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The U.S. Centers for Disease Control and Prevention (CDC) recently reissued its Level 2 - Practice Enhanced Precautions Global Polio notice.
As of January 5, 2024, the CDC's Travel Health Notice confirmed that polio and poliovirus are health risks in about thirty-one countries that have recently reported outbreaks.
The CDC says that adults who previously completed the whole, routine polio vaccine series may receive a single, lifetime booster dose of the polio vaccine before traveling to any of these destinations.
Any other traveler should ensure they are up-to-date on their polio vaccination schedule.
In the U.S., the IPV vaccine has been deployed since 2000.
Jeri Beales, MSN RN at Destination Health Travel Clinic in Natick, MA, 01760, told Precision Vaccinations, "It's a common misconception that polio has been eradicated worldwide. We forget that polio is still out there because cases are so rare in the U.S. Decades of vaccination efforts in the U.S. have kept infections at bay; still, sadly, polio has regained a foothold in various countries."
"So, if you have plans to travel to a country experiencing a polio outbreak, you may be putting yourself and your family at risk. Adults need to receive a one-time additional dose of polio before traveling to any high-risk countries because the vaccines you received as a child may no longer be protective. Like a lot of vaccines, the effectiveness wears off with time."
"And don't forget, if you're traveling with children, check with their pediatrician to ensure they are up-to-date on their polio immunizations.
In late 2023, the WHO announced that the risk of the international spread of poliovirus remains a Public Health Emergency of International Concern and recommended its extension and Temporary Recommendations for three months.
According to the CDC, most people with polio do not feel sick. Some people have only minor symptoms, such as fever, tiredness, nausea, headache, nasal congestion, sore throat, cough, neck and back stiffness, and arm and leg pain.
However, in rare cases, polio infection causes permanent loss of muscle function. Polio can be fatal if the muscles used for breathing are paralyzed or if there is an infection of the brain.
Note: This news article was updated with the provider's perspective on Jan.16, 2024.
The Annals of Internal Medicine recently confirmed the Advisory Committee on Immunization Practices (ACIP) voted to approve the Recommended Adult Immunization Schedule for Ages 19 Years or Older.
The 2024 adult immunization schedule summarizes the U.S. Centers for Disease Control and Prevention (CDC) ACIP recommendations in the cover page, tables, notes, appendix, and addendum.
The complete ACIP recommendations for each vaccine are available at this CDC link.
As of January 12, 2024, the new schedule has also been approved by the director of the CDC and by the American College of Physicians, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, the American College of Nurse-Midwives, the American Academy of Physician Associates, the American Pharmacists Association, and the Society for Healthcare Epidemiology of America.
According to recent reports out of the states of Pennsylvania and Washington, measles outbreaks have been confirmed in potentially unvaccinated people in 2024.
On January 12, 2024, the Philadelphia Health Department confirmed eight measles cases spanning 2023 and 2024.
Health agencies alerted healthcare providers in the northwest after six measles cases were identified in Clark and Wahkiakum counties in Washington.
The U.S. Centers for Disease Control and Prevention (CDC) says that since the United States has such a high measles vaccination rate, most measles cases are related to international travelers.
Last year, ten countries reported over 90% of all measles cases worldwide, led by Yemen and India.
During 2023, a total of 48 measles cases were reported by twenty U.S. jurisdictions. The CDC did not disclose the vaccination status of the measles cases.
The good news from the CDC is that various measles vaccines (MMR) are available in 2024, generally available at clinics and pharmacies in the U.S.
Furthermore, before heading abroad in 2024, the CDC publishes this digital app to help travelers determine whether or not they need MMR vaccination before departure.
As the influenza and Respiratory syncytial virus (RSV) seasons diminish in the U.S., world leaders express their disappointment with respiratory disease vaccination rates.
"Too many people are in need of serious medical care for flu, for COVID, when we can prevent it," said Maria Van Kerkhove, the World Health Organization's interim director of epidemic and pandemic preparedness, as reported by Reuters on January 12, 204.
Kerhove cited "incredibly low" vaccination rates against flu and COVID-19 in many countries this season.
According to the U.S. Centers for Disease Control and Prevention's (CDC) latest data, the percentage of the population reporting receipt of COVID-19, influenza, and RSV vaccines remains low for adults.
- The updated 2023-24 COVID-19 vaccine is 21.4% for adults 18+, including 41.5% for adults 65+.
- Influenza vaccination is 46.8% for adults 18+, including 74.1% among adults 65+.
- RSV vaccinations for adults over 60 years of age is 20.1%.
