Credit CDC
# 8699
We’ve been watching with growing concern for a couple of years now the renewed spread of Polio – which was not long ago thought to be on the brink of global eradication – in Africa and parts of the Middle East. A month ago (May 5th), after convening a meeting of their Emergency Committee we saw the WHO Declare Polio Spread A Public Health Emergency Of International Concern (PHEIC).
As a result, new, strict polio vaccination requirements are being implemented for those countries with `active polio’.
Those countries include Cameroon, Pakistan and Syria as `exporting wild polio’ and Afghanistan, Equatorial Guinea, Ethiopia, Iraq, Israel, Somalia and Nigeria as `infected with wild poliovirus’. Yesterday, in an effort to inform clinicians (and their patients) in the United States on new polio booster requirements for travel to these polio hotspots, the CDC has released the following HAN Advisory:
Distributed via the CDC Health Alert Network
June 2, 2014, 16:00 (4:00 PM ET)
CDCHAN-00362Summary
On 5 May 2014, the Director-General of the World Health Organization (WHO) accepted the recommendations of an Emergency Committee, declaring the international spread of polio to be a public health emergency of international concern (PHEIC) under the authority of the International Health Regulations (IHR) (2005) and issued vaccination requirements for travelers in order to prevent further spread of the disease. IHR is an international agreement among countries to prevent, protect or control the international spread of disease. All countries have agreed to be bound by recommended activities under IHR.
The “temporary recommendations” in response to this PHEIC, the second ever to be issued under IHR, will be reviewed and possibly revised by WHO’s Emergency Committee in three months. The burden for enforcement of the polio vaccination requirements under this PHEIC declaration lies with polio-affected countries (termed “polio-infected” by WHO). At this time, the United States government is not expected to implement requirements for entry into the United States.
U.S. clinicians should be aware of possible new vaccination requirements for patients planning travel for greater than four weeks to countries with ongoing poliovirus transmission. The May 5 WHO statement names 10 such countries, three designated as “exporting wild poliovirus” (Cameroon, Pakistan and Syria [Syrian Arab Republic]) that should “ensure” recent (4 to 52 weeks before travel) polio boosters among all departing residents and long-term travelers (of more than 4 weeks), and an additional seven countries “infected with wild poliovirus” (Afghanistan, Equatorial Guinea, Ethiopia, Iraq, Israel, Somalia and Nigeria) that should “encourage” recent polio vaccination boosters among residents and long-term travelers.
At this time, CDC is not aware of what specific steps will be taken by these 10 countries to comply with the PHEIC declaration. U.S. citizens who plan to travel to any of the polio infected countries should have documentation of a polio booster in their yellow International Certificate of Vaccination in order to avoid delays in transit.
Background
Currently 10 countries have active transmission of wild poliovirus (WPV) that could spread to other countries through international travel. From January through April 2014, months normally considered the low-transmission season for polio, the virus already has been carried to three countries: from Pakistan to Afghanistan, from Syria to Iraq, and from Cameroon to Equatorial Guinea. WHO considers this an “extraordinary event” and a public health risk to other countries. If the current spread of WPV continues, cases could multiply considerably as the high-transmission season has already begun. The consequences of further international spread are particularly acute today given that several countries with complex humanitarian emergencies or other major challenges are bordering the infected countries.
Follow the link to continue reading the CDC’s specific recommendations.
