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The 10th 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 August 2016.
As with the 9th meeting, the Emergency Committee reviewed the data on circulating vaccine-derived polioviruses (cVDPV) as well as circulating wild poliovirus (WPV1).
The Committee was concerned by the 2 new cases of WPV1 reported from different local government areas (Gwoza and Jere) in Borno State, Nigeria during July 2016. These cases, together with the cVDPV reported in May 2016, suggest polioviruses have been circulating undetected in Borno for several years and indicate significant gaps in surveillance.
The Committee is concerned that Gwoza district borders with the north province of Cameroon and is considered inaccessible. Historically poliovirus transmission has occurred in the Lake Chad area, and the international borders around Borno with Cameroon, Chad and Niger, such that the risk of international spread between these four countries is considered extremely high and may already be occurring.
The Committee recognised the progress being made in Afghanistan and Pakistan and noted that there has been no spread of WPV1 between these two countries since the previous meeting. The Committee, however, is concerned by deteriorating security in parts of Afghanistan making more children inaccessible, potentially delaying the completion of global polio eradication in 2016. Globally there are significant vulnerable areas and populations that are inadequately immunised due to conflict and poor coverage. These vulnerable areas include countries in the Middle East, the Horn of Africa, and Central Africa.
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 to the following countries:
Countries currently exporting wild poliovirus (WPV) or cVDPV:
Countries infected with wild poliovirus or cVDPV detected in the last 6 months but not currently exporting:
In addition, all travellers to Somalia, Equatorial Guinea, Cameroon, Niger, Chad and Ukraine 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 circulation of VDPV)
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:
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).