Updated: May 24, 2005 The Public Health Agency of Canada (PHAC) continues to monitor the global polio situation, including recent reports of human polio infection in Yemen and Indonesia. Yemen As of May 17, 2005, the World Health Organization has confirmed 66 cases of polio in Yemen. Cases have been recorded in several areas, including Hodeidah, Sana'a, Taiz, Hajjah, and Hadramaut. The viral strain has been identified as wild poliovirus type-1 and has been genetically linked to poliovirus circulating in Sudan, which originated in Nigeria. Yemen had been polio-free since 1996, when surveillance first began. Indonesia On May 2, 2005, the World Health Organization (WHO) confirmed a single case of wild poliovirus type 1, from an acute flaccid paralysis (AFP) case, in Giri Jaya village, Sukabumi District, West Java, Indonesia. The case, an 18 month old child who was previously un-immunized, was identified by the national surveillance system. Seven additional cases have since been confirmed, bringing Indonesia's total to eight cases. The virus, genetically linked to poliovirus originating in Nigeria, travelled to Indonesia through Sudan. Indonesia had not had a wild poliovirus case since 1995. Global Polio Situation Worldwide, polio remains endemic (constantly present) in six countries: Nigeria, India, Pakistan, Niger, Afghanistan, and Egypt. 2005 Facts and Figures In 2005 between January 01 and April 26, 92 cases of poliovirus have been confirmed in the following countries: Sudan (22), India (14), Nigeria (46), Cameroon (1), Pakistan (4), Ethiopia (1), and Yemen (4). 2004 Facts and Figures As of April 20, 2005, a total of 1,267 cases of polio were reported in 18 countries for 2004. This figure represents a 61% increase over the 784 cases reported for 2003. The increase is attributed to a decrease in immunization activity in sub-Saharan Africa. In November 2004, the World Health Organization reported that, in 2004, sub-Saharan Africa experienced epidemic poliomyelitis when, from August 2003 to July 2004, the state of Kano, Nigeria, halted immunization against the disease, and some neighbouring countries had low routine immunization coverage. As a result, several African countries ( Benin, Chad, Burkina Faso, Cameroon, the Central African Republic, Côte d'Ivoire, Ghana, Guinea, Mali, Togo, Sudan and Botswana in southern Africa) that had been polio free, reported imported cases of polio - all linked to wild polio-virus circulating in Northern Nigeria. Polio has since become re-established (that is, continued circulation for more than 6 months) in four of these countries - Sudan, Cote d'Ivoire, Chad and Burkina Faso. Sources: Global Polio Eradication Initiative, World Health Organization (WHO) Poliomyelitis, or polio, is an acute infectious disease caused by one of three gastrointestinal viruses, either polio virus type 1, 2 or 3. The polio virus can attack the nervous system and destroy the nerve cells that activate muscles. As a result, the affected muscles no longer function, and irreversible paralysis can occur. In severe cases, the disease may lead to death. Polio mainly affects children under 3 years of age, but can strike older children and adults as well. For additional information on the prevention and treatment of polio, consult the Public Health Agency of Canada's Disease Information Backgrounder on Polio. Recommendations The Public Health Agency of Canada recommends that Canadian international travellers contact a physician or travel medicine clinic [link to: http://www.phac-aspc.gc.ca/tmp-pmv/travel/clinic_e.html] prior to departure for an individual risk assessment. Based on travellers' current health status, previous immunization history and anticipated travel itinerary, their need for immunizations including polio can be assessed. For Canadians travelling to countries where poliomyelitis occurs, primary immunization of children and, if indicated, primary immunization of adults or a booster dose for adults, are recommended in accordance with the recommendations of the National Advisory Committee on Immunization (NACI). For additional information: Read the Travel Medicine Program's previous Travel Health Advisories on polio. Consult the Public Health Agency of Canada's document: Immunizations Recommended for Travel Outside of Canada. Visit the Public Health Agency of Canada's Disease Information Backgrounder on Poliomyelitis. Visit the Public Health Agency of Canada's National Advisory Committee on Immunization NACI to view the Canadian Immunization Guide, 6th Edition. Visit the World Health Organization's Global Polio Eradication Initiative website at: www.polioeradication.org.