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Pakistan: No coronavirus case in Pindi district [and no polio drive refusal cases] : Deputy Commissioner| DAWN.

[March 13, 2020] Aamir Yasin writes:

RAWALPINDI: Deputy Commissioner retired Capt Anwarul Haq on Thursday said there was no coronavirus case reported in Rawalpindi district.

Talking to media in his office, he said three special high-dependency units had been established to deal with the threat of coronavirus at Benazir Bhutto Hospital (BBH), Holy Family Hospital (HFH) and the District Headquarter (DHQ) Hospital.

Besides, a 100-bed ward has been established at the Rawalpindi Institute of Urology (RIU) to quarantine suspected patients.

He said 760 people coming from abroad were tested for coronavirus but none of them was tested positive. He said 480 devotees had returned from Iran after the spread of the virus there and the district administration had complete data in this regard. The DC said 11 staff members have been deployed in different imambargahs for screening of suspected patients.

The government installed screening systems at airports and he was monitoring the system at the Islamabad International Airport. He said the district health authority had provided doctors and technicians for the airport.

The administration seized 40,000 facemasks from hoarders to ensure its availability in the market on the original prices.

The deputy commissioner said for the first time no refusal case was reported during the recent anti-polio drive in the district and the 100 per cent target to immunise children less than five years of age was achieved.

He said three to four suspected polio cases were reported but their results were negative.

He said 1,600 sanitary patrols were recruited for the anti-polio campaign.

The DC also said a new standard operating procedure (SOP) has been implemented to eliminate the dengue virus.

He said at a meeting with officials of private housing societies it was agreed to constitute teams for anti-dengue surveillance in their areas, adding diagnostic facilities were being extended at the grassroots level.

He said the Ghazi Barotha project was the only solution to the lingering water shortage in the city but it would take eight to 10 years for completion.

However, the government is trying to start the project as the underground water is receding fast.

“The government is also working to construct small dams in the district which will provide clean drinking water to the residents and raise the underground water level,” he said.

To a query about price hike, he said earlier there were 40 price magistrates but now their number has been increased to 63 for taking action against profiteers involved in price hike and adulteration. He said the district administration had been asked to compile data of people visiting the land revenue department for registration of their properties and transfer of immoveable properties.

“After getting the mobile phone numbers, the administration will get information from them about any official demanding for bribe,” he said.

He said a software had been launched for the online registration of schools and controlling their fees.

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Pakistan: Two new polio cases reported from two KP districts | The News International.

[March 13, 2020] [Bureau Report]

PESHAWAR: The Khyber Pakhtunkhwa on Thursday reported two more polio cases, rising the number of polio cases to 15 in the province in the year 2020. According to government officials, the latest two polio cases were reported from Bhittani tehsil of Lakki Marwat district and Shakai tehsil of South Waziristan tribal district. Both the cases were tested positive for poliomyelitis at the National Institute of Health (NIH) laboratory in Islamabad, where stool samples of the acute flaccid paralysis (AFP) were collected from 14-month old female child from Lakki Marwat and 13-month old boy in South Waziristan. Only a day earlier, KP had reported polio cases from Tank district. It is pertinent to mention here that the total number of polio cases have soared to 15 in the province and 29 in the country in 2020 so far.

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"THE FIRST CALL": Polio eradication staff support COVID-19 response | GPEI.


Polio staff conduct COVID-19 awareness training in Gadap, Pakistan. ©WHO Pakistan.

Using the vast infrastructure developed to identify the poliovirus and deliver vaccination campaigns, the polio eradication programme is pitching in to protect the vulnerable from COVID-19, especially in polio-endemic countries. From Pakistan to Nigeria, the programme is drawing on years of experience fighting outbreaks to support governments as they respond to the new virus.


Few health programmes have as much practice tracking virus or reaching out to communities as the Pakistan polio eradication programme. This means the polio team is in a strong position to support the Government of Pakistan in COVID-19 preparedness and response.

Currently, the polio team is providing assistance across the entire country, with a special focus on strengthening surveillance and awareness raising. Working side-by-side with the Government of Pakistan, within three weeks the team has managed to train over 280 surveillance officers in COVID-19 surveillance. It has also supported the development of a new data system that’s fully integrated with existing data management system for polio.  All polio surveillance staff are now doubling up and supporting disease surveillance for COVID-19. Through cascade trainings, they have sensitized over 6,260 health professionals on COVID-19, alongside their polio duties, in light of the national emergency. These efforts will continue unabated as the virus continues to spread.

