Afghanistan Polio Eradication InitiativeSurveillance Update Week 13(Ending on Saturday 4 April 2009)National Surveillance OfficeApril 07, 2009

AFP Case Classification Afghanistan 08-09 Data up to 4 Apr 09^ 58 AFP cases pending lab results 8 Inadequate AFP case pending 60 days follow 4 Pending ERC

Year20082009Reported AFP cases1383335Confirmed315Compatible30Discarded1349260Pending070 ^

Confirmed Polio cases & Compatibles Afghanistan 07-092007NSL1=06NSL3=11Comp=02NSL1=25NSL3=06Comp=32008Polio cases are placed by village 2009Recent NSL1 from Kajaki District of Helmand Province, onset is 2 Mar, age 9m, 01 OPV dosesNSL1=5NSL3=0Comp=0 Data up to 4 Apr 09

ProvinceNo. polio cases 2008 Date of Last case 2008No. polio cases 2009 Date of Last case 2009P1P3P1P3P1P3P1P3Farah1110-02-0815-04-08----Hirat1026-09-08----Hilmand7001-12-082-02-03-09-Kandahar10215-10-0825-04-083-27-01-09-Uruzgan5014-10-08----Zabul1002-09-08----Nangarhar0327-11-08----

2008NSL1=25NSL3=062004NSL1= 2NSL3= 21999NSL1= 45NSL3= 18P1 & P3 Poliovirus Isolates Afghanistan 1999, 04, 07-092007NSL1=06NSL3= 11NSL1=5NSL3=02009 Data up to 4 Apr 09

Distribution of P1 & P3 by Month & District 07-09MarFebJanAprMayJun20072008NSL1=0NSL3=0NSL1=0NSL3=0NSL1=1NSL3=0NSL1=1NSL3=1NSL1=0NSL3=0NSL1=2NSL3=0NSL1=2NSL3=0NSL1=1NSL3=1NSL1=1NSL3=0NSL1=0NSL3=2NSL1=1NSL3=1NSL1=3NSL3=02009NSL1=3NSL3=0NSL1=1NSL3=0NSL1=1NSL3=0 Data up to 4 Apr 09NSL1=0NSL3=0

Distribution of P1 & P3 by Month & District 07-08SepAugJulOctNovDec20072008NSL1=0NSL3=3NSL1=0NSL3=1NSL1=0NSL3=1NSL1=2NSL3=1NSL1=0NSL3=3NSL1=0NSL3=1NSL1=2NSL3=1NSL1=2NSL3=0NSL1=6NSL3=0NSL1=6NSL3=0NSL1=0NSL3=1NSL1=1NSL3=0 Data up to 4 Apr 09

List Of Confirmed Polio Cases Afghanistan 2008*Confirmed by contact Data up to 4 Apr 09

