Polio Outbreaks 2019: Advice for Clinicians

This page contains advice for clinicians about the current outbreaks of polio in the Philippines, Papua New Guinea and the Papua Province of Indonesia.

Page last updated: 26 September 2019

2019 Outbreak of Polio in the Philippines

On 14 September 2019 a case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was confirmed on the island of Mindanao in the southern Philippines. The Philippine Department of Health announced an outbreak of polio in the country on 19 September 2019. Environmental samples genetically linked to this case have also been isolated in Manila and Davao City in 2019.

The Government of the Philippines, supported by partners of the Global Polio Eradication Initiative, UNICEF and the World Health Organization (WHO), are undertaking detailed investigations, enhancing surveillance, strengthening routine immunization and implementing an outbreak response.

2019 Outbreak of Polio in Papua Province, Indonesia

On 12 February 2019, circulating vaccine-derived poliovirus type 1 (cVDPV1) was confirmed in the Papua Province of Indonesia (Papua Province). While this Indonesian province shares a border with Papua New Guinea, this outbreak is not linked to the outbreak currently affecting Papua New Guinea.

The Indonesian Ministry of Health, supported by WHO, is undertaking contact tracing and testing as well as strengthened disease surveillance and polio vaccination of children in the Papua Province.

2018-19 Outbreak of Polio in Papua New Guinea

On 22 June 2018, the Government of Papua New Guinea notified WHO of an outbreak of circulating vaccine-derived poliovirus type 1 (cVDPV1).

The Government of Papua New Guinea is working with partners, including WHO and UNICEF, to take appropriate outbreak response measures including surveillance, contact tracing, testing and vaccination.

Other outbreaks

There are a number of polio outbreaks currently occurring globally. Information about these outbreaks and the situation in the Philippines, Papua New Guinea and Indonesia, can be found on the World Health Organization and Global Polio Eradication Initiative websites.

Circulating vaccine-derived poliovirus (cVDPV)

On very rare occasions, if a population is seriously under-immunised, the vaccine-virus can begin circulating in the community and, over a period of some12-18 months, can mutate and cause severe symptoms. These viruses are called circulating vaccine-derived polioviruses (cVDPV).

This cannot occur with the injectable polio vaccine used in Australia.

Risk of Polio spreading in Australia

Polio is very unlikely to spread in Australia because of high rates of vaccine coverage, good sanitation, and the quality and ability of the health system to respond to cases.

The Australian Government continues to closely monitor the situation.

Public Health Emergency of International Concern

In 2014, WHO declared the international spread of polio a Public Health Emergency of International Concern (PHEIC). WHO has issued Temporary Recommendations under the International Health Regulations 2005 for affected countries to reduce the risk of the international spread of polio.

Recommendations for Vaccination

  • Australian residents planning to visit affected countries for less than 4 weeks should be up to date with their polio vaccination. For adults, this is a 3 dose primary course, with a booster within the last 10 years. For children, a 3 dose primary course with a booster at 4 years old is currently recommended. These recommended vaccines may be given before arrival in the affected country.
  • Australian residents travelling to affected countries who intend to stay for longer than 4 weeks should have a documented polio booster within 4 weeks to 12 months prior to the date of departure from the affected country. The booster may be given before arrival in the affected country as long as it is given within 4 weeks to 12 months prior to leaving the affected country.
  • Individuals who are already residing in affected countries for 4 weeks or longer should have a documented polio booster within 4 weeks to 12 months prior to departure from the affected country (refer to WHO’s International Travel and Health website). The booster may have been given before arrival in the affected country, as long as it has been given within 4 weeks to 12 months prior to leaving the affected country. Individuals leaving the affected country in less than 4 weeks should still receive a polio booster as this will still have benefit.

Polio vaccines

Polio vaccine boosters can be given as inactivated polio vaccine (IPV) either alone (IPOL) or as part of another vaccine, such as in combination with diphtheria, tetanus and pertussis (eg Boostrix IPV, Adacel Polio).

Polio vaccine boosters can also be given as oral polio vaccine (OPV). OPV is not available in Australia.

Further advice about polio vaccines can be found in the Australian Immunisation Handbook.

Documentation

Consistent with WHO recommendations, polio-affected countries may require proof of vaccination when leaving the country.

Documentation should be provided on an International Certificate of Vaccination or Prophylaxis (“Yellow Book”). Copies of the International Certificate of Vaccination or Prophylaxis Booklets can be ordered from WHO Press or downloaded from the WHO website.

Australian Entry Requirements

The Department of Home Affairs website provides advice about entry requirements. Visa applicants from polio-affected countries, applying to come to Australia, may be required to provide a valid polio vaccination certificate.

There are no additional health entry requirements for Australian citizens or permanent residents as a result of the outbreak in the Philippines, PNG or Papua Province.