Poliomyelitis Outbreak weekly Report Weak 07 (9-51 February 2054) EWARN

AFP cases reported week 7: Cumulative AFP cases report to 51 February 2014: Total number is = 5 Total number is = 83 cases Total Deaths is = 0 Total Deaths is = 0

The Epi Curve of Acute Flaccid Paralysis (AFP) cases and confirmed WPV cases by week of onset of paralysis as of 15 February 2014:

AFP WPV

12

10

8

6

4 NumberofCases 2

0 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4 5 6 7 Epi Week

**there are two AFP cases dated back to week 21 & 27 Proportion of vaccinated children among confirmed polio cases: The proportion of children among the confirmed polio cases who received at least one dose of OPV is 38.1% (5 cases); no case received three doses 0%. The remaining 65.1% (8 cases) did not received any dose. No history of contact with affected child for all reported cases. Table 5: Confirmed polio cases by month of onset: Total number in 2013 up to date September 2013 October 2013 November 2013 December 2013 13 4 5 4 0 Table 2: Wild Polio cases by sub-district and date of onset of paralysis, Syria 2013/2014 Governorate District Sub district Number of cases First case Last case Deir-Ez-Zor Al-Mayadin Ashara 3 28/09/2013 11/10/2013 Deir-Ez-Zor Al-Mayadin Al-Mayadin 1 20/9/2013 20/9/2013 Deir-Ez-Zor Al-Mayadin Thiban 1 01/11/2013 01/11/2013 Deir-Ez-Zor Deir-Ez-Zor Kisreh 2 17/10/2013 19/10/2013 Deir-Ez-Zor Deir-Ez-Zor Basira 3 81/00/2013 17/10/2013 Areha Areha 1 10/11/2013 10/11/2013 Jebel Saman Jebel Saman 1 18/11/2013 18/11/2013 Aleppo Al bab 1 10/11/2013 10/11/2013 Total 13 20/9/2013 10/11/2013

For any queries: please do not hesitate to contact the EWARN Unit at the [email protected]

Table 3: Investigation of AFP cases with paralysis onset in 2013/2014 up to Week (7/14) / Ending on: (51/2/14) by sub-district 3102 3102

AFP cases classification AFP cases classification

4

pending Sub district

on and lab on and lab

1

District

3 3

ication > 90

Polio Polio

Total Total

VDPV VDPV

Governorate

cases pending

Type 1 Type

specimens specimens

Pending Pending Pending

polio AFP) polio AFP) polio

Confirmed Confirmed

Polio Cases*

onset 2013 onset 201 onset

days onset from days onset from

Compatible

Polio Cases* Cases* Polio

classif classification > 90

Classification Classification

AFP AFP cases pending AFP cases pending AFP cases

Non polio AFP rate

Wild Virus Polio

% % with **adequate ConfirmedTotal

Sabin like type type like Sabin type like Sabin

Polio Compatible

Discarded (non Discarded (non Discarded

% % with ***adequate

Total AFP cases AFP cases Total classificati AFP cases Total classificati

> 90 days onset from > 90 days onset from

Wild Virus Polio Type

Non polio AFP rate**

Ashara 29 3 0 23 3 0 0 23 0 3 0 0 0 0 0 0 0 - 0 0 0 Al-Mayadin Al-Mayadin 3 1 0 0 8 0 0 0 0 1 2 0 0 2 0 0 0 - 0 0 0 Thiban 4 1 0 3 0 1 0 3 0 1 0 0 0 0 0 0 0 - 0 0 0

Deir-Ez-Zor 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 - 0 0 0

Zor - Kisreh 10 2 0 1 0 0 0 4 0 2 0 0 0 0 0 0 0 - 0 0 0

Ez .87 16.4 0 - Basira 3 3 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 - 0 0 0 Deir-Ez-Zor

Deir Muhasan 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 - 0 0 0 Tabni 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 - 0 0 0 sur 1 0 0 1 0 0 0 1 0 0 1 0 0 1 0 0 0 - 0 0 0 8 0 0 8 0 0 0 1 0 0 0 0 0 0 0 0 0 - 0 0 0 2 0 0 2 0 0 0 2 0 0 0 0 0 0 0 0 0 - 0 0 0 Ain Al Arab Sarin Jebel Saman Aleppo City 2 1 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 - 0 0 0 .05 40 0 Al bab Dayr Hafir 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 - 0 0 0

Aleppo Menbej Maskana 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 - 0 0 0 Saraqab Saraqab 2 0 0 2 0 0 0 2 0 0 0 0 0 0 0 0 0 - 0 0 0 MaaretTams Maaret 2 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 - 0 0 0 rin Tamsrin Ariha 2 1 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 - 0 0 0

Ariha Ehsem 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 - 25 50

Idleb Jisr-Ash- Darkosh 2 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 - 0 0 0 Shugur Al Ma'ra Khan Shaykun 1 0 0 1 0 0 0 0 0 0 1 0 0 1 0 0 0 - 0 0 0 Al Ma'ra Kafr Nobol 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 - 0 0 0 Harim Dana 1 0 0 1 0 0 0 0 0 0 1 0 0 1 0 0 0 - 0 0 0

As Madiq Castle 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 - 0 0 0 Suqaylabiyah - 0 0

Hama Muhradah Kafr Zeta 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 - 0 0 0

- Tell Abiad Tell Abiad 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 .27 0 - 0

qa

Ar Raq Al Thwarah Mansura 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 Al-Hasakeh Ras Al ain 1 0 0 0 1 0 0 .20 0 0 0 0 0 0 0 0 0 0 0 - 0 0 0 0 Total 76 12 0 55 8 0 1 .16 38 0 18.4 12 7 0 0 7 0 0 0 - 0 0 14.3 0 *Confirmed polio cases refer to wild virus isolation from AFP cases or from contacts of negative index AFP cases **Adequate here refers to two stool specimens collected at least 24 hours apart, within 14 days of paralysis onset.

For any queries: please do not hesitate to contact the EWARN Unit at the [email protected]

Percentage of AFP cases with adequate samples 5/10/2013 – 15/2/2014

AFP and confirmed polio Cases by Sub districts in Syria 15 February 2014

For any queries: please do not hesitate to contact the EWARN Unit at the [email protected]

Sex & Age Distribution of AFP Cases as of Age Distribution of reported Cases as of 15 February 2014: 15 February 2014: 35 Sex Distribution 30 25 20 Female 15 34% 10 5 0 Male 00-01 > 01-02 > 02-03 > 03-04 > 04-05 > 05-10 > 10-15 > 15 66% AFP WPV

Age range Mean AFP 4 months – 12 years 24.3 month WPV 5 months – 29 months 14 month

Symptoms of AFP Cases as of 15 February 2014:

Intramuscular Injection Neurological s&s Vomiting Runny nose Constipation

Symptoms Diarrhea Sore throat Fever Paralysis

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Proportion

Comments: 1- Confirmed wild polio cases reported from 3 governorate. 2- One new AFP case reported last week from Mansura in Ar-Raqqah. 3- Daily zero reports send regularly via all District level officers (DLOs) from 152 health facilities. 4- Active surveillance started in 50 HFs, which visited 2-3 times per week. Mobile and Dial connections interruption; our DLOs cannot send daily Zero report to central level some times.

For any queries: please do not hesitate to contact the EWARN Unit at the [email protected]