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General Information:
- Previously, polio had been decreasing in incidence and nearing worldwide eradication.
- From 2012 to 2013, the incidence doubled from 223 to 403 cases, and is anticipated to be higher in 2014 (May and June are the highest transmission months).
- The WHO declared a Public Health Emergency of International Concern on Monday (5/5/14).
- Polio has been transmitted across international borders by travelers and is still circulating within endemic areas.
- In addition to improving vaccination within these countries, the public health emergency calls for all travelers from these countries to complete a polio vaccine series and travel with vaccination records.
Relevance to the EM Physician:
- Previously unvaccinated travelers should be given a 3-dose polio vaccine series.
- If a traveler has completed the 3-dose series in the past, the CDC recommends one single lifetime booster dose of inactivated polio virus (IPV).
Bottom Line:
- Polio is increasing in incidence in 10 countries: Syria, Pakistan, Cameroon, Afghanistan, Equatorial Guinea, Ethiopia, Iraq, Israel, Somalia and Nigeria.
- For those who received an IPV series as a child, a single IPV booster is recommended for travelers to those countries to assure lifelong immunity.
University of Maryland Section of Global Emergency Health
Author: Jenny Reifel Saltzberg, MD
References
http://www.who.int/mediacentre/news/statements/2014/polio-20140505/en/
http://www.who.int/wer/2014/wer8909.pdf