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WHO - Poliovirus Detected From Environmental Samples in Israel

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Global Alert and Response (GAR)

In Israel, wild poliovirus type 1 (WPV1) was isolated from sewage samples collected on 9 April 2013 in Rahat, southern Israel. The virus has been detected in sewage only; no case of paralytic polio has been reported. Genetic sequencing and epidemiological investigations are ongoing to determine its origin. Preliminary analyses indicate the strain is not related to the virus currently affecting the Horn of Africa. The virus isolate was detected through routine environmental surveillance in Israel that involves regular testing of sewage water. Israel has been free of indigenous WPV transmission since 1988. In the past, wild poliovirus has been detected in environmental samples collected in this region between 1991 and 2002 without occurrence of cases of paralytic polio in the area.

Following detection of the wild poliovirus, health authorities in Israel are conducting a full epidemiological and public health investigation, actively searching for potential cases of paralytic polio as well as for any un-immunized persons. Routine immunization levels are estimated at 94 percent. Outcomes of the investigation will determine the need for any additional catch-up immunization activities, as necessary. Similar activities are being implemented by health authorities in Gaza and the West Bank. Specimens collected through environmental surveillance since 2002 in both Gaza and the West Bank have consistently tested negative for the presence of WPV.

Given that there are high levels of population immunity levels in the area, and the investigations and response being implemented, the World Health Organization (WHO) assesses the risk of further international spread of this virus strain from Israel as low to moderate.

It is important that all countries, in particular those with frequent travel and contacts with polio affected countries, strengthen surveillance for cases of acute flaccid paralysis (AFP), in order to rapidly detect any new poliovirus importations and facilitate a rapid response. Countries should also analyze routine immunization coverage data to identify any subnational gaps in population immunity to guide catch-up immunization activities and thereby minimize the consequences of any new virus introduction. Priority should be given to areas at high-risk of importations and where OPV3/DPT3 vaccine coverage is less than 80 percent.

WHO’s International Travel and Health recommends that all travellers to and from polio affected areas be fully vaccinated against polio. Three countries remain endemic for indigenous transmission of WPV: Nigeria, Pakistan and Afghanistan. Additionally, in 2013, the Horn of Africa is affected by an outbreak of WPV, with six cases confirmed in Kenya and Somalia.

http://www.who.int/csr/don/2013_06_03/en/

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The Lancet, Early Online Publication, 8 November 2013

doi:10.1016/S0140-6736(13)62220-5

WHO has confirmed an outbreak of at least ten cases of polio in Syria, where vaccination coverage has dramatically decreased during the civil war.1 Furthermore, wild-type poliovirus 1 (WPV1) has been isolated from sewage and faeces from asymptomatic carriers in Israel since February, 2013.2 Tourists and travellers could bring the infection to other countries. Precautions during the Hajj in Saudi Arabia in October, 2013, ensured that visitors from regions with known polio transmission were vaccinated, but Syria was not on the list.3

(READ COMPLETE ARTICLE)

newsweek.com - by Susan Scuttl - November 8, 2013

A recent polio outbreak in Syria, coupled with reports of polio virus found in Israeli sewers, is causing anxiety in Europe. As Syrians flee the chaos of civil war and seek refuge on the continent, German scientists warn that an epidemic could occur.

Not all of Europe is at risk; a few countries have been singled out as potential polio hotbeds.

(READ COMPLETE ARTICLE)

I am not touching in to the technical side of the polio out break in Syria and its virus found in Israeli sewers or its potential polio hotbed in Europe. What is more attractive is to notify some countries, where Syrian refugees will be potentially settled. In addtion to providing qualitative and quantitative information to the world, the report informs some countries to take premeasures to prevent symptoms spread of polio in their countries and be more careful in advance.

So, a lucky message of the news is that if there are preventive measures then out break of any dangerous sickness can be controlled and its risk could be minimized. My view point is that it would be hard for many countries to prevent flow of refugees to their land, but it wuold be so easy to be prepared to confront such situations. On such occasions international community can support host country with premeasures by adapting good planning to be responsive to the situation.

 

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