Qatar, supported by WHO, ramps up surveillance for polio during the FIFA World Cup 2022

Around the time when the Fédération Internationale de Football Association (FIFA) World Cup tournament was introduced, in 1930, children didn’t have access to polio vaccines. Additionally, systems to search for polio symptoms in children were most likely weak across the world. This scenario has changed now.  

To prepare for an estimated 1.2 million football fans congregating in Qatar to watch the World Cup tournament, the Government of Qatar took several measures to mitigate risks associated with the spread of diseases, including polio. As part of these interventions, the country requested the World Health Organization (WHO) for technical support to assess and improve surveillance for polio.

Taking stock of existing disease surveillance systems

To kick off these efforts, after months of joint planning and coordination, a team from WHO’s Eastern Mediterranean Region visited Qatar at the end of September 2022 to conduct an elaborate review of the surveillance system for acute flaccid paralysis (AFP). They examined activities at four main health care facilities − where both Qataris and visitors in the country frequently visit − to assess their contribution to AFP surveillance.

The team also conducted a virtual capacity development session for more than 200 public and private health professionals to understand the global and regional polio situation, and the importance of AFP surveillance and case reporting.

Reviewing systems to detect and respond to polio cases

On noting the recent spread of polioviruses across the world, and ease with which viruses can be transmitted, WHO sensitized officials at the Ministry of Public Health on the standard operating procedures for polio outbreaks. This includes a template to develop a national preparedness plan for a polio outbreak.

As next steps, the team conducted a polio outbreak simulation exercise to test the level of preparedness and the blueprint of activities that should be conducted in case of an outbreak. The POSE ensures users are aware of activities to conduct within the crucial first 72 hours of confirmation of a polio outbreak. This exercise also aimed to ensure all existing tools in use are valid, and refreshed health officials’ knowledge on the different kinds of polioviruses that exist and vaccines that can be used to boost immunity.  

Need to strengthen AFP case notification

One of the most highly developed countries in the Region, Qatar has a state-of-the-art online health client database, which is used by 90% of health service providers. The country also uses unique codes for all residents regardless of their nationality, which helps them manage infectious disease outbreaks. Health facilities offer high quality of health care, which encourages communities’ uptake in health services. Taking this into account, the surveillance review revealed that the electronic health system in Qatar is able to track AFP cases once notified.

The country, however, faces challenges in the notification of AFP cases, largely due to the lack of a comprehensive list of diseases related to AFP in the electronic databases currently in use in health facilities and hospitals. Additionally, physicians lack awareness about AFP and case notification, which is attributed to Qatar being polio-free since 1990.

Recommendations for stronger surveillance of polio  

Recommendations made by WHO to the Ministry of Public Health are aimed at developing the capacity of staff to notify AFP cases early; conduct regular active search for children with AFP, including through active surveillance visits; and execute 60-day follow up examination for AFP cases. The WHO team also advised Qatar to maintain updated and functional AFP surveillance guidelines, and a national preparedness and response plan for polio outbreaks and response.

WHO also encouraged the Ministry of Public Health to set up a system for environmental surveillance to search for polioviruses in sewage and wastewater at prime sites across the country. This would help to cast a wider net to search for any poliovirus both in visitors and communities living in the country.

Qatar plays a key role in polio eradication

The Government of Qatar is a key partner in polio eradication efforts. Qatar’s Minister of Public Health, HE Dr Hanan Mohamed Al Kuwari has been serving as the co-chair of the Regional Subcommittee for Polio Eradication and Outbreaks in the Eastern Mediterranean Region since February 2022. In this capacity, HE Dr Al Kuwari has been instrumental in shining the spotlight on the current status of polio in the Region and efforts needed to end polio by the end of 2023.   

Polio Director for the Eastern Mediterranean Region calls for people at all levels to act to end polio  

Credit: WHOAmman, 24 October 2022 –On World Polio Day, marked on 24 October across the world, countries around the world are stepping up efforts to end polio.

This year’s theme for the day has been ‘Together We End Polio’ and emphasis has been on how polio eradication efforts also play a key role in improving both children’s and mothers’ access to vaccines and other health and nutritional services.

At present, only 2 countries worldwide remain with indigenous transmission of wild poliovirus type 1 (WPV1) – Afghanistan and Pakistan. In Afghanistan, in 2022, the WPV1 has left 2 children paralyzed, whereas in Pakistan, 20 children have been affected this year.

