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November 26, 1999 / Vol. 48 / No. 46 - page 8 / 20

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1060 Poliomyelitis Eradication — Continued

MMWR

November 26, 1999

TABLE 1. Number of reported cases of acute flaccid paralysis (AFP) and confirmed poliomyelitis* and key surveillance indicators, by country — Eastern Mediterranean Region, 1998–October 1999

1998

1999

Egypt

295

35

1.21

82

229

7

1.32

76

Iran

348

4

1.43

76

196

3

1.08

72

Iraq

155

37

1.19

72

160

38

1.59

78

Jordan

33

0

1.80

76

21

0

1.45

81

Kuwait

6

0

1.15

83

4

0

1.00

100

Lebanon

11

0

1.26

0

12

0

1.86

8

Libya

18

0

1.00

50

19

0

1.38

63

Morocco

81

0

0.85

33

54

0

0.74

46

Oman

8

0

1.00

88

16

0

2.45

88

Pakistan

751

339

0.64

60

813

270

1.19

72

Palestine

14

0

1.21

100

6

0

0.64

83

Qatar

2

0

2.18

0

2

0

1.80

Saudi Arabia

84

1

1.08

88

66

0

1.11

79

Somalia

32

12

0.69

28

32

11

0.93

31

Sudan

88

50

0.31

33

80

31

0.47

34

Syria

85

0

1.32

98

63

0

1.16

84

Tunisia

37

0

1.19

81

32

0

1.33

94

No. AFP cases

No. confirmed cases

Nonpolio AFP rate

% persons with AFP with two stool specimens§

No. AFP cases

No. confirmed cases

Nonpolio AFP rate

% persons with AFP with two stool specimens

121 4 5 0

59 0 0 0

0.66 2.00 3.10 0.00

50 50 100

169 3 1 0

75 0 0 0

1.29 2.37 0.80 0.00

55 100 100

*A confirmed case of polio is defined as AFP and at least one of the following: 1) laboratory- confirmed wild poliovirus infection, 2) inadequate stool specimens and residual paralysis at 60 days, 3) death, or 4) no follow-up investigation at 60 days.

  • Number of AFP cases per 100,000 population aged <15 years. Minimum expected rate is one

case of nonpolio AFP per 100,000 per year. §Two stool specimens collected at least 24 hours apart within 14 days of paralysis onset from

  • 80% of AFP cases.

Annualized nonpolio AFP rate.

Country

Afghanistan Bahrain Cyprus Djibouti

Emirates

4

0

0.60

0

5

0

1.01

40

Yemen

27

16

0.13

33

90

11

1.19

58

68

1.21

446

2073

64

0.88

553

United Arab

Total

2209

Syria, and Tunisia) achieved the WHO-recommended target of two adequate stool specimens collected from at least 80% of persons with AFP. An additional five coun- tries (Bahrain, Egypt, Iran, Iraq, and Jordan) collected stool specimens from 71% to 79% of persons with AFP reported during the same period, and six countries (Leba- non, Morocco, Qatar, Somalia, Sudan, and United Arab Emirates) collected adequate specimens from <50% of persons with AFP. Despite high national AFP surveillance performance indicators during 1997 and 1998 in Egypt and Iraq, circulation of wild poliovirus type 3 in Egypt and type 1 in Iraq continued undetected for >2 years.

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