World Health Organization Temporary Polio International Health Regulations Recommendations

On May 5^th, 2014, the World Health Organization's (WHO) Director General (DG) declared the recent international spread of wild poliovirus (polio), a public health emergency of international concern (PHEIC). The WHO DG determined that a coordinated response from the international community was required in order to prevent further spread of the disease.

From January to April of 2014, considered the low transmission season for polio, the WHO reported that there was international spread of wild polioviruses to three countries, one in Central Asia, one in the Middle East, and another in Central Africa. In the context of the global effort to eradicate polio, this constitutes an extraordinary event as the world approaches the near-cessation of international spread of polio. Several neighbouring countries experiencing complex humanitarian emergencies or other major challenges remain at risk of reinfection, primarily due to interruption in their immunization programs.

Due to the continued international spread of polio, the WHO DG issued temporary recommendations under the International Health Regulations (2005). The recommendations, which focus on immunization and surveillance activities, are for countries currently affected by polio, and do not apply to Canada.

The Emergency Committee met on February 17^th, 2015 to reassess the temporary recommendations. Since its last meeting on November 2^nd to 7^th, 2014, there has been continued poliovirus transmission within Pakistan and one new poliovirus exportation from Pakistan to neighbouring Afghanistan. In addition, despite the overall decrease in the number of exportations, the risk of new international spread to vulnerable countries remains with the expansion of conflict-affected areas. The WHO DG declared that the international spread of wild poliovirus continued to be a PHEIC and endorsed the continuation of its previous recommendations. The WHO DG also endorsed recommendations for states who are no longer infected by wild poliovirus but which remain vulnerable to international spread. In three months' time, the situation and temporary recommendations will be reassessed.

In Canada, the risk of importing and spreading wild poliovirus into the general Canadian public remains low. Canada was certified polio-free in 1994, thanks in part to high coverage of routine immunizations for children and a comprehensive, national surveillance program for vaccine preventable diseases, including polio.

The Public Health Agency of Canada is not advising any travel restrictions related to polio at this time; however a Travel Health Notice includes information on countries where polio is occurring and provides immunization and other travel-related recommendations to Canadian travellers. Another Travel Health Notice provides additional information regarding the WHO temporary polio vaccine recommendations.