What is the issue?
On Monday 5 May 2014 the WHO Director General (DG) declared the recent international spread of wild poliovirus a “public health emergency of international concern” and issued Temporary Recommendations under the International Health Regulations (IHR) 2005.
Unrelated to this announcement, a probable polio case was diagnosed in a Victorian who works in the Horn of Africa. The man became ill in April while in Somalia and returned to Melbourne in May. The case is being managed by the Victorian Department of Health according to its public health guidelines. He poses no risk to the community but serves as a timely reminder of the importance of immunisation for travellers, healthcare workers and indeed all Victorians. As long as polio exists anywhere in the world it represents a risk to Victorians.
Who is at risk?
Travellers to any of the countries listed below need to be up to date with routinely recommended vaccinations against polio, including a booster, and have documented evidence of this prior to departure. Documented evidence should include a completed World Health Organization International Certificate of Vaccination or Prophylaxis which are available at some travel clinics or otherwise can be ordered from the World Health Organization (WHO).
Healthcare workers who have never been immunised against polio are at particular risk if they come into contact with a polio case. Those who have not had a booster in the last ten years are also considered at risk.
Any Victorian who is unimmunised or under-immunised against polio could potentially contract it from an imported case.
Polio symptoms generally appear between three and 21 days after infection. However, many people infected with poliovirus have no symptoms and may not even know they are affected.
If illness is clinically apparent, initial symptoms include fever, malaise, headache, nausea and vomiting and muscle stiffness. This can be followed in some cases by rapid onset of paralysis, usually involving limbs asymmetrically and potentially involving muscles of respiration or swallowing.
Clinicians are reminded to be vigilant for signs of poliovirus infection, including acute flaccid paralysis, in travellers returning from polio infected countries. Polio is a group A notifiable condition and medical practitioners are therefore required to notify their Department of Health immediately on suspicion, by phoning 1300 651 160.