The Travel Health and Vaccine Specialists

Health Alert


LEVEL 2 - PRACTICE ENHANCED PRECAUTIONS

Polio in Somalia

Updated October 30, 2018

Key points
There is a polio outbreak in Somalia.
CDC recommends that all travelers to Somalia be vaccinated fully against polio.
Before traveling to Somalia, adults who completed their routine polio vaccine series as children should receive a single, lifetime adult booster dose of polio vaccine.
The current outbreak in Somalia is caused by vaccine-derived poliovirus, a sign of low polio vaccine coverage in the country.
What is polio?
Polio is a crippling and potentially deadly disease that affects the nervous system. It is spread through contact with the feces (poop) of an infected person. It is also spread by drinking water or eating food that is contaminated with infected feces.

Most people with polio do not feel sick. Some people have only minor symptoms, such as fever, tiredness, nausea, headache, nasal congestion, sore throat, cough, stiffness in the neck and back, and pain in the arms and legs. In rare cases, polio infection causes permanent loss of muscle function (paralysis). Polio can be fatal if the muscles used for breathing are paralyzed or if there is an infection of the brain.

What is vaccine-derived polio?
The oral polio vaccine (made from a weakened strain of the poliovirus) is given as drops in the mouth to protect against polio. This vaccine has been extremely effective in wiping out polio in developing countries, when most of the population gets vaccinated. In areas where there are low rates of vaccination against polio and sanitation is poor, the weakened vaccine virus can spread from person to person. Over time, as the virus spreads, it can regain its ability to cause disease in people who are not vaccinated. Polio caused by a vaccine strain is called vaccine-derived polio.

Vaccine-derived polio cannot spread in the United States because the U.S has high vaccination rates against polio and the oral polio vaccine is not used here.

What is the current situation?
A polio outbreak has been reported in Mogadishu and the Hiran and Middle Shabelle regions of Somalia. This outbreak is caused by vaccine-derived poliovirus (VDPV), a sign of low oral polio vaccine coverage in the country.

What can travelers do to prevent polio?
Get the polio vaccine. CDC recommends that all travelers to Somalia be vaccinated fully against polio. In addition, adults who have been fully vaccinated should receive a single lifetime booster dose of polio vaccine. Even if you were vaccinated as a child or have been sick with polio before, you may need a booster dose to make sure you are protected. See the Polio Vaccine Information Statement (VIS) for more information.

If you will be in Somalia for more than 4 weeks, the Somalia government may require you to show proof of polio vaccination before you leave the country. To meet this requirement, you should get the polio vaccine between 4 weeks and 12 months before you leave Somalia. Talk to your doctor about whether this requirement applies to you.

Clinician Information
For travelers going to countries with circulating VDPV who have completed their routine polio vaccine series but who have not already received an adult booster dose, CDC recommends administering a single lifetime inactivated poliovirus vaccine (IPV) booster dose.

Travelers who will be in Somalia for more than 4 weeks may need an additional booster if the most recent dose of polio vaccine (completion of routine series or adult booster) was administered more than 12 months before the date of departure from Somalia.

See the Vaccine section in Chapter 3, Poliomyelitis, CDC Health Information for International Travel, for specific vaccination details.

Additional Information
Poliomyelitis in Epidemiology and Prevention of Vaccine-Preventable Diseases—“Pink Book”
Polio Vaccination Information for Healthcare Professionals
Traveler Information
CDC Polio Homepage
Polio for Travelers
Polio Vaccine Information Statement
Food and Water Safety
Page created: July 23, 2018
Page last updated: October 26, 2018
Page last reviewed: October 26, 2018
Content source: Centers for Disease Control and Prevention
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)
Division of Global Migration and Quarantine (DGMQ)