Ministry of Health and WHO introduce environmental surveillance for poliovirus in Iraq

Baghdad, 9 May 2022— The Ministry of Health (MoH) and the World Health Organization (WHO) have launched the environmental surveillance (ES) for polioviruses to further strengthen the nationwide polio surveillance system in Iraq.

The establishment of ES for polioviruses will complement AFP surveillance for more robust polio surveillance that ensures early detection of polioviruses in humans or the environment.

“The environmental surveillance is a milestone in enhancing polio surveillance in Iraq,” said Dr Ahmed Zouiten, WHO Representative in Iraq. “Maintaining polio-free status in Iraq is only possible with effective and continued environmental surveillance,”

“This is just an initial stage of our quest to advance ES in Iraq. We’re planning to expand the number and locations of ES sites in high-risk areas, including religious mass gathering sites such as in the holy sites of Karbala and Najaf and high-population movement areas like Basra and Erbil,” he added.

Wild polioviruses have been detected in the environment in the absence of reported AFP cases. Environmental surveillance is also a potential tool for monitoring circulating vaccine-derived poliovirus (cVDPV2). ES has been used successfully to monitor enteric virus circulation and assess the extent or duration of epidemic poliovirus circulation in a specific population.

In coordination with the MoH and National Polio Lab (NPL), WHO has supported NPL renovation and procured supplies, including equipment, kits and reagents. Prior to the launch of the ES, WHO conducted intensive training on sewage sample collection, and surveillance monitoring for efficient collection and transportation of the samples.

In addition, WHO has held ten-day on-the-job training for the NPL staff on laboratory techniques for poliovirus isolation from sewage samples and the best practices for the storage, testing, interpretation of results and data reporting. The training, conducted by one of the WHO regional polio experts, included testing the fresh samples collected from one of the two assigned sites in Baghdad (Al-Rustumia Sewage Station) as well as biosafety measures and waste management microscopic observation.

“This step came as part of the National Polio Outbreak Preparedness and Response Plan. It’s crucial to be vigilant to detect any possible emerging of vaccine-derived poliovirus circulation and/or wild poliovirus importation,” said Dr Firas Al-Khafaji, the National Professional Officer of EPI and polio surveillance for WHO Iraq.

Iraq has been free of vaccine-derived polioviruses (VDPV) and wild poliovirus (WPV) since 2014, when two cases of wild poliovirus were confirmed after a 14-year absence. However, Iraq is still at high risk for the importation of WPV or the emergence or importation of VDPVs due to a high level of internal and external population movement, relatively low routine immunization coverage and limited access in some areas.

The MoH, in cooperation with WHO, initiated a comprehensive multi-year plan (cMYP) to reach every child through routine immunization and other immunization strategies, including the National Basic Health Services Package and supplementary immunization activities (SIAs).