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International Measures to Stop Spread of Wild Poliovirus (Update 9)

22 November 2016

The 11th meeting of the Emergency Committee under the International Health Regulations (IHR) (2015) regarding the international spread of wild poliovirus in was convened by the WHO Director General on 11 November 2016.

As with the 10th meeting, the Emergency Committee reviewed the data on circulating vaccine-derived polioviruses (cVDPV) as well as circulating wild poliovirus (WPV1).

The Committee agreed that the situation still constitutes a Public Health Emergency of International Concern (PHEIC) and recommended the extension of the Temporary Recommendations The Committee provided the Director General with updated risk categorisations as follows:

Countries currently exporting wild poliovirus (WPV1) or cVDPV:

  • Pakistan (WPV1) (last exportation 2 August 2016, to Afghanistan).

States infected with WPV or cVDPVs but not currently exporting:

  • Infected countries (WPV1):
    • Nigeria (last case 21 August 2016).
    • Afghanistan (last case 7 October 2016).
  • Infected countries (cVDPV):
    • Nigeria (last isolate from a community survey 26 August 2016).
    • Guinea (last case 14 December 2015).
    • Lao People’s Democratic Republic (last case 11 January 2016).

In addition, all travellers to Cameroon, Niger, Chad, Equatorial Guinea, Central African Republic, Ukraine, Madagascar and Myanmar should ensure they have had a full primary course of poliomyelitis vaccine and be offered a booster if it has been more than 10 years since their last dose (these countries are no longer infected with wild poliovirus or cVDPV but remain vulnerable to international spread or to the emergence and cVDPV).

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 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 advice which is different to that in Scotland (please look at Travel Health Pro Clinical updates for full details).