Adding to the capacity of the government and WHO Emergency team, the polio team are also engaged in COVID-19 contact tracing and improving testing in six reference laboratories. They have been trained to support and supplement the current efforts, preparing for a sudden surge in cases and responding to the increase in travelers that need to be traced as a result of the rise in cases. The regional reference laboratory for polio in Islamabad is also providing technical support to COVID-19 testing and has been evolving to cater to the increased demands.

As this is a new disease, polio staff are lending their skills as health risk communicators – providing accurate information and listening to people’s concerns. The government of Pakistan extended a national help line originally used for polio-related calls to now cater to the public’s need for information on COVID-19. The help line was quickly adapted by the polio communication team once the first COVID-19 case was announced. The polio communications team is using strategies routinely used to promote polio vaccines to disseminate information about the COVID-19 virus, including working with Facebook, to ensure accurate information sharing, and airing television adverts.  As time goes on, the teams will train more and more people ensuring the provision of positive health practices messages that can curb the transmission of the virus.


Currently, community volunteers who work for the polio programme to report children with acute flaccid paralysis (AFP) are delivering messages on handwashing to reduce spread of COVID-19, in addition to polio. UNICEF is similarly using its Immunization Communication Network to disseminate information on personal hygiene.

Field staff have taken the initiative of using their routine visits to health facilities, during which they check for children with AFP, to check for and report people who may have COVID-19. Meanwhile, programme staff are building the capacity of health workers to respond to the novel coronavirus.

To coordinate approaches, the WHO Afghanistan polio team has a designated focal point connecting with the wider COVID-19 operation led by the Government of Afghanistan. The polio eradication teams at regional and provincial levels are working closely with the Ministry of Public Health, non-governmental organizations delivering Afghanistan’s Basic Package of Health Services and other partners to enhance Afghanistan’s preparedness.


“In the field, when there is an emergency, the first call is to the polio personnel,” says Fiona Braka, WHO polio team lead in Nigeria.

In Ogun and Lagos states, where cases of COVID-19 have been detected, over 50 polio programme medical staff are working flat out to mitigate further spread, using lessons learnt from their years battling the poliovirus. Staff are engaged in integrated disease surveillance, contact tracing, and data collection and analysis. Public health experts working for the Stop Transmission of Polio programme, supported by the US Centers for Disease Control and Prevention, are using their skills to undertake COVID-19 case investigations. Meanwhile the polio programme communications team is supporting the Government of Nigeria in the production of daily situation reports.

The Emergency Operation Centers in these affected states, usually used for polio eradication coordination, are doubling up as coordination hubs for COVID-19 response. The programme is also lending phones, vehicles and administrative support to the COVID-19 effort.

In states where no cases of COVID-19 have been reported, polio staff are supporting preparedness activities. At a local level, polio programme infrastructure is being used to strengthen disease surveillance. Polio staff are leading training on COVID-19 response protocols and are working to build awareness of the virus in the community. Specials efforts are being undertaken to train frontline workers as they are at high risk of contagion.

Beyond polio-endemic countries.

Trained specialists in the STOP program, part of the Global Polio Eradication Initiative, are actively supporting preparations or response to COVID-19 in 13 countries worldwide. The WHO Regional Office for Africa’s Rapid Response Team, who usually respond to polio outbreaks, are aiding COVID-19 preparedness in countries including Angola, Cameroon and the Central African Republic. Meanwhile, polio staff in other offices are ready to lend support, or are already lending support, to colleagues working to mitigate and respond to the new virus.

In our work to end polio, the programme sees the devastating impact that communicable diseases have. With this in mind, we are fully committed to supporting national health systems by engaging our expertise and assets to help mitigate and contain the COVID-19 pandemic, alongside continuing concerted efforts to eradicate polio.

For the latest information and advice on the COVID-19 disease outbreak visit the WHO website.

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Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study | The Lancet.

[Open Access] [Published: March 11, 2020] [Online First]



Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described.


In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death.


191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days.


The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future.


Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

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Somalia Weekly Polio Update: Week 9, 2020 | UNICEF and WHO via ReliefWeb.

[Sources: UNICEF, WHO] [Published: 12 March 2020]

Situation Update.

  • A vaccine-derived poliovirus type 1 (VDPV1) positive stool sample from a child with acute flaccid paralysis (AFP) was reported this week (Epid: SOM-AWL-LUH-20-001) from Lughaya district in Awdal Region. This child is a 56- month-old male with reported paralysis that developed on 26 January 2020. Currently, this case is classified as an event, as per the latest GPEI guidelines.

