Clinical advice for the 2018 Polio outbreak in Papua New Guinea

In Sunshine Coast by PHN Communications

In June 2018, the Government of Papua New Guinea notified the World Health Organization (WHO) of an outbreak of circulating vaccine-derived poliovirus. The Government of Papua New Guinea is working with partners, including WHO and UNICEF, to take appropriate outbreak response measures including contact tracing, testing and vaccination. Polio is very unlikely to spread in Australia because of high rates of vaccine coverage, good sanitation, and the quality and ability of the health system to respond to cases.

Recommendations for Vaccination

  • Australian residents planning to visit PNG for less than 4 weeks should be up to date with their polio vaccination. For adults, this is a 3 dose primary course, with a booster within the last 10 years. For children, a 3 dose primary course with a booster at 4 years old is currently recommended. These recommended vaccines may be given before arrival in PNG.
  • Australian residents travelling to PNG intending to stay for longer than 4 weeks should have a documented polio booster within 4 weeks to 12 months prior to the date of departure from PNG. The booster may be given before arrival in PNG, as long as it is given within 4 weeks to 12 months prior to leaving PNG.
  • Individuals who are already residing in PNG for 4 weeks or longer should have a documented polio booster within 4 weeks to 12 months prior to departure from PNG (refer to WHO’s International Travel and Health website). The booster may have been given before arrival in PNG, as long as it has been given within 4 weeks to 12 months prior to leaving PNG. Individuals leaving PNG in less than 4 weeks should still receive a polio booster as this will still have benefit.

Documentation

Consistent with WHO recommendations, polio-affected countries may require proof of vaccination when leaving the country. Documentation should be provided on an International Certificate of Vaccination or Prophylaxis (“Yellow Book”). Copies of the International Certificate of Vaccination or Prophylaxis Booklets can be ordered from WHO Press or downloaded from the WHO website.

Polio vaccines

Polio vaccine boosters can be given as inactivated polio vaccine (IPV) either alone (IPOL) or as part of another vaccine, such as in combination with diphtheria, tetanus and pertussis (eg Boostrix IPV, Adacel Polio). Polio vaccine boosters can also be given as oral polio vaccine (OPV). OPV is not available in Australia.

Inactivated polio vaccine (IPV) is funded for children under the National Immunisation Program for individuals holding a Medicare card. The recommended schedules consist of

  • a primary schedule of 3 doses at 2, 4 and 6 months of age with a booster dose at 4 years of age;
  • a catch up (up to 3 doses) schedule for individuals 10 to 19 years of age who do not have a documented history of at least 3 doses of IPV containing vaccine
  • Other individuals needing polio vaccination will need to obtain it on private prescription.

Further advice about polio vaccines can be found in the Australian Immunisation Handbook or you can contact your local Public Health Unit: https://www.health.qld.gov.au/system-governance/contact-us/contact/public-health-units

You can keep up to date regarding outbreak by visiting the Australian Government Department of Health website: http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-polio-PNG-clinicians.htm

Dr Heidi Carroll
A/Executive Director
Communicable Diseases Branch
Department of Health, Queensland