Additional travel restrictions may be placed on Pakistan if present recommendations are not implemented fully, says expert panel of global health agency
Expressing concern over continuing cross-border spread of wild poliovirus, the International Health Regulations (IHR) Emergency Committee of WHO has said that the situation still constitutes a public health emergency. The committee has declared the spread of wild poliovirus as a public health emergency last May. Noting that there have been three “new exportations” of the disease from Pakistan, the IHR panel has extended the temporary recommendations on international travel it had issued earlier to curb the disease.
“The risk of new international spread from Pakistan was assessed to have increased substantively since 31 July 2014, as cases have escalated during the current high transmission season and there has been no significant improvement in the underlying factors that are driving transmission in the country,” a WHO news release said. The IHR panel also noted that the risk of spread from the other nine currently infected states—Afghanistan, Cameroon, Syria, Equatorial Guinea, Ethiopia, Israel, Nigeria, Somalia and Syrian Arab Republic—appears to have declined. Only two states Somalia (I case) and Afghanistan (7 cases, most of which were due to imported virus) have reported new cases since July 31.
The committee has issued additional precautionary measures to be implemented by Pakistan. These include restricting international travel from the country by persons who do not have documentation of appropriate polio vaccination and administration of vaccine to people who need to travel urgently. Pakistan has also been asked to furnish a detailed status report on implementing the recommendations on international travel.
If the existing and additional temporary recommendations for the vaccination of travellers from Pakistan cannot be fully implemented by the time the committee meets, it will consider additional measures such as entry screening to reduce the risk of international spread, says the WHO news release.
The recommendations were issued following the third meeting of the IHR panel, which was convened by the director general of WHO through electronic correspondence from November 2 to November 7 this year.
According to the WHO press release, the IHR committee recommended that Pakistan, Cameroon, Equatorial Guinea and the Syrian Arab Republic should ensure that all residents and long-term visitors receive a dose of oral polio vaccine (OPV) or inactivated poliovirus vaccine (IPV) between four weeks and 12 months prior to international travel.
And ensure that those undertaking urgent travel (i.e. within four weeks), who have not received a dose of OPV or IPV in the previous four weeks to 12 months, receive a dose of polio vaccine at least by the time of departure as this will still provide benefit, particularly for frequent travellers.
If the temporary recommendations for the vaccination of travellers from Pakistan cannot be fully implemented by the time the committee next meets, the committee will consider additional measures such as entry screening to reduce the risk of international spread, according to the press release.
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