Polio Resurgence: CDC Urges Travelers to Take Precautions

The Centers for Disease Control and Prevention (CDC) this week issued an advisory urging Americans to take “enhanced” precautions if traveling to 32 countries where the poliovirus is circulating. These destinations include countries in Europe (such as the United Kingdom, Germany, Poland, Spain, and Finland), Africa (including Tanzania), and the Eastern Mediterranean (Israel, Afghanistan, and others).

Polio Vaccination: What Travelers Require to Know

If you’re planning a trip to any of these areas, the CDC urges you to ensure you are up to date on your polio vaccinations and to consider getting a booster shot – even if you previously completed the full polio vaccine series, which is said to provide lifelong immunity to the majority of people who receive it.

“Polio continues to be an issue and is an increasing issue in many countries of the world related primarily to decreases in vaccination,” says Robert H. Hopkins Jr., MD, medical director of the National Foundation for Infectious Diseases (NFID). “If you are fully vaccinated, your risk is extremely low – near zero – of getting a polio infection,” Dr. Hopkins says.

Why Polio Is Dangerous

Polio is a highly transmissible disease. The virus lives in feces and can spread when an infected person doesn’t wash their hands properly after defecating. Poliovirus also spreads through contaminated water or food.

Most people with polio have no symptoms, although some may experience mild issues such as fever, fatigue, stiffness in the arms and back, and pain in the arms and legs. Still, 1 in 200 will experience irreversible paralysis when the virus invades their nervous system. Among those paralyzed, 5 to 10 percent die when their breathing muscles grow immobilized, according to the World Health Organization (WHO).

There is no cure for polio.

Polio Elimination and Current Risks

Following the introduction of the polio vaccination in 1955 and widespread vaccination efforts, polio was considered eliminated in the United States by 1979. However, with the elimination of polio, many people today may not realize how serious the disease can be.

“I’ve never seen a case of polio as a physician, but I know people in their seventies or eighties who have had polio — it’s something you carry with you your whole life and we don’t have any real treatments,” says Adam Lauring, MD, PhD, chief of the division of infectious diseases in the department of internal medicine at the University of Michigan Medical School in Ann Arbor. “The effects can be severe with some patients losing use of their arms and legs, and some winding up on ventilators, as the disease can affect muscles that help you breathe.”

The Impact of Undervaccination

Polio vaccination is currently part of the routine childhood immunization schedule, with the CDC recommending four doses of inactivated polio vaccine (IPV) for maximum protection. However, vaccine hesitancy has grown in recent years due to misinformation, religious and cultural beliefs, and distrust in institutions.

Vaccination for polio—as well as measles, mumps, and rubella (MMR), diphtheria, tetanus, pertussis, and varicella—has been decreasing among kindergartners, according to the CDC. Agency data from the 2024–25 school year shows that 92.5 percent of kindergartners had received the polio vaccine.

If the downward trend continues, the United States could eventually be at risk of losing its elimination status with regards to polio. “The greatest risk is posed by unvaccinated U.S. Travelers being infected by polio internationally and bringing it back to their home communities,” Hopkins says. The risk of polio is growing globally as countries become increasingly underimmunized.

Afghanistan and Polio Eradication Efforts

As of November 1, 2024, Afghanistan reported 23 cases of wild poliovirus type 1 (WPV1) in 2024, with onset during January–September 30, 2024. This is the highest number of cases in four years. During the three previous years, 12 WPV1 cases were reported, including six during 2023. [2]

In Afghanistan, supplemental immunization activities (SIAs) are conducted using various methods, such as house-to-house, mosque-to-mosque, and site-to-site vaccination. [3]

That’s why the CDC is stressing that travelers to areas where there is greater risk make sure they’ve had their polio shots, and consider getting a booster even if they’ve received the full series of polio vaccinations as a child.

“With this kind of resurgence of polio circulation, I think some people — especially those with immunocompromising conditions — might seriously think about getting a booster out of an abundance of caution,” says Dr. Lauring. “These shots are safe and effective. I encourage people to reach out to their doctors and discuss.”

He further notes that some of the higher-risk areas listed may come as a surprise to many American travelers. “You might not think before you move to London, ‘Hey, I better receive my polio shot,’” says Laurin. “So stay informed about which areas have circulating virus.”

CDC – Afghanistan Traveler View