title: Response to a Large Polio Outbreak in a Setting of Conflict - Middle East, 2013-2015.
abstract: As the world advances toward the eradication of polio, outbreaks of wild poliovirus (WPV) in polio-free regions pose a substantial risk to the timeline for global eradication. Countries and regions experiencing active conflict, chronic insecurity, and large-scale displacement of persons are particularly vulnerable to outbreaks because of the disruption of health care and immunization services (1). A polio outbreak occurred in the Middle East, beginning in Syria in 2013 with subsequent spread to Iraq (2). The outbreak occurred 2 years after the onset of the Syrian civil war, resulted in 38 cases, and was the first time WPV was detected in Syria in approximately a decade (3,4). The national governments of eight countries designated the outbreak a public health emergency and collaborated with partners in the Global Polio Eradication Initiative (GPEI) to develop a multiphase outbreak response plan focused on improving the quality of acute flaccid paralysis (AFP) surveillance* and administering polio vaccines to >27 million children during multiple rounds of supplementary immunization activities (SIAs).†Successful implementation of the response plan led to containment and interruption of the outbreak within 6 months of its identification. The concerted approach adopted in response to this outbreak could serve as a model for responding to polio outbreaks in settings of conflict and political instability.
authors.forename: Chukwuma
authors.initials: C
authors.lastname: Mbaeyi
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Ryan
authors.forename: Philip
authors.initials: P
authors.lastname: Smith
authors.forename: Abdirahman
authors.initials: A
authors.lastname: Mahamud
authors.forename: Noha
authors.initials: N
authors.lastname: Farag
authors.forename: Salah
authors.initials: S
authors.lastname: Haithami
authors.forename: Magdi
authors.initials: M
authors.lastname: Sharaf
authors.forename: Jaume C
authors.initials: JC
authors.lastname: Jorba
authors.forename: Derek
authors.initials: D
authors.lastname: Ehrhardt
mesh_terms: D004196:Disease Outbreaks / Q000517:prevention & control*; D006801:Humans; D017589:Immunization Programs; D008877:Middle East / Q000453:epidemiology; D011051:Poliomyelitis / Q000453:epidemiology / Q000517:prevention & control*; D017955:Poliovirus / Q000302:isolation & purification; D023321:Poliovirus Vaccines / Q000008:administration & dosage; D014857:Warfare
chemical_list: D023321:Poliovirus Vaccines