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Update on the Global Status of Polio

This information is current as of today, April 16, 2013 at 21:27 EDT

Updated: April 16, 2013

What Is the Current Situation?

Polio is a serious disease that can cause paralysis and death. If you are going to one of the countries listed below, CDC recommends that you make sure you are up to date on your polio vaccine. If your vaccine is not up to date, you will need to get vaccinated.

Polio Boosters Are Recommended for Travelers Visiting the Following Countries:

Afghanistan
Algeria
Benin
Burkina Faso
Cameroon
Central African Republic
Chad
China
India
Iran
Libya
Mali
Niger
Nigeria
Pakistan
South Sudan
Sudan
Tajikistan
Turkmenistan
Uzbekistan

What Is Polio?

Polio, or poliomyelitis, is a disease caused by a virus that affects a person's nervous system. Polio is mainly spread by ingesting items contaminated with the feces of an infected person. Polio can also be spread through, water, other drinks and uncooked food. The disease mainly affects children less than 5 years old, but unvaccinated people of any age are at risk. Even though most infected people have no symptoms, signs and symptoms of severe illness may include paralysis of limbs and respiratory muscles.
In the late 1940s to the early 1950s, in the United States alone, polio crippled around 35,000 people each year, making it one of the most feared diseases of the twentieth century. By 1979 the country became polio free. For more about polio and how it was eradicated in the United States, see A Polio-Free U.S. Thanks to Vaccine Efforts.

How Can Travelers Protect Themselves?

Get vaccinated for polio.

Talk to your doctor to find out if you are up-to-date with your polio vaccination and whether you need a booster dose before traveling.
Even if you were vaccinated as a child or have been sick with polio before, you may need a booster shot to make sure that you are protected. If you are traveling with children, be sure that they have been fully vaccinated, too.

Follow safe food and water practices.

Eat foods that are fully cooked and served hot.
Eat and drink dairy products that have been pasteurized.
Eat only fruits and vegetables that you can wash with safe water and peel yourself.
Drink only bottled or boiled water or beverages that have been bottled and sealed (carbonated drinks or sports drinks). Avoid tap water, fountain drinks, and ice.

Practice good hand hygiene.

Wash hands often with soap and water. If soap and water are not available, you can use an alcohol-based hand cleaner.
Wash hands especially before eating, drinking, or preparing food and after using the bathroom, changing diapers, and coughing or sneezing.

For more travel health information, see the Destinations section, and search for the country you are planning to visit.

Clinician Information:

Polio vaccination is recommended for all travelers to polio-endemic areas, to countries with re-established transmission or recently imported cases, or to countries at risk because of their proximity to these areas. See the list of countries above.
Outbreaks continue to be a risk for major portions of Africa and some portions of central and south Asia. Susceptible people are still at risk for infection until poliovirus transmission is eliminated worldwide. Therefore, adults and children traveling to these areas should be fully vaccinated against polio according to the recommendations below.

Vaccine Recommendations: Infants and Children

The Advisory Committee on Immunization Practices (ACIP) recommends that all infants and children in the United States should receive 4 doses of inactivated poliovirus vaccine (IPV), administered at 2 months, 4 months, 6–18 months, and 4–6 years of age.
If accelerated protection is needed, the minimum interval between the first 3 doses is 4 weeks (28 days), and the minimum interval from dose 3 to dose 4 is 6 months.
A dose of IPV should be administered at age ≥4 years regardless of the number of previous doses.

Vaccine Recommendations: Adults

Travelers who have received the full series with either IPV or oral polio vaccine (OPV) as a child without an adult booster dose (either OPV or IPV) should receive another dose of IPV before departure.
Available data do not indicate the need for more than one lifetime IPV booster dose for adults.
Adults who are unvaccinated, incompletely vaccinated, or whose vaccination status is unknown should receive 3 doses of IPV (2 doses at 4–8 week intervals followed by a third dose 6–12 months after the second dose). (See Chapter 3, Poliomyelitis, CDC Health Information for International Travel 2012, for details.)

OPV has not been used in the United States since 2000; however, it is used in many other countries and has played a major role in eliminating polio from large parts of the world. IPV, which is given by intramuscular injection, is now used in the United States and a number of other developed countries.

Additional Information:

Poliomyelitis (CDC Health Information for International Travel 2012)
Polio, (CDC website)
Polio Vaccination (CDC's National Center for Immunization and Respiratory Diseases)
Immunization Schedules (CDC's National Center for Immunization and Respiratory Diseases)
Global Polio Eradication Initiative

* The Global Polio Eradication Initiative comprises the World Health Organization (WHO), Rotary International, the United Nations Children’s Fund (UNICEF), the US Centers for Disease Control and Prevention (CDC), national ministries of health, and other partners.