So far, 33 countries have outbreaks of variant polioviruses, which can also cause paralysis in children. These include the United Kingdom (UK) and United States of America (USA), Israel and Malawi. Yemen and Somalia are among high-risk countries where variant polioviruses continue to circulate incessantly.

Despite the circulation of WPV1 and the variant polioviruses, the world and Eastern Mediterranean Region have made incredible progress. Since 1988, when the Global Polio Eradication Initiative (GPEI) was set up, polio cases have plummeted by 99% from an estimated annual total of 350 000. Additionally, governments and communities in both Afghanistan and Pakistan have been showing their highest levels of commitment towards polio eradication.

In a live interview with the WHO’s Regional Office for the Eastern Mediterranean on World Polio Day, Dr Hamid Jafari, Polio Director for WHO’s Eastern Mediterranean Region emphasized everyone has a role to play: caregivers must make concerted efforts to have their children vaccinated during immunization campaigns or at health facilities; and policymakers and donors can support the polio eradication programme, which also strengthens the response to health emergencies such as COVID-19. He added the media also has a role to play in raising awareness around the benefits of polio vaccination.

Dr Jafari also stressed that polio is a health emergency of international concern, and that while countries with outbreaks and indigenous transmission of poliovirus need to urgently stop transmission, countries that haven’t been affected yet still need to be prepared to detect polio and respond to outbreaks.

Dr Jafari thanked polio health workers for the sacrifices they make to reach every child possible, in addition to donors who have stepped up efforts to end polio. At a recent pledging event, organized by the GPEI, at the World Health Summit in October 2022, donors committed to supporting eradication efforts with US$ 2.6 million, which will go towards reaching more vulnerable children with vaccines among other crucial activities.  

Listen back to the interview at the @WHOEMRO twitter account: https://twitter.com/WHOEMRO/status/1584157258321383424 (From 14 min onwards)

Djibouti, 12 October 2022 – The national polio vaccination campaign, initiated by the Government of Djibouti and carried out by the Ministry of Health, in collaboration with WHO and UNICEF, started on Monday 10 October 2022. It will run for five days, until Friday 14 October 2022.

More than 150 000 children under the age of 5 in Djibouti will receive an additional dose of the polio vaccine in this campaign, which follows 2 earlier vaccination rounds, in February and March 2022. The Ministry of Health, through this campaign, aims to protect all children throughout the country against poliovirus.

Djibouti was declared polio-free in 2002, but there are currently outbreaks of circulating variant polioviruses in the Horn of Africa, which increases the risk for all children in the Region.

This campaign, like the first 2 rounds, is a supplementary vaccination campaign offering children under 5 years of age an additional dose of oral polio vaccine to protect them from poliovirus, on top of their regular childhood vaccinations.

“It is our duty to protect Djibouti by ensuring that our children under 5 receive the polio vaccine whenever it is offered. I encourage all parents to make the vaccination of their children a priority – for them and for Djibouti,” said His Excellency the Minister of Health Dr Ahmed Robleh Abdilleh.

The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) are supporting the campaign by providing novel oral polio vaccine type 2 (nOPV2), a next-generation polio vaccine. The 2 UN agencies also provide technical support to teams and staff working in the health system, including in disease surveillance.

“WHO provided technical support to the Ministry of Health for the planning and execution of this campaign. With the number and severity of polio outbreaks in the region on the rise, coupled with Djibouti’s geographic location and historical role as a crossroads, its children are increasingly vulnerable to polio. For this reason, it is essential that we vaccinate all children under age five, even if these children are up to date with their regular vaccinations,” said Dr Reinhilde Van De Weert, WHO Representative in Djibouti.

During this campaign, 378 vaccination teams will crisscross every neighbourhood for 5 days and go door-to-door in Djibouti’s towns and even the most remote localities to vaccinate every child.

“Despite the extraordinary progress that has been made in the polio eradication effort over the past 3 decades, new cases of polio are emerging around the world, and this is not acceptable. It is vital that we do everything we can to protect children, once and for all,” said Ms Beate Dastel, UNICEF Representative in Djibouti.

Poliovirus mainly affects children under the age of 5 and can lead to lifelong paralysis. It can easily be prevented by vaccination. Parents are urged to accept polio vaccines whenever offered.

The vaccination campaign in Djibouti is also supported by Gavi, the vaccine alliance, CDC (Centers for Disease Control) and AFENET (African Field Epidemiology Network). It is part of the global poliovirus eradication effort, led by the Global Polio Eradication Initiative (GPEI).