MMWR Morb Mortal Wkly Rep. 2016 Nov 25;65(46):1295-1299. doi: 10.15585/mmwr.mm6546a4.
Pakistan, Afghanistan, and Nigeria remain the only countries where endemic wild poliovirus type 1 (WPV1) transmission continues. This report describes the activities, challenges, and progress toward polio eradication in Pakistan during January 2015-September 2016 and updates previous reports (1,2). In 2015, a total of 54 WPV1 cases were reported in Pakistan, an 82% decrease from 2014. In 2016, 15 WPV1 cases had been reported as of November 1, representing a 61% decrease compared with the 38 cases reported during the same period in 2015 (Figure 1). Among the 15 WPV1 cases reported in 2016, children aged <36 months accounted for 13 cases; four of those children had received only a single dose of oral poliovirus vaccine (OPV). Seven of the 15 WPV1 cases occurred in the province of Khyber Pakhtunkhwa (KP), five in Sindh, two in the Federally Administered Tribal Areas (FATA), and one in Balochistan (3). During January-September 2016, WPV1 was detected in 9% (36 of 384) of environmental samples collected, compared with 19% (69 of 354) of samples collected during the same period in 2015. Rigorous implementation of the 2015-2016 National Emergency Action Plan (NEAP) (4), coordinated by the National Emergency Operations Center (EOC), has resulted in a substantial decrease in overall WPV1 circulation compared with the previous year. However, detection of WPV1 cases in high-risk areas and the detection of WPV1 in environmental samples from geographic areas where no polio cases are identified highlight the need to continue to improve the quality of supplemental immunization activities (SIAs),* immunization campaigns focused on vaccinating children with OPV outside of routine immunization services, and surveillance for acute flaccid paralysis (AFP). Continuation and refinement of successful program strategies, as outlined in the new 2016-2017 NEAP (5), with particular focus on identifying children missed by vaccination, community-based vaccination, and rapid response to virus identification are needed to stop WPV transmission.
巴基斯坦、阿富汗和尼日利亚仍然是唯一存在野生脊髓灰质炎 1 型病毒（WPV1）地方性传播的国家。本报告描述了 2015 年 1 月至 2016 年 9 月期间巴基斯坦在消灭脊灰炎方面的活动、挑战和进展，并更新了以往的报告（1,2）。2015 年，巴基斯坦共报告 54 例 WPV1 病例，比 2014 年减少 82%。截至 2016 年 11 月 1 日，2016 年已报告 15 例 WPV1 病例，比 2015 年同期报告的 38 例减少 61%（图 1）。2016 年报告的 15 例 WPV1 病例中，年龄<36 个月的儿童占 13 例；其中 4 例儿童仅接受了一剂口服脊髓灰质炎疫苗（OPV）。15 例 WPV1 病例中有 7 例发生在开伯尔-普赫图赫瓦省（KP），5 例发生在信德省，2 例发生在联邦部落地区（FATA），1 例发生在俾路支省（3）。2016 年 1 月至 9 月，在采集的 384 份环境样本中检测到 WPV1 的比例为 9%（36 份），而 2015 年同期采集的 354 份样本中检测到 WPV1 的比例为 19%。在国家应急行动中心（EOC）的协调下，严格执行 2015-2016 年国家应急行动计划（NEAP）（4），与上一年相比，WPV1 的总体循环显著减少。然而，在高危地区发现 WPV1 病例以及在没有脊灰炎病例的地理区域发现 WPV1 环境样本，突出表明需要继续提高补充免疫活动（SIAs）*的质量，重点是在常规免疫服务之外为儿童接种 OPV 疫苗，并开展急性弛缓性麻痹（AFP）监测。需要继续和完善新的 2016-2017 年国家应急行动计划（5）中概述的成功方案战略，特别注重发现漏种儿童、社区疫苗接种和对病毒鉴定的快速反应，以阻止 WPV 传播。
