​Public health development with respect to Health Regulations Emergency Committee statement regarding the international spread of wild poliovirus

ECDC comment

​The third meeting of the International Health Regulations Emergency Committee, held from 2-7 November 2014, regarding the international spread of wild poliovirus, states that the situation still constitutes a Public Health Emergency of International Concern (PHEIC).

The third meeting of the International Health Regulations Emergency Committee, held from 2-7 November 2014, regarding the international spread of wild poliovirus, states that the situation still constitutes a Public Health Emergency of International Concern (PHEIC). The Committee recommended the extension of the Temporary Recommendations for a further three months to the 10 wild polio virus-affected areas: the four ‘currently exporting countries’ (Cameroon, Equatorial Guinea, Pakistan and the Syrian Arabic Republic) and the remaining ‘affected but currently not exporting’ countries (Afghanistan, Ethiopia, Iraq, Israel, Somalia and Nigeria).

Recognising the escalating wild poliovirus transmission in Pakistan, with more reported cases than at any time in the past 14 years, further measures were proposed by the Committee:

  • Pakistan should note that the recommendation stated previously for urgent travel remains valid (i.e. those undertaking urgent travel (within four weeks), from Pakistan and have not received appropriate polio vaccination must receive a dose of polio vaccine at least by the time of departure and be provided with appropriate documentation of that dose).
  • “In addition to the previous recommendation Pakistan should restrict at the point of departure the international travel of any resident lacking documentation of appropriate polio vaccination. These recommendations apply to international travellers from all points of departure, irrespective of the means of conveyance (e.g. road, air, sea);
  • In advance of the next meeting of the Committee, Pakistan should provide a report on the implementation by month of the Temporary Recommendations on international travel.

Risk to Europe 

The conclusions of the International Health Regulations Emergency Committee do not change the ECDC risk assessment for Europe. The continuing circulation in ten countries of wild poliovirus shows that there is a continued risk for the disease being imported into the EU/EEA. ECDC previously concluded that in the event of importation of wild-type poliovirus resulting in the re-establishment of virus circulation in the EU, the overall risk to EU residents would be:

  • very low in OPV-vaccinated populations for both poliovirus infection and disease;
  • moderate in IPV-only cohorts for poliovirus infection and very low for disease; and
  • high in low- or unvaccinated groups for poliovirus infection and moderate for disease.

ECDC endorses the temporary recommendation of WHO and suggests the following actions to EU/EEA Member States:

  • Revise polio vaccination advice to EU travellers and residents to the ten affected countries, and in particular to Pakistan.
  • Advise travellers to, and EU residents in, polio-affected countries to have an additional IPV dose within 12 months from planned travel to polio-affected countries. 
  • Prioritise assessment of polio vaccination uptake at the national, subnational and local levels, and the identification of vulnerable and undervaccinated populations; efforts should be increased to improve vaccination coverage to 90 per cent in accordance with national or regional immunisation recommendations.
  • Assess the vaccination status of refugees and migrants from polio-affected countries at the time of entry into the EU/EEA; people not vaccinated against polio or other diseases should be offered age-appropriate vaccinations and in accordance with the host country’s vaccination schedule.

ECDC continues to support the EU-wide response to the threat of poliovirus spreading across Europe and will, upon request, support individual EU Member States in all areas related to their preparedness, e.g. the detection and control of poliovirus importations.

WHO statement on the third meeting of the International Health Regulations Emergency Committee regarding the international spread of wild poliovirus