Variant type 2 poliovirus in Gaza – WHO/UNICEF Situation Report (16 July – 05 August 2024)

14 August 2024

Situation Highlights

• On 16 July 2024, the Global Polio Laboratory Network (GPLN) notified the detection of six circulating variant poliovirus type 2 (cVDPV2) isolates in environmental samples from Deir al-Balah and Khan Younis in Gaza.
• Seven samples were collected and six of these tested positive for cVDPV2.
• Further genomic sequencing of these isolates by the US Centers for Disease Control and Prevention (CDC) in Atlanta indicates that these isolates have close genetic linkage with each other and are also related to the cVDPV2 that was circulating in Egypt during the second half of 2023 – which was last detected in Egypt in samples collected in December 2023.
• Based on the analysis of genetic changes in the isolates, the variant poliovirus could have been introduced in Gaza as early as September 2023.
• A socio-epidemiological field investigation and risk assessment conducted jointly by the Ministry of Health (MOH), WHO, UNRWA and UNICEF has been concluded. Assessment findings are guiding response planning and efforts, which include implementing two vaccination campaigns, strengthening surveillance for poliovirus in Gaza and strengthening routine immunization in the current complex situation in Gaza.
• Due to immediate acute flaccid paralysis (AFP) surveillance strengthening efforts put in place in Gaza, three cases of AFP were reported between 22-29 July 2024 by the MOH. The cases were promptly investigated and samples collected and sent to the laboratory in Jordan with support of WHO. The results are awaited.
• Currently, only 16 out of 36 hospitals are partially functional and 48 out of 107 primary health care facilities are operational. The impact on the health system, insecurity, inaccessibility, population displacement, and shortages of medical supplies have contributed to reduced immunization rates. Coupled with poor quality of water and destruction of sanitation, there is a heightened risk of vaccine-preventable diseases, including polio and other outbreaks.
• WHO considers there to be a high risk of cVDPV2 spread within Gaza, and internationally, in the absence of urgent response.