Travel health tips - polio in Nigeria & Western Africa

12/01/2009's roving medical expert and afficionado of Adventure Travel Health, Dr. Erik McLaughlin MD, suggests that travellers to Nigeria and Western Africa should review their immunization history in light of a recent polio outbreak.

Why should travellers be concerned?

Polio is a viral infection that can cause paralysis and even death. Most developed nations have eliminated polio from within their borders, due to successful vaccination programs. However, developing and poorer nations do not have this luxury and there is a current outbreak of polio in Nigeria and Western Africa. This can pose a risk to travelers, visiting these areas, who are not properly vaccinated.

From 2003 to 2007 a polio outbreak, originating in Nigeria, spread to more than 20 countries and infected over 1,500 people. The majority of these countries were previously considered "polio free". Outbreaks of polio have also been reported in developed nations such as the Netherlands in 1992-93. Only seven countries has endemic polio in 2002: Afghanistan, Egypt, India, Niger, Nigeria, Pakistan and Somalia.

Polio Basics:

A viral infection, most commonly spread by fecal-oral transmission, polio can causes non-specific febrile illness in 90% of infected persons. Roughly 1% of those infected will go on to develop flaccid paralysis, typically of the lower extremities. Polio is a vaccine preventable disease and those who are rendered paralyzed do not regain function of the muscles and nerves involved.

Infectious Agent:

Polio virus is from the genus Enterovirus and has three main types, numbered 1 through 3. All three types of polio can cause paralysis. Type one is most commonly associated with paralysis and is responsible for most epidemics.


Fecal-oral route is most common, spread with dirty hands and unclean water

Polio Vaccines:

There are two main types of vaccines against polio, oral and injectable. IPV (injectable polio vaccine) is now used in most developed nations and requires a total of four injections, typically given in childhood, before the age of 6 years. OPV (oral polio vaccine) is also usually given in childhood, as a multi-dose series. OPV is a live virus and is capable of causing paralytic polio in extremely rare circumstances. Vaccine Acquired Polio (VAP) is associated with impaired immune systems of the vaccine recipient or those who live in close contact with the recipient. Adults who are planning travel to high-risk areas should strongly consider a booster immunization with IPV, prior to travel. This will generally confer lifelong immunity.

This underscores the need for travelers to know their immunization history and keep their records. A large number of immunizations are given in childhood, and that can impact your travels in adulthood.

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Written by's roving medical expert and afficionado of Adventure Travel Health, Dr. Erik McLaughlin MD.

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