Polio Remains a Public Health Emergency of International Concern: WHO
The World Health Organization (WHO) has issued a report stating that the risk of the poliovirus spreading internationally remains a significant concern for public health. Currently, there are no travel restrictions in place for Pakistan. The potential for the international transmission of Wild Poliovirus type 1 (WPV1) in Pakistan, Afghanistan, and Africa is influenced by various factors. One of the reasons for polio transmission in Pakistan is the ongoing spread of the virus from eastern Afghanistan across the border. Additionally, there is a worrisome number of unvaccinated children in southern Afghanistan, posing a continuous risk of WPV1 reintroduction in that region. The report highlights suboptimal immunization coverage during vaccination campaigns in southeastern Africa, specifically in Malawi, Mozambique, Zambia, and Zimbabwe, which may lead to insufficient population immunity to stop transmission. In Pakistan, a new WPV1 case was reported in Khyber Pakhtunkhwa province on February 20, 2023. Furthermore, environmental surveillance has detected three positive samples in 2023, two in Punjab and one in KP, with two of them linked to viruses circulating in Afghanistan. In Afghanistan, no new cases have been reported in 2023, with the last case occurring on August 29, 2022. However, there have been 18 positive environmental samples in 2023, all from the eastern region, with three from Kunar and 15 from Nangarhar. Regarding the WPV1 outbreak in southern Africa, there have been no new cases reported since August 10, 2022, in Mozambique. To mitigate the risk of polio spread, the WHO committee recommends that all residents and long-term visitors (staying more than four weeks) of all ages should receive a dose of either bivalent oral poliovirus vaccine (bOPV) or inactivated poliovirus vaccine (IPV) between four weeks and 12 months before international travel. Travelers should also obtain an International Certificate of Vaccination or Prophylaxis as proof of vaccination. The committee emphasizes the need to restrict international travel for residents lacking appropriate polio vaccination documentation at the point of departure, regardless of the mode of transportation.