On Monday 5 May 2014, the WHO Director General (DG) declared the international spread of wild poliovirus a “public health emergency of international concern” and issued Temporary Recommendations under the International Health Regulations (2005).
These recommendations aim to prevent further international spread of poliomyelitis which, if it occurs, could result in the failure to eradicate one of the world’s most serious vaccine preventable diseases.
The Temporary Recommendations are reviewed approximately every 3 months. The current recommendations are available on the WHO website.
Health professionals are reminded to be vigilant for signs of poliovirus infection, including acute flaccid paralysis, in travellers returning from polio infected countries and to notify their state or territory Department of Health and the National Enterovirus Reference Laboratory immediately on suspicion of this disease.
Recommendations for Australian travellers
It is recommended that Australians travelling to polio infected countries are up to date with routinely recommended vaccinations against polio, including a booster, prior to departure.
Additionally Australians travelling to polio infected countries may be required to provide documented evidence of having received a dose of polio vaccine within 12 months prior to departure from these countries. If you do not have documented evidence of polio vaccination within this 12 month period, you may be required to be vaccinated prior to departure from these countries.
The current list of polio infected countries is available on the Global Polio Eradication Initiative website.
Documented evidence should include a completed WHO “yellow booklet” International Certificate of Vaccination or Prophylaxis which are available at some travel clinics or otherwise can be ordered by your doctor from the WHO.
Australian travellers should consult with their general practitioner regarding their vaccination requirements.
The Global Polio Eradication Programme
The Global Polio Eradication Programme has made significant progress in eliminating poliomyelitis since its inception in 1988. At that time over 125 countries were considered to have endemic polio and an estimated 350,000 children were paralysed each year. Since the programme began more than 2.5 billion children have been immunised against polio and the global incidence of polio cases has decreased by 99%. - The Global Polio Eradication Initiative provides up to date information on current polio cases worldwide.
Status of Polio in Australia
The Western Pacific Region, including Australia, was declared polio-free in 2000. Australia has an excellent record of polio control with the last case of poliomyelitis caused by a locally acquired wild poliovirus in Australia reported in 1972.
A comprehensive national risk assessment of polio transmission following importation of a poliovirus in Australia was undertaken in 2012. This assessment found the risk of transmission following importation was low, mainly due Australia’s very high vaccination coverage against polio.
In Australia the National Immunisation Programme provides polio immunisation for children with doses of inactivated polio vaccine provided at 2, 4 and 6 months of age followed by a booster at 4 years of age. Coverage rates associated with the childhood programme are above 90%. A booster dose is also recommended, though not funded, for adults who are travelling to polio infected areas as per WHO International Travel and Health, 2012 guidelines and health care workers in possible contact with the poliovirus.
The Department provides advice on the need for vaccination when travelling to polio infected countries through the Department of Foreign Affairs and Trade’s Smartraveller website.
Poliovirus infections are nationally notifiable in Australia. Australia has maintained WHO certification standard surveillance including for clinical cases of acute flaccid paralysis (AFP) which is supplemented by sentinel environmental and human enterovirus surveillance.
Australia maintains a polio response plan, ‘Poliomyelitis Outbreak Response Plan for Australia’. Any single case of poliomyelitis in Australia is considered a public health emergency and would activate the polio response plan.
Australia the National Immunisation Programme provides polio immunisation for children with doses of inactivated polio vaccine provided at 2, 4 and 6 months of age followed by a booster at 4 years.