Sunday, May 16, 2010

Outbreak Notice

This information is current as of today, May 16, 2010 at 12:02 EDT

Released:
May 14, 2010

Current Situation

An outbreak of polio is currently ongoing in the Republic of Tajikistan. This outbreak represents the first importation of polio in the World Health Organization (WHO) European Region since it was certified polio-free in 2002.
As of April 21, 2010, the Tajikistan Ministry of Health has reported 120 cases of acute flaccid paralysis, the most common sign of polio. Of the 120 cases, 108 are in children younger than 5 years old. Ten children have died.
Uzbekistan has also reported several cases of acute flaccid paralysis. These cases have occurred near the country’s border with Tajikistan.
Polio is a disease that is most often spread through contact with the stool (bowel movement) of an infected person. Polio germs can also be spread through food and water. The disease mainly affects children under 5 years old, but unvaccinated people of any age are at risk. Signs and symptoms of the illness include limb, respiratory, and facial paralysis, as well as diarrhea.
Recommendations for US Travelers to Tajikistan and Uzbekistan

Get vaccinated for polio
  • Talk to your doctor to find out if you are up to date with your polio vaccination.
  • Even if you were vaccinated as a child or have been sick with polio before, you may need a booster shot to make sure that you are protected.
  • If you are traveling with children, be sure that they have been vaccinated, too.
Follow safe food and water practices
  • Eat foods that are fully cooked and served hot.
  • Eat and drink dairy products that have been pasteurized.
  • Eat only fruits and vegetables that you can wash with safe water and peel yourself.
  • Drink only bottled or boiled water or beverages that have been bottled and sealed (carbonated drinks, or sports drinks). Avoid tap water, fountain drinks, and ice.
Practice good hand hygiene
  • Wash hands often with soap and water. If soap and water are not available, you can use an alcohol-based hand gel.
  • Wash hands especially before eating, drinking or preparing food and after using the bathroom, changing diapers, and coughing or sneezing.
Polio Risk Areas in Tajikistan

Cases have been reported in the following 20 central and southwestern districts: Beshkent, Bokhtar, Djilikul, Dushanbe City, Faizabad, Gazimal, Gissar, Kabadien, Khodjamaston, Khovaling, Kofarnokhon, Kolkhozobad, Leninsk-Rudaky, Pandj, Sarband, Shajrinau, Shartuz, Tursunzade, Vakhsh, Varzob.
The Government of Tajikistan has requested technical guidance and support from WHO. WHO is communicating with neighboring countries about the outbreak. Tajikistan borders Afghanistan to the south, Uzbekistan to the west, Kyrgyzstan to the north, and People's Republic of China to the east.
Information for Healthcare Providers

Vaccine Recommendations: Infants and Children
  • The Advisory Committee on Immunization Practices (ACIP) recommends that all infants and children in the United States receive 4 doses of inactivated poliovirus vaccine (IPV), administered at 2 months, 4 months, 6–18 months, and 4–6 years of age.
  • If accelerated protection is needed, the minimum interval between the first three doses is 4 weeks, and the minimum interval from dose 3 to dose 4 is 6 months.
  • A dose of IPV should be administered at age ≥4 years regardless of the number of previous doses.
Vaccine Recommendations: Adults
  • Travelers who have received the series with either IPV or oral polio vaccine (OPV) as a child without an adult booster dose (either OPV or IPV) should receive another dose of IPV before departure.
  • Available data do not indicate the need for more than one lifetime IPV booster dose for adults.
  • Travelers who are unvaccinated, incompletely vaccinated, or whose vaccination status is unknown should receive 3 doses of IPV (2 doses at 4–8 week intervals followed by a third dose 6–12 months after the second dose). (See Chapter 2, Poliomyelitis, CDC Health Information for International Travel 2010, for details.)
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