Outbreak of poliomyelitis, Republic of the Congo, September 2010-February 2011/Flambee de poliomyelite, Republique du Congo, septembre 2010-fevrier 2011

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Date: Apr. 8, 2011
From: Weekly Epidemiological Record(Vol. 86, Issue 15)
Publisher: World Health Organization
Document Type: Report
Length: 1,594 words
Lexile Measure: 1730L

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On 4 November 2010, a case of poliomyelitis due to wild poliovirus type 1 (WPV1) was confirmed in a resident of the port city Pointe Noire, Republic of the Congo--the first WPV case in the country in 10 years. The detected WPV1 was genetically most closely related to WPV1 isolated in Angola in 2010. Subsequent investigation, including active case-finding, revealed that increased numbers of acute flaccid paralysis (AFP) cases had been admitted to hospitals beginning in September 2010. Weekly admissions rose from approximately 10 AFP cases in early October to approximately 80 per week by the end of October. After response immunization activities were initiated in November, the number of AFP cases fell to <5 per week by the end of December. As of 15 March 2011, a total of 560 AFP cases with onset of paralysis from 20 September 2010 to 27 February 2011 were identified nationally. Among the 560 AFP cases, 467 (83%) were reported among residents of the neighbouring departments of Kouilou and Pointe Noire, where the outbreak began and where approximately 21% of the Republic of the Congo's 4.2 million total population reside; 318 (68%) of AFP cases in the outbreak area of Kouilou and Pointe Noire were males (of which 305 were >15 years of age) and the case-fatality rate (CFR) was 40% (187 of 467 AFP cases died). Vaccination status was unknown for all but 155 of 560 AFP cases (28%). Among the 155 with known vaccination status, 113 (73%) reported having received at least 1 dose of oral polio vaccine (OPV), and 77 (50 %) reported having received at least 3 doses of OPV.

As of 15 March 2011, WPV1 had been confirmed virologically in specimens collected from 70 of the 560 AFP cases (12%). Adequate specimens (2 stool specimens collected within 14 days of onset and arriving at a WHO accredited poliovirus laboratory in <<good condition*) were collected from only 106 of the 560 AFP cases (19%) and no stools could be obtained from 328 AFP cases, of which 190 died. The AFP cases with either inadequate or no stool specimens were reviewed by the national polio expert committee who classified 317 cases as polio-compatible including those who died, were lost to follow-up, or had residual paralysis on follow-up. Exceptionally, these 317 polio-compatible cases were reported as confirmed polio due to their geographical and temporal association with the outbreak, thereby...

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Gale Document Number: GALE|A256070533