International Measures to Stop Spread of Wild Poliovirus (update 12)

The 17th meeting of the Emergency Committeeunder the International Health Regulations (IHR) (2015) regarding the international spread of wild poliovirus in was convened by the WHO Director General on 30 April 2018.

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. The Committee provided the Director General with updated risk categories as per information below:

1. States infected with WPV1 with potential risk of international spread:

• Afghanistan
• Nigeria
• Pakistan

2. States infected with cVDPVs:

• Democratic Republic of Congo
• Kenya
• Nigeria
• Somalia
• Syria

3. States no longer infected by WPV1 or cVDPV, but which remain vulnerable to re-infection by WPV or cVDPV:

• Cameroon
• Niger
• Chad
• Central African Republic

TRAVAX recommends polio vaccination within 10 years for travel to countries where it is three years or less since the last case, for:

• Ukraine
• Madagascar
• Myanmar
• Guinea
• Lao People’s Democratic Republic

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 WHOand ECDCrecommendations 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 can 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 potentially exporting countries (listed under points 1 and 2 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.
• In addition, all travellers to countries still vulnerable to re-infection by WPV or cVDPV (listed under point 3 above) 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.
• 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 WHOPlease see POLIO FAQ for further clarification.

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