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Published On: Mon, May 5th, 2014

WHO committee: Polio spread an ‘extraordinary event’ and a public health risk to other States

World Health Organization Director, Dr. Margaret Chan, upon the advice from an Emergency Committee of independent experts, declared recent international spread of wild poliovirus a “public health emergency of international concern,” and issued Temporary Recommendations under the International Health Regulations (2005) to prevent further spread of the disease as the high season approaches.

Image/Chris Zahniser, B.S.N., R.N., M.P.H.

Image/Chris Zahniser, B.S.N., R.N., M.P.H.

The near-cessation of international spread of wild poliovirus from January 2012 through the 2013 low transmission season for this disease (i.e. January to April) stands a stark contrast to January to April this year.

The virus has been exported to three countries in three major epidemiological zones: in central Asia (from Pakistan to Afghanistan), in the Middle East (Syria to Iraq) and in Central Africa (Cameroon to Equatorial Guinea).

Although outbreaks have been an expected risk in global eradication, the Committee deemed consequences of further international spread to be particularly acute at this moment, with several countries with complex humanitarian emergencies or other major challenges bordering these infected countries.

The WHO notes, as we enter the high transmission season for wild poliovirus, a coordinated international response is essential to raise immunity and stem the spread of the virus. The Director-General’s recommendations are a signal of the international community’s commitment to protecting global progress against polio and using all necessary measures to end the disease forever.

The Director-General’s emergency recommendations are as follows:

For countries currently exporting wild poliovirus (Pakistan, Cameroon, and Syria):
  * the head of state or government should officially declare that the interruption of polio transmission is now a national public health emergency, if this has not been done already;

  * they should ensure that all residents and long-term visitors (of over 4 weeks) receive an additional dose of oral polio vaccine (OPV) or inactivated poliovirus vaccine (IPV) between 4 weeks and 12 months before each international journey;

  * they should ensure that residents and long-term visitors who are going on urgent travel (less than 4 weeks’ notice) and have not been vaccinated with OPV or IPV within the previous 4 weeks to 12 months, receive a dose at least by the time of departure as this will still provide benefit, particularly for frequent travellers;

  * they should ensure travellers are provided with a WHO/IHR “yellow booklet (http://polioeradication.us2.list-manage.com/track/click?u=1519be1cd815ed6195660c2c8&id=0f88b9b64b&e=db8d2b3a1b) ” International Certificate of Vaccination or Prophylaxis or equivalent to record their polio vaccination and serve as proof of vaccination;

  * they should maintain these measures until at least 6 months have passed without new exportations and with documentation that there is strong surveillance for the virus and that people are getting vaccinated in all infected and high risk areas. Without such documentation, these measures should be maintained until at least 12 months have passed without new exportations.

For countries which currently have wild poliovirus but have not transmitted it to another country in the low-transmission season in 2014 (Afghanistan, Equatorial Guinea, Ethiopia, Iraq, Israel, Somalia and Nigeria):

  * the head of state or government should officially declare that the interruption of polio transmission is now a national public health emergency, if this has not been done already;

  * they should encourage residents and long-term visitors to receive an additional dose of OPV or IPV 4 weeks to 12 months prior to each international journey; those undertaking urgent travel (less than 4 weeks’ notice) who have not been vaccinated with a dose of OPV or IPV within the previous 4 weeks to 12 months should be encouraged to receive a dose by the time of departure;

  * ensure travellers have access to an appropriate document to record their polio vaccination status;

  * maintain these measures until at least 6 months have passed without the detection of wild poliovirus transmission in the country from any source.

The WHO Director-General will convene the Emergency Committee again in three months to reassess the situation and the temporary recommendations

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About the Author

- Writer, Co-Founder and Executive Editor of The Global Dispatch. Robert has been covering news in the areas of health, world news and politics for a variety of online news sources. He is also the Editor-in-Chief of the website, Outbreak News Today and hosts the podcast, Outbreak News Interviews on iTunes, Stitcher and Spotify Robert is politically Independent and a born again Christian Follow @bactiman63

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