Alert – Polio in Asia and Eastern Europe reaches Alert – Level 2

Key points

• Everyone should be fully vaccinated against poliovirus according to schedule (see Polio Vaccination: What Everyone Should Know).
• Before any international travel, anyone unvaccinated, incompletely vaccinated, or with an unknown polio vaccination status should complete the routine polio vaccine series.
• Some international destinations are considered high risk for polio. Before travel to any high-risk destination, CDC recommends that adults who previously completed the full, routine polio vaccine series receive a single, lifetime booster dose of polio vaccine.
• Destinations in Asia and Eastern Europe currently considered high risk for polio are listed below.

Map: Countries in Asia and Eastern Europe where a booster dose of polio vaccine is recommended before travel  (see larger map)

What is polio?

Polio is a crippling and potentially deadly disease that affects the nervous system. Good hand washing practices can help prevent the spread of this disease. Because the virus lives in the feces (poop) of an infected person, people infected with the disease can spread it to others when they do not wash their hands well after defecating (pooping). People can also be infected if they drink water or eat food contaminated with infected feces.

Most people with polio do not feel sick. Some people have only minor symptoms, such as fever, tiredness, nausea, headache, nasal congestion, sore throat, cough, stiffness in the neck and back, and pain in the arms and legs. In rare cases, polio infection causes permanent loss of muscle function (paralysis). Polio can be fatal if the muscles used for breathing are paralyzed or if there is an infection of the brain.

What is the current situation?

The following destinations in Asia and Eastern Europe are currently considered high risk for polio (see map):

• Afghanistan
• Israel
• Occupied Palestinian Territories
• Pakistan
• Ukraine
• Yemen

What can travelers do to prevent polio?

Get the polio vaccine.

Adult travelers that (1) previously completed the full, routine polio vaccine series, (2) have not yet received an adult booster dose, and (3) are going to any of the destinations listed above, should receive a single, lifetime booster dose of polio vaccine. Even those who have been sick with polio previously may need a booster dose of polio vaccine. See the Polio Vaccine Information Statement (VIS) for more information.

To help prevent the international spread of polio, the World Health Organization recommends that the destinations listed above require residents and long-term (4 weeks or more) visitors show proof of polio vaccination before leaving the country (See: WHO Statement of the Thirty-second Polio IHR Emergency Committee for PolioExternal Link).

Clinician Information

Ensure that anyone unvaccinated, incompletely vaccinated, or with an unknown polio vaccination status completes the routine polio vaccine series before international travel.

CDC recommends administering a single, lifetime booster dose of inactivated poliovirus vaccine (IPV) to adult travelers that meet all three of the following conditions

• Are going to destinations considered high risk for polio
• Have previously completed the full, routine polio vaccine series
• Have not already received an adult booster dose