Somalia polio Update

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Somalia polio Update

• 21 September 2005

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Somalia Regions
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AFP surveillance indicators, Somalia, 2005
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AFP cases with date of onset in 2005, Somalia
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AFP cases with date of onset after 12/7/2005,
Somalia
Banadir (Mogadishu)
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Mogadishu AFP Cases 2005 (19/9/05)
Wild
Discarded
Pending
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Epidemiologic Situation

• Somalia did not report any polio case since the
  last case in October 2002
• A case from Mogadishu south (Wardigley district),
  had onset of paralysis on 12 July, reported on
  21st and stool specimens were collected on 23
  24 July in addition to 5 contact samples
• Specimens reached Nairobi on 2nd August reached
  KEMRI Lab on 3rd.
• Preliminary culture results for ve P1 were
  reported on 26 August on 8 September, The RRL
  in south Africa confirmed NSL1 virus.
• The child is 15 months old received only one dose
  of mOPV just before the onset of paralysis
  (during the NID of 26 June)

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Epidemiologic Situation

• This was followed by the confirmation of another
  case from Mogadishu north, Yaqshid district not
  far from the first case
• In Banadir region 7 AFP cases were reported from
  the beginning of 2005 up to the date of onset of
  the first case (July) and all of them were
  discarded including one case from Wardigley
  south.
• Six cases were reported after 12 July (one
  confirmed, one discarded and 4 pending). All the
  cases from Yaqshid or Wardigley.

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Epidemiologic Situation

• Genomic sequence data for the two confirmed cases
  showed that both isolates closely match Yemen
  Isolates (99.3 similarity to an isolate from
  Aden with Donset in June) indicating that it is a
  recent single importation from Yemen.
• The extent of transmission is still unknown.
  There is a cluster of cases in Mogadishu In
  addition to the 4 pending cases there is
  preliminary information about 24 more cases
  reported and being investigated
• The cases cluster is mainly in North Mogadishu
  which is the most insecure part of the already
  phase 5 capital.
• So far no other clusters are showing in other
  regions. But there are hot cases reported from
  Hargeisa and Lower Shabelli. Also, a case
  developed illness in Jowhar and paralysis in
  Mogadishu is still pending ITD

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Important activities

• Activities were intensified in Somalia since the
  beginning of the Sudan and later the Yemen
  epidemics
• Somalia Had 5 NIDs conducted so far in 2005
  (January-February-June-July- August). Two of the
  campaigns were implemented after the onset of the
  first case. mOPV was used in the June and July
  rounds.
• September round was planned to take place from
  28-30. the date for Mogadishu was advanced to
  22-24.
• mOPV will be used in the coming and subsequent
  rounds planned to take place in November and
  December.
• A joint WHO/UNICEF international mission to
  Mogadishu started today to help in assessment of
  the situation as well as monitor the
  implementation of the campaign (21-24 September)

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Important activities

• WHO/UNICEF Staff from all programmes from
  Mogadishu and other parts of Somalia are being
  deployed to support the implementation and
  monitoring of the campaign.
• Women groups in Mogadishu will deploy 50 social
  mobilizers to raise awareness about the outbreak
  and ensure acceptance and high coverage of the
  campaign
• Local Media is maximally utilized to raise
  awareness. (monitoring data shows that more than
  50 of missed children is due to refusal)
• Independent monitoring that was introduced in
  2005 is further expanding to provide real picture
  of implementation
• Finger marking will be used in Mogadishu

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Important activities

• In addition to coordinator, operational officer,
  Admin/Fin officer, Logistic assistant, data
  manager and the 4 STCs inside the four zones of
  Somalia, WHO fielded 2 staff from EMRO and 2 STCs
  to support the programme.
• Alternative arrangements were made to test the
  newly collected specimens from cases and contacts
  in VACSERA Egypt, until KEMRI lab is accredited.
• Retesting of samples of all 2005 cases (for
  Somalia and South Sudan) is done in Khartoum
  laboratory with priority given to the recent
  cases backwards.

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Important activities

• Surveillance activities were intensified in
  Mogadishu and other parts of Somalia. 100
  animators are moving H-H in Mogadishu searching
  for AFP cases.
• Special representative to Secretary General, UN
  political office for Somalia appealed in this
  speech on the Somalia peace day to all
  stakeholders to support the fight against polio
• An operation room was created in Somalia WHO
  office under the leadership of WR with very close
  collaboration with UNICEF.