1. Weekly Polio Update Nigeria March 7, 2014

2. As at March 7, 2014 Nigeria has:- 1 confirmed WPV1 in 1 State compared to 4 cases in 4 States for the same period in 2013. o Date of onset of latest case is February 1, 2014 There have been no confirmed WPV3 since November 2012. There are no confirmed circulating vaccine derived poliovirus (cVDPV2) just as same period in 2013. Nigeria polio cases as at Week 10, 2014 W1 (n=1) W3 (n=0) # Infected States: 1

3. Nigeria Wild poliovirus distribution 2013 & 2014 as at week 10, 2014 20132014 W1 (n=4) W3 (n=0) # Infected States: 4 W1 (n=1) W3 (n=0) # Infected State: 1

4. 20132014 # Infected State: 0 cVDPV2 (n=0) # Infected State: 0 cVDPV2 (n=0) Nigeria cVDPV2 distribution, 2013 & 2014 as at week 10, 2014

5. Nigeria: Polio Compatible Cases Jan – Dec, 2013 as at week 10, 2014 Clustering of compatible cases in 2013 Compatibles (n= 79) Infected LGAs = 61 StatesLGAsWards Date onset of paralysis FCT, Abuja Municipal Area Council Kabusa15/08/2013 Kubwa25/08/2013 Gui15/11/2013 Kabusa27/11/2013 KadunaKaduna South Tudun Wada South23/04/2013 Badiko27/05/2013 KanoKaraye Magajin Gari15/05/2013 Kafi28/05/2013 Kwanyawa28/05/2013 Katsina Funtua Maigamji20/04/2013 Dukke20/05/2013 Tudun Iya03/06/2013 Matazu Kogari15/06/2013 Dissi13/08/2013 NigerBosso Bosso II24/01/2013 Garatu19/03/2013 SokotoIllela Kalmalo08/08/2013 Illela08/10/2013 No polio-compatible cases in 2014, however there 79 cases in 2013.

6. Latest onset of confirmed WPV was 01-Feb-2014 from Gaya LGA, Kano State. 2013 - 2014 WPV & cVDPV2 cases by Zone and State as at week 10, 2014

7. WPV 1 Epidemiology

8. WPV 1 monthly onset, with targeted SIAs 2008 – 2013 as at week 10, 2014

9. WPV 1 monthly onset, with targeted SIAs 2012 – 2014 as at week 10, 2014

10. NB: PI = Primary Isolation; ITD = Intratypic Differentiation WPV1 cases 2012 – 2014 by week and samples pending lab results for 2014 (PI & ITD) as at week 10, 2014 WeeksWk4'14Wk5'14Wk6'14Wk7'14Wk8'14Wk9'14Wk10'14 Pending PI126731821033 Pending ITD0146000

11. Nigeria Distribution of WPV1-infected LGAs by quarter, 2012 – 2014 as at week 10, 2014 Qter_1’13 Qter_2’13 # Infected LGAs 13 WPV1 (n=18) # Infected LGAs: 14 WPV1 (n= 19) Qter_3’13 Qter_4’13 # Infected LGAs: 12 WPV1 (n= 13) # Infected LGAs: 3 WPV1 (n= 3) Qter_1’14* Qter_4’12 # Infected LGAs: 15 WPV1 (n=20) # Infected LGAs: 1 WPV1 (n=1) Cases pending lab confirmation in 2014: 1 (January 2014), 367 (February 2014) and 13 (March 2014) Latest Onset WPV1 was 01/02/2014. note no pending lab results for 2013

12. Nigeria Distribution of WPV1-infected LGAs in last 6 month: Oct 2013 – Mar 2014 as at week 10, 2014 Oct’13 # Infected LGAs: 0 WPV1 (n=0) Nov’13 Cases pending lab confirmation in 2014: 1 (January 2014), 367 (February 2014) and 13 (March 2014) Latest Onset WPV1 was 01/02/2014. note no pending lab results for 2013 Dec’13 # Infected LGAs: 2 WPV1 (n=2) # Infected LGAs: 1 WPV1 (n=1) # Infected LGAs: 0 WPV1 (n=0) Jan’14* # Infected LGAs: 1 WPV1 (n=1) Feb’14* # Infected LGAs: 0 WPV1 (n=0) Mar’14*

13. WPV 3 Epidemiology

14. WPV 3 monthly onset, with targeted SIAs, 2009 – 2014 as at week 10, 2014

15. WPV 3 monthly onset, with targeted SIAs, 2010 – 2014 as at week 10, 2014

16. NB: PI = Primary Isolation; ITD = Intratypic Differentiation WPV3 cases 2012 – 2014 by week and samples pending lab results (PI & ITD) for 2013 as at week 10, 2014 WeeksWk4'14Wk5'14Wk6'14Wk7'14Wk8'14Wk9'14Wk10'14 Pending PI126731821033 Pending ITD0146000

