[Source: European Centre for Disease Prevention and Control (ECDC), full PDF document: (LINK). Abstract.]

International spread of wild-type poliovirus in 2014 declared a Public Health Emergency of International Concern under the International Health Regulations (IHR)

8 May 2014

Main conclusions
  • The overall polio vaccination uptake is high in the EU and the likelihood of a vaccinated person developing poliomyelitis is very low regardless of whether the person was vaccinated with OPV or IPV.
    • The likelihood that a person vaccinated with IPV will develop an asymptomatic infection after exposure to an infective dose of poliovirus is higher than for someone vaccinated with OPV.
    • This is likely to be part of the explanation for the circulation of wild-type poliovirus in Israel despite the high vaccination coverage and the absence of disease.

  • The highest risks of developing asymptomatic infections as well as developing poliomyelitis after exposure to poliovirus are found among the unvaccinated people in the EU.
    • The highest risk of large outbreaks of poliomyelitis is in areas where unvaccinated populations are geographically clustered or live in poor sanitary conditions or a combination of both conditions.
    • Based on historical outbreaks, the groups of highest concern for propagated outbreaks are the orthodox Christian group in the Netherlands, and the large Roma populations in south-eastern parts of the EU.
    • The orthodox Christian group live in good sanitary conditions but have a low vaccination uptake as a result of religious beliefs.
    • The Roma is a heterogeneous and under-vaccinated group, and many of them live in poor sanitary conditions.
    • Both groups benefit from the herd protection that comes from living within highly vaccinated communities but the conditions are met for rapidly evolving outbreaks in the unlikely event of wild-type poliovirus being introduced into either of these two groups.

  • ECDC does not consider that the risk of poliovirus transmission in the EU following an importation of poliovirus has changed since the Risk Assessment Wild-type poliovirus 1 transmission in Israel ? what is the risk to the EU/EEA, September 2013.
  • ECDC does not consider that there is a need to screen travellers arriving in the EU from the ?exporting countries? for polio vaccination or polio infection as the WHO Temporary Recommendations requests the exporting countries to ensure vaccination before international travel.
  • To ensure that EU travellers are fully protected, and to facilitate their return from ?exporting countries?, EU Member States should consider issuing specific vaccination advice aligned with the WHO Temporary Recommendations and alert travellers to the need to carry a valid certificate of polio vaccination.
    • The Temporary Recommendations raise practical questions regarding polio vaccination and verification of polio vaccination for EU travellers to the 10 countries listed in the Temporary Recommendations which there may be opportunities for EU-wide solutions and recommendations.

  • ECDC continues to support EU-wide response to the threat of spread of poliovirus and will, upon request, support individual EU Member States with their preparedness for detecting and controlling poliovirus importations.


Suggested citation: European Centre for Disease Prevention and Control. International spread of wild-type poliovirus in 2014 declared a Public Health Emergency of International Concern under the International Health Regulations (IHR). 8 May 2014. Stockholm: ECDC; 2014.

? European Centre for Disease Prevention and Control, Stockholm, 2014