Polio in Somalia and Kenya
Released: June 03, 2013
1 What is the current situation?
According to the Polio Global Eradication Initiative, there have been four cases reported from Somalia in May 2013. These are the first wild poliovirus cases reported in Somalia since 2007.
Also, two cases have been reported from Dadaab, Kenya. These are the first wild poliovirus cases confirmed in Kenya since July 2011. Dadaab hosts a major refugee camp, housing nearly 500,000 people from across the Horn of Africa, including from Somalia. Countries across the Horn of Africa are now at risk of this outbreak because of large-scale population movements and persistent immunity gaps in some areas.
CDC recommends that all travelers to Somalia and Kenya, and surrounding countries of Djibouti, Ethiopia, South Sudan, Uganda and Tanzania be fully vaccinated against polio. In addition, adults should receive a one-time booster dose of polio vaccine.
2 What is polio?
Polio is a disease caused by a virus that is mainly spread by eating or drinking items contaminated with the feces of an infected person. Polio can also be spread through water, other drinks, and raw or undercooked food.
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. Most people recover completely. In rare cases, polio causes permanent loss of muscle function in the arms or legs (usually the legs) or death.
3 What can travelers do to prevent polio?
- Get the polio vaccine:
- Ask your doctor or nurse to find out if you are up-to-date with your polio vaccination and whether you need a booster dose before travelling. Even if you were vaccinated as a child or have been sick with polio before, you may need a booster shot to make sure that you are protected.
- Make sure children are vaccinated.
- Eat Safe Foods:
- Food that is cooked and served hot
- Hard-cooked eggs
- Fruits and vegetables you have washed in clean water or peeled yourself
- Pasteurized dairy products
- Don’t Eat:
- Food served at room temperature
- Food from street vendors
- Raw or soft-cooked (runny) eggs
- Raw or undercooked (rare) meat or fish
- Unwashed or unpeeled raw fruits and vegetables
- Peelings from fruit or vegetables
- Condiments (such as salsa) made with fresh ingredients
- Unpasteurized dairy products
- ”Bushmeat” (monkeys, bats, or other wild game)
- Drink Safe Beverages:
- Bottled water that is sealed (carbonated is safer)
- Water that has been disinfected (boiled, filtered, treated)
- Ice made with bottled or disinfected water
- Carbonated drinks
- Hot coffee or tea
- Pasteurized milk
- Don’t Drink:
- Tap or well water
- Ice made with tap or well water
- Drinks made with tap or well water (such as reconstituted juice)
- Flavored ice and popsicles
- Unpasteurized milk
- Practice hygiene and cleanliness:
- Wash your hands often.
- If soap and water aren’t available, clean hands with hand sanitizer (containing at least 60% alcohol).
- Don’t touch your eyes, nose, or mouth. If you need to touch your face, make sure your hands are clean.
- Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
- Try to avoid close contact, such as kissing, hugging, or sharing eating utensils or cups with people who are sick.
4 Clinician Information:
CDC uses several criteria for determining whether to recommend polio vaccination for travelers to certain countries. These criteria include:
- Wild poliovirus is circulating (endemic countries)
- Cases of polio due to the wild virus have been reported within the previous 12 months
- The country borders others where cases of wild polio have been reported within the previous 12 months
- The surveillance systems are able to adequately capture cases of acute flaccid paralysis (AFP) within the country
Outbreaks continue to be a risk for major portions of Africa and some portions of central and south Asia. 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 3 doses is 4 weeks (28 days), 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 full 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.
- Adults 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).
- OPV has not been used in the United States since 2000; however, it is used in many other countries and has played a major role in eliminating polio from large parts of the world. IPV, which is given by intramuscular injection, is now used in the United States and a number of other developed countries.
Communicated by: CDC
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