New vaccination recommendations for residents and visitors to polio-infected countries – update July 7th 2014


On May 5th 2014, WHO declared a public health emergency of international concern regarding wild polio virus exportation from Pakistan, Syria, and Cameroon to other countries, and the potential risk of spread of wild polio virus from other polio affected countries.(1)

WHO has recommended that ten countries, identified as having exported polio in the past year or where polio virus was identified should ensure that their residents and long-term visitors have up-to-date vaccination against polio before international travel. All travellers should be issued with an International Certificate of Vaccination or Prophylaxis as proof of vaccination.

Poliomyelitis - Multistate (world) - Monitoring global outbreaks
Update 7/7/2014: During the past week, six new infections with wild poliovirus 1 (WPV1) were reported, five in Pakistan and one in Afghanistan. Equatorial Guinea, which borders Cameroon, has been added to the list of 'virus-exporting countries' which should implement a set of Temporary Recommendations recently issued by the Director-General of the World Health Organization under the International Health Regulations (2005). Among other measures, these recommendations call for the vaccination of all residents and long-term visitors prior to international travel. The addition of Equatorial Guinea to the list follows the detection of wild poliovirus genetically linked to the current outbreak in Central Africa in a sewage sample collected near Sao Paulo, Brazil.

The WHO recommendations divide the 10 polio-affected countries into two groups.

  • Four ‘currently exporting countries’ (Equatorial Guinea, Pakistan, Cameroon and Syria) from which the virus has been carried to other countries in 2014.
  • Six countries (Afghanistan, Ethiopia, Iraq, Israel, Somalia and Nigeria) which are affected but are currently not exporting poliovirus.

The European Centre for Disease Prevention and Control (ECDC) has recommended the following:

  • Travellers from the EU, who are fully vaccinated against polio according to the national immunisation schedule where they live and plan to travel to any of the 10 polio-infected countries, should receive an additional dose of IPV.
  • In order to comply with the WHO recommendations and avoid having to be vaccinated in the polio-infected country, it is important that travellers to polio-infected countries time this additional IPV dose so that it is given within 12 months of the date when they plan to leave the polio-infected country.


  1. WHO statement on the meeting of the International Health Regulations Emergency Committee concerning the international spread of wild poliovirus
  2. International certificate of vaccination or prophylaxis
  3. WHO. International Travel and Health (2012) guidance
  4. Polio Public Health Emergency: Temporary Recommendations to Reduce International Spread of Poliovirus
  5. ECDC. Rapid Risk Assessment International spread of wild-type poliovirus in 2014 declared a Public Health Emergency of International Concern under the International Health Regulations (IHR) – May 2014