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Head To Head: Should countries aim for elimination in the covid-19 pandemic? | The BMJ.

[Open Access] [Published 09 September 2020]

Elimination is possible and is the only way to prevent the biggest loss of life and economic harm in the long run, says Andrew Lee. But Simon ThornleyArthur J Morris, and Gerhard Sundborn argue that the cost to quality of life years is too big a risk when “possible” is not the same as “achievable”

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  1. Andrew Lee, reader in global public health,
  2. Simon Thornley, epidemiologist,
  3. Arthur J Morris, clinical microbiologist,
  4. Gerhard Sundborn, senior lecturer.

Andrew Lee is a member of the UK Faculty of Public Health, the Royal College of General Practitioners, and the Royal Society for Public Health. He has previously received research grant funding from the National Institute for Health Research.

Simon Thornley and Arthur J Morris are providing paid advice to Auckland International Airport related to health risks associated with covid-19.

Dr. Gerhard Sundborn is a Senior Lecturer In Pacific Health and Population Health at the Faculty of Medical and Health Sciences, the University of Auckland.


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Sudan Situation Report, 10 Sep 2020 | ReliefWeb.

[Situation Report] [Source: OCHA] [Posted: 10 Sep 2020] [Originally Published: 10 Sep 2020] [Origin: View original]

HIGHLIGHTS.

  • On 8 September, HAC reported that more than 557,000 people were affected by floods in 17 out of Sudan’s 18 states.
  • The states most affected by floods are Khartoum, North Darfur and Sennar, which account for 43 per cent of all people affected.
  • On 7 September, the Sudan Ministry of Health reported 19 confirmed cases of vaccine-derived poliovirus in 10 states.
  • The Government is planning to vaccinate 8.6 million children under five years against polio from 4 October 2020.
  • COVID-19 transmissions continue and over 13,400 people had contracted the virus in the country, as of 5 September 2020.

Health ministry confirms 19 vaccine-derived polio cases in Sudan.

The Federal Ministry of Health (FMoH) on 7 September 2020, reported 19 confirmed cases of vaccine-derived poliovirus (cVDPV2) in 10 states (Blue Nile, East Darfur, Gedaref, Gezira, Kassala, Red Sea, River Nile, South Darfur, West Darfur, White Nile). The first case was reported in South Darfur on 7 March and notified on 12 March 2020. A total of 320 cases of Acute Flaccid Paralysis (AFP) have been reported, of which 247 cases (77 per cent) were discarded as non-polio AFP cases, 54 cases (17 per cent) are pending classification and 19 cases (7 per cent) were cVDPV2 positive.

On 9 August 2020, FMoH notified the World Health Organisation (WHO) of the detection of a vaccine-derived polio (cVDPV2) in the country and announced an outbreak. According to the notification, the virus is genetically linked with Chad. The initial investigation of the two first cases indicated these cases were linked to cVDPV2s from the CHA-NDJ-1 emergence group, which was first detected in October 2019 and is currently circulating in Chad and Cameroon, WHO said last week.

As the poliovirus types detected in Sudan and Chad are genetically linked indicating cross-border spread, Sudan and Chad are working together to synchronize activities to contain the outbreaks, the UN Children's Agency (UNICEF) and WHO said.

AFP is a neurological condition characterized by weakness or paralysis and reduced muscle tone. The term acute flaccid paralysis (AFP) is often used to describe an instance with a sudden onset, as might be found with polio. AFP is the most common sign of acute polio and used for surveillance during polio outbreaks.

Routine vaccination coverage during 2020 has declined compared with 2019 because of programmatic issues and the impact of COVID-19 containment measures, according to FMoH. The immunization trend started to improve in June 2020 and accelerated routine vaccination started on 26 August 2020. The government is planning two rounds of national vaccination campaigns targeting 8.6 million children under five years of age to ensure they are protected against polio. The first round will start on 4 October and the second round will take place during the first week of November.

UNICEF and WHO will support the government's response to the polio outbreak.

Sudan's last reported wild poliovirus case was in March 2009 and the country was announced polio-free in 2015 by WHO. However, the country has been considered at high risk for importation of polioviruses for several years due to a decline in population immunity resulting from insecurity and conflict in certain areas.

According to WHO, polio is a highly infectious viral disease that largely affects children under 5 years of age. The virus is transmitted person-to-person mainly through the faecal-oral route or, less frequently, by a common vehicle (e.g. contaminated water or food) and multiplies in the intestine, from where it can invade the nervous system and cause paralysis.

As for the vaccine-derived poliovirus, it can occur in the following situations, WHO explains. Oral polio vaccine (OPV) contains an attenuated (weakened) vaccine-virus, activating an immune response in the body. When a child is immunized with OPV, the weakened vaccine-virus replicates in the intestine for a limited period, with the body developing immunity by building up antibodies. During this time, the vaccine-virus is also excreted. In areas of inadequate sanitation, this excreted vaccine-virus can spread in the immediate community (and this can offer protection to other children through 'passive' immunization), before eventually dying out.

On rare occasions, if a population is seriously under-immunised, an excreted vaccine-virus can continue to circulate for an extended period. The longer it is allowed to survive, the more genetic changes it undergoes. In very rare instances, the vaccine-virus can genetically change into a form that can paralyse -- this is what is known as a circulating vaccine-derived poliovirus (cVDPV), according to WHO.

UN Office for the Coordination of Humanitarian Affairs
To learn more about OCHA's activities, please visit https://www.unocha.org/.


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Ghana: Polio vaccination under way in Tema West | GhanaWeb.

[12 September 2020]

Children under five years in all communities in the Tema West Municipality are being vaccinated against the poliomyelitis virus.

The immunisation exercise, being conducted by the Ghana Health Service in eight regions and 179 districts across the country, is expected to boost the immunity of children zero to 59 months and provide further protection against the virus.

In all, some 28, 277 children under five years in all communities in the Municipality are being targeted for immunisation which is expected to end on Sunday.

Unlike previous immunisation exercises, where schools were mostly target, this particular exercise is being conducted door-to-door since schools are closed due to the COVID-19 pandemic.

Mr Isaac Abrefa Busia, Tema West Municipal Public Health Officer, told the Ghana News Agency (GNA) that the vaccines were safe and effective for children, and called on caregivers to ensure that children under five years were immunised.

He said with a 103.8 per cent coverage in the last immunisation exercise, he hoped the current exercise would witness a high coverage in spite of the COVID-19 pandemic and fear that caregivers were likely to refuse vaccination for fear contracting the virus.

He said parents and caregivers were being sensitised as part of the campaign to ensure maximum coverage.

He explained that “the more your child receives vaccines, the more protected the child is against vaccine preventable diseases including paralysis and sometimes death.”

Mr Abrefa Busia, therefore, entreated caregivers to allow health personnel to administer the vaccines irrespective of the number of times the child may have been vaccinated.


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