Polio in Tajikistan - Update
29 April 2010 - 171 cases of acute flaccid paralysis (AFP) have been reported by the Ministry of Health of the Republic of Tajikistan from January to present. 32 of these cases are confirmed wild poliovirus type 1, results are pending for the remaining cases. The majority of these cases have an onset of paralysis within the past 3 weeks. There have been 12 deaths.
Of the 32 confirmed wild poliovirus cases, 17 are under the age of two years, 14 are between the ages of two and five years, and one is between the ages of six and 15 years. Sixty-six percent are male. To date, 15 of the confirmed polio cases had paralysis onset during March and 17 have had paralysis onset during April. Information on vaccination history is available for 21 of the 32 confirmed cases. Of these cases, 2 (10%) have reported to have received less than three doses of OPV and 19 (90%) received three or more doses of OPV.
All cases are reported from the south-west of the country, including the capital city Dushanbe. This region borders Afghanistan and Uzbekistan,. Genetic sequencing has now determined that the poliovirus is most closely related to virus from Uttar Pradesh, India.
In response to the outbreak, the government of Tajikistan confirmed they are planning three supplementary rounds of immunization targeting every child <5 years (approx. 1.1 million children). Monovalent oral poliovirus type 1 vaccine will be used to quickly build immunity levels among children in the country. The first round will begin in the capital Dushanbe and six surrounding districts on May 1 with other regions to begin vaccination of children <5 years on May 4. Two additional national rounds have been tentatively scheduled for 18-22 May and 1-5 June.
Neighbouring countries are responding to the outbreak by heightening surveillance at all health care facilities and reporting sites while reviewing immunization status of children. Uzbekistan (target population 2.89 million children <5 years) is planning two national rounds of supplementary immunization with efforts to synchronize these rounds with Tajikistan in May and June. A campaign in Kyrgyzstan to boost the immunity of children against vaccine preventable disease including polio, which was planned by the government as part of European Immunization Week, will end tomorrow. Kyrgyzstan is planning to conduct additional sub-national immunization days in defined geographic areas.
WHO maintains its recommendation not to impose restrictions to the international movement of persons as a control measure at this time. It is important that international travellers to and from polio affected areas are adequately immunized against polio as recommended in Chapter 6 of International Travel and Health.