MMWR Morb Mortal Wkly Rep. 2023 Aug 18;72(33):880-885. doi: 10.15585/mmwr.mm7233a1.
Since the establishment of the Global Polio Eradication Initiative in 1988, Pakistan remains one of only two countries (along with Afghanistan) with continued endemic transmission of wild poliovirus (WPV). This report describes Pakistan's progress toward polio eradication during January 2022-June 2023. During 2022, Pakistan reported 20 WPV type 1 (WPV1) cases, all of which occurred within a small geographic area encompassing three districts in south Khyber Pakhtunkhwa. As of June 23, only a single WPV1 case from Bannu district in Khyber Pakhtunkhwa province has been reported in 2023, compared with 13 cases during the same period in 2022. In addition, 11 WPV1 isolates have been reported from various environmental surveillance (ES) sewage sampling sites to date in 2023, including in Karachi, the capital of the southern province of Sindh. Substantial gaps remain in the quality of supplementary immunization activities (SIAs), especially in poliovirus reservoir areas. Despite the attenuation and apparently limited geographic scope of poliovirus circulation in Pakistan, the isolation of WPV1 from an ES site in Karachi is cause for concern about the actual geographic limits of transmission. Interrupting WPV1 transmission will require meticulous tracking and sustained innovative efforts to vaccinate children who are regularly missed during SIAs and rapidly responding to any new WPV1 isolations.
自 1988 年全球根除脊髓灰质炎倡议成立以来，巴基斯坦一直是仅有两个持续存在野生脊髓灰质炎病毒（WPV）地方性传播的国家之一（另一个是阿富汗）。本报告描述了巴基斯坦在 2022 年 1 月至 2023 年 6 月期间根除脊髓灰质炎的进展情况。2022 年，巴基斯坦报告了 20 例 WPV1 病例，均发生在包含开伯尔-普赫图赫瓦省三个地区在内的一个小地理区域内。截至 6 月 23 日，2023 年仅在开伯尔-普赫图赫瓦省的本努地区报告了 1 例 WPV1 病例，而 2022 年同期报告了 13 例。此外，截至 2023 年，已在多个环境监测（ES）污水采样点报告了 11 例 WPV1 分离株，包括南部信德省首府卡拉奇。补充免疫活动（SIA）的质量仍然存在很大差距，尤其是在脊髓灰质炎病毒储存区。尽管巴基斯坦脊髓灰质炎病毒的衰减和明显有限的地理传播范围，但在卡拉奇的 ES 点分离出 WPV1 令人担忧传播的实际地理范围。要阻断 WPV1 的传播，需要对经常在 SIA 期间错过接种的儿童进行细致跟踪，并持续创新努力，以确保接种，并迅速应对任何新的 WPV1 分离株。
