Polio vaccination suggestions for Travelers

Polio is an infectious disease. This condition is caused by a virus called the poliovirus. This condition spreads easily from person to person (is contagious). People can get the virus by:

• Eating food or drinking water contaminated with the virus found in human waste.
• Coming in contact with infected mucus or sputum from the nose or mouth.
• Coming in contact with infected air droplets from a cough or sneeze.

The virus can cause a range of symptoms. Most people with the virus do not have symptoms.

What are the symptoms of polio?

If symptoms develop, it takes 5–35 days for them to begin once you have the virus. Symptoms depend on the type of polio you have. Symptoms usually last 72 hours or less. They include:

• General discomfort, body aches, or uneasiness (malaise).
• Headache.
• Red or sore throat.
• Slight fever.
• Nausea.

Rarely, the brain or spinal cord can be involved, and symptoms may include:

• A sudden (acute) weakness in the arms or legs.
• Feeling numbness or tingling in the legs.
• Difficulty breathing.

What are the vaccination suggestions for travelers?

A set of age-appropriate polio vaccines should be completed before traveling to:

• Countries with active polio disease.
• A region with a polio outbreak.
• A region that has active poliovirus.

Polio is not common, but outbreaks can still occur in some places around the world. They often occur in places where people have not been fully vaccinated. Talk to your health care provider about the areas and countries where polio is still active. To make sure you are fully protected from the polio virus, vaccinations should be completed well in advance of travel. Ask your health care provider how far in advance the vaccination should be done.

Infants and Children

Before travel, a child should get the routine four doses of inactivated polio vaccine (IPV). The IPV doses should be given at 2 months, 4 months, 6–18 months, and 4–6 years. Talk to your child’s health care provider about the best schedule of doses for your child.

Adults

An adult who has had the routine set of polio vaccine has lifelong immunity to polio. However, to be safe, adults who will be traveling to a country or region with active poliovirus—and who have completed the suggested childhood vaccine series—should get a booster dose of IPV before leaving. Only one IPV booster dose is suggested during adulthood.

In addition, an adult IPV booster dose may be suggested for certain adults who plan to travel to some border areas of active poliovirus. These travelers include those working in health care settings, refugee camps, or other humanitarian aid settings.

An adult who is unvaccinated, incompletely vaccinated, or whose vaccination status is unknown should get a set of three IPV doses before traveling to a country with active polio. Those adults should generally get:

• Two doses of IPV given 4–8 weeks apart.
• A third dose given at 6–12 months after the second.

Talk to your health care provider about the best schedule of doses for you.

Pregnant or Breastfeeding Women

If a woman is pregnant and is unvaccinated or incompletely vaccinated and needs immediate protection against polio because of planned travel to a country with active polio, IPV can be given as suggested for adults. If a woman is breastfeeding, it is considered safe for both the mother and infant to be given IPV.

People With a Weak Immune System

IPV is generally safe for travelers with weakened immune systems (immunocompromised). However, there are certain types of polio vaccines that an immunocompromised person should avoid. Talk to your health care provider about the best vaccine for you.

What are food and beverage safety practices for travelers?

Unclean food and water may expose travelers to the poliovirus. Travelers to developing countries are especially at risk. Reduce your risk for polio by avoiding:

• Tap or well water. Drink only bottled and sealed water. If you must drink tap water, make sure you boil, filter, or treat it before drinking.
• Ice made with well water. Only use ice that has been made with bottled or disinfected water.
• Fountain drinks. Drink bottled and sealed carbonated or sports drinks. Hot coffee or tea is also safe to drink.
• Food served at room temperature. Eat only food that is fully cooked and served hot.
• Food from street vendors.
• Raw, soft-cooked, or runny eggs. Eat only hard-cooked eggs.
• Raw, undercooked, or rare meat or fish.
• Unwashed or unpeeled raw fruits and vegetables. Eat only fruits and vegetables that you have washed in clean water or peeled yourself.
• Condiments made with fresh ingredients, such as salsa.
• Salads.
• Flavored ice or frozen ice pops.
• Unpasteurized dairy products.
• Wild game meat.

What else can I do to reduce the risk of polio?

• Wash your hands often with soap and water. If soap and water are not available, use hand sanitizer.
• Try to avoid touching 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 when coughing or sneezing. Do not use your hands.
• Try to avoid close contact—such as kissing, hugging, or sharing eating utensils or cups—with people who are sick.
• Try to avoid swallowing or inhaling water into your nose or mouth while bathing, showering, or swimming. In some areas, tap water may not be safe for brushing teeth. In those areas, use bottled water for brushing teeth.
• Elderly or immunocompromised travelers should try to avoid inhaling steam and water vapor.

To learn about polio outbreak locations and additional recommended vaccinations and precautions for travelers, visit the Centers for Disease Control and Prevention (CDC) website: http://wwwnc.cdc.gov/travel/diseases/poliomyelitits