Date: 10 Sep 2018
Source: The Guardian [edited]
An outbreak of polio in Papua New Guinea has reached Port Moresby, with the 1st case in the nation's capital prompting an emergency vaccination campaign. A 6-year-old boy from the capital's Five Mile settlement was confirmed as infected after laboratory tests were conducted in Australia. PNG was declared polio-free in 2000, but in 2018 there has been an outbreak with 10 confirmed cases of the disease, which largely affects young children. The children affected in PNG range from 12 months old to just under 10. All of them have experienced some paralysis, with some unable to walk, others affected less severely. The oldest of these children died on Monday [10 Sep 2018] night, though Keith Feldon, co-coordinator of the national polio emergency response in PNG, said the boy was also infected with meningitis and tuberculosis, and he wouldn't attribute the death to polio.
The capital is home to roughly 300 000 people. Previous cases were found in more remote parts of the country: 3 in Morobe, 2 in Eastern Highlands, 2 in Enga, and 2 in Madang. "This is very concerning; every new case of polio isn't just a statistic. Each represents a child that will be permanently paralysed," said Pasco Kase, secretary of the national department of health. In response, the government will conduct an emergency vaccination campaign in Port Moresby beginning on [24 Sep 2018], with a nationwide campaign to follow on [1 Oct 2018]. Port Moresby is due to host the Apec summit in November  with world leaders including Chinese president Xi Jinping, Australian prime minister Scott Morrison, and US vice president Mike Pence due to attend.
The lead-up to the summit has been fraught, as the poorest nation in the Apec group has scrambled to prepare buildings, accommodation and infrastructure. There are also concerns about security given the high rates of crime in Port Moresby. The World Health Organization representative in Papua New Guinea, Dr Luo Dapeng, said: "The confirmation of polio in an urban area is very worrisome." Dapeng said the PNG government and partner organisations were going to "rapidly scale up" the response in Port Moresby and were continuing to search for all possible cases. Efforts were being concentrated in densely populated areas such as settlements, mining communities and areas with significant movement of people.
The 1st cases were detected in the Morobe province on the north coast of the country, where polio vaccine coverage is low. Water, sanitation and hygiene are serious challenges in the region, adding to the crisis of controlling the highly infectious virus. The outbreak can be largely attributed to "several years of sub-optimal vaccination coverage," said Feldon. While you would hope for 80 percent of the community to be vaccinated, PNG has been seeing rates of 50-60 percent vaccination coverage across the country, said Feldon. The estimated budget for the outbreak response plan is USD 15.4 million, and the PNG government has pledged roughly USD 2.2 million toward the effort, with other money coming from the Bill and Melinda Gates Foundation and the governments of the United States, Canada and Korea. [Byline: Kate Lyons]
Date: 7 Sep 2018
Source: Relief Web [edited]
Polio case confirmed in Port Moresby Report from Government of Papua New Guinea, World Health Organization, UN Children's Fund
First case reported in the capital city; emergency vaccination starts [24 Sep 2018] in NCD [National Capital District].
One new case of polio has been confirmed in a 6-year old boy from 5-Mile Settlement. This is the 1st case reported from Port Moresby, the capital of Papua New Guinea.
The National Department of Health (NDOH) announced the finding after laboratory tests conducted by the Victorian Infectious Disease Reference Laboratory, a World Health Organization (WHO) Polio Regional Reference Laboratory in Australia. The United States Centers for Disease Control and Prevention confirmed that this case is linked to the ongoing polio outbreak in the country.
"In response to this recent case in Port Moresby, the NDOH and partners will start an emergency polio vaccination campaign on [24 Sep 2018] in the National Capital District. A nationwide polio campaign will commence on [1 Oct 2018]."
WHO Representative in Papua New Guinea, Dr Luo Dapeng said, "the confirmation of polio in an urban area is very worrisome, and WHO and partners are working together to support the Government to continue to actively search for all possible polio cases, rapidly scale up the response in Port Moresby with the emergency vaccination, and embark on a nationwide vaccination in the succeeding rounds of the campaign."
The NDOH and WHO have jointly deployed experts to conduct surveillance and are working with partners to engage with communities on polio prevention and reporting of suspected cases.
"We are working closely with health promotion colleagues in implementing social mobilisation and community engagement activities" said UNICEF Representative Mr David McLoughlin. "We appeal to community and church leaders to support the health promotion and vaccination teams to gain access and effectively deliver the essential health service," he added.
As of [6 Sep 2018], Papua New Guinea has confirmed a total of 10 polio cases: 3 in Morobe, 2 in Eastern Highlands, 2 in Enga, 2 in Madang and 1 in the National Capital District.
The Government of Papua New Guinea declared a Public Health Emergency on [26 Jun 2018] after confirmation that poliovirus is circulating in the country. A polio vaccination campaign is currently ongoing to vaccinate children under 5 years old in Morobe, Madang, Eastern Highlands, Enga, Chimbu, Southern Highlands, Western Highlands, Jiwaka and Hela. Vaccination teams are intensifying efforts, particularly in densely populated areas such as settlements, mining communities and areas where there is significant movement of people to ensure that all children are vaccinated and protected against polio.
In response to the polio outbreak in the country, an outbreak response plan has been developed and includes 4 sub-national and national vaccination rounds as well as enhanced surveillance activities. The total estimated budget for the plan is USD 15.4 million, against which the Government has committed approximately USD 2.2 million (PNG Kina 6.6 million), releasing PNG Kina 2 million for the 1st and 2nd rounds.
Financial support for the outbreak response includes the Bill and Melinda Gates Foundation, United States Agency for International Development (USAID), Canada and the Republic of Korea. The Global Polio Eradication Initiative (GPEI) partners, in partnership with the Government, will continue to work with donors to secure the urgently required outbreak response funding.
[It is unfortunate but not surprising that there has been poliovirus transmission in the national capital district, as there is population movement within the country. What is not stated in the above media reports is that this outbreak involves a circulating vaccine derived poliovirus type 1 (cVDPV1). The key pre-disposing community factor for cVDPVs is low vaccination coverages that permit the vaccine virus to continue to circulate and mutate to a reversion in neurovirulence close to that of the wild poliovirus (WPV). As mentioned in previous comments, unfortunately, many countries following interruption of WPV circulation within the country and ultimate declaration of polio-free status have been unable to maintain the high vaccination coverages that were seen during the peak of the polio eradication efforts within the countries. This double edge sword of the vaccine (oral polio vaccine - OPV) where the very trait that made it desirable to use for eradication goals -- that of vaccinating not just the individual vaccinee, but all contacts of the vaccinee -- is now coming back through reversion of neurovirulence after multiple passages through susceptible individuals.
With the confirmation of this case in Port Moresby, there are now 10 confirmed cases of cVDPV1 associated polio in Papua New Guinea that have been identified. Hopefully, the subnational and soon to be national vaccination campaigns will interrupt the ongoing transmission of this cVDPV1.
For a map of Papua New Guinea showing provinces, see