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Week-45 Ending 12 November 2017 Isolation of VDPV2 from an Environmental Surveillance Site

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Week-45 Ending 12 November 2017 Isolation of VDPV2 from an Environmental Surveillance Site Somalia Weekly Update Week-45 Ending 12 November 2017 Isolation of VDPV2 from an Environmental Surveillance Site • A VDPV2 was isolated from an environmental sample from Mogadishu-Somalia • The ES site is ‘21October’ Sewage site in Waberi District, 21October site Banadir Region in Central Somalia. Established on 19th September 2017. The sample was collected on 22nd October, 2017 • KEMRI lab results was received on 1st Nov 2017 as PV2 • Sequencing result from CDC was received on 9th Nov 2017 as VDPV2 with 38 nucleotide difference from the parent Sabin Response activities so far; • Heightened AFP surveillance with active case searches in the community and health facilities: 1 AFP cases identified and 54 community samples collected • Additional ES samples collected and new site selection in progress • Preparation being finalized to conduct IPV vaccination campaign in 4 catchment districts of the 21October ES site • Request for mOPV being worked on, incase circulation of the VDPV2 is confirmed Part -I AFP-Surveillance Week-45 Somalia Weekly EPI/POL Update Epidemiological Curve January 1, 2014 – November 12, 2017 18 16 14 12 10 8 6 4 2 0 Pending Lab Pending ERG Discarded Compatable WPV aVDPV Graph no. 1 Week-45 Somalia Weekly EPI/POL Update Weekly AFP cases reported by Provinces, 2016-2017 Somalia. (cases are distributed across weeks based on date of onset of paralysis). PROVINCE 2016W41 2016W42 2016W43 2016W44 2016W45 2016W46 2016W47 2016W48 2016W49 2016W50 2016W51 2016W52 2017W01 2017W02 2017W03 2017W04 2017W05 2017W06 2017W07 2017W08 2017W09 2017W10 2017W11 2017W12 2017W13 2017W14 2017W15 2017W16 2017W17 2017W18 2017W19 2017W20 2017W21 2017W22 2017W23 2017W24 2017W25 2017W26 2017W27 2017W28 2017W29 2017W30 2017W31 2017W32 2017W33 2017W34 2017W35 2017W36 2017W37 2017W38 2017W39 2017W40 2017W41 2017W42 2017W43 2017W44 Total 2016 Total 2017 Total BANADIR 2 1 2 1 30 1 1 1 2 1 3 1 2 1 1 1 1 1 2 1 1 2 2 2 1 2 30 GALGADUD 2 1 1 25 1 1 1 1 1 1 1 2 1 1 1 1 1 2 1 1 2 1 1 1 1 24 M. SHABELLE 1 1 19 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 1 1 1 1 22 L. SHABELLE 1 2 1 24 1 1 1 1 1 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 1 1 26 HIRAN 1 1 15 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 19 BARI 1 1 2 1 1 24 1 2 1 1 1 2 1 1 1 1 1 2 1 1 1 1 1 20 NUGAL 1 1 1 11 2 1 1 1 1 1 1 1 9 MUDUG 2 1 1 14 1 2 1 1 1 1 1 1 1 1 1 12 TOGDHER 1 1 1 11 1 1 1 1 1 1 1 1 8 GALBEED 1 1 1 1 1 1 1 19 1 3 1 1 1 1 1 1 1 1 2 1 2 1 2 20 SANAQ 2 1 7 1 1 1 1 1 5 AWDAL 1 1 1 18 1 1 1 1 2 1 1 1 1 1 1 1 1 1 1 1 17 SAHIL 1 1 8 1 1 1 1 1 1 1 1 8 SOOL 5 1 2 1 1 1 1 1 2 10 LOWER JUBA 2 1 1 1 1 2 1 1 26 2 1 1 2 2 1 1 1 1 1 1 1 1 2 2 1 1 1 1 24 1 - BAY 2 1 2 19 3 1 3 1 1 1 1 1 1 1 1 2 2 19 GEDO 2 1 1 1 21 1 2 1 1 1 1 1 1 1 1 1 1 2 2 1 18 MIDDLE JUBA 1 11 1 1 1 1 2 1 2 1 10 BAKOOL 1 1 9 1 1 1 1 1 1 1 1 8 Table no. Table Total Somalia 5 11 7 3 4 4 12 7 7 3 5 4 316 6 8 10 6 3 8 9 11 7 12 8 6 9 8 8 4 10 8 6 9 8 5 9 10 2 5 9 3 7 6 7 7 6 9 5 7 10 4 5 7 3 2 7 10 309 Silent (not reporting) for > 8 weeks - 11 new AFP cases were reported this week making the total 309 AFP cases reported in 2017. Reported AFP cases - In addition 923 contact samples (3 contacts for each case) and 167 community samples were collected from 24 districts Community Samples collected in silent regions Community Samples collected but regions not silent Week-45 Somalia Weekly EPI/POL Update Classification of AFP cases by status (2016 & 2017) 2016 2017 REGION Pending Discarded VDPV Total Discarded Pending Total 309 AFP Cases BANADIR 0 30 0 30 27 3 30 Reported