NoEpidProvinceDistrictDonsetPropFeverAsymSexAgeRoutineSIAsDlast OPVDstool 1Dstool2HcaseLabRCluster1AFG/08/08/001HILMANDNAD ALI12-01-08YYNM280328-10-0715-01-0816-01-08YESNSL1A-3A2AFG/08/08/005HILMANDNAD ALI20-01-08YYNM110120-09-0725-01-0826-01-08NONSL1 A-3A3AFG/08/08/012KANDAHARMAYWAND09-02-08YYYM84015Unknown14-02-0815-02-08NONSL3 B-1C4AFG/03/08/012FARAHBALABULUK10-02-08YYNF260222-04-07 20-02-0821-02-08NONSL1A-3A 5AFG/08/08/027KANDAHARMAYWAND07-03-08YYYM1451209-03-08 13-03-0814-03-08YESNSL1A-3A 6AFG/03/08/041FARAHBALABULUK15-04-08YYYF1601213-04-08 18-04-0819-04-08YESNSL3B-1C7AFG/08/08/045*KANDAHARSHAHWALIKOT25-04-08YYNM1200No dose30-04-08DiedNONSL3B-1C8AFG/06/08/070NANGARHARJALALABAD14-05-08YYNM84615-05-0816-05-08DiedNONSL3B-1C9AFG/08/08/063KANDAHARGHORAK28-05-08YYYM3000No dose01-06-0802-06-08YESNSL1A-3A10AFG/08/08/071KANDAHARMAYWAND03-06-08YYNF6605Unknown10-06-0814-06-08NoNSL1A-3A11AFG/08/08/081UROZGANTARINKOT24-06-08YYYM1800No dose01-07-0802-07-08YESNSL1A-3A12AFG/08/08/078UROZGANSHAHID HASSAS22-06-08YYNM104501-06-0827-06-0828-06-08NONSL1A-3A13AFG/08/08/087KANDAHARSPIN BOLDAK03-07-08YYYF100229-06-0814-07-0815-07-08YESNSL1A-3A 14AFG/06/08/111NANGARHARJALALABAD24-07-08YYNF1421028-06-0824-07-0825-07-08NONSL3B-1C15AFG/08/08/099UROZGANTARINKOT24-07-08YYNM2400No dose30-07-0831-07-08NONSL1A-3A16AFG/08/08/111KANDAHARSPIN BOLDAK05-08-08YNNM1801229-06-0816-08-0817-08-08NONSL1A-3A17AFG/08/08/117HILMANDMUSAQALA26-08-08YYNM220903-08-0830-08-0831-08-08NONSL1A-3A18AFG/08/08/119ZABULSHAHJOY02-09-08YYYM141122-01-0804-09-0805-09-08YESNSL1A-3A19AFG/08/08/120HILMANDSANGIN01-09-08YYNM180204-08-0808-09-0809-09-08NONSL1A-3A20AFG/08/08/124KANDAHARKANDAHAR10-09-08YYNM180602-06-0815-09-08DiedNONSL1A-3A21AFG/08/08/122UROZGANTARINKOT11-09-08YYYF80010Unknown12-09-0813-09-08NONSL1A-3A22AFG/08/08/138KANDAHARMAYWAND25-09-08YYYF2200No dose04-10-0805-10-08YESNSL1A-3A23AFG/08/08/152KANDAHARSHAHWALIKOT09-10-08YYNF240117-06-0719-10-0820-10-08NONSL1A-3A24AFG/08/08/153KANDAHARSHAHWALIKOT15-10-08YYNF2000No dose20-10-0821-10-08NONSL1A-3A25AFG/03/08/129HERATPASHTUM ZARGHUN26-09-08YNNF9635Unknown29-09-0830-09-09NONSL1A-3A26AFG/08/08/157UROZGANTARINKOT14-10-08YYYF2400No dose26-10-0827-10-08YESNSL1A-3A27AFG/08/08/160HILMANDSANGIN27-10-08YYNM92121-10-0801-11-0802-11-08NONSL1A-3A28AFG/08/08/164KANDAHARSPIN BOLDAK15-10-08YYYM240321-09-0806-11-0807-11-08YESNSL1A-3A29AFG/08/08/167HILMANDNAHRI SARAJ30-10-08YYYF240819-10-089-11-0810-11-08YESNSL1A-3A30AFG/06/08/168NANGARHARJALALABAD27-11-08YYYM1811224-11-0802-12-0803-12-08NONSL3B-1C31AFG/06/08/188*HILMANDLASHKARGA01-12-08YYNM180624-11-0829-12-0830-12-08NONSL1A-3A

List Of Confirmed Polio Cases Afghanistan 2009*Confirmed by contact Data up to 4 Apr 09

NoEpidProvinceDistrictDonsetProgFeverAsymSexAgeRoutineSIAsDlast OPVDstool 1Dstool2HcaseLabRCluster1AFG/08/09/007KANDAHARSHAH WALI KOT16-01-09YYYM1800-21-01-0922-01-09NNSL1A-3A2AFG/08/09/010KANDAHARDaman27-01-09YYYM120324-11-0801-02-0902-02-09NNSL1A-3A 3AFG/08/09/017*KANDAHARPanjwai21-01-09YYNF80102-06-200814-02-0915-02-09NNSL1A-3A 4AFG/08/09/020HILMANDNadiali06-02-09YYYM110114-04-0817-02-0918-02-09YNSL1A-3A 5AFG/08/09/027HILMANDKajaki02-03-09YYYM90104-08-0811-03-0912-03-09YNSL1A-3A

Polio Virus Isolates By Type & Month, Afghanistan 05-09sNID NID Short interval additional dose 20082009 Data up to 4 Apr 09

Afghanistan & Pakistan P1 isolatesby genetic cluster 2008

Data up to 4 Apr 09

PakistanProvinceA-3AA-3DB-4APENDBaluchistan11000NWFP42140Sindh9700Islamabad0030Punjab16240Total2515410