17. Nigeria Distribution of WPV3-infected LGAs by quarter, 2012 – 2014 as at week 10, 2014 # Infected LGAs: 1 WPV3 (n=1) Qter_4’12 # Infected LGAs: 0 WPV3 (n=0) Qter_1’13 # Infected LGAs: 0 WPV3 (n=0) Qter_3’13 # Infected LGAs: 0 WPV3 (n=0) Qter_2’13 # Infected LGAs: 0 WPV3 (n=0) Qter_4’13 # Infected LGAs: 0 WPV3 (n=0) Qter_1’14* * Cases pending lab confirmation in 2014: 1 (January 2014), 367 (February 2014) and 13 (March) - Latest Onset WPV3 was 10/11/2012. No pending lab results for 2013

18. Nigeria Distribution of WPV3-infected LGAs in last 6 months Oct 2013 – Mar 2014 as at week 10, 2014 # Infected LGAs: 0 WPV3 (n=0) Oct’13 # Infected LGAs: 0 WPV3 (n=0) Nov’13 # Infected LGAs: 0 WPV3 (n=0) Dec’13 Jan’14* # Infected LGAs: 0 WPV3 (n=0) Feb’14* # Infected LGAs: 0 WPV3 (n=0) * Cases pending lab confirmation in 2014: 1 (January 2014), 367 (February 2014) and 13 (March) - Latest Onset WPV3 was 10/11/2012. No pending lab results for 2013 Mar’14* # Infected LGAs: 0 WPV3 (n=0)

19. cVDPV2

20. cVDPV2 cases by month 2009 – 2013 as at week 10, 2014

21. Nigeria Distribution of cVDPV2 by LGAs/quarter, 2012 – 2014 as at week 10, 2014 Latest Onset for cVDPV2 was 24/12/2013. Qter_4, 2012 # Infected LGAs: 1 cVDPV2 (n=2) # Infected LGAs: 0 cVDPV2 (n=0) Qter_2, 2013 Qter_1, 2013 Qter_3, 2013 Qter_4, 2013 # Infected LGAs: 3 cVDPV2 (n=5) # Infected LGAs: 0 cVDPV2 (n=0) # Infected LGAs: 0 cVDPV2 (n=0) # Infected LGAs: 0 cVDPV2 (n=0) Qter_1, 2014

22. Age and OPV doses of WPV cases

23. Age 2013 (n=53) 65% < 3 yrs Age 2012 (n=122) 70% < 3 yrs Age group of WPV cases 2012 and 2013, as at week 10, 2014

24. OPV status 2013 (n=53) 36% < 3 doses OPV status 2012 (n=122) 47% < 3 doses OPV status of WPV cases 2012 and 2013 as at week 10, 2014

25. OPV status 2013 (n=5,859) 6% < 3 doses OPV status 2012 (n=5,274) 9% < 3 doses Nigeria OPV status of non-polio AFP cases 6 – 59 mths, 2012 – 2013 as at week 10, 2014

26. Summary Tables

27. WPV type by week of onset from week 10, 2013 – week 10, 2014

28. cVDPV2 by week of onset from week 10, 2013 – week 10, 2014 tOPV was administered in 4 LGAs (Mafa, Maiduguri, Jere and Konduga) Borno State in December, 2013

29. 2013/2014 WPV cases, Pending PI and ITD, as at week 10, 2014 * HR States; NB: PI = Primary Isolation; ITD = Intratypic Differentiation

30. Status of Laboratory results 2011- 2013 (2013 data is as at March 7, 2014)

31. Nigeria OPV status of non-polio AFP cases 6 – 59 mths, 2011 – 2013 as at week 10, 2014

32. 2012 Two AFP surveillance core indicators are NP AFP rate > 2/100,000 children under age of 15 years and % stool adequacy of >80% 2013 LGAs not meeting both indicators (79) LGAs meeting both indicators (695) LGAs reporting no AFP (0) LGAs not meeting both indicators (62) LGAs meeting both indicators (712) LGAs reporting no AFP (0) LGAs meeting 2 AFP Surveillance core indicators, 2012/2013 as at week 10, 2014

33. In 2013, E nvironmental surveillance detected 2 WPV1 in Sokoto State and 16 cVDPV2 (Sokoto 6, Kano 2 and Borno 8). 4 cVDPV2 (Kano 1 and Borno 3) in 2014 Tracking of Environmental Samples, week 9, 2013 – week 10, 2014

34. SIAs 2013 bOPV tOPV Non -Implementing States/LGAs Feb’13Jan’13 Mar’13 Apr’13 May’13 Jun’13Jul’13

35. bOPV YF + bOPV Sep’13 Oct’13 Nov’13 Dec’13 IMC + bOPV MenAfrivac + bOPV Not Implementing Scope of Polio SIAs and harmonization with non-Polio SIAs, Nigeria September– December 2013

36. Trends of LQA Results in 11 HR States

37. Trends in LQAs from the 85 High Risk LGAs*

38. Trends in LQAs from the 11 High risk states

39. Trends of LQA Results in Bauchi, Borno & Yobe States BAUCHI BORNO YOBE

40. Trends of LQA Results in Jigawa, Kaduna, Kano & Katsina States KANO JIGAWA KADUNA KATSINA

41. KEBBI ZAMFARA NIGER SOKOTO Trends of LQA Results in Kebbi, Niger, Sokoto & Zamfara States