Afghanistan
Polio

Afghanistan: Recommended Vaccinations

Polio

Country Risk

Wild Polio Virus (WPV1) is a risk in Afghanistan, particularly in southern provinces. The most recent WPV1 cases were reported in October 2020.

For more information, see: The Global Polio Eradication Initiative (GPEI)


Entry requirements

A valid International Vaccination Certificate with proof of Polio vaccination is required on arrival from travellers coming from Pakistan. Vaccination with Oral Polio Vaccine or Inactivated Polio Vaccine must be administered between 4 weeks and 12 months prior to entry. Long-term visitors staying for more than 4 weeks may be required to provide proof of vaccination when departing Afghanistan. 


Recommendations

Long-term visitors (4 weeks or more) and residents of Afghanistan departing the country should receive a booster dose of Polio vaccine between 4 weeks and 12 months prior to travel.


Proof of polio, Haemophilus influenzae and Meningococcal meningitis vaccination is required for travellers 
going to Hajj


Description

Polio, also known as Poliomyelitis, is caused by one of three poliovirus (PV) serotypes belonging to the Picornaviridae family. It is a highly contagious illness transmitted by close person to person contact, mainly through the oral-fecal route – an infected person who does not practice proper hand or body hygiene passes the infection to another person. It can also spread through infected saliva and respiratory system secretions. Polioviruses grow in the intestinal system and are shed through feces. The infection typically spreads in areas with poor water and sewage sanitation; wild poliovirus is found in this type of environment and puts unvaccinated people at risk.

Risk

As a result of global eradication efforts, Polio is now only endemic in Afghanistan, Nigeria, and Pakistan. However, countries with low vaccination rates continue to be at risk for re-introduction of the virus due to imported cases resulting from travel. Unvaccinated travellers, especially children, pregnant women, and those with a weakened immune system going to areas with Polio outbreaks are at risk.

Symptoms

In the majority of cases, the infection is asymptomatic – persons do not exhibit symptoms. Those that do have very mild symptoms and the infection may go unnoticed. Symptoms include fever, headache, fatigue, stiff neck, muscle pain, and vomiting. In some cases, the virus enters the bloodstream to attack the Central Nervous System which causes paralysis, usually in the legs. This is also known as Acute Flaccid Paralysis where the limbs become floppy. In severe cases, patients can become quadriplegic when the thorax and abdomen muscles become paralyzed and have difficulty breathing, swallowing, or speaking. Post-Polio Syndrome, characterized by muscle weakness, joint and muscle pain, and severe fatigue, can occur in survivors 15 to 40 years after being exposed to the virus. Treatment includes supportive care of symptoms, antispasmodic medication, physiotherapy, and even orthopedic surgery.

Prevention
  • Wash your hands thoroughly and frequently with soap and water. If not available, use an alcohol-based hand sanitizer. Practice good body hygiene.
Vaccination

Travellers of all ages should ensure that they are up-to-date with their Polio vaccination. A primary vaccination series is necessary for those not previously or only partially vaccinated. If you have been fully vaccinated as a child, you should get a Polio booster once as an adult. To prevent the international spread of Polio, some countries require travellers to get an additional Polio booster 4 weeks to 12 months prior to entering the country. A booster dose is also recommended for long-term travellers (4 weeks or more) going to countries with risk of Polio virus transmission. The inactivated injectable vaccine is available in Canada and the USA and the live attenuated oral vaccine is available in some countries. Polio-containing combination vaccines are also available for children. All provide life-time protection.


Information last updated: February 23, 2021. 

  • McMinn PC, Van Tu P. Enterovirus Infections That Cause Central Nervous System Disease (Including Poliomyelitis). In: McGill, A; Ryan, E; Hill, D; Solomon, T, eds. Hunter's Tropical Medicine and Emerging Infectious Diseases. 9th ed. New York: Saunders Elsevier; 2013: 349-353.
  • Centres for Disease Control and Prevention: Yellow Book, Poliomyelitis
  • Committee to Advice on Tropical Medicine and Travel, PHAC: Statement on Poliovirus and the International Traveller
  • Public Health Agency of Canada: Canadian Immunization Guide, Poliomyelitis Vaccine
  • World Health Organization: International Travel and Health, Vaccine Preventable Diseases and Vaccines