Progress Toward Poliomyelitis Eradication — Pakistan, January 2017–September 2018

Progress Toward Poliomyelitis Eradication — Pakistan, January 2018–September 2019

“…During January 2018–September 2019 the number of WPV1 cases in Pakistan increased, compared with the number during the previous 4 years. This report updates previous reports on Pakistan’s polio eradication activities, progress, and challenges ( 2 , 3 ). In 2018, Pakistan reported 12 WPV1 cases, a 50% increase from eight cases in 2017, and a 31% increase in the proportion of WPV1-positive sites under environmental surveillance (i.e., sampling of sewage to detect poliovirus).…”

Progress Toward Polio Eradication — Worldwide, January 2017–March 2019

“…For the first time since 2014, the number of annual WPV case reports in Afghanistan and Pakistan rose in 2018, in spite of targeted efforts to increase immunization in security-compromised districts, reduce vaccine refusal, and reach highly mobile populations. Genomic sequence analysis of isolates from AFP patients and environmental samples demonstrates not only persistent local transmission in reservoirs in both countries, but also ongoing transmission along two common corridors because of transnational population movements ( 4 , 5 ). Efforts are underway to enhance continuous immunization at border points in both countries.…”

“…However, national coverage estimates often mask low coverage and poor SIA quality in a substantial number of subnational areas. In the countries with endemic WPV transmission, estimated national Pol3 coverage in 2017 was 60% in Afghanistan, 40% in Nigeria, and 75% in Pakistan ( 4 – 6 ).…”

“…In Pakistan, WPV1 was detected in 107 (17%) of 630 samples in 2017 and 141 (21%) of 677 samples in 2018 (Table 1). Genomic sequencing of poliovirus isolates from both environmental samples and confirmed AFP cases indicates multiple chains of transmission; five genetic clusters (groups of isolates sharing ≥95% of genetic relatedness) persisted during the reporting period in the core reservoirs along shared transnational population movement corridors between Afghanistan and Pakistan ( 4 , 5 ).…”

Progress Toward Measles Elimination — Pakistan, 2000–2018

“…Pakistan remains one of only three countries worldwide that has never interrupted wild poliovirus type 1 transmission ( 9 ); therefore, polio eradication activities remain intense in the country. Measles elimination efforts can leverage the polio assets, experience, and capacity to identify and reach communities not accessing routine immunization services; engage local leaders and community members to ensure that all children in the target age groups participate in SIAs; use epidemiologic investigations to identify areas that need additional SIAs; and improve outbreak preparedness and response to rapidly contain outbreaks.…”