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 recent imported cases, or to countries at risk because of proximity to endemic or recently infected countries.

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 four additional countries in Africa, imported wild poliovirus was either known (Angola, Chad) or suspected (Democratic Republic of the Congo, southern Sudan) to have persisted for >12 months as of mid-2009, leading to their designation as having “re-established” transmission. This designation is considered equivalent to polio-endemic countries for travel preparation purposes.

The following countries, however, have had imported polio cases or cases related to an imported poliovirus in the past 24 months: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Côte d'Ivoire, the Democratic Republic of the Congo (DRC), Ethiopia, Ghana, Guinea, Kenya, Liberia, Mali, Mauritania, Nepal, Niger, Senegal, Sierra Leone, Sudan, Tajikistan, Togo, and Uganda. The following countries are at risk for poliovirus importation because they are located near endemic or recently infected countries: Bangladesh, Bhutan, Congo, Djibouti, Equatorial Guinea, Eritrea, Gabon, Gambia, Guinea-Bissau, Kazakhstan, Kyrgyzstan, Namibia, Rwanda, Somalia, Tanzania, Turkmenistan, Uzbekistan, the Xinjiang Uyghur Autonomous Region of China, and Zambia. This updated notice adds Tajikistan to the list of countries reporting cases, and Kazakhstan, Kyrgyzstan, Turkmenistan, Uzbekistan, and the Xinjiang Uyghur Automonous Region of China to the list of countries at risk for importation.

Outbreaks continue to be a risk for major portions of Africa and some portions of southern Asia/Asian subcontinent, and 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 three 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 one 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 2, Poliomyelitis, CDC Health Information for International Travel 2010, for details.)