As WHO assesses risk of poliovirus transmission within Philippines to be high, Taiwan CDC urges travelers intending to visit Philippines to confirm completion of routine polio vaccination prior to their trips

Since the Philippines declared a polio outbreak on September 19, 2019, a cumulative total of 3 confirmed polio cases have been reported to date and all 3 cases were caused by vaccine-derived poliovirus type 2 (VDPV2) and developed acute flaccid paralysis.  All 3 cases had not received polio vaccines. The Philippines had reported low routine polio vaccination coverage with an average of only 66%. On October 25, 2019, the World Health Organization (WHO) reported that the Philippines had been assessed as high-risk for local poliovirus transmission, moderate-risk for regional poliovirus transmission, and low-risk for global poliovirus transmission. The Taiwan Centers for Disease Control (Taiwan CDC) pointed out that although Taiwan was certified polio-free by WHO in 2000, due to frequent international exchanges and travel, permanent residents in polio-affected areas and travelers planning to visit affected areas are urged to confirm the completion of routine polio vaccination in order to prevent the risk of importing poliovirus. 

According to Taiwan CDC, on September 16, 2019, the first case was confirmed in a 3-year-old girl from Lanao del Sur in the southern Philippines. On September 20, the second case was confirmed in a 5-year-old boy from Laguna Province in the northern Philippines. Recently, on October 24, the third case was confirmed in a 4-year-old girl from Maguindanao, Mindanao. The third case’s virus strain is similar to the first case’s. The Philippines began vaccinating children under 5 years old against poliovirus in October and would implement subsequent vaccination campaigns in late November and January next year. 

WHO recommends that all travellers and residents in polio-affected areas be fully vaccinated against polio. Residents (and visitors for more than 4 weeks) from infected areas should receive an additional dose of inactivated polio vaccine (IPV) within 4 weeks to 12 months of travel. In light of the frequent exchanges between the Philippines and Taiwan due to tourism and business, Taiwan CDC has requested the Ministry of Foreign Affairs (MOFA) and the Ministry of Labor (MOL) to assist in the promotion of the WHO’s vaccination recommendation to travelers and migrant workers from the Philippines. In addition, travelers planning to visit the Philippines are urged to ensure they have completed the routine polio vaccination, and children who have not completed the vaccination are advised to postpone travels to the affected areas in order to lower the risk of infection. Currently, the routine 4-dose polio vaccination schedule for the 5-in-1 polio vaccine is recommended at the age of 2, 4, 6, and 18 months. One dose of DTaP-IPV is recommended at the age of 5 years before entering the elementary school.  

Polio is caused by poliovirus, which is spread through infected fecal matter entering the mouth. Virus can be detectable in pharyngeal secretions of the infected individual from 36 hours to approximately 1 week of exposure to the virus and in feces of the infected individual from 72 hours to 3-6 or more weeks of exposure to the virus. More than 90% of the infected individuals develop nonspecific symptoms or are asymptomatic. Few patients experience mild symptoms such as fever, headache, fatigue, nausea and vomiting. 1 to 2% of the patients develop aseptic meningitis. Less than 1% of the patients develop paralysis. Nevertheless, polio can be effectively prevented through vaccination. For more information, please visit the Taiwan CDC website at or call the toll-free Communicable Disease Reporting and Consultation Hotline, 1922 (or 0800-001922).