Latest epidemiological update on polio outbreak in central Asia

As of 1 June 2010, Tajikistan had reported 564 cases of acute flaccid paralysis (AFP), 183 of which had been laboratory confirmed for wild poliovirus type 1. All laboratory-confirmed cases reported so far are from the south-western part of the country and the capital, Dushanbe. The number of cases reported has declined in week 22. 14 AFP cases are negative for wild poliovirus.

The National Polio Expert Committee of Tajikistan met on 1 June 2010 to review and classify AFP cases. It will continue to meet to ensure that all cases are appropriately classified.

Tajikistan has concluded two nationwide rounds of vaccination, using monovalent oral polio vaccine type 1 (mOPV1). During the first round, over 1.1 million children under 6 years of age were immunized: 99.4% of the target group. The second round saw a similarly high coverage rate. The third round of the vaccination programme began on 1 June, with a target group expanded to include all children under 15 years of age. A fourth round will be held for this group on 15–19 June.

WHO’s international expert team in Tajikistan continues to conduct outbreak investigation and epidemiological assessment, and provides technical assistance to the Government, along with the United Nations Children’s Fund (UNICEF) and other key partners. WHO considers Tajikistan’s vaccination programme successful so far, and is working closely with the Ministry of Health on assessing needs for additional rounds. A WHO regional reference laboratory in Moscow, Russian Federation continues to test samples from patients with AFP.

WHO has sent one of its experts in rehabilitation to assess the services provided to people affected by polio. He has met with the key stakeholders and will conclude his assessment with training for physicians treating these people.

WHO also works closely with Tajikistan’s neighbours in the WHO European Region (Kazakhstan, Kyrgyzstan, Turkmenistan and Uzbekistan) on prevention and response measures. These countries’ governments have strengthened surveillance, and have begun or will soon begin vaccination campaigns. With its international partners, WHO has sent expert teams to Kyrgyzstan and Uzbekistan to help strengthen surveillance and to support national and subregional vaccination activities.

Uzbekistan

In Uzbekistan, 41 AFP cases have been reported since January 2010; 26 are negative for poliovirus, while 15 are pending laboratory results. With UNICEF and other partners, WHO is helping to implement and monitor a three-round national polio vaccination campaign, aiming to reach almost 2.9 million children under 5 years of age. The first round was held on 17–22 May, and the Uzbek Ministry of Health reported coverage exceeding the number originally targeted, as the children vaccinated included some who were not registered with public health centres before the campaign.
The second round of the vaccination campaign is scheduled for 7–13 June. The WHO Regional Director for Europe, Zsuzsanna Jakab, will visit Uzbekistan during this period on the invitation of the Minister of Health. In the capital, Tashkent, Ms Jakab will meet leading representatives of the Government and public health authorities to discuss polio vaccination and a range of other public health challenges in Uzbekistan.

The third round of nationwide polio vaccination is tentatively planned for 5–9 July.