GENEVA, Switzerland — The World Health Organization on Monday released a statement concerning the international spread of poliovirus. Members of the emergency committee reported that toward the end of 2013, 60% of polio cases were the result of the international spread of the virus, with increasing evidence suggesting that adult travelers contributed to the spread.
Pakistan, Cameroon and the Syrian Arab Republic pose the most significant risk of further polio exportations in 2014.The WHO advised these states to officially declare the situation as a national public health emergency. Additionally, according to the WHO, these states should:
- Ensure all residents and long-term visitors (those staying greater than four weeks) receive a dose of OPV or inactivated poliovirus vaccine (IPV) between 4 weeks and 12 months prior to international travel;
- Ensure that those undertaking urgent travel receive a dose of polio vaccine at least by the time of departure; and
- Ensure that travelers are provided a certificate that serves as proof of vaccination.
States should maintain these measures until the following criteria have been met:
- At least 6 months have passed without new exportations;
- There is documentation of full application of high-quality eradication activities in all infected and high-risk areas; and
- In the absence of such documentation, these measures should be maintained until at least 12 months have passed without new exportations, according to the WHO.
The following states are currently infected with wild poliovirus, but aren't exporting: Afghanistan, Equatorial Guinea, Ethiopia, Iraq, Israel, Somalia and Nigeria.
"The consequences of further international spread are particularly acute today, given the large number of polio-free but conflict-torn and fragile states which have severely compromised routine immunization services and are at high risk of re-infection," the WHO said in its statement. "Such states would experience extreme difficulty in mounting an effective response were wild poliovirus to be reintroduced. As much international spread occurs across land borders, WHO should continue to facilitate a coordinated regional approach to accelerate interruption of virus transmission in each epidemiologic zone."