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Monthly Board Report - February 2001
Outbreak of Poliomyelitis in Dominican Republic & Haiti
Adapted from a notice written by Monika Naus, MD, MHSc, FRCPC, FACPM, Physician Manager and Provincial Epidemiologist, Communicable Diseases, Disease Control Service, Public Health Branch of the Ministry of Health and Long Term Care, December 6, 2000
An outbreak of poliomyelitis in the Dominican Republic and Haiti has raised concerns here in Ontario, as these are popular vacation destinations for people in Ontario, particularly in winter. The Americas have been certified polio-free since 1994, however, most countries have continued to ensure high coverage with at least three doses of polio vaccine to prevent resurgence of the disease in case of an importation. Global efforts to eradicate polio have been progressing although a strain of wild polio remains endemic in about 30 countries worldwide.
Vaccination levels in the Dominican Republic and Haiti fell in the late 1990’s this has been a factor in the current outbreak. To date, four laboratory confirmed cases have been identified and an additional 16 cases of paralysis are under investigation. The cases identified so far have resided in the central part of the country, not in the coastal areas (personal communication Dr. Ron St. John, Health Canada). Both the Dominican Republic and Haiti have started a mass vaccination campaign with oral polio vaccine to control this outbreak.
With respect to travel health advice provided through our local health departments, travelers should be assessed for their vaccination status and those who are not adequately immunized must be considered at risk of acquiring poliomyelitis if traveling to the Dominican Republic or Haiti. For unvaccinated adults, primary immunization with IPV (injectable polio vaccine) is recommended according to the schedule in the Canadian Immunization Guide (5th edition, 1998). For those adults who are fully immunized, a single booster dose of IPV might be considered for persons believed to be at increased risk of exposure because of their itinerary in these countries.
For more information, please see the Health Canada travel medicine web site:
http://www.hc-sc.gc.ca/hpb/lcdc/osh/polio_drh_e.html
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