Polio Outbreaks

Polio Outbreaks 2024

The World Health Organization (WHO) confirmed during the 39th meeting of the IHR Emergency Committee for Polio held in August 2024 that the spread of the poliovirus remained a Public Health Emergency of International Concern (PHEIC). The WHO updated its polio outbreak by country map in October 2024. As of October 25, 2024, the Global Polio Eradication Initiative (GPEI) confirmed that various countries reported wild polio (WPV1), circulating vaccine-derived poliovirus type 2 (cVDPV2), and circulating vaccine-derived poliovirus type 1 (cVDPV1) cases in 2024. From January 2023 - June 2024, 74 cVDPV outbreaks (672 confirmed polio cases) were detected in 39 countries or areas. The current GPEI target date is to stop all cVDPV transmission by the end of 2026. 

The U.S. Centers for Disease Control and Prevention (CDC) announced on October 17, 2024, that from January 2023 to June 2024, a total of 74 cVDPV outbreaks were detected in 39 countries, with 672 confirmed acute flaccid paralysis (AFP) cases identified in 27 of the 39 countries. The CDC reissued a Global Polio Alert - Level 2, Practice Enhanced Precautions Travel Health Notice on August 20, 2024, regarding polio outbreaks and poliovirus detections in 37 countries. The European Centre for Disease Prevention and Control (ECDC) published an interactive map in 2024 displaying countries confirming polio or poliovirus cases.

Polio Cases in the Americas

The WHO / Pan American Health Organization (PAHO) issued an Epidemiological Update - Poliomyelitis in the Americas Region and reported Acute Flaccid Paralysis (AFP) Surveillance in 2024. The PAHO/WHO reminds Member States that the risk of the emergence of a cVDPV1 or circulating vaccine-derived poliovirus type 3 (cVDPV3) has increased due to low vaccination coverage. In addition, the PAHO/WHO reports a continuing risk of importing a WPV1 or vaccine-derived poliovirus  (VDPV), mainly cVDPV2. cVDPV2 cases peaked in 2020, with over 1,000 cases of paralysis in 24 countries. As of January 2024, 325 cases of cVDPV2 had been reported in 2023, compared to 689 cases in 2022.

Polio in the United States

The United States was added to a list of polio-identified countries in 2022. The International Health Regulations classify the U.S. as a state infected with cVDPV2, with or without evidence of local transmission. Therefore, the U.S. is subject to Temporary Recommendations issued by the International Health Regulations Emergency Committee on Polio Eradication. 

The CDC reported (Volume 30, Number 11—November 2024) that wastewater surveillance for poliovirus identified ongoing transmission of poliovirus in Rockland County and adjacent New York counties during an outbreak of poliovirus in the U.S. It also retrospectively demonstrated the presence of poliovirus in the community for several months before the paralytic polio case was identified in 2022. Genetic characterization of the detected polioviruses confirmed that almost all wastewater detections were related to the virus isolated from the paralytic polio case. However, wastewater surveillance in NYC also identified a separate importation of VDPV2 that was not genetically related to the New York state case or other outbreaks globally. 

Afghanistan Polio Outbreak

Afghanistan is affected by ongoing endemic wild poliovirus transmission. There were 18 WPV1-positive environmental samples reported in 2023. According to the Ministry of Health, Afghanistan detected its initial human polio case in May 2023. As of June 2, 2023, local media reported four confirmed polio cases 2023 from the province of Nangarhar. Two polio patients were confirmed in 2022, four in 2021, and 56 in 2020.

Africa Polio Outbreaks

Kenya's Ministry of Health announced on October 1, 2024, that five polio cases have been confirmed,d and one positive environmental surveillance sample has been taken in Kamukunji Sub-County, Nairobi. In June 2024, Somalia launched a significant polio vaccination campaign for children. On May 24, 2024, Angola reported AFP and environmental detections. On May 14, 2024, the closure of the WPV1 outbreaks in Malawi and Mozambique was announced. Over 100 million vaccine doses have been administered in the most at-risk areas. Zimbabwe is inoculating more than 4 million children against polio in February 2024 after health authorities detected three cases caused by the rare mutation of the weakened virus in oral vaccines.

India Polio Outbreaks

National Immunization Days are held across India twice a year, with the government aiming to give two drops of OPV to every child under five and the Times of India reported on May 29, 2023, that Prayagraj's health department officials launched a polio vaccination program for 8.5 lakh children. 

Indonesia Polio Outbreaks

Indonesia reported four cases of cVDPV2 from October 2022 to February 2023, and in late December 2023, the Indonesian Ministry of Health notified WHO of two new confirmed cases of cVDPV2. Despite Indonesia having a strong capacity to respond to poliovirus outbreaks and West Java having a moderate to strong outbreak response capacity to interrupt transmission, there is a high susceptibility of the population to poliovirus type 2 after switching from trivalent to bivalent OPV. The ongoing polio outbreak in Indonesia poses a high risk at the national level, a moderate regional threat, and a low global risk as of 2024. The GPEI published a report of the Indonesia Polio Outbreak Response Assessment – July 2023. BMC Public Health published in March 2021 - Scaling up public health interventions: a case study of the polio immunization program in Indonesia.

Israel Polio Outbreaks

As of March 7, 2023, there have been reports of (4) VDPV3-positive polio cases in children during 2023. On March 2, 2023, the Israel Ministry of Health (MOH) reported three additional children tested positive for poliovirus on Twitter. On February 27, 2023, the Israel MOH issued an official alert describing a local case of Acute flaccid paralysis (AFP).

Pakistan Polio Outbreaks

As of October 2024, 28 WPV1 cases were confirmed, and numerous WPV1-positive environmental samples were reported this year. From January 2023 to June 2024, 14 WPV1 cases were reported in Pakistan, compared with 21 cases from January 2022 to June 2023. In 2022, 20 WPV1 cases and 20 paralyzed children were reported in the southern KP province.

South America Poliovirus Detections

The Pan American Health Organization (PAHO) published an alert on October 14, 2024, confirming the detection of circulating vaccine-derived poliovirus type 3 (cVDPV3) in wastewater samples collected in Cayenne, French Guiana. Additional testing identified positive samples collected in Remire-Montjoly and at Saint Georges de l’Oyapock. In 2024, the PAHO identified Argentina, Haiti, and Peru as at very high risk for the reintroduction of polio. In 2024, the PAHO reported 176 Virus Isolation Test Results were pending in the Americas.

Spain Poliovirus Detection

In Spain, circulating vaccine-derived poliovirus type 2 (cVDPV2) was isolated from a single positive sample collected in Barcelona for the first time in September 2024.

United Kingdom Poliovirus 

In May 2022, six positive samples were reported following the isolation of VDPV2 from environmental samples in London, UK. London and UK, public health authorities continue to intensify surveillance efforts, including for potential cases of paralysis, offering an additional dose of inactivated polio vaccine (IPV) to all children (aged 1-9 years of age) across London. The UKHSA National Polio Guidelines outline public health actions when a cVDPV2 is detected in environmental samples.

New York Poliovirus

The New York State Department of Health (NYSDOH) confirmed the presence of poliovirus in wastewater on March 23, 2023, for the first time since October 2022. This sensitive result was collected in February 2023, followed by non-detections in wastewater samples. However, unvaccinated residents should still act now to protect themselves from polio.

Polio Vaccines

As of 2024, various polio vaccines are available worldwide. Due to the high vaccination rate (93%), the CDC reports very few polio cases. According to the CDC, the IPV has been the only vaccine in the U.S. since 2000. However,