in 2017 GALGADUD 0 25 0 25 24 0 24 HIRAN 0 15 0 15 18 1 19 L. SHABELLE 0 24 0 24 23 3 26 M. SHABELLE 0 19 0 19 20 2 22 BARI 0 24 0 24 19 1 20 MUDUG 0 14 0 14 10 2 12 285 0 24 0 0 NUGAL 0 11 0 11 8 1 9 15 2 17 Discarded WPV Pending Compatible VDPV AWDAL 0 18 0 18 GALBEED 0 19 0 19 17 3 20 SAHIL 0 8 0 8 8 0 8 SANAQ 0 7 0 7 5 0 5 SOOL 0 5 0 5 8 2 10 TOGDHER 0 10 1 11 7 1 8 BAKOOL 0 9 0 9 7 1 8 3 0 18 1 19 2 21 BAY 0 19 0 19 - In process (lab) Pending ERG Pending ITD GEDO 0 21 0 21 18 0 18 LOWER JUBA 0 26 0 26 23 1 24 MIDDLE JUBA 0 11 0 11 10 0 10 Chart no. 1 no. Table Grand Total 0 315 1 316 285 24 309 Week-45 Somalia Weekly EPI/POL Update Surveillance Indicators by Zone and Region 2017 Annualized NP-AFP Rate by Zone, 2017 12.0 10.0 11.1 8.0 6.0 6.3 5.5 5.8 4.0 4.9 2.0 0.0 Central Puntland Somaliland South Total Somalia Graph no. 2 Annualized NP-AFP rate by accessibility status 10.0 8.0 7.7 6.0 5.8 4.0 5.5 5.6 2.0 - In-accessible Partially Accessible Somalia Map no. 1 Acceessible Map no. 2 Graph no. 3 Week-45 Somalia Weekly EPI/POL Update Surveillance Indicators (NP-AFP rate and Stool adequacy) by district, 2017 . All the 115 districts in Somalia have reported at least 1 AFP case since the beginning of 2017. The NP-AFP rate for 112 districts is >2. The 3 districts that did not meet this indicator are; Badan from Somaliland and Heliwa and Karan from Central. 112 districts had stool adequacy above 80% while three districts (Badade, Kismayo and Bossaso) did not meet the required stool adequacy rate. Badade and kismayo are partially accessible from south while Bossaso is fully accessible district in Puntland. Map no. 3 Map no. 4 Week-45 Somalia Weekly EPI/POL Update Distribution of NP-AFP cases and zero-dose cases Vs accessibility of districts . AFP cases were reported from across the country from all zones, all regions and also from the accessible and the inaccessible parts of the country. All but one of the total 39 zero dose AFP cases reported in 2017 were reported from access compromised Map no. 5 districts. Map no.6 Week-45 Somalia Weekly EPI/POL Update Number of NP-AFP cases reported across years during the same period (2013-2017) by zone 600 500 496 400 367 300 309 274 256 200 164 100 121 131 123 104 100 93 79 68 73 60 56 59 42 36 22 36 54 49 41 41 32 52 48 26 0 CENTRAL Puntland Somaliland SOUTH SOMALIA 2012 2013 2014 2015 2016 2017 . Overall number of AFP cases reported in 2017 exceeded the number of AFP cases reported in 2015 and 2016 in the zones except Puntland for the same period . Week-45 Somalia Weekly EPI/POL Update CASES AND CONTACT SAMPLES WITH LAB RESULT OF Number of AFP Cases and Contact samples with 18.0% NP-EV AND SLV Entero virus and Sabin like Virus Isolation 16.0% 16.5% NP-AFP Cases Contact Cases 14.0% EV - EV 13.8% - 13.6% 13.5% 12.0% 12.5%12.3% 11.7% # SLs 11.2% result # SLVs # 10.0% 10.8% 10.6% Zone # Samples from Samples # from Samples # from Samples # from Samples # Contacts with lab with Contacts cases NP withcases contacts withNP contacts 8.0% withlab result Cases 8.1% 7.7% 7.1% Central 224 37 8 339 36 20 6.0% 5.9% 5.5% 5.0% Puntland 74 8 5 110 15 6 4.0% 3.9% 4.1% 120 6 7 183 14 3 2.0% 2.7% Somaliland 1.6% 0.0% South 150 19 3 221 31 6 % Specimens from cases with % Specimens from % SL from cases % SL from Contacts NPEV Contactswith NPEV Central Puntland Somaliland South Somalia Somalia 568 70 23 853 96 35 Table no.-3 Week-45 Somalia Weekly EPI/POL Update Early case detection within 7 days from onset of paralysis at zonal and region levels Notification within 7 days, Zonal Notification within 7 days, Regional 100% 100% 121 30 24 19 26 22 12 9 17 8 10 8 8 40 66 90% 292 19 19 292 17 9 80% 80% 15 65 4 70% 16 60% 60% 50% 40% 40% 30% 20% 20% 10% 0% 0% CENTRAL NE NW SOUTH SOMALIA CENTRAL NE NW SOUTH SOMALIA .
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