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WHO: Wild poliovirus transmission international concern
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Margaret Chan, PhD, the director-general of WHO, declared the spread of wild poliovirus a public health emergency of international concern based on information and advice provided by members of the Emergency Committee concerning recent progress of the international spread of the disease.
Bruce Aylward, MD, the assistant director-general for polio, emergencies and country collaboration, provided an update and assessment of the recent progress of stopping the international spread of wild poliovirus in 2014. Sixty percent of polio cases in 2013 resulted from international transmission, with increasing evidence that adult travelers contributed to the spread. Between January and April 2014, during what is considered the low season for polio transmission, three new wild poliovirus events occurred in Asia, the Middle East and central Africa.
The Emergency Committee recommended that states currently exporting wild poliovirus (Pakistan, Cameroon and the Syrian Arab Republic):
- Declare polio transmission a national public health emergency;
- Ensure residents and long-term visitors (visiting for more than 4 weeks) are vaccinated 4 weeks to 12 months before international travel;
- Guarantee those urgently traveling, who have not been vaccinated, receive a dose of polio vaccine by the time of departure at the latest; and
- Provide travelers with an “International Certificate of Vaccination or Prophylaxis” form to record their vaccinations.
States currently exporting wild poliovirus have the highest risk for further spread in 2014, according to the Emergency Committee. Members suggest that these areas maintain these measures until 6 months have passed without new exportations and there is documentation that eradication efforts have been fully applied. If documentation is not provided, these measures should be maintained until 12 months have passed without new exportations.
Regarding states infected with wild poliovirus but not currently exporting, (Afghanistan, Equatorial Guinea, Ethiopia, Iraq, Israel, Somalia and Nigeria), the committee recommends:
- They declare polio transmission a national public health emergency;
- Encourage residents and long-term visitors to receive vaccination 4 weeks to 12 months before international travel, and urgent travelers to receive vaccination at least by the time of departure; and
- Provide travelers with a document to record their vaccination status.
These areas are advised to maintain these measures until 6 months has passed without detection of transmission in the country and there is documentation that eradication efforts were fully applied to high-risk areas. These measures should be maintained until 12 months have passed without new exportations if no documentation is provided.