Conclusions of the eighteenth IHR Emergency Committee do not change the ECDC risk assessment for Europe concerning polio
Statement of the Eighteenth IHR Emergency Committee Regarding the International Spread of Poliovirus, 15 August 2018
The eighteenth meeting of the Emergency Committee under the International Health Regulations (2005) (IHR) regarding the international spread of poliovirus was convened by WHO’s Director General on 15 August 2018 at WHO headquarters in Geneva.
The Committee unanimously agreed that the risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC), and recommended the extension of Temporary Recommendations for a further three months.
ECDC comment on the risk to Europe
The conclusions of the IHR Emergency Committee do not change the ECDC risk assessment for Europe. The continuing circulation of wild poliovirus type 1 (WPV1) in three countries shows that there is a continued risk of the disease being imported into the EU/EEA.
Furthermore, the occurrence of outbreaks of circulating vaccine-derived poliovirus (cVDPV), which only emerge and circulate due to lack of polio population immunity, shows the potential risk for further international spread.
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 oral polio vaccine (OPV)-vaccinated populations for both poliovirus infection and disease;
- moderate in inactivated polio vaccine (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 recommendations of WHO for reducing the risk of international spread of WPV1 and cVDPVs, in particular with regards to EU/EEA citizens who are resident in or long-term visitors (> 4 weeks) to:
States infected with WPV1 and cVDPV types 1 (cVDPV1) or 3 (cVDPV3) (Afghanistan, Nigeria, Pakistan, Papua New Guinea and Somalia):
- Ensure that all residents and longterm visitors (> 4 weeks) of all ages receive a dose of bivalent oral poliovirus vaccine (bOPV) or IPV between 4 weeks and 12 months prior to international travel.
- Ensure that those undertaking urgent travel (i.e. within four weeks), who have not received a dose of bOPV or IPV in the previous four 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 travelers.
States infected with cVDPV2 (DR Congo, Kenya, Nigeria, Somalia and Syria):
- Encourage residents and longterm visitors to receive a dose of IPV (if available in country) 4 weeks to 12 months prior to international travel. Those undertaking urgent travel (i.e. within 4 weeks) should be encouraged to receive a dose at least by the time of departure.