WHO, USA Disease Control Centre applaud Malawi for strong polio surveillance systems

Deputy Health Minister Phale (left) with UN partners during the press conference

* As they join the country in strategies put in place to eliminate the disease

* Parents urged have their under-15 children to receive routine polio vaccines

* To contain further spread of the disease from the lone case that has been identified

* Immunization for children should be given a priority in awake of the lone outbreak

* Ministry of Health commended for responding favourably when the lone case was reported

By Tione Andsen, MANA & Duncan Mlanjira, Maravi Express

United Nations agency, World Health Organisation (WHO) and the America Centre for Disease Control (CDC) have both applauded Malawi for having strong health surveillance systems which saw the country to have no polio case for the past 30 years, as they join in strategies put in place to eliminate the disease following Government’s fears of its possible outbreak.

Last week, though it was just one reported case of polio registered from one unnamed district of the country and it being a very infectious disease, the Ministry of Health warned the public “to continue observing good personal hygiene practice as we know that the virus is spread through ingestion of contaminated food or water”.

The Ministry also indicated that laboratory results showed that the reported single case was “an imported virus as there is no evidence of community circulation of the virus and assures the nation that the situation is under control”.

The Ministry also assured the public that with support from partners, it  has put in place strategies for elimination of polio, saying they are in line with the strategies recommended by the WHO, through the Global Polio End Game Strategy.

On Tuesday, Deputy Minister of Health, Enock Phale held a polio update press conference in Lilongwe in the company of WHO Country Representative, Dr. Janet Kayita; acting UN Resident Coordinator, Rudolf Schwenk and CDC Country Director, Dr Kesley Mirkovic — where Phale assured the public of the strategies put in place for disease’s elimination in the country.

While commending Malawi for having strong surveillance systems for all these years, Kayita urged parents of children under the age of 15 to take them and receive routine polio vaccines to contain further spread of the disease from the lone case that has been identified.

In his remarks, Schwenk said immunization for children should be given a priority in awake of the lone outbreak while thanking the Ministry of Health for responding favourably when the case was confirmed.

He also added credence of the importance of intensifying polio immunization programme in the country in order to eliminate it.

America’s CDC Country Director, Mirkovic said the declaration of public health emergency has shown the Ministry of Health’s strong leadership, adding that CDC has provided capacity building, technical support.

Phale also said “vaccines are the most effective and available prevention strategy for this disease in addition to improved water and sanitation practices”.

“Worldwide, we still have few countries mainly outside Africa where Wild Polio Virus is endemic.”

He said countries have always been aware that as long as there was poliovirus (wild or vaccine-derived) circulating in one corner of the world, there was a risk that the virus can be exported or imported from that country to another country, mostly due to travel.  

“Malawi has sustained good coverages of all its vaccine antigen above 80% now for two decades and polio vaccine is no exception,” he said, adding that the country provides vaccine that targets Polio virus type 1 and type 3 following the eradication of Polio virus type 2 many years back.

“We are vaccinating our children with Inactivated Polio Virus vaccine with sustained good coverage to date since introduction in 2018,” he said.

He urged political, religious and community leaders to support government in encouraging their communities to take part in the Polio eradication activities by taking their children for the routine polio immunization and for the supplemental polio immunizations which will start soon.

Last week, the Ministry said the strategies put in place include the Independent National Polio Expert Committees (National Expert Committee and the National Polio Certification Committee) — which oversee and coordinate the polio surveillance and reporting system in the Country in line with the WHO recommendations.

The first step was declaring the lone case identified as a Public Health Emergency and that there will be Emergence Operations Committee meetings and a risk assessment of the situation will be done with support from the partners.

It also said it will also work very closely with our neighbouring countries and diseases know no borders since, according to the laboratory results, the lone case was an imported virus as there is no evidence of community circulation of the virus while assuring the nation that the situation is under control.

The high risk group of poliovirus, that causes irreversible paralysis disease mainly in children zero to 15 years of age, are those that are unvaccinated or those that have received fewer doses of polio vaccines — but also has a potential to infect immunocompromised adults.

“Normally a child would present to a health facility with acute onset of limb weakness which progresses to paralysis,” the Minister of Health Khumbize Kandodo Chiponda said in a statement last week.

“If it is a leg or an arm, it may become relatively smaller (wasted) than the normal body mass and loses function because it is weaker than the rest of the body.”

She stressed that vaccines are the most effective and available prevention strategy for this disease in addition to improved water and sanitation practices.

“Worldwide, we still have few countries mainly out side Africa where Wild Polio Virus type 1 is endemic. The Malawi Government established the National Expanded Programme on Immunization (EPI) in 1979 to deal with vaccine preventable diseases including Polio, Measles and Neonatal Tetanus.

“These diseases are undergoing eradication and elimination,” she said, adding that Malawi has sustained good coverages of all its vaccine antigen above 80% now for two decades and polio vaccine is no exception.

“Our partners like WHO, UNICEF and many others have been key stakeholders in strengthening the Global Polio Eradication Strategy. The last polio case in Malawi was reported in 1992 — meaning that this is the first case in 30 years.”

She also assured the public that Malawi also obtained a Polio-free status in 2005 while the WHO African region received its Polio-free status certificate in the year 2020.

“These are remarkable milestones in the polio eradication initiative in the country. In practice, any suspected child from zero to 15 years of age — coming with acute onset of flaccid paralysis or weakness — is supposed to be reported as a suspected Polio case.

“The requirement is to report 2 non-polio AFP per 100,000 as well as adequate stool specimen. Malawi has been meeting these indicators throughout the years and sustained its Polio surveillance robustly,” the Minister said.