CDC issues polio Level 2 advisory

The Centers for Disease Control and Prevention has a Level 2 travel health notice in place for global polio, telling travelers to “practice enhanced precautions” before visiting countries with recent poliovirus detections. The notice, updated regularly and still posted on the CDC’s Travelers’ Health site as of May 15, says the list is based on countries that detected poliovirus in people or environmental samples in the past 13 months. The agency says travelers should make sure they are up to date on polio vaccination before any international trip. For adults who already completed the routine series, the CDC says a single lifetime booster dose may be considered before travel to a listed destination. ### Which places are on the CDC’s current list? The CDC notice lists 29 destinations with circulating poliovirus: Afghanistan, Algeria, Angola, Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Côte d’Ivoire, Democratic Republic of the Congo, Djibouti, Ethiopia, Gaza, Germany, Guinea, Israel, Laos, Namibia, Niger, Nigeria, Pakistan, Papua New Guinea, Poland, Senegal, Somalia, South Sudan, Sudan, Tanzania, United Kingdom and Yemen. The agency says the list is informed by the latest global epidemiological data and is updated as conditions change. (wwwnc.cdc.gov) March 4 guidance from the World Health Organization’s polio emergency committee described ongoing review of wild poliovirus type 1 and circulating vaccine-derived polioviruses, with technical updates from countries including Afghanistan, Angola, Germany, Laos, Namibia, Pakistan and Papua New Guinea. WHO said its latest review came as the global program aims to interrupt endemic wild poliovirus transmission in 2026 and stop cVDPV2 outbreaks by 2028. (wwwnc.cdc.gov) ### Why is Europe on a polio notice if polio was largely eliminated there? The CDC says its travel notice covers countries that found poliovirus either in humans or in environmental samples such as sewage within the last 13 months. That means a country can appear on the list even without a large outbreak of paralytic disease, because the notice tracks circulation, not only confirmed illness. (who.int) WHO’s March 4 statement said Germany had one wild poliovirus type 1-positive environmental sample reported in 2025. The CDC’s list also includes the United Kingdom and Poland, reflecting the agency’s use of recent detection data rather than a narrower count of clinical cases alone. ### What is the CDC telling adult travelers to do before departure? CDC vaccination guidance says adults who were never vaccinated should complete a three-dose primary series. (wwwnc.cdc.gov) Adults who started but did not finish vaccination should get the remaining doses before departure. Adults who are fully vaccinated and traveling to a country with increased risk of exposure may receive a one-time booster dose of inactivated polio vaccine, according to the agency. The CDC also says some countries may require proof of polio vaccination on the yellow International Certificate of Vaccination or Prophylaxis when a traveler leaves that country. That requirement depends on the destination’s rules, so the agency directs travelers to country-specific pages and current travel notices before departure. ### What about children and families leaving for summer trips? (cdc.gov) CDC guidance says U.S. children are routinely vaccinated with four doses of inactivated polio vaccine at ages 2 months, 4 months, 6 to 18 months, and 4 to 6 years. Children traveling to countries where the risk is greater should complete the routine series before departure, the agency says. If there is not enough time, CDC recommends an accelerated schedule starting at 6 weeks of age. (cdc.gov) For families planning international travel, the practical step is to check immunization records early enough to schedule missed doses or a booster discussion with a clinician. The CDC says remaining doses on an accelerated schedule can be given in the visited country or after return if the series cannot be completed before leaving. ### How serious is the disease the notice is trying to prevent? (cdc.gov) The CDC says polio is a crippling and potentially deadly disease that affects the nervous system. Most infected people do not feel sick, the agency says, but some have fever, fatigue, nausea, headache, congestion, sore throat, cough, neck and back stiffness, or pain in the arms and legs. In rare cases, infection causes paralysis, and it can be fatal if breathing muscles are affected. (cdc.gov) WHO said on March 4 that nine new wild poliovirus type 1 cases had been reported since its previous emergency committee meeting, with five in Afghanistan and four in Pakistan. WHO also reported 673 WPV1-positive environmental samples in 2025 to date, including 608 from Pakistan, 64 from Afghanistan and one from Germany. ### Where should travelers look before they book or board? (wwwnc.cdc.gov) The CDC’s Travelers’ Health notice for global polio is updated regularly, and the agency links travelers to country pages that carry the same Level 2 flag where applicable. The CDC’s separate vaccination page says travelers should review recommendations before departure and speak with a healthcare provider about incomplete vaccination or eligibility for a one-time adult booster. As of May 15, the CDC notice remains active on its Travelers’ Health site, which is the agency’s main page for future updates. (who.int) (wwwnc.cdc.gov)