24 Nov 2017

Polio: Public Health Emergency of International Concern

An update on the polio Public Health Emergency of International Concern (PHEIC) Polio: Public Health Emergency of International Concern

The fifteenth meeting of the Emergency Committee (EC) under International Health Regulations (IHR) 2005 [1] was convened on 14 November 2017, to review the data on wild poliovirus (WPV) and circulating vaccine derived polioviruses (cVDPV). The EC concluded that the risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC) and the Temporary Recommendations under IHR (2005) remain current.

Wild polio type 1 (WPV1): infected countries (Pakistan, Afghanistan and Nigeria)

Continued progress towards elimination was reported with a fall in the number of cases of wild polio reported globally. Pakistan have reported only five cases during 2017 and Afghanistan ten. However, hard to reach children in Afghanistan, particularly in the southern region, and the widespread detection of WPV through environmental surveillance in Pakistan, are a concern.

Although it has been 13 months since the detection of WPV in Nigeria, concerns remain regarding the risk of polioviruses still circulating in the inaccessible areas of Borno state.

The situation in the Lake Chad basin region including the inaccessible Lake Chad islands continues to be a concern. The risk of international spread from Nigeria to other countries in the region (including Cameroon, Chad, Niger and the Central African Republic) and internationally, remains high.

Vaccine derived poliovirus (VDPV)

Rarely, where a population is under-immunised, the live virus present in oral polio vaccine can mutate and spread causing outbreaks (circulating vaccine derived poliovirus cVDPV) [2]. Outbreaks of cVDPV in DR Congo and Syria are of concern and highlight gaps in the polio eradication programme in hard to reach populations of these countries.

The size of the outbreak in Syria was highlighted, and the difficulties of accessing at risk population due to conflict. Countries surrounding the outbreak zone in Syria were commended for their response to prevent importation, particularly among Syrian refugees. The committee urged any country receiving Syrian refugees to ensure polio vaccination with IPV.

IHR Temporary Recommendation categories: States infected with WPV1, cVDPV1 or cVDPV3 with the potential risk of international spread:

  • Afghanistan
  • Nigeria
  • Pakistan

These countries have a certificate requirement for polio vaccination under International Health Regulations (IHR). Please refer to Country Information Pages.

States infected with cVDPV2, with potential risk of international spread:

  • DR Congo*
  • Nigeria
  • Pakistan
  • Syria*
*There is no certificate requirement under IHR for these countries. However, travellers are encouraged to carry proof of polio vaccination.

States no longer infected by WPV1 or cVDPV, but which remain vulnerable to re-infection by WPV or cVDPV:


  • Cameroon
  • Central African Republic
  • Chad
  • Niger


  • Guinea
  • Lao People’s Democratic Republic (Lao PDR)

In addition to the countries detailed in this report, the Global Polio Eradication Initiative highlight the following countries to be no longer polio infected, but at high risk of outbreaks: Ethiopia, Equatorial Guinea, Iraq, Kenya, Liberia, Madagascar, Myanmar, Ukraine, Niger, Sierra Leone, Somalia and South Sudan. NaTHNaC recommends a booster dose of a polio-containing vaccine for those who have not received a dose within the previous 10 years travelling to these countries.

The polio status of countries is reviewed by WHO on a regular basis and polio vaccination recommendations are subject to change. For polio vaccination recommendation for travellers to these countries see our Country Information pages.

Advice for travellers

Polio is transmitted via the faecal-oral route, either by exposure to water contaminated by infected human faeces, or by person to person contact. You should practise strict food, water and personal hygiene. Independent of your destination, you should complete a primary vaccination course for polio according to the UK schedule. Travellers are encouraged to carry documentary evidence of their polio vaccination status. An International Certificate of Vaccination or Prophylaxis is required by some countries see our Country Information pages for country specific information.

Advice for health professionals

All travellers regardless of destination should be up to date with routine vaccination courses and boosters as recommended in the UK. See our Country Information pages for country specific recommendations and certificate requirements. For specific outbreak information, check our Outbreak Surveillance. The polio status of countries is reviewed by WHO on a regular basis and polio vaccination recommendations are subject to change.


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