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Polio cases in Syria

27 June 2017

Background

In early June 2017, an outbreak of circulating vaccine-derived poliovirus type 2 (CVDPV2) was confirmed in Syria in Mayadeen district, Deir Al Zour governorate and in Raqqa district in the governorate of Raqqa. A total of: 17 cases have been reported so far: 16 cases in Mayadeen district and one in Raqqa. This is the firsts outbreak of polio in the area for three years.

Vaccination coverage is estimated to have halved since 2011 and is now reported to be around 41% owing to the ongoing conflict in Syria which limits access to health services. Less than half of the health facilities open before the conflict are currently fully functional, and 26% of them are not in operation at all. Circulating vaccine-derived poliovirus tends to occur in populations which are under-immunised.

Syria

Map by kind permission of the University of Texas Map Libraries

Important information and data about the polio outbreak

∙    700,000 children under five years of age have not received vaccines as a result of the violence.

∙    The children affected first reported symptoms of acute flaccid paralysis (AFP) between March 3 and May 23 2017.

∙    402 attacks on healthcare workers, clinics and hospitals took place in Syria’s civil war between November 2015 and December 2016.

Response to the outbreak

Outbreak response plans are being finalised with the support of the World Health Organization (WHO) and other agencies but there are significant accessibility constraints as Islamic State group controls most of Deir Al Zour governorate and large sections of Raqqa district. A total of 320,000 children under the age of 5 are due to be vaccinated in Deir Ezzor and a further 90,000 in Mayadeen. Where possible, surveillance of AFP cases has also been intensified throughout the country.

Heightened surveillance and increased immunisation activities have been introduced in neighbouring countries.

Polio – facts about the disease

Polio is a highly infectious virus which is transmitted by food and water contaminated by human faeces which is infected with the poliovirus. Young children who are not yet toilet-trained are a main source of transmission. Hygienic sanitation and following safe food and water precautions play a key role in controlling the human spread of polio along with vaccination programmes. If enough children are fully vaccinated against polio (around 85%) and herd immunity is achieved, transmission can be effectively interrupted. For most people polio is a mild illness and causes flu-like symptoms but it can potentially be fatal. It can affect the nervous system and around one in every 200 infections can lead to irreversible paralysis. Among those few who are paralysed, 5% to 10% die when their breathing muscles become immobilised.

Advice for those travelling to or working in the affected areas

Anyone travelling to or working in countries where poliovirus transmission has taken place in the past 3 years should ensure they have completed their primary vaccination course against polio. This is usually part of routine childhood vaccines. In addition, they should be given a booster of polio-vaccine if they have not received one in the past 10 years.

For further advice please click on the related information topics on the right hand panel of this screen

Sources

·    Polio Update, ACAPS 21 June 2017

·    Polio returns to Syria after three years, Middle East Eye, 9 June 2017

·    Circulating vaccine-derived poliovirus type 2 – Syrian Arab Republic, Disease Outbreak News, World Health Organization, 13 June 2017

·    WHO says child from Raqqa among 15 new polio cases in Syria, Reuters 20 June 2017

·    Syria polio update: 17 cases of cVDPV2 have now been confirmed including one in Raqqa, Outbreak News Today 21 June 2017

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