WHO and Unicef helping respond to new polio cases at Angola/Zambia border, maximum vigilance against virus importations urged as global polio eradication nears

Brazzaville/Nairob, 8 February 2002: The UN agencies involved in the global effort to eradicate polio are helping to plan a major immunization drive in western Zambia and eastern Angola, in response to three polio cases virologically confirmed amongst Angolan refugees. Two joint World Health Organization / United Nations Children's Fund missions, one to Zambia and one to Angola, are joining the national ministries of health to determine if the virus has spread and to help plan the responsive polio vaccination campaign.

"The challenge will be to reach every child in order to contain the virus, including in areas we have not been able to access in the past, " said Dr Stella Goings, the UNICEF Representative for Zambia. "But, in our efforts to reach these unprotected children, we must ensure the safety of the health workers and the volunteers."

"Due to the ongoing conflict in Angola which makes access to some areas almost impossible, these are the first polio cases we have seen in the border areas between Angola and Zambia since the last case found in Zambia in 1995," said Dr Edward Maganu, World Health Organization (WHO) Representative for Zambia. "To stop transmission of the wild poliovirus, we must help coordinate or "synchronise" the immunization response between Zambia and Angola, in addition to continued routine immunization coverage and surveillance for the disease."

Three children from the same family, ages 1, 3 and 6 were examined in late December 2001 at Mambolomoka, a town in the Western Province of Zambia near the Angolan border. The children, who had never been vaccinated against polio, had a history of fever and paralysis in their legs. Laboratory results confirm they had been infected with wild poliovirus type 1, and genetic sequencing indicates the virus is related to wild polioviruses found previously in Angola. The family had been living in Kalabo District near the Angolan border since September 2001. The investigation is ongoing to determine the exact origin of the wild polioviruses. Angolan health authorities have indicated they will make every effort to investigate the districts in Moxico and Kuando Kubango provinces which may be affected.

WHO and UNICEF have long been concerned about the possibility of circulating wild poliovirus in inaccessible areas of Angola and the threat of virus importation to neighbouring countries. Due to ongoing conflict and insecurity in eastern Angola, an estimated 15% of Angolan children have not been immunized during either the country's polio National Immunization Days (NIDs) which have taken place since 1996 or through routine immunization. Insecurity has also hampered polio surveillance efforts, making it impossible to confirm whether the poliovirus has been circulating in the area.

"In our effort to eradicate this crippling disease, it is crucial that every child be immunized against polio, no matter where they live," said Dr Jean-Marie Okwo-Bele, Regional Advisor in the Vaccine Preventable Diseases Unit of the WHO African Region. "One poliovirus infection threatens all children who aren't protected - at village level, in the Province, and in neighbouring countries. "

The fact these cases were immediately identified is an indication that Zambia's polio surveillance system is working very well due to the Central Board of Health's efforts. Certification-standard acute flaccid paralysis (AFP) surveillance is the only way to identify and respond to polio cases, and is critical in both endemic and polio-free countries.

There have been no polio cases in Zambia since 1995, and immunization coverage in the country is good. As a standard practice, all Angolan refugees in camps are immunized against the disease and the Zambian health authorities have been vigilant in ensuring children are vaccinated. However, because the Angolan/Zambian border is long and relatively porous, there are logistical challenges to monitoring every border crossing and immunizing every child.

In response to these three new cases, the WHO/UNICEF mission is offering immediate support to help strengthen polio surveillance in the area. The agencies are also supporting Zambian and Angolan health officials in the planning of responsive polio sub-National Immunization Days in the North Western and Western Provinces and in eastern Angola. These activities are expected to begin in early March targeting all children under five.

"If the two countries coordinate the immunization response, they will guarantee to reach more children, including those on the move," said Dr Pier Paolo Balladelli, WHO Representative for Angola. "This has been proven time and again in synchronised polio campaigns across Africa."

As part of its ongoing support to eradicate polio in southern Africa and around the world, Rotary International has committed to help fund the responsive immunization activities. "Eradicating polio is Rotary International's top priority," said Luis Giay, Chairman of the Rotary Foundation Trustees. "Where ever the poliovirus remains, Rotary International will be there to help fund the immunization response in coordination with our partners."

This polio eradication effort will require additional logistical support from the police, the army, non-governmental organizations, donors and international agencies. Enhanced social mobilization activities will enable communities to conduct house-to-house immunization; to recognize suspected cases; and to help refugees and migrants have their children immunized. 

For more information, please contact :

Ms Edita Nsubuga, Communication Officer, 
UNICEF, Lusaka, 
tel: (+260 1) 252055/252430(Ext 276); 
mobile: 260 97 790728, 
ensubuga [at] unicef.org

WHO Zambia: 
tel: (+260 1) 25 53 36 for Dr Edward Maganu, 
WHO Representative, 
EMaganu [at] who.org.zm ; Ms N. Mweemba, Health Information and Promotion officer, Nweemba [at] who.org.zm or Dr Pascal Mkanda, EPI team leader, Pmkanda [at] who.org.zm

WHO Angola: 
Mr Jose Caetano, information officer, 
WHO Angola, 
tel: (+244 2) 332398, 
jose.caetano [at] undp.org

UNICEF Angola: 
Jose Luis Mendonca, Information Officer, 
tel: (244 2) 33 23 48/95, 
jlmendonca [at] unicef.org or Celso Malavoloneke, Programme Communication Officer, tel: (244 2) 33 10 10, mobile: (244 91 51 28 92), 
cmalavoloneke [at] unicef.org

WHO HQ, Geneva, 
Ms Christine McNab, Communications Officer, , 
Tel (+41 22) 791 4688,, mcnabc [at] who.int

UNICEF HQ, New York, 
Mr Mohammad Jalloh, Communications Officer, , Tel (1 212) 326 7516, mjalloh [at] unicef.org