Malawi records Africa’s first wild polio virus cases in over 5 years

The case was detected in a three-year-old girl who began showing signs of paralysis from November 19, 2021
Detection of WPV1 outside the world’s two remaining endemic countries is a serious concern and underscores the importance of prioritising polio immunisation activities. Photo: iStock
Detection of WPV1 outside the world’s two remaining endemic countries is a serious concern and underscores the importance of prioritising polio immunisation activities. Photo: iStock

Malawi has recorded Africa’s first wild poliovirus (WPV) case in five years, the Global Polio Laboratory Network (GPLN) confirmed February 17, 2022. The case has been found to be genetically linked to the WPV1 detected in October 2019 in Pakistan’s Sindh province — one of two countries where it continues to remain endemic. The other is Afghanistan.

“Detection of WPV1 outside the world’s two remaining endemic countries is a serious concern and underscores the importance of prioritising polio immunisation activities. Until polio is fully eradicated, all countries remain at risk of importation and must maintain high vaccination coverage to protect all children from polio,” the Global Polio Eradication Initiative (GPEI) noted.

The case was detected in a three-year-old girl who began showing signs of paralysis from November 19, 2021. Her stool specimens were collected for testing November 26 and 27.

The virus was sequenced and confirmed by the National Institute for Communicable Diseases in South Africa and the US Centers for Disease Control and Prevention in February.

“The GPEI is supporting health authorities in Malawi to conduct a thorough assessment of the situation and begin urgent immunisation activities in the sub-region to mitigate any risk of spread. Surveillance measures are also being expanded in Malawi and neighbouring countries to detect any other potential undetected transmission,” GPEI said.

This is the first WPV case in Malawi in three decades. Africa was declared free of WPV in August 2020. This detection does not change that status.

Detection of polio in countries where it has been eradicated, has been recorded in the past. The polio eradication programme “has moved quickly to successfully stop transmission of the virus in these areas.”

In November 2021, the World Health Organization (WHO) had stated that cases of wild poliovirus are on the decline. Only two cases of the disease were detected last year — both in countries where it remains endemic (Pakistan and Afghanistan).

Between January and October 2020, 129 cases were reported. According to the 30th meeting of the Emergency Committee under the International Health Regulations held November 3, Pakistan’s key hurdle in curbing the spread of polio remains “persistently missed children” who have not been vaccinated.

Migrants, nomads and displaced populations are also part of the country’s “high-risk population”. In a conflict zone like Afghanistan, “the cumulative backlog of unvaccinated children due to extended inaccessibility” is the biggest reason why the disease continues to spread.

Vigilance is key in curbing the spread. “Ramping up surveillance in Malawi and neighboring countries in response to the detected case. The imperative is to search for evidence of transmission and achieve rapid and high levels of coverage through immunisation response,” Aidan O’Leary, director of polio eradication at WHO said. 

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