Polio is an infectious disease caused by a virus that can spread from person to person or through contaminated water or food. Many people who are infected don’t feel sick or have symptoms. Some people have only minor symptoms such as fever, nausea, headache, nasal congestion, sore throat, cough, stiffness in the neck and back, and pain in the arms and legs. A small proportion of those with symptoms develop paralysis.
The World Health Organization has advised of an increase in polio activity in areas which have previously seen eradication. This includes New York (widespread wastewater detection as well as a confirmed case), Jerusalem (a confirmed case), London (wastewater detections), and Aceh province, Indonesia (four cases from the same community).This has led to a declaration of a State of Emergency in New York, with a view to increasing immunisation rates to prevent future outbreaks, and catch up and booster vaccination programmes in London and Israel. The overall risk of a polio disease transmission in New Zealand due to importation is low. The risk of ongoing transmission in New Zealand is also low. While we have high levels of sanitation and the ability of the health system to respond to cases in New Zealand, there has been a decline in childhood vaccination coverage in the context of COVID-19.
In December 2023, two cases of polio were detected in Indonesia, the first case from Klaten district, Central Java province, with a history of recent travel to Sampang district, East Java province. The second case from Pamekasan district in East Java province. Two environmental samples taken from the Saksak River, Bangkalan district East, Java province in December 2023, also tested positive for polio. There have been four cases reported in Indonesia in 2021 and one case in 2022.
In response to this polio outbreak, Indonesia has initiated several public health responses including contact tracing, active case finding and risk assessment. Catch-up on routine immunisation is being initiated to enhance vaccine coverage.
The overall risk is assessed as high at the national level in Indonesia and moderate at the western pacific regional level. WHO recommends that all travellers to polio-affected countries be fully vaccinated against polio.
The international poliovirus situation is evolving, likely due to impacts of the COVID-19 pandemic such as interruptions to immunisation and other health services, exacerbated by conflict and complex emergencies in some fragile states. The New Zealand Ministry of Health continues to closely monitor the situation.
There is no cure, but polio can be prevented through vaccination. Good hand washing practices can help prevent the spread of this disease. Because the virus that causes polio lives in the faeces (poop) of an infected person, people infected with the disease can spread it to others when they do not wash their hands well after using the toilet. People can also be infected if they drink water or eat food contaminated with infected faeces.
Infections from vaccine-derived poliovirus occur on occasion in countries still using live poliovirus vaccine, and has now been seen in countries that do not use live poliovirus vaccine (e.g. USA) Vaccination against polio before travel will protect against these outbreaks. New Zealand does not use live poliovirus vaccine. New Zealanders travelling to polio-affected areas (please refer to the list of endemic countries or countries with poliovirus outbreak) should be up to date with routinely recommended vaccinations against polio, including boosters, prior to departure. More specifically:
- New Zealand residents planning to visit these areas for less than 4 weeks should be up to date with their polio vaccination. For adults, this is a 3 dose primary course, with a booster within the last 10 years. For children, a 3 dose primary course with a booster at 4 years old is currently recommended. These recommended vaccines may be given before arrival into the region.
- New Zealand residents intending to stay for longer than 4 weeks should have a documented polio booster within 4 weeks to 12 months prior to the date of departure. The booster may be given before arrival, as long as it is given within 4 weeks to 12 months prior to leaving the region .
- Individuals who are already residing in the affected region for 4 weeks or longer should have a documented polio booster within 4 weeks to 12 months prior to departure. The booster may have been given before arrival, as long as it has been given within 4 weeks to 12 months prior to leaving. Individuals leaving in less than 4 weeks should still receive a polio booster as this will still have benefit.
- Travellers should be provided with a written record of such vaccination, preferably using the International Certificate of Vaccination or Prophylaxis, and keep this record during international travels.
This advice is in addition to any other travel-specific vaccinations that may be required.
Polio has been eradicated from New Zealand and from most of the countries around the world.
- World Health Organization. “Vaccine-preventable diseases and vaccines.”
- See the Papua New Guinea travel advisory
- See the Nigeria travel advisory
- See the Somalia travel advisory
- See the Democratic Republic of the Congo travel advisory
- See the Niger travel advisory
- See the Mozambique travel advisory
- See the Cameroon travel advisory
- See the Chad travel advisory
- See the Central African Republic travel advisory
- See the Kenya travel advisory
- See the Afghanistan travel advisory
- See the Pakistan travel advisory
- See the Philippines travel advisory
- See the United States of America travel advisory
- See the United Kingdom travel advisory
- See the Israel and the Occupied Palestinian Territories travel advisory
- See the Indonesia travel advisory
Reviewed:19 Feb 2024, 13:30
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