Polio in Somalia, Kenya, Ethiopia

• Warning - Level 3, Avoid Nonessential Travel

• Alert - Level 2, Practice Enhanced Precautions

• Watch - Level 1, Practice Usual Precautions

Updated: January 22, 2014

What is the current situation?

According to the Global Polio Eradication Initiative , in 2013, 183 cases of polio were reported from Somalia, 14 polio cases were reported from Kenya and eight cases were reported from the Somali Region of Ethiopia. These are the first wild poliovirus cases reported in Somalia since 2007, in Kenya since July 2011, and in Ethiopia since 2008. CDC recommends that all travelers to Somalia, Kenya, and Ethiopia be fully vaccinated against polio. In addition, adults should receive a one-time booster dose of polio vaccine.

Because of the risk of cross-border transmission, CDC recommends a one-time booster dose of polio vaccine for fully vaccinated adults who are traveling to Djibouti, Eritrea, Sudan, South Sudan,* Uganda, and Yemen to work in health care facilities, refugee camps, or other humanitarian aid settings. This kind of work might put people in contact with someone who has polio.

 

What is polio?

Polio is a disease caused by a virus that is mainly spread by person-to-person contact and 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.

 

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 traveling. Even if you were vaccinated as a child or have been sick with polio before, you may need a booster dose to make sure that you are protected. See individual destination pages for vaccine recommendation information.

◦                      Make sure children are vaccinated.

◦                      See Vaccine Information Statements (VIS) for more information.

•  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

◦                      Salads

◦                      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

•  For more information, see Food and Water Safety.

•  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.

Clinician Information:

All travelers to any country should be up-to-date on routine vaccinations, including polio vaccine. CDC recommends a one-time adult inactivated poliovirus vaccine (IPV) booster dose for travelers to certain countries. See the Vaccine section in Chapter 3, Poliomyelitis, CDC Health Information for International Travel, for specific vaccination details.

 

*Cases of polio reported in South Sudan in September 2013 were determined to be false positives. Therefore, the recommendation for booster doses of polio vaccine for travelers is now limited to certain high-risk groups.