In 2015, two cases of circulating vaccine-derived poliovirus type-2 were reported in the Rakhine State of Myanmar. This is a very rare strain of poliovirus that can spread in under-immunized communities with poor sanitation and high population density.
The discovery of these cases was important for Bangladesh as three sub-districts, under two districts in the Chittagong Hill Tracts share a border with Myanmar (Naikhongchhari in Bandarban district and Teknaf and Ukhiya in Cox’s Bazar district). In the last decade, displaced people from the Rakhine state have moved in to four refugee camps in Teknaf and Ukhiya. Unofficial movements across this border have consequences for public health.
Response
In response to the confirmed cases in Myanmar, Bangladesh National Expanded Programme on Immunization (EPI) decided to conduct a ‘Mop Up’ vaccination campaign with trivalent oral polio vaccine (tOPV). With technical assistance from WHO and UNICEF, the campaign targeted children below the age of 5 years at Naikhongchhari, Teknaf and Ukhiya sub-districts. Children up to the age of 10 years were also proposed to be brought under the campaign by administering additional tOPV at border crossing points.
WHO Surveillance Medical Officers helped to develop a micro-plan for the ‘Mop Up’ campaign, paying special attention to hard-to-reach and high-risk areas, refugee camps and the mobile population. Health workers and volunteers helped to spread the word about the campaign. Announcements were made at the mosques and mobile loud speakers used to inform the community about the ‘Mop Up’ campaign dates.
Coverage
A total of 114,979 children were targeted for the Mop Up and 115,760 (101%) children were reached during the first round of the campaign, according to the independent observers who visited and monitored the vaccinations at fixed sites.
Despite the short notice period, the first round mop-up campaign was smoothly implemented as communities were aware and generally accepting of the campaign efforts. Special emphasis was given to the importance of social mobilization activities starting early enough that people are aware of the campaign dates. Partner support also played a crucial role for adequate monitoring of the campaign.
A fully immunized population will be protected against both vaccine-derived and wild polioviruses. WHO Bangladesh is committed to providing technical and logistical support to the Ministry of Health and Family Welfare to sustain high immunization coverage in Bangladesh.