21 July 2010

Wild-type polio outbreak: Russian Federation and Tajikistan

This report updates the NaTHNaC Clinical Update of 27 April 2010.

On 1 June 2010, wild type poliovirus (type 1) was confirmed in a nine month old child who had arrived in Irkutsk, in the Siberian region of Russia, from Tajikistan [1]. As of 6 July 2010 the World Health Organization (WHO) reported a total of six cases of acute flaccid paralysis due to wild-type poliovirus in Russia [2]. The polio virus (type 1) in the Russian cases is genetically related to the strain in the ongoing outbreak in Tajikistan [1-3]. These additional five cases are being evaluated to determine whether they are imported or indigenously acquired. Surveillance and control measures have been heightened and authorities in Russia are now testing all children arriving from Tajikistan for polio [1].

As of 12 July 2010, Tajikistan reported 413 cases of laboratory-confirmed poliomyelitis (wild type 1 poliovirus) with 19 deaths [4, 5]. Most cases have been reported from the southwest of the country [5]. Immunisation campaigns are underway in Tajikistan, as well as in the neighbouring countries of Uzbekistan, Kyrgyzstan and Turkmenistan [4, 5].

Advice for clinicians regarding the reporting of symptoms in travellers returning from Tajikistan or neighbouring countries is provided by the Department of Health, Chief Medical Officer.

 Advice for travellers

NaTHNaC recommends that those travelling to Tajikistan and the Russian Federation should have completed their primary vaccination course against polio. In addition, they should receive a booster dose of a polio-containing vaccine if they have not received one in the last 10 years.

NaTHNaC also recommends that travellers to any countries that are endemic for polio or that have had imported cases of polio in the last three years, should receive a booster dose of a polio-containing vaccine if they have not received one in the previous 10 years. These countries can be identified on the NaTHNaC Country Information Pages, and were reviewed in the Clinical Update of 24 May 2010.

Polio is a virus transmitted through food and water. Travellers to areas with ongoing polio transmission should practise strict food and water hygiene. More information on polio can be found on the NaTHNaC Health Information Sheet on polio.

References

1. Global polio eradication initiative: Monthly situation report – May 2010. [Accessed 21 July 2010].  Available at: http://www.polioeradication.org/content/general/poliositrepMay

2010.asp

2. Global polio eradication initiative: Monthly situation report – June 2010. [Accessed 21 July 2010].  Available at: http://www.polioeradication.org/content/general/current_monthly

_sitrep.asp

3. World Health Organization. Polio in Tajikistan, first importation since Europe certified polio-free. 23 April 2010. [Accessed 21 July, 2010]. Available at: http://www.who.int/csr/don/2010_04_23/en/index.html

4. Global polio eradication initiative. Wild Poliovirus Weekly Update. 7 July 2010. [Accessed 21 July 2010]. Available at:  http://www.polioeradication.org/casecount.asp

5. World Health Organization. Epidemiological Brief. Tajikistan polio outbreak and regional response. 19 July 2010. [Accessed 21 July 2010]. Available at: http://www.euro.who.int/__data/assets/pdf_file/0019/118342/

EPI_TJK_Issue3.pdf

Links

NaTHNaC health information sheet: Polio

Health Protection Agency: Polio

World Health Organization: Polio fact sheet

World Health Organization: Global Polio Eradication Initiative