Poliovirus Outbreak Response Notes

Poliovirus Outbreak - Immediate Actions Required

Background

  • A circulating vaccine-derived poliovirus type 2 (cVDPV2-n) outbreak has been confirmed in Papua New Guinea (PNG).
  • First detection: Environmental sample from Lae City (Morobe Province) on April 4, 2025.
  • Second detection: Environmental sample from Joyce Bay Treatment Plant, Port Moresby, on April 9, 2025.
  • Poliovirus type 2 (cVDPV2-n) detected in stool samples from healthy children in Lae City on May 8, 2025.
  • The virus is genetically linked to cVDPV2 found in Indonesia, indicating ongoing community transmission.
  • The situation is officially classified as a Poliovirus Outbreak.

Required Immediate Actions for All Provinces

1. Activate Provincial Emergency Operations Centres (EOCs)
  • Develop and implement a provincial response and surveillance plan.
    • Include active Acute Flaccid Paralysis (AFP) case search and on-the-job training.
  • Review weekly surveillance performance:
    • AFP case detection.
    • Investigations.
    • Active searches.
    • Sensitization.
    • Contact sampling.
  • Develop and review routine immunization enhancement plans.
    • Address gaps in outreach and implementation.
    • Address issues in immunization intensification activities.
  • Conduct weekly reviews of immunization session implementation.
    • Focus on reaching all eligible children.
    • Track the number of children vaccinated against their target.
  • Analyze immunization data.
    • Identify and target areas with low coverage and high population density.
    • Take corrective actions to accelerate immunization implementation.
  • Provide weekly updates to the national EOC on response activities.
    • AFP surveillance.
    • Environmental surveillance.
    • Routine immunization.
2. Enhance Acute Flaccid Paralysis (AFP) Surveillance
  • AFP surveillance is critical for detecting polio.
  • In 2025, 26 cases have been reported from 10 provinces, while 11 provinces are silent, indicating potential under-detection.
  • Improve detection and investigation of AFP cases:
    • Train and sensitize health workers on AFP case definition, investigation, and proper stool collection.
    • Conduct active case searches in all health facilities, especially hospitals (minimum six months record review).
    • Collect 3 contact samples (one sample from each contact) for all inadequate AFP cases.
    • In Morobe and NCD: Conduct community-level active case searches.
    • Engage community volunteers to raise AFP awareness and reporting mechanisms.
3. Enhance Environmental Surveillance
  • Provinces with existing polio environmental surveillance (NCD and Morobe) should continue collecting samples twice a month until further notice.
  • Western Highlands and Eastern Highlands Provinces have been selected for environmental surveillance expansion; collaborate with responsible teams to establish the surveillance system.
  • Depending on future risk assessments and NEOC decisions, environmental surveillance may be expanded to other provinces currently without surveillance sites.
  • All provinces are requested to cooperate if contacted by the NDOH team for the establishment of polio environment surveillance sites.
4. Intensify and Improve Routine Immunization Coverage
  • Routine immunization coverage is very low in most provinces.
  • Improve coverage:
    • Mobilize provincial resources to accelerate routine immunization program implementation in respective provinces for all vaccines.
    • NCD and Morobe Province should continue the IPV vaccination of children under five years in the affected districts and expand the IPV under 5 years vaccination to the whole province as vaccine supply allows.
    • Provinces receiving support through WHO PIRI and AIHSS are urged to accelerate routine implementation to rapidly boost immunity and protect children from poliovirus.
    • Maintain vaccine stock availability through regular vaccine stock take, cold chain maintenance, and vaccination data completeness.
5. Strengthen Province Preparedness for Nationwide Immunization Campaign
  • The National Department of Health (NDOH) is planning a nationwide immunization response scheduled for July/August 2025.
  • Provinces are requested to begin mobilizing resources, fast-track routine immunization activities, conduct cold chain maintenance, and strengthen advocacy and communication efforts and community engagement to support the upcoming campaign.
  • Detailed information regarding the planned nationwide campaign will be communicated to all PHAs in due course.

NDOH Contact Information

  1. Mr. Berry Ropa - A/Manager Health Security & Surveillance Branch
    • Ph/WhatsApp: 71291609
    • Email: bropa2013@gmail.com
  2. Ms Martha Pogo - A/EPI Manager
    • Ph/WhatsApp: 79430218
    • Email: martzpogo@gmail.com

Reporting

  • All PHAs are to submit a report on their plans and results of actions taken in response to the poliovirus outbreak.