Polio Outbreaks

Authored by
Staff
Last reviewed
February 22, 2024
Content Overview
Polio outbreaks continue in 2024. Polio is a vaccine preventable disease according to the U.S. CDC, WHO, and European Medicines Agency.

Polio Outbreaks 2024

The World Health Organization (WHO) confirmed in December 2023 that the spread of the poliovirus remained a Public Health Emergency of International Concern (PHEIC) and recommended its extension and Temporary Recommendations for a further three months through March 2024. The European Centre for Disease Prevention and Control (ECDC) published an interactive map in 2023 displaying countries that continue confirming polio or poliovirus cases. 

The WHO / Pan American Health Organization (PAHO) issued an Epidemiological Update - Poliomyelitis in the Region of the Americas and reported Acute Flaccid Paralysis (AFP) Surveillance in 2023. The PAHO/WHO reminds Member States that the risk of the emergence of a circulating vaccine-derived poliovirus type 1 (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 circulating vaccine-derived poliovirus type 2 (cVDPV2).  Following the cessation of oral polio vaccine 2 (OPV2), cVDPV2 cases peaked in 2020, with over 1,000 cases of paralysis in 24 countries and outnumbering the number of instances of wild-type poliovirus. As of January 2024, 325 cases of cVDPV2 had been reported in 2023, compared to 689 cases in 2022.

The U.S. Centers for Disease Control and Prevention (CDC) issued an updated Global Polio Alert - Level 2, Practice Enhanced Precautions Travel Health Notice on January 5, 2024, regarding polio outbreaks and poliovirus detections in 31 countries. Furthermore, the U.S. was added to a list of countries where polio was identified in 2022. The International Health Regulations classify the USA as a state infected with cVDPV2, with or without evidence of local transmission. It is, therefore, subject to Temporary Recommendations issued by the International Health Regulations Emergency Committee on Polio Eradication (published August 25, 2023).

The Independent Monitoring Board (IMB) presented the 22nd review that concluded on September 13, 2023; despite recent progress toward eradication, remaining challenges make stopping transmission of WPV1 in 2023 unlikely, while ending all variant poliovirus outbreaks will take even more time. In 2023, the Global Polio Eradication Initiative (GPEI) confirmed various countries reported WPV1, cVDPV2, and cVDPV1 cases. The Paris Pact principles combine official development assistance and private investment and support the objective of global polio eradication by 2026. 

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 in 2023 from the province of Nangarhar. Two polio patients were confirmed in 2022, four in 2021, and 56 in 2020.

Africa Polio Outbreaks

The country of Zimbabwe is inoculating more than 4 million children against polio beginning in February 2024 after health authorities detected three polio cases caused by the rare mutation of the weakened virus used in oral vaccines.

With 117 confirmed cases of circulating variant polioviruses and 107 detections in sampled wastewater in the WHO African Region as of July 2023, the Africa Regional Certification Commission (ARCC) has urged countries and health partners to address gaps in polio immunity to avert the outbreak urgently. As of August 2023, more than 670 million doses of the nOPV2 vaccine have been given to children in 31 countries, and crucial campaigns have taken place in Burundi, Cameroon, Chad, and Niger. On July 24, 2023, @WHOAFRO Tweeted that Madagascar launched a polio vaccination campaign to protect over 18 million people.

In February 2023, the UN Foundation published recommendations for governments, the WHO, and UNICEF for polio transition priority countries in Africa. Since then, over 33 million children across five southern African countries have been vaccinated against the virus, with over 80 million vaccihttps://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-10647-6ne doses administered over the past year. In 2021, the median vaccination coverage was 81.5% for the third dose of the polio vaccine. 

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

DAWN reported about 28 environmental samples collected from Pakistan’s 19 districts in 2024/2024 have tested positive for WPV1. In 2023, the total number of WPV1 cases in 2023 remains six. In 2022, 20 WPV1 cases and 20 paralyzed children were reported in the southern KP province.

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 single positive 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.