Africa on alert as Malawi declares polio outbreak

A health worker administers a vaccine on a child at Hamar-Jajab
Mother gets a vaccination for her young son. Copyright: UN Photo/Mokhtar Mohamed, CC0 1.0

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  • Africa last detected polio in Nigeria in 2016, with the continent certified polio-free in 2020
  • But Malawi declared polio outbreak last week after detecting the disease in a young child
  • There is a need to strengthen surveillance capacities to halt its possible spread, says an expert

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[NAIROBI] Malawi and neighbouring countries are on high alert following the detection of wild poliovirus type 1 in a young child, the World Health Organization (WHO) has said.

The detection of the virus in Lilongwe, the country’s capital, is the first to occur on the continent in more than five years, after the last case was identified in northern Nigeria in 2016. The Malawi government declared an outbreak of wild poliovirus type 1 last week (17 February).

It is known as wild poliovirus to distinguish it from vaccine-derived polio, a separate outbreak of the disease spread by previous polio vaccination programs, which has now affected 21 countries in the region, according to the WHO.

“The WHO is supporting the Malawi government to carry out a risk assessment and outbreak response.”

Janet Kayita, WHO, Malawi

“This is a very worrying situation, and that is why the government of Malawi has declared this detection to be a national public health emergency,” Janet Kayita, WHO representative in Malawi, told SciDev.Net.

She explained that polio is a highly infectious disease that spreads rapidly through population movements, and across international borders, particularly among those who remain unvaccinated or under-vaccinated.

“The WHO is supporting the Malawi government to carry out a risk assessment and outbreak response. This includes supplemental immunisation and dedicated campaigns aimed at ensuring all children are vaccinated,” Kayita added.

Surveillance of the disease, she explained, is also being ramped up in neighbouring countries Mozambique, Tanzania and Zambia.

“The identification of wild poliovirus type 1 in Malawi is a matter of international concern. It is a threat to children in Malawi, the subregion and beyond. There is an urgent need to strengthen surveillance capacities in the neighboring countries to halt its possible spread,” she said.

Kayita, who is also a pediatrician, told SciDev.Net that a laboratory analysis shows that the virus is linked to that which was detected in Pakistan in 2019.

“We consider it an imported case and this detection does not affect the WHO African region’s wild polio-free certification status officially marked in August 2020,” she said.

An international rapid response team from the Global Polio Eradication Initiative is in Malawi to monitor the situation and to also give the government technical assistance.

“It has triggered an operation led by six core partners in the Global Polio Eradication Initiative: WHO, GAVI [the Vaccine Alliance], the US Centers for Disease Control and Prevention, Rotary International and Bill & Melinda Gates Foundation,” she said.

The Global Polio Eradication Initiative was launched in 1988 by the World Health Assembly with a goal to eradicate polio worldwide.

Queen Dube, chief of health services in Malawi’s Ministry of Health, told SciDev.Net that the country has a surveillance system whereby any child under 16 years of age who presents with limb weakness at a health facility is also required to submit a stool sample for a suspected polio disease.

“This is exactly what happened when this three-and-a-half-year-girl visited Kamuzu Central Hospital in Lilongwe,” Dube said. “The samples were then sent to NICD [National Institute for Communicable Diseases] lab in South Africa where polio was detected and confirmed.”

She added: “One case of polio warrants an outbreak and a declaration of public health emergency. However, there is no evidence of community circulation of the virus [and] as such there is an opportunity to contain the outbreak with proper and high-quality response strategies.”

Dube explained that Malawi awaits the results from the same NICD laboratory for contacts of the young child.

Malawi’s Ministry of Health and partners have launched an emergency response strategy to boost disease surveillance across Malawi and large-scale polio immunisation campaigns.

“As long as wild polio exists anywhere in the world, all countries remain at risk of importation of the virus,” added Matshidiso Moeti, director of WHO Africa region, in a WHO statement published last week (17 February).

This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.