6 May 2005: Outbreak of polio in Indonesia and Yemen

The World Health Organization has reported a total of four confirmed cases of poliomyelitis in Indonesia [1]. These are the first cases of wild type polio in Indonesia since 1995.

The first case was confirmed on 2 May 2005 in Giri Jaya village, Sukabumi District, West Java . Two further cases have occurred in the same village as the index case, and a third from a neighbouring village. All cases have occurred in previously unvaccinated children. The cases had onset dates of 13 March and 2, 9 and 10 April 2005 .

Genetic analysis of the virus has indicated that its origin is west Africa and suggests that the virus has travelled to Indonesia through Sudan . The virus also has similarities with wild polio virus isolated in Saudi Arabia and Yemen .

In April, Yemen also reported polio cases [2], the first confirmed cases since 1996. Twenty-two cases have occurred across five governorates, including two districts of the country's capital San'a. This suggests that the virus has spread across the country. The origins of this outbreak virus are being investigated.

An intensive, coordinated outbreak response has been launched in both countries, together with immunisation campaigns. In Yemen a new monovalent vaccine against type 1 poliovirus (the type that is responsible for the outbreak) is being used.

Yemen and Indonesia bring to 16 the number of previously polio-free countries that have reported cases of polio since 2003. An ongoing outbreak in Africa that has its origins in northern Nigeria raises concern that additional countries may be at risk for the introduction of polio. Countries in which vaccine coverage of the local population may have fallen below protective levels are particularly vulnerable.

Currently six countries are considered endemic for polio (Nigeria, Niger, Afghanistan, India, Pakistan and Egypt) and six other countries have re-established polio transmission since 2003 (Sudan, Mali, Chad, Central African Republic, Burkina Faso and C ? te d'Ivoire).

Travellers to Indonesia and Yemen as well as to other polio risk countries are reminded to ensure that their polio vaccination schedule is up to date. Travellers whose last dose of polio vaccine was more than ten years previously should receive a booster using the combined tetanus, diphtheria, and inactivated polio vaccine.

References

World Health Organization Polio Eradication Initiative.

Outbreak of polio in Indonesia . 6 May 2005

http://www.polioeradication.org/

content/pressreleases/Indonesiapolio6May2005.pdf

World Health Organization. Polio outbreak spreads across Yemen

29 April 2005 http://www.who.int/mediacentre/

news/releases/2005/pr19/en/index.html