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Polio: Global Update

Updated: April 11, 2014

Travel Health Notice

Poliomyelitis (polio) has been eliminated from most countries; however it continues to occur in some areas of the world.

The Public Health Agency of Canada recommends that travellers get vaccinated against polio when going to countries where polio has not been eliminatedExternal link (is endemic), countries with recently imported cases or where the virus has been detected, or countries located near those that are endemic or have cases of recent infection. 

PolioExternal link is a contagious disease. It can be prevented by vaccination. It is spread from person to person and through contaminated food and water. Polio can attack the central nervous system and destroy the nerve cells that activate muscles, which may cause paralysis and death.

Where is polio a concern?

  • Polio has not been eliminated in three countries: Afghanistan, Nigeria and Pakistan.
  • Since the beginning of 2014, cases have been reported in the three endemic countries as well as in Cameroon, Equatorial Guinea, Ethiopia, Iraq and Syria.
    • The cases in Cameroon confirm that the strain detected in 2013 continues to be transmitted. Polio had not been reported in Cameroon since 2009.
    • These were the first cases reported in Equatorial Guinea since 1999 and in Iraq since 2000.
    • In Ethiopia and Syria, cases of polio were most recently detected in 2013, and previously in 2008 and 1999 respectively.
  • In 2013, cases were also reported in Kenya and Somalia. These were the first cases reported since 2011 in Kenya and 2007 in Somalia.
  • Wild poliovirus type 1 has been detected in sewage samples in Israel and in the West Bank and Gaza Strip. However, no cases of paralytic polio have been reported to date in these countries.
  • India has been certified polio free, but remains vulnerable to reintroduction of the disease. As of March 1, 2014, the Government of India requires visitors from polio endemic countries and countries with recently imported cases of polio to have proof of vaccination with Oral Polio Vaccine (OPV) prior to entry in India. This requirement is not mandatory for Canadian citizens residing in polio infected countries or Canadian travellers in transit through polio infected countries.
  • In addition, it is not mandatory for Canadian citizens residing in India to receive OPV before travelling to polio infected areas. However, all Canadian travellers should complete the inactivated polio vaccine (IPV) series, and if necessary, receive an additional booster prior to travel to countries at risk (see recommendations below).
  • Both OPV and IPV (given by shot) protect against polio; however, a person who has received only IPV can still excrete wild polio virus in their stool after an environmental exposure.
  • Only IPV is available and used in Canada.

For a map of infected districtsExternal link and a list of countries with confirmed cases of polioExternal link, please visit the website of the Global Polio Eradication InitiativeExternal link.

Recommendations

Consult a health care provider or visit a travel health clinic preferably six weeks before you travel.

  1. Get vaccinated.
    1. All travellers need to get vaccinated if they are going to:
      1. Countries where polio has not been eliminated.
      2. Countries with recently imported cases of polio or where the virus has been detected.
      3. Countries close to those where polio is endemic or those where recent cases have been reported.
    2. For infants and children under 18 years of age:
      1. Polio is part of the routine vaccine schedule in Canada. See provincial/territorial immunization schedules for further information.
      2. If the routine vaccine schedule is not complete before travel, talk to a health care provider about the remaining doses you can get before leaving.
    3. For adults 18 years of age and older:
      1. If you have completed your polio vaccine series and have not received a booster dose against polio since your 18th birthday:
        • Get a one-time booster dose before leaving.
      2. If you have not completed your polio vaccine series:
        • Get the remaining doses before leaving.
      3. If you have not received any vaccines against polio:
        • Get fully vaccinated against polio.
  2. Practise safe food and water precautions.