International Measures to Stop Spread of Wild Polio Virus (update 19)

The 24th meeting of the Emergency Committee under the International Health Regulations (IHR) (2005) regarding the international spread of wild poliovirus was convened by the WHO Director General on 26 March 2020.

The global situation with polio is ongoing and TRAVAX users are urged to check updated outbreaks and individual country recommendations

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 categories as below:

1. States infected with WPV1, cVDPV1 or cVDPV3 with the potential risk of international spread; these countries have a certificate requirement for polio vaccination under IHR (2005):

• Afghanistan - WPV1
• Pakistan - WPV1
• Nigeria - WPV1
• Malaysia - cVDPV1
• Myanmar - cVDPV1
• Philippines - cVDPV1

2. States infected with cVDPV2, with potential or demonstrated risk of international spread; with the exception of countries marked with an asterisk (*) there is no certificate requirement under IHR (2005) for these countries. Travellers are, however, encouraged to carry proof of polio vaccination:

• Afghanistan*
• Angola
• Benin
• Burkina Faso
• Cameroon
• Central African Republic
• Chad
• Cote d’Ivoire
• China
• Democratic Republic of Congo
• Ethiopia
• Ghana
• Malaysia*
• Niger
• Nigeria*
• Pakistan*
• Philippines*
• Somalia
• Togo
• Zambia

* These countries have a certificate requirement for polio vaccination under IHR (2005) due to infection with WPV1 or cVDPV1.

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

• Kenya
• Mozambique
• Papua New Guinea
• Indonesia

Advice for Travellers

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

See individual country recommendations on TRAVAX.

In order to comply with the WHO recommendations and also to avoid travellers receiving live oral polio vaccine when departing polio-infected countries, authorities in the UK have made the following vaccination recommendations:

• Travellers should consider 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.
• Travellers should carry proof of vaccination. For countries listed under point 1 this should be documented on the standard International Certificate of Vaccination or Prophylaxis (ICVP). The ICVP is the yellow booklet normally used for yellow fever vaccination. Failure to produce an ICVP may result in vaccination on departure, possibly with live oral polio vaccine, this may cause problems for individuals with weakened immune systems (including pregnancy) who should NOT receive live oral polio vaccine.
• 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 Please see POLIO FAQ for further clarification.
• Out with Scotland, paper ICVP’s should be obtained from NaTHNaC, please look at Travel Health Pro for full details.
• 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.