Contribution of Contact Sampling in Increasing Sensitivity of Poliovirus Detection during a Polio Outbreak – Somalia, 2013

In 1988, the World Health Assembly (WHA) of the World Health Organization (WHO) resolved to interrupt wild poliovirus (WPV) transmission worldwide and launched the Global Polio Eradication Initiative (GPEI) [1]. In 2012, the WHA declared the completion of polio eradication a programmatic emergency for public health [2], and it reported that annual WPV cases increased from 223 in 2012 to 416 in 2013 [3], an increase partly caused by several large outbreaks in previously polio-free countries in the Horn of Africa, Middle East, and Central Africa [3–8]. On May 9, 2013, a WPV type 1 (WPV1) case, genetically linked to WPV in Nigeria, was confirmed in a 32-month-old girl from Mogadishu, which is located in the Banadir Region of Somalia; the ensuing outbreak ultimately spread into 2 additional countries in the Horn of Africa [9, 10]. Before this outbreak, Somalia had been polio-free since March 2007 [5, 11]. We reviewed acute flaccid paralysis (AFP) surveillance data from the 2013 polio outbreak in Somalia to examine the added contribution of WPV detection from stool specimens collected from contacts of persons with AFP.