Response to a Large Polio Outbreak in a Setting of Conflict — Middle East, 2013–2015

Sustainable development must account for pandemic risk

“…Reducing local and international instability is essential to prevent disease spread, even for infectious agents at the brink of eradication. The spread of wild poliovirus from Pakistan into Syria in 2013 and 2014, for example, was a consequence of reduced vaccination levels owing to years of conflict in both countries (20). Conversely, not controlling epidemics can contribute to the dismantling of societal functions, leading to the exacerbation of violence, sexual exploitation, educational disruption, food insecurity, and corruption (21).…”

Strategic Response to an Outbreak of Circulating Vaccine-Derived Poliovirus Type 2 — Syria, 2017–2018

“…Multiple rounds of supplementary immunization activities (SIAs), implemented in response to a WPV outbreak during 2013–2014 ( 9 ), mitigated the poor quality of routine immunization services in parts of the country; however, the frequency and quality of these activities lessened after the outbreak was declared over. In 2016, the year after the response to the WPV outbreak officially concluded, six SIAs were conducted in Deir-ez-Zor governorate; two used tOPV, with reported administrative coverage † of 7% and 23%.…”

Emerging outbreaks associated with conflict and failing healthcare systems in the Middle East

“…3 An estimated 58% of the polio cases reported in children during the outbreak in Syria and Iraq had never received the polio vaccine. 29 Third, several boosters of polio vaccines are required to confer protective immunity, which impedes the success of polio vaccination programs. Incomplete vaccination was reported in 37% of the children with polio in Syria and Iraq in October 2013.…”