In the News
Update on the Global Status of Polio

This information is current as of today, February 10, 2012 at 01:57 EST

Updated: September 29, 2011

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Information for Travelers
Information for Health-Care Professionals

Information for Travelers

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:

More About Polio

Polio is a disease caused by a germ that lives in the throat and intestines. It is most often spread through contact with the stool (bowel movement) of an infected person. Polio germs can also be spread through food and water. The disease mainly affects children under 5 years old, but unvaccinated people of any age are at risk.

Advice for Travelers

If you are traveling to a country where you are at risk of getting polio, talk to your doctor to find out if you are up-to-date with your polio vaccination. Even if you were vaccinated as a child or have been sick with polio before, you may need a booster shot before you travel to make sure that you are protected against all 3 types of poliovirus. If you are traveling with children, be sure that they have been vaccinated too.

It is also important to wash your hands with soap and water. If soap and water are not available, you can use an alcohol-based hand gel. Wash your hands often, but especially at these times:

To help prevent polio and other diseases, follow these tips to help make food and drink choices:

• Eat foods that are fully cooked and served hot.
• Eat and drink only 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 (water, carbonated drinks, or sports drinks). Avoid tap water, fountain drinks, and ice. If this is not possible, learn how to make water safer to drink.

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

Information for Health Care Professionals

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.

According to the Global Polio Eradication Initiative (GPEI),* since 2006 only 4 countries (Afghanistan, India, Nigeria, and Pakistan) remain polio-endemic with indigenous poliovirus circulation. In 4 additional countries in Africa, imported wild poliovirus was either known (Angola, Chad) or suspected (Democratic Republic of the Congo, South Sudan) to have persisted for more than12 months as of mid-2009, leading to their designation as having “re-established” transmission. This designation is considered equivalent to “polio-endemic” for travel preparation purposes.

In the past 24 months, however, the following countries have reported cases of poliomyelitis related to importation or re-established transmission of wild polioviruses: Angola, Burkina Faso, Burundi, Cameroon, Chad, Congo, Côte d'Ivoire, the Democratic Republic of the Congo (DRC), Gabon, Guinea, Kazakhstan, Kenya, Liberia, Mali, Mauritania, Nepal, Niger, Russia, Senegal, Sierra Leone, Tajikistan, Turkmenistan, and Uganda.

In particular, Central and West Africa are experiencing several polio outbreaks and ongoing virus transmission following importation of wild poliovirus from India or Nigeria. There is risk of spread to other countries in Central, West, East, and North Africa and to the Middle East, given the yearly Hajj and other travel.

The following countries are at risk for poliovirus importation because they are located near endemic or recently infected countries: Armenia, Azerbaijan, Bangladesh, Benin, Bhutan, Central African Republic, Djibouti, Equatorial Guinea, Eritrea, Ethiopia, Gambia, Georgia, Ghana, Guinea-Bissau, Iran, Kyrgyzstan, Namibia, Rwanda, Somalia, Sudan and South Sudan, Tanzania, Togo, Uzbekistan, and Zambia.

Outbreaks continue to be a risk for major portions of Africa and some portions of southern Asia/Asian subcontinent, including India. 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, 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 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 1 lifetime IPV booster dose for adults.
• Travelers 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.)

More Information

Polio is an infectious disease caused by a virus and spread from person to person. The disease mainly affects children under 5 years of age. Polio may be spread when the virus enters the mouth of a person who has come in contact with the stool of an infected person (for example, by changing diapers and not washing hands before touching the mouth) or from fecal contamination of food or drinking water. Most people infected with the poliovirus have no symptoms, but in some people the infection causes paralysis and even death. Until the 1950s, polio crippled thousands of children in industrialized countries. Soon after the introduction of effective vaccines in the late 1950s (IPV) and early 1960s (OPV), polio was brought under control and practically eliminated as a public health problem in industrialized countries.

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.
For more information, see:

• Poliomyelitis (CDC Health Information for International Travel 2012)
• Polio Vaccination (CDC's National Center for Immunization and Respiratory Diseases)
• Immunization Schedules (CDC's National Center for Immunization and Respiratory Diseases)

See the Global Polio Eradication Initiative website for more information. For additional information about these outbreaks, see the Monthly Situation Reports.

* 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.