongoing in an effort to recommence house-to-house campaigns, which are essential to stopping WPV1 transmission in Afghanistan. To increase community demand for polio vaccination, additional community health needs should be addressed, and polio vaccination should be integrated with humanitarian services. * SIAs are mass house-to-house campaigns targeting children aged <5 years with OPV, regardless of their vaccination history. TABLE. Acute flaccid paralysis (AFP) surveillance performance indicators and reported cases of wild poliovirus (WPV1) and vaccine-derived poliovirus type 2 (VDPV2) *, by region and period -Afghanistan, January 2019-July 2020 Region of Afghanistan AFP surveillance indicators (2019) No. of WPV1 cases reported No. of cVDPV2 cases reported No. of aVDPV2 cases reported No. AFP cases NPAFP rate % AFP cases with adequate stool specimens