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International Measures to Stop Spread of Wild Poliovirus (Update 3)

07 May 2015

The fifth meeting of the Emergency Committee under the International Health Regulations (IHR) (2015) regarding the international spread of wild poliovirus in 2014-2015 was convened by the WHO Director General on 24 April 2015.

The Committee concluded that progress has been made in the year since the temporary recommendations came into force. No cases of wild poliovirus have been reported in Africa in the last 8 months. Afghanistan and Pakistan have reported a decrease of more than  50% in cases for 2015, compared with the same time period in 2014. Pakistan has not exported wild poliovirus since October 2014, and have vaccinated an average of 370 000 travellers per month since November 2014, pre-departure and at exit points.

Israel is no longer infected by wild poliovirus, but is still considered vulnerable to international spread.

It was also noted that the international spread of wild poliovirus has continued with three documented exportations from Afghanistan into Pakistan in October 2014.

The Committee agreed that the situation still constitutes a Public Health Emergency of International Concern (PHEIC) and recommended the extension of the Temporary Recommendations for a further three months to the remaining 7 wild poliovirus-affected areas:

  • Countries currently exporting wild poliovirus: Afghanistan and Pakistan.
  • Countries infected with wild poliovirus but not currently exporting: Cameroon, Equatorial Guinea (until 3 May), Iraq (until 19 May), Somalia and Nigeria.
  • Countries no longer infected with wild poliovirus but remain vulnerable to international spread: Ethiopia, Israel and Syria.

Advice for Travellers

Travellers should be encouraged to take strict precautions with food, water and personal hygiene.

In addition, in order to comply with the WHO and ECDC recommendations and also to avoid travellers being vaccinated in the polio-infected country, authorities in the UK have made the following vaccination recommendations.

In Scotland, Health Protection Scotland (HPS) advise:

  • Travellers should receive a booster dose of a polio-containing vaccine if they have not had one in the past 12 months and are visiting one of the polio-infected or exporting countries (listed above) for longer than 4 weeks (this advice supersedes the current advice in the Green Book).
  • Travellers should acquire this additional dose within 12 months of the date they plan to leave the polio-infected country.
  • Travellers visiting one of these countries for less than 4 weeks should ensure they are up-to-date with routine polio vaccination, including 10 yearly boosters.
  • Travellers should carry proof of vaccination. In particular, for Pakistan and Equatorial Guinea, this should be documented on the standard International Certificate of Vaccination or Prophylaxis (ICVP). The ICVP is the 'Yellow Card' normally used for yellow fever vaccination.
  • In Scotland, paper ICVP’s can be obtained from HPS by contacting TRAVAX administration, email your FULL NAME and FULL POSTAL ADDRESS to: NSS.HPSTravax@nhs.net electronic copies can be downloaded from WHO

In England, Public Health England and NaTHNaC have issued interim advice which is different to that in Scotland (please look at NaTHNaC Clinical updates for full details).