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Travel Bulletin: CDC Updates Global Status of Polio

By Healthytravelblog @healthytravel1

SOURCE: Centers for Disease Control and Prevention

Polio is a serious disease that can cause paralysis and death. If you are going to one of the countries listed below, CDC recommends that you make sure you are up to date on your polio vaccine. If your vaccine is not up to date, you will need to get vaccinated.

Polio Boosters Are Recommended for Travelers Visiting the Following Countries:

Afghanistan, Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, China, Congo, Cote d’Ivoire, Democratic Republic of the Congo (DRC), Djibouti, Equatorial Guinea, Eritrea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea Bissau, Iran, Kazakhstan, Kenya, Kyrgyzstan, Liberia, Mali, Mauritania, Namibia, Niger, Nigeria, Pakistan, Rwanda, Senegal, Sierra Leone, Somalia, Sudan, South Sudan, Tajikistan, Tanzania, Togo, Turkmenistan, Uzbekistan, Uganda, Zambia

What Is Polio?

Polio, or poliomyelitis, is a disease caused by a virus that affects a person’s nervous system. Polio is mainly spread by ingesting items contaminated with the feces of an infected person. Polio can also be spread through, water, other drinks and uncooked food. The disease mainly affects children less than 5 years old, but unvaccinated people of any age are at risk. Even though most infected people have no symptoms, signs and symptoms of severe illness may include paralysis of limbs and respiratory muscles.

In the late 1940s to the early 1950s, in the United States alone, polio crippled around 35,000 people each year, making it one of the most feared diseases of the twentieth century. By 1979 the country became polio free.

How Can Travelers Protect Themselves?

Get vaccinated for polio.

Talk to your doctor to find out if you are up-to-date with your polio vaccination and whether you need a booster dose before traveling.

Even if you were vaccinated as a child or have been sick with polio before, you may need a booster shot to make sure that you are protected. If you are traveling with children, be sure that they have been fully vaccinated, too.

Follow safe food and water practices.

Eat foods that are fully cooked and served hot.

Eat and drink dairy products that have been pasteurized.

Eat only fruits and vegetables that you can wash with safe water and peel yourself.

Drink only bottled or boiled water or beverages that have been bottled and sealed (carbonated drinks or sports drinks). Avoid tap water, fountain drinks, and ice.

Practice good hand hygiene.

Wash hands often with soap and water. If soap and water are not available, you can use an alcohol-based hand cleaner.

Wash hands especially before eating, drinking, or preparing food and after using the bathroom, changing diapers, and coughing or sneezing.

Clinician Information:

Polio vaccination is recommended for all travelers to polio-endemic areas, to countries with re-established transmission or recently imported cases, or to countries at risk because of their proximity to these areas. See the list of countries above.

According to the Global Polio Eradication Initiative (GPEI),* since 2006 only 4 countries (Afghanistan, India, Nigeria, and Pakistan) have been polio-endemic with indigenous polio virus circulation. India, however, has succeeded in interrupting wild polio virus transmission. As of January 14, 2012, India has gone more than 12 months without a polio case and has been officially removed from the endemic countries list.

In 4 additional countries in Africa, imported wild polio virus was either known (Angola, Chad) or suspected (Democratic Republic of the Congo, South Sudan) to have persisted for more than12 months as of mid-2009, leading to their designation as having “re-established” transmission. (South Sudan has apparently succeeded in interrupting polio virus transmission; the last documented case was in June 2009.) This designation is considered equivalent to “polio-endemic” for travel preparation purposes.

During the past 12 months, the following countries have reported cases of poliomyelitis related to importation or re-established transmission of wild polio viruses: Angola, Cameroon, Central African Republic, Chad, China, Cote d’Ivoire, the Democratic Republic of the Congo (DRC), Guinea, Kenya, Mali, and Niger.

The following countries are at risk for polio virus importation because they are located near endemic, re-established transmission, or recently infected countries: Benin, Burkina Faso, Burundi, Congo, Djibouti, Equatorial Guinea, Eritrea, Ethiopia, Gabon, Gambia, Ghana, Guinea-Bissau, Iran, Kazakhstan, Kyrgyzstan, Liberia, Mauritania, Namibia, Rwanda, Senegal, Sierra Leone, Somalia, Sudan and South Sudan, Tajikistan, Tanzania, Togo, Turkmenistan, Uganda, Uzbekistan, and Zambia.

Outbreaks continue to be a risk for major portions of Africa and some portions of central and south Asia. Susceptible people are still at risk for infection until polio virus transmission is eliminated worldwide. Therefore, adults and children traveling to these areas should be fully vaccinated against polio according to the recommendations below.

Vaccine Recommendations: Infants and Children

The Advisory Committee on Immunization Practices (ACIP) recommends that all infants and children in the United States should receive 4 doses of inactivated polio virus vaccine (IPV), administered at 2 months, 4 months, 6–18 months, and 4–6 years of age.

If accelerated protection is needed, the minimum interval between the first 3 doses is 4 weeks (28 days), and the minimum interval from dose 3 to dose 4 is 6 months.

A dose of IPV should be administered at age older than 4 years regardless of the number of previous doses.

Vaccine Recommendations: Adults

Travelers who have received the full series with either IPV or oral polio vaccine (OPV) as a child without an adult booster dose (either OPV or IPV) should receive another dose of IPV before departure.

Available data do not indicate the need for more than one lifetime IPV booster dose for adults.

Adults who are unvaccinated, incompletely vaccinated, or whose vaccination status is unknown should receive 3 doses of IPV (2 doses at 4–8 week intervals followed by a third dose 6–12 months after the second dose).

OPV has not been used in the United States since 2000; however, it is used in many other countries and has played a major role in eliminating polio from large parts of the world. IPV, which is given by intramuscular injection, is now used in the United States and a number of other developed countries.

Copyright © 2012, Centers for Disease Control and Prevention


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