As of January 12, 2024, the CDC recommends that all six months and older stay current on COVID-19 and receive a seasonal flu vaccine.
Furthermore, if you are 60 years and older, talk to a healthcare provider to see if RSV vaccination is proper for you this season.
These reportatory vaccines are generally available at U.S.-based pharmacies.
For new mothers, the extended half-life monoclonal antibody Beyfortus™ offers passive immunization for infants and young children to prevent lower respiratory tract infections caused by RSV.
Beyfortus was recently approved for use in China, and the manufacturers have committed to deliver significant quantities to the U.S. in 2024.
In response to an active polio outbreak, the Indonesian government has recently requested the WHO Director-General’s approval to release the novel oral polio vaccine type 2 (nOPV2).
As of January 11, 2024, the WHO issued a Disease Outbreak News alert (DON500) confirming the approval of more than 20 million doses of nOPV2 for two rounds of supplementary immunization activities scheduled for January 15, 2024, and February 19, 2024.
Previously, Indonesia reported four cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) from October 2022 to February 2023.
In late December 2023, the Indonesian Ministry of Health notified WHO of two new confirmed cases of cVDPV2.
Genetic sequencing of isolates at the BioFarma National Polio Laboratory indicates cVDPV2 with 36 nucleotide changes, genetically linked to a case reported in West Java province to the WHO in March 2023.
Vaccine-derived poliovirus is a well-documented strain that has mutated from the strain initially used in oral polio vaccines.
In sporadic instances, the vaccine-derived virus can genetically mutate into a form that can cause paralysis, just as the wild poliovirus does – this is what is known as a vaccine-derived poliovirus (VDPV).
The detection of VDPV in at least two different sources, at least two months apart, that are genetically linked and showing evidence of transmission in the community is classified as cVDPV.
According to the WHO, the overall risk is assessed as high at the national level. At the regional level, the overall risk is assessed to be moderate.
Furthermore, the WHO advises against implementing any travel or trade restrictions on Indonesia based on the current information available on this event.
As of January 12, 2024, about 1 billion doses of the nOPV2 vaccines have been distributed.
Preliminary data from World Health Organization (WHO) Member States indicate that the number of cholera cases reported in 2023 has surpassed 2022, with over 667,000 cases and 4000 deaths.
In total, at least 30 countries have reported cholera outbreaks in 2023.
As of January 11, 2024, nearly a year has passed since the WHO classified the global resurgence of cholera as a grade 3 emergency.
Based on the large number of outbreaks and their geographic expansion, alongside the shortage of cholera vaccines and other resources, the WHO continues to assess the risk at a global level as very high.
The U.S. Food and Drug Administration, the European Medicine Agency, and the U.K. NHS recommend oral cholera vaccines (OCV) for specific conditions in countries that are undergoing outbreaks.
During 2023, around 65 million OCV doses were requested, with 45% being approved and allocated to 12 countries,
There are three WHO pre-qualified OCVs: Dukoral®, Shanchol™, and Euvichol®.
In August 2023, the U.S. Centers for Disease Control and Prevention (CDC) published Cholera Vaccine: Recommendations, highlighting CVD 103-HgR (Vaxchora®) for travelers ages 2–64 years old going to areas of active toxigenic Vibrio cholerae O1 transmission.
Cholera is an acute intestinal infection that spreads through food and water contaminated with the bacterium Vibrio cholerae, often from feces. Cholera can kill people within hours when not treated, but immediate access to treatment saves lives, says the WHO.
According to the U.S. Centers for Disease Control and Prevention (CDC) latest FluView report, the current flu season in the United States may be winding down.
As of January 12, 2024, the CDC stated that a week of decreased data has been noted after several weeks of increased key flu indicators.
Nationwide, 5.7% of patient visits reported through ILINet during week #1 of 2024 were due to respiratory illness that included fever plus a cough or sore throat. This has decreased compared to Week #52 of 2023.
Based on mortality surveillance data available on January 11, 2024, 1.3% of the deaths during the week ending January 6, 2024 (Week #1) were due to influenza. This percentage increased (≥ 0.1 percentage point change) compared to Week #52.
However, seasonal influenza activity remains elevated in most parts of the country.
And the CDC will continue monitoring the data for an indication of a second period of increased influenza activity that often occurs after the winter holidays.
Should there be a rekindling of influenza activity, ample flu shots should be available at most pharmacies in the U.S. The CDC says vaccination now can still provide benefits this flu season.
The CDC reported that over 155 million influenza vaccines had been distributed last year.
