Travel related diseases



What is Poliomyelitis?

Poliomyelitis is an acute viral illness caused by poliovirus, of which there are three types, namely poliovirus type 1, 2 and 3. The incubation period can range from 5-35 days, but is commonly 7-14 days, especially for paralytic cases. Patients can present with minor symptoms such as fever, headache, sore throat, vomiting, diarrhea or constipation. Some may progress to muscle pain and muscle weakness in the limbs and face. The breathing and swallowing functions may be affected and this is life-threatening.

Generally speaking, disability is more common than death. The outcome varies with the form (paralytic or non-paralytic) and the site affected. In over 90% of cases, the brain and spinal cord are not affected and complete recovery is likely.

How does it spread?

Poliomyelitis is primarily acquired by fecal-oral transmission. It may also spread through foodstuffs and milk products contaminated with feces. There is no evidence that the disease can be spread by insects.

How can you prevent it?

Travellers are advised to complete the vaccination before travel. Poliomyelitis immunisation effectively prevents poliomyelitis in most persons (immunisation is over 90% effective). There are two types of poliomyelitis vaccine, one given orally and the other by injection. Polio vaccination is one of the recommended childhood immunisations and should begin during infancy. At least 3 doses should be given, and 4 doses are preferred (more doses may be recommended in areas where polio is prevalent). Travellers are also advised to consult their family doctors if immunisation has not been completed. While travelling, foodstuffs (including milk products) suspected to be contaminated should be avoided.

How is it treated?

The goal of treatment is to control symptoms while the infection runs its course. Symptomatic treatments include analgesics, physiotherapy, braces or corrective shoes, or even surgical interventions to maximize recovery of muscle strength and function. Lifesaving measures, particularly assistance with breathing, may be necessary in severe cases.

Poliomyelitis, 2015

Temporary Recommendations by the World Health Organization

States currently exporting wild poliovirus or circulating vaccine-derived poliovirus (cVDPV), i.e. Pakistan and Afghanistan, should ensure that all residents and long-term visitors (i.e. > 4 weeks) receive a dose of polio vaccine between 4 weeks to 12 months prior to international travel. For those undertaking urgent travel (i.e. within 4 weeks) who have not received a dose of polio vaccine in the previous 4 weeks to 12 months, should receive a dose of polio vaccine at least by the time of departure as this will provide benefit, particularly for frequent travellers. Travellers are provided with an International Certificate of Vaccination or Prophylaxis to record their polio vaccination and serve as proof of vaccination.

The WHO also encourages residents and long-term visitors of those infected countries which are not exporting wild poliovirus or cVDPV, i.e. Nigeria, Guinea, Madagascar, Ukraine, Myanmar and Lao People’s Democratic Republic, to receive a dose of polio vaccine 4 weeks to 12 months prior to international travel. For those undertaking urgent travel (i.e. within 4 weeks) should be encouraged to receive a dose at least by the time of departure. Travellers who receive such vaccination should have access to an appropriate document to record their polio vaccination status.

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Last revision date: 4 February 2016