AfghanistanProvinceA-3AA-3DB-4APENDHelmand7000Kandahar10000Farah1000Uruzgan5000Zabul1000Herat1000Total25000

Afghanistan & Pakistan P1 isolatesby genetic cluster 2009

Data up to 4 Apr 09

PakistanProvinceA-3AA-3DB-4APENDBaluchistan0000NWFP0110Sindh1000Islamabad0000Punjab0010Total1120

AfghanistanProvinceA-3AA-3DB-4APENDHelmand11Kandahar30Farah00Uruzgan00Zabul00Herat00Total41

Afghanistan & Pakistan P3 isolatesby genetic cluster 2008 Data up to 4 Apr 09

Cluster B-1C PAKDistrictDonsetNowshera27-AprNowshera14 -MayBajour14-JulBajour19-JulPeshawar (2)24-JulBajaour10 AugPeshawar12-AugPeshawar (2)24-AugIslamabad01-SepMohmand05-SepKhyber16-SepPeshawar05-SepPeshawar (2)12-SepPeshawar15-SepPeshawar16-SepPeshawar (2)17-SepIslamabad27-SepPeshawar3-OctPeshawar6- OctPeshawar11-OctPeshawar22-OctKohat28 OctPeshawar30-OctCharsada13-OctKhyber1-NovPeshawar19-NovPeshawar22-NovKhyber1-DecPeshawar1-DecPeshawar03-DecPeshawar11-DecHaydarabad29-NovKHIGIqbad06-Dec

Cluster B-1C AFGDistrictDonsetMaywand09-FebBalabuluk15-AprShah Wali Kot25-AprJalalabad14-MayJalalabad21-JulJalalabad27- Nov*

Afghanistan & Pakistan P3 isolates by genetic cluster 2009 Data up to 4 Apr 09

Cluster B-1C PAKDistrictDonsetSialkot11 JanCharsada11 JanCharsada19 JanKhi Baldia11 Feb

Cluster B-1C AFGDistrictDonset

Regional Reference Lab Update Afghanistan 2009 Data up to 4 Apr 09

Month of onsetCasesCases under processNegative casesNPEV positive NPEV %Within 28 daysPositive casesCultureITDWild Vaccine Jan11900892118%100%27Feb10700891312%100%14Mar391030615%97%11Week 1Mar306021310%80%00Week 2Mar22120915%45%00Week 3Mar1818-------Week 4Mar total10937060109%66%11Total AFP cases3353702384413%89%412 ( 3.58 %)Contacts1883001212815%84%18 ( 4.25 %)

AFP Cases Labeled As Hot & Pending in Lab, Afghanistan 2009Hot by criteria=AFP cases have (Fever + rapid progress+ Asymmetric paralysis + Age

Reported AFP Cases, Comparison By Month, Afghanistan 06-09@ of 2/100,0000

AFP Cases By Week Of Onset Afghanistan 2009Week (Sun-Sat) Expected 2= Two cases/100,000

AFP Cases Pending ERC, Afghanistan 2009 Data up to 4 Apr 09

EPIDDONSETDistrictProvinceSexAgeDosesDstool2 (or 1)AsymProgressFeverLab result60d follow-up resultAFG/08/09/02309-01-09NAWAY_I_BARAKZAYIHILMANDM8124-02-09YESYESYESNVIRES WEAKAFG/08/09/01519-01-09NAHRI SARRAJHILMANDM72005-02-09NOYESYESNVIRES WEAKAFG/05/09/03525-01-09GHORBANDPARWANF144004-03-09YESYESNOEVDIEDAFG/03/09/02414-02-09SHAHRAKGHORM5918.YESYESYESNO STOOLSDIED

Population Density Map Afghanistan 2009

Non-Polio AFP Rate by Province, Afghanistan per 100,000 under 15 years (Annualized)

200920082007 Data up to 4 Apr 09

% of AFP cases reported within 7 days of paralysis onset by region Afghanistan 07-09 Data up to 4 Apr 09

Proportion Of Adequate Stools By Region Afghanistan 07-09 Data up to 4 Apr 09

AFP Cases with Stool Specimen Reaching The RRL Within 3 and 7 Days of 2nd Specimen Collection By Region, Afghanistan 07-09Within 3 daysWithin 7 days Data up to 4 Apr 09

Percentage of Entero -Virus and SL isolation Afghanistan 07-09Entero VirusSLPercentageEV % by month 07-09 Data up to 4 Apr 09

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**Correct the dots and number next to the map*********************