WHO plans urgent action on Ruweng polio outbreak

A wild poliovirus sample isolated on 22 July from a stool sample from Ruweng County, Western Upper Nile/Unity (Wahdah) State, southern Sudan, came from a two year-old girl, originally from Akot-weng village in Gul Dit Payam (district), WHO official Jeff Partridge told IRIN on Wednesday. At the time of the onset of acute flaccid paralysis (AFP) in April, which ultimately drew attention to the polio outbreak, the girl’s family was living in the toich (wetlands) area two to three hours walk from Padit, where people can get fish, and water and grazing for their cattle during the dry season (January-May), he said. Similar cases of paralysis were also reported in the toich where the case was presented, he added. Due to ongoing insecurity, Ruweng was the only county accessible to the inter-agency Operation Lifeline Sudan (OLS) where WHO has been unable to establish surveillance staffing for polio on the ground, Partridge said. For the same reason, no immunisation of the under-five population has been done this year, although Ruweng has five districts with an estimated under-five population of 12,800. This is the first P1-type wild poliovirus that has been isolated from southern Sudan since the start of the polio eradication programme there in 1998, although it was isolated in four AFP cases in north Sudan last year, according to Partridge. WHO was “very concerned” about the incident, because one could presume that there were many more infected carriers, due to inadequate vaccination cover and because there was a lot of population movement in Ruweng County, among others reasons, he said. “We look at this as an outbreak, because it’s proof that the virus is there, that polio is circulating in south Sudan,” he added. “Fortunately, most areas WHO would want to visit are not flight-denied at this time, and no active fighting is happening”, so the agency plans to send emergency teams, complete with cold-chain requirements, into Pagol, Padit and Biem between 28 July and early August. These teams will try to find the polio-positive patient in order to do a detailed case investigation, as well as to collect samples from contacts of the positive case, random children in the surrounding households, and from households in Pagol, Padit and Biem and surrounding villages, WHO added.