    • No new cases of children with cVDPV2 were reported this week. The date of onset of the most recent case of cVDPV2 in a child with AFP was 8 May 2019. A total of three cVDPV2 cases were reported in Somalia in 2019.

    • No new cVDPV3 - positive cases or environmental samples were identified in 2019 or 2020 to date. The onset of the most recent case of cVDPV3 in a child with AFP was 7 September 2018.

    • In total, 16 children with VDVP have been identified across Somalia since the initial detection of the ongoing cVDPV2 and cVDPV3 outbreaks in late 2017.

Operational and Outbreak Coordination.

  • A field team is visiting Lughaya district on 8 March to conduct a detailed investigation of the child with VDPV1 that was reported this week.

  • The cVDPV2-positive environmental samples collected in December 2019 and January 2020 reflect undetected virus transmission, indicating gaps in surveillance and population immunity likely stemming from areas where the population is inaccessible to the polio programme’s surveillance and immunization activities.

  • A targeted mOPV2 response is currently being designed in response to these recent virus isolations. Given that mOPV2 has not been used since late 2018 in the south and central regions, there will be a number of susceptible children who were born since the last case response activities and remain unvaccinated. The polio programme aims to implement the first round of mOPV2 in selected areas from 22 to 25 March.

  • Priorities for outbreak response in view of the new epidemiology include further strengthening surveillance and conducting active case search, including in hard-to-access areas, identifying population groups susceptible to harbouring the virus, monitoring population movement and continuing efforts to gain access to security- compromised areas with vaccine.

  • An integrated measles and polio campaign will be implemented in Somaliland and Puntland from 22 to 26 March.

Download report (PDF | 198.24 KB)

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Multiplex PCR-Based Neutralization (MPBN) Assay for Titers Determination of the Three Types of Anti-Poliovirus Neutralizing-Antibodies | Vaccines.

[Open Access] [Received: 11 February 2020 / Revised: 2 March 2020 / Accepted: 3 March 2020 / Published: 5 March 2020]


Determination of poliovirus-neutralizing antibodies is an important part of clinical studies of poliovirus vaccines, epidemiological surveillance and seroprevalence studies that are crucial for global polio eradication campaigns. The conventional neutralization test is based on inhibition of cytopathic effect caused by poliovirus by serial dilutions of test serum. It is laborious, time-consuming and not suitable for large scale analysis. To overcome these limitations, a multiplex PCR-based neutralization (MPBN) assay was developed to measure the neutralizing antibody titers of anti-poliovirus sera against three serotypes of the virus in the same reaction and in shorter time. All three anti-poliovirus sera types were analyzed in a single assay. The MPBN assay was reproducible, robust and sensitive. Its lower limits of titration for the three anti-poliovirus sera types were within range of 0.76–1.64 per mL. Different anti-poliovirus sera were tested with conventional and MPBN assays; the results obtained by both methods correlated well and generated similar results. The MPBN is the first neutralization assay that specifically titrates anti-poliovirus antibodies against the three serotypes of the virus in the same reaction; it can be completed in two to three days instead of ten days for the conventional assay and can be automated for high-throughput implementation.

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Pakistan: Parents Advised To Participate In Oral Polio Vaccination To Save Their Children In Future | UrduPoint.

[12th March 2020]

ISLAMABAD, (UrduPoint / Pakistan Point News - 12th Mar, 2020 ) :Coordinator, National Emergency Operations Centre for Polio Eradication Rana Muhammad Safdar Thursday urged parents to actively participate in the KP and other national anti-polio drives for their children to enable them polio-free in future.

Talking to private news channel, parents are advised to bring their children under the age of 5 to receive the oral polio vaccination (OPV) that is available on their door steps with our technical staff members.

He said "Parents are requested to avoid fake propaganda against polio vaccine and vaccinate their children to protect them from the polio virus." The present government is striving to hit the virus hard through this special campaign, he said, adding, its our top priority to focus on reaching still missed children in core reservoirs through continued improvement of operations and protect every missed child with the vital polio vaccine.

He said polio teams knocking at the doors of every house for vaccination and asking parents to allow them to vaccinate each ans every children below 5 years in their home.

He also added that religious scholars should take active part in the drive to persuade the parents who refused to allow polio workers to administer vaccine to their children.

Expressing serious concern over the recent spike in polio cases, he said Federal and provincial governments are undertaking effective awareness and immunization campaigns through electronic and print media.

He added while there was no cure for polio, vaccination was the most effective way to protect children from the crippling disease so parents should vaccinate their child in all polio drives.

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