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World Health Organisation statement on international spread of wild polio virus.

23 May 2014

On 5 May 2014, the World Health Organisation (WHO) released a statement on the meeting of the International Health Regulations Emergency Committee concerning the international spread of wild poliovirus.

The exportation of wild poliovirus has been declared a Public Health Emergency of International Concern (PHEIC) and a coordinated international response has been called for.

During 2014, there has been international spread of wild poliovirus from 3 of the 10 States currently infected: central Asia (from Pakistan to Afghanistan), the Middle East (Syrian Arab Republic to Iraq) and Central Africa (Cameroon to Equatorial Guinea).

(Via WHO Media Centre - accessed 07/05/14)

 

WHO has issued the following recommendations:

States currently exporting wild poliovirus

Pakistan, Cameroon, and the Syrian Arab Republic.

  • Ensure that all residents and long-term visitors (i.e. > 4 weeks) receive a dose of OPV or inactivated poliovirus vaccine (IPV) between 4 weeks and 12 months prior to international travel.
  • Ensure that those undertaking urgent travel (i.e. within 4 weeks), who have not received a dose of OPV 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 travellers.
  • Ensure that travellers are provided with an International Certificate of Vaccination or Prophylaxis in the form specified in Annex 6 of the International Health Regulations (2005) to record their polio vaccination and serve as proof of vaccination.

States infected with wild poliovirus but not currently exporting

Afghanistan, Equatorial Guinea, Ethiopia, Iraq, Israel, Somalia and Nigeria.

  • Encourage residents and long-term visitors to receive a dose of OPV or IPV 4 weeks to 12 months prior to international travel; those undertaking urgent travel (i.e. within 4 weeks) should be encouraged to receive a dose at least by the time of departure.
  • Ensure that travellers who receive vaccination have an appropriate document to record their polio vaccination status.

Advice for UK Travellers

Current position on UK travellers to/from States Exporting and Infected with Wild Poliovirus:

Travellers to affected countries:

There are a significant number of people who travel from the UK to these countries, in particular to Pakistan and Nigeria to visit family, and who may present for advice ahead of travelling. It is not mandatory for UK travellers to receive polio vaccination before travel to any of the polio affected countries.

Health Protection Scotland currently recommend that travellers to areas or countries where there are recent reports of wild polio circulating should receive  a poliomyelitis booster (or course) according to UK guidelines if not already protected, and take precautions with food, water and personal hygiene. Vaccination is using injectable, inactivated polio vaccine (in combination with diphtheria and tetanus) and boosters are recommended 10 yearly for those at risk. Oral polio vaccine is no longer available for routine use in the UK.

Refer to TRAVAX detailed country-by-country information on current polio-affected areas.

WHO are advising that travellers staying longer than 4 weeks in either Pakistan, Cameroon or Syria be required to show evidence of recent vaccination (in the previous 12 months) at the point of exit. HPS in discussion with Scottish Government and the Department of Health are currently considering whether or not to advise additional vaccination beyond the current recommendation to have a booster after 10 years. We are seeking clarification on the approach that will be taken on exit in Pakistan, which will come into force on June 1st, before deciding on the most appropriate vaccination approach for travellers from Scotland.

Screening of returning travellers:

The WHO temporary recommendations do not recommend  entry screening of passengers from affected countries. The UK is not recommending the implementation of screening for vaccination or infection at point of entry in the UK for passengers from affected countries.