Response to a Large Polio Outbreak in a Setting of Conflict - Middle East, 2013-2015

As the world advances toward the eradication of polio, outbreaks of wild poliovirus in polio-free regions pose a substantial risk to the timeline for global eradication. A polio outbreak occurred in the Middle East, beginning in Syria in 2013 with subsequent spread to Iraq. The outbreak occurred 2 years after the onset of the Syrian civil war. The national governments of eight countries designated the outbreak a public health emergency and collaborated with partners in the Global Polio Eradication Initiative to develop a multiphase outbreak response plan focused on improving the quality of acute flaccid paralysis surveillance and administering polio vaccines to >27 million children during multiple rounds of supplementary immunization activities. Successful implementation of the response plan led to containment and interruption of the outbreak within 6 months of its identification. The concerted approach adopted in response to this outbreak could serve as a model for responding to polio outbreaks in settings of conflict and political instability.