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Syrian Arab Republic

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Map of the Syrian Arab Republic

Prior to the current outbreak, Syria’s last confirmed polio case (due to an imported wild poliovirus) was in 1999. Syria remained polio-free until October 2013 when wild poliovirus was confirmed in Deir ez-Zor and Aleppo, following importation of wild poliovirus closely related to strains currently circulating in Pakistan. So far, the total numbers of confirmed polio cases are 35 for the year 2013 and one case for 2014.

Routine immunization

Routine immunization against polio has been mandatory since 1964. The coverage rate of the oral polio vaccine (OPV) 3rd dose was above 90% until 2010 and then declined sharply to 68% in 2012 due to the crisis in the country. The Global Polio Eradication Initiative, in collaboration with UNICEF and WHO, has developed a rapid and effective response plan to strengthen routine immunization.  

National immunization days

In response to the polio outbreak, the Ministry of Health in collaboration with partners, including UNICEF and WHO, developed a six-month response plan. The main pillar of the plan was to conduct six national immunization day rounds using bivalent OPV (bOPV). The results were as follows:

May 2014

Apr 2014

Mar 2014

Feb 2014

Jan 2014

Dec 2013

Number of vaccinated children

2 835 099

2 913 640

2 919 682

2 745 554

2 532 476

2 246 762

Following each round, a post-campaign assessment was done by independent monitors. The results were as follows:

May 2014

Apr 2014

Mar 2014

Feb 2014

Jan 2014

Dec 2013

Coverage (%)

91

92

93

88

88

79

By recall

82

84

84

68

62

38

By finger marking

Acute flaccid paralysis surveillance

The acute flaccid paralysis (AFP) surveillance indicators were above certification level until 2011, the year the crisis in the country begun. Due to the crisis, all indicators dropped to unsatisfactory levels. The non-polio AFP rate and adequate stool sample collection rate dropped to below 2 per 100 000 and 80%, respectively.

After the confirmation of the polio outbreak, all governorates took action to improve the AFP surveillance system. The result of these efforts can be seen in the 2014 performance so far. To date, the key surveillance indicators of non-polio AFP rate, stool adequacy rate, non-polio enterovirus (NPEV) isolation rate and Sabin-like (SL) virus isolation have reached 3.2 per 100 000, 91%, 2% and 7.3%, respectively.

Country indicators

Laboratory

The Syrian national poliovirus laboratory is a WHO-accredited laboratory of the Eastern Mediterranean Region poliovirus laboratories network. The laboratory has continued to function despite the current crisis.

Phase 1 of laboratory containment of polioviruses has been completed and a report documenting the quality of containment activities has been submitted to WHO.

Related links

WHO Syrian Arab Republic country office

Syrian Arab Republic certification status

Routine immunization

Targets and percentage coverage by supplementary immunization activity in the Eastern Mediterranean Region by year

Acute flaccid paralysis surveillance indicators in the Eastern Mediterranean Region