On 5th May 2014, the World Health Organization (WHO) issued a statement declaring that the recent international spread of wild poliovirus is a Public Health Emergency of International Concern. In order to prevent further spread of polio, as the high risk season approaches, WHO issued Temporary Recommendations under the International Health Regulations (2005) [1, 2].
Health professionals and travellers should refer to NaTHNaC Country Information Pages for country specific polio vaccine recommendations and requirements.
Pakistan, Cameroon, and the Syrian Arab Republic have been identified as countries with the greatest risk of further wild poliovirus exportations in 2014. The WHO recommended that these States should:
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ensure that all residents and long-term visitors (i.e. > 4 weeks) receive a dose of oral polio vaccine (OPV) or inactivated poliovirus vaccine (IPV) between 4 weeks and 12 months prior to international travel;
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ensure that those undertaking urgent travel (i.e. within 4 weeks), who have not received a dose of OPV or IPV in the previous 4 weeks to 12 months, receive a dose of polio vaccine at least by the time of departure as this will still provide benefit, particularly for frequent travellers;
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ensure that such travellers are provided with an International Certificate of Vaccination or Prophylaxis in the form specified in Annex 6 of the International Health Regulations (2005) to record their polio vaccination and serve as proof of vaccination;
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maintain these measures until the following criteria have been met: (i) at least 6 months have passed without new exportations and (ii) there is documentation of full application of high quality eradication activities in all infected and high risk areas; in the absence of such documentation these measures should be maintained until at least 12 months have passed without new exportations.
Public Health England and NaTHNaC issued interim guidance on polio vaccine following the WHO announcement, see NaTHNaC clinical update 27 May 2014.
In response to the World Health Organization’s emergency recommendations, the government of Pakistan now requires all departing travellers who have spent more than 4 weeks in Pakistan to produce a valid vaccination certificate at the time of their departure. This certificate should show that either oral polio vaccine (OPV) or inactivated polio vaccine (IPV) has been administered between 4 weeks and 12 months before departure from Pakistan [3].
Although protection from a booster dose of polio vaccine following a primary course is expected to last 10 years [4], a booster dose of IPV or OPV within 4 weeks to 12 months of travel, boosts intestinal mucosal immunity and reduces the risk of poliovirus shedding [5].
Reports indicate that the Pakistani Government has set up medically-staffed booths in the international departure terminals at the four international airports (Islamabad, Karachi, Lahore, and Peshawar) where the oral polio vaccine is available. Recipients will then be issued a polio vaccination certificate and will be allowed to depart the country. The International Certificate of Vaccination or prophylaxis (ICVP) for polio will be valid for one year only. Airport vaccination is a temporary measure and the Pakistani Government has not indicated for how long this option will be available [6].
http://www.nathnac.org/pro/clinical_updates/polio_pk_requirements_110614.htm
The vaccine containing diphtheria, tetanus and polio, with certificates are only available from yellow fever centres at the moment and are available at The Travel Clinic Ltd, Cambridge and Ipswich
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