02 Sep 2019

Ghana: new outbreak of circulating vaccine-derived poliovirus (cVDPV)

The first case circulating vaccine-derived poliovirus type 2 (cVDPV2) has been reported in Ghana Ghana: new outbreak of circulating vaccine-derived poliovirus (cVDPV)

On 23 August 2019, the Ministry of Health, Ghana reported a confirmed case of vaccine-derived polio virus type 2 (cVDPV2) in a two-year-old child from Andonyama (a sub-district of Chereponi, Northern Region) who developed acute flaccid paralysis on the 23 July 2019 [1, 2].

This is the first case of cVDPV reported in Ghana; in early July 2019, a cVDPV2 was confirmed in an environmental sample collected in June 2019 in Tamale Metropolis, Northern Ghana [3]. An additional cVDPV2 positive environmental sample was collected from Accra district, Greater Accra Region on 13 August 2019 [1]. These positive environmental samples and the case of cVDPV2 appear to be linked to the strain of vaccine-derived poliovirus that emerged in Jigwa State Nigeria, which subsequently spread to other parts of Nigeria [1-3].

In line with the Polio Endgame Strategy, the national immunisation programme of Ghana switched from the use of tri-valent oral polio vaccine in 2016, to a three-dose schedule of bivalent oral polio vaccine (protection from types 1 and 3 polio virus); vaccine coverage rate is high (98%) [4]. An additional single dose of inactivated polio vaccine (protection against types 1,2 and 3) was introduced into routine vaccination programme in June 2018 [2].

A risk assessment is underway, and an outbreak response is being considered [2]. Surveillance is being strengthened in neighbouring Togo, Benin, Côte d’Ivoire and Burkina Faso [1].

CVDPV, like wild poliovirus (WPV), has the potential to cause paralysis in unvaccinated or partially vaccinated individuals. CVDPVs can arise in populations who are inadequately vaccinated and where sanitation and personal hygiene is poor [5]. Eradication of cVDPV is an important part of the strategy to end polio transmission globally [6].

Advice for travellers

Circulating vaccine-derived poliovirus (cVDPV) can be transmitted via the faecal-oral route, through exposure to water contaminated by infected human faeces, or by direct person to person contact. You are advised to practise strict food, water and personal hygiene.

Independent of your travel destination, you should be up to date with routine vaccination courses and boosters as recommended in the UK.

If you are travelling to Ghana, you should make sure you have completed a full course of a polio-containing vaccine. Vaccines used in the UK will provide protection against all types of polio virus. If your last dose of polio vaccine was given 10 or more years ago, you should have a booster dose before travel to Ghana

Children who are travelling should be up to date with an age appropriate course of polio vaccine.

For specific outbreak information, check our Outbreak Surveillance section.

The polio status of countries is reviewed by World Health Organization (WHO) on a regular basis and polio vaccination recommendations are subject to change. For individual country specific advice, check our Country Information pages.

Further details on the global polio situation are available from the Global Polio Eradication Initiative.

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