Updated
March 8th, 2019

Polio Remains a Worldwide Threat in 2019

The risk of poliovirus spreading remains a public health emergency of international concern

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A World Health Organization (WHO) Committee unanimously agreed on March 1, 2019, that the risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC).

The Emergency Committee reviewed the data on wild poliovirus (WPV1) and the circulating vaccine-derived polioviruses (cVDPV). This WHO committee voted to extend the Temporary Recommendations for an additional 3 months. 

Noting the spread of polioviruses in several countries close to international borders, this WHO committee strongly urges that surveillance, population immunity assessments, and outbreak preparedness activities intensify in all neighboring countries. 

‘Many countries remain vulnerable to WPV importation,’ said the WHO. 

The WHO Committee said in a statement that it ‘was very concerned by the increase in WPV1 cases in 2018. And, this trend appears to be continuing in 2019, with 6 cases already confirmed.’ 

The WHO issued temporary recommendations for countries infected with WPV1, cVDPV1 or cVDPV3 with the potential risk of international spread:

WPV1:                                              

  • Afghanistan (most recent detection 26 January 2019)    
  • Pakistan (most recent detection 28 January 2019)
  • Nigeria (most recent detection 27 Sept 2016)           

cVDPV1:

  • Papua New Guinea (most recent detection 7 November 2018)
  • Indonesia (most recent detection 25 January 2019)

cVDPV3

  • Somalia (most recent detection 7 Sept 2018)

The WHO says these countries should: 

  • Officially declare, if not already done, at the level of head of state or government, that the interruption of poliovirus transmission is a national public health emergency.
  • Ensure that all residents and long-­term visitors (i.e. > four weeks) of all ages, receive a dose of bivalent oral poliovirus vaccine (bOPV) or inactivated poliovirus vaccine (IPV) between 4 weeks and 12 months prior to international travel.
  • Ensure that those undertaking urgent travel (i.e. within four weeks), who have not received a dose of bOPV or IPV in the previous 4 weeks to 12 months, receive a dose of polio vaccine at least by the time of departure as this will still provide benefit, particularly for frequent travelers.
  • Ensure that such travelers are provided with an International Certificate of Vaccination or Prophylaxis in the form specified in Annex 6 of the IHR to record their polio vaccination and serve as proof of vaccination.
  • Restrict at the point of departure the international travel of any resident lacking documentation of appropriate polio vaccination. These recommendations apply to international travelers from all points of departure, irrespective of the means of conveyance.

Countries infected with cVDPV2s, with the potential risk of international spread, are as follows:

  • DR Congo (most recent detection 7 October 2018)
  • Kenya (most recent detection 21 March 2018)
  • Mozambique (most recent detection 17 December 2018)
  • Niger (most recent detection 5 December 2018)
  • Nigeria (most recent detection 15 January 2019)
  • Somalia (most recent detection 11 October 2018)

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The WHO says these countries should take the following actions:

  • Officially declare, if not already done, at the level of head of state or government, that the interruption of poliovirus transmission is a national public health emergency.
  • Consider requesting vaccines from the global mOPV2 stockpile based on the recommendations of the Advisory Group on mOPV2.
  • Encourage residents and long­-term visitors to receive a dose of IPV (if available in country) 4 weeks to 12 months prior to international travel; those undertaking urgent travel (i.e. within four weeks) should be encouraged to receive a dose at least by the time of departure.
  • Ensure that travelers who receive such vaccination have access to an appropriate document to record their polio vaccination status.
  • Intensify regional cooperation and cross-­border coordination to enhance surveillance for prompt detection of poliovirus, and vaccinate refugees, travelers and cross­border populations, according to the advice of the WHO Advisory Group.
  • Further intensify efforts to increase routine immunization coverage, including sharing coverage data, as high routine immunization coverage is an essential element of the polio eradication strategy, particularly as the world moves closer to eradication.
  • Maintain these measures until the following criteria have been met: (i) at least six months have passed without the detection of circulation of VDPV2 in the country from any source, and (ii) there is documentation of full application of high quality eradication activities in all infected and high risk areas; in the absence of such documentation these measures should be maintained until the state meets the criteria of a ‘state no longer infected’.
  • At the end of 12 months without evidence of polio transmission, provide a report to the Director-General on measures taken to implement the Temporary Recommendations.

To alert USA citizens, the Centers for Disease Control and Prevention (CDC) issued various Travel Alerts, which recommend that all travelers to these countries be fully vaccinated against polio. 

The CDC says adults who completed their routine polio vaccine series as children should receive a single, lifetime adult booster dose of the polio vaccine.     

And, the CDC recommends that all infants and children in the USA be vaccinated against polio, as part of a routine, age-appropriate vaccination series. 

Polio is caused by the poliovirus, which spreads from person to person, by drinking water or eating food that is contaminated with infected feces. In certain cases, polio can invade an infected person’s brain and spinal cord, causing paralysis, says the CDC.    

The oral polio vaccine is given as drops in the mouth to protect against polio. 

Besides the polio vaccination, the CDC suggests you are up-to-date on several Routine Vaccines before visiting these countries. 

These vaccines and related medications can be found at most ‘travel-pharmacies’ in the USA.  

Pre-trip, vaccine and medication counseling appointments can be scheduled at Vax-Before-Travel.