NY Travel Clinic

CDC recommends that travelers to Ukraine, Madagascar, Mali, and Guinea be fully vaccinated against polio

Cases of polio have recently been reported in Ukraine, Madagascar, Mali, and Guinea.  The CDC recommends that if you will be travelling to these countries you should be fully vaccinated against polio.  The CDC also states that adults who have been fully vaccinated should receive a single lifetime booster dose of polio vaccine.  Polio can be lethal.

Polio is caused by a virus and affects the nervous system.  It’s mainly spread by person-to-person contact, from the stool of an infected person, and when an infected person coughs or sneezes.  Polio is also spread by drinking water or other drinks or eating raw or undercooked food contaminated with the feces of an infected person.

To prevent infection you need to be vaccinated against it and practice precautions.  Wash your hands often with soap and water, or use hand sanitizer (containing at least 60% alcohol).  Don’t touch your eyes, nose, or mouth with unclean hands.  Cover your mouth and nose with a tissue or your sleeve when you sneeze or cough.  Avoid close contact, such as kissing, hugging, or sharing eating utensils or cups with people who are sick.

Most people with polio have no symptoms. Some people have fever, nausea, headache, stiffness in the neck and back, nasal congestion, sore throat, cough, pain in the arms and legs, and fatigue. Most people recover completely. In some cases, polio causes permanent loss of muscle function in the arms or legs (usually the legs).  Symptoms take three to 35 days to appear.

According to the CDC, “a person is considered to be fully immunized if he or she has received a primary series of at least three doses of inactivated poliovirus vaccine (IPV), live oral poliovirus vaccine (OPV), or four doses of any combination of IPV and OPV.”  OPV was no longer recommended in the United States as of January 1, 2000.

Ideally you should be vaccinated more than 12 months before travel to an area with polio cases.  Two doses of IPV should be administered at an interval of 4–8 weeks, and a third dose should be administered 6–12 months after the second.  If 3 doses of IPV cannot be administered within the recommended intervals before travel, the CDC recommends the following:

If you have more than 8 weeks before protection is needed, 3 doses of IPV should be administered 4 or more weeks apart.

If you have less than 8 weeks but more than 4 weeks before you travel, 2 doses of IPV should be administered 4 or more weeks apart.

If you have less than 4 weeks before you travel, a single dose of IPV is recommended.

If less than 3 doses are administered, the remaining IPV doses to complete a 3-dose series should be administered when possible, at the intervals recommended above, if you remain at increased risk for poliovirus exposure.

The CDC states that “IPV should not be administered to people who have experienced a severe allergic reaction (such as anaphylaxis) after a previous dose of IPV or after receiving streptomycin, polymyxin B, or neomycin, which IPV contains in trace amounts; hypersensitivity reactions can occur after IPV administration among people sensitive to these 3 antibiotics.”  Generally, there no serious adverse reactions to IPV.

Madagascar tops the list of most recent polio cases in the alert, with 9 thus far. Two cases have been reported in Ukraine, one in Mali, and one in Guinea.  Before you travel to these or other countries, speak with your doctor.

Because polio can cause serious complications, and can be lethal, it’s important to be fully vaccinated against it.