The situation On 19 September 2019, the Department of Health (DOH) confirmed the re-emergence of polio in the Philippines and declared a national polio outbreak. This follows a confirmed Vaccine Derived Poliovirus Type 2 (VPDV2) case in a three-year old child in Lanao de Sur (Mindanao). Subsequently, another case of polio (strain to be confirmed) was reported on 20 September, and this time in a five-year-old boy from Laguna, bringing the total number of people afflicted with the disease to two. The re-emergence of the disease comes almost 20 years since the Philippines was declared polio-free in 2000. The last known case of wild poliovirus recorded in the Philippines was in 1993.
Between 1 July and 27 August 2019, four environmental samples tested positive for VPDV1 from Tondo (Manila) with no genetic linkage found with any known VDPV1, indicating new emergence. Between 13 and 22 August 2019, two environmental samples tested positive for VDPV2 from Tondo (Manila) and Davao City. Both samples were founded to be genetically linked. As a result, VDPV2 was classified as circulating (cVDPV2).
After the confirmation of the VDPV2 case in Mindanao, the DOH is prioritizing the following activities in collaboration with UNICEF, WHO and other partner organizations1:
- Second round of synchronized polio vaccinations (planned October 2019).
- Development and dissemination of appropriate risk communication messages.
- Case investigation and tracing activities, as well as enhanced surveillance.
- Procurement of required vaccine supplies for campaigns.
UNICEF and WHO are supporting DOH with convening the Health Cluster for coordination with partner organizations in response to the outbreak. This is expected to happen during week of 23 September 2019.
Actions that countries may take:
- To mitigate the risk of importations countries should ensure high coverage with bivalent Oral Polio Vaccine (bOPV) and Inactivated Polio Vaccine (IPV) under national EPI/ routine immunisation programme.
- Countries should identify pockets with low routine immunisation coverage in rural and urban areas. Marginalized and migratory populations living in urban slums, waterways along rivers or their banks, international and national borders, populations movements due to social, economic and economic reasons, displaced populations due to floods/typhoons/insecurities/ other reasons, nomadic groups, isolated settlements in forest, pockets with vaccine hesitancy issues etc. generally have low coverage and are particularly at risk of importation or emergence of vaccine derived polioviruses. Countries should undertake special drives to reach them with bOPV and IPV and other antigens as per their national EPI schedules.
- AFP surveillance sensitivity should be maintained as per global norms to rapidly detect and response to any wild or vaccine derived polioviruses.
- Countries should update their emergency preparedness and response plans to respond in case of any virus detection.
- Travel related guidance on polio vaccination is available at https://www.who.int/ith/updates/20140612/en/