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Public Health Dispatch: Outbreak of Poliomyelitis --- Dominican Republic and Haiti, 2000--2001

During July 12, 2000--February 8, 2001, 12 laboratory-confirmed poliomyelitis cases attributed to vaccine-derived poliovirus type 1 were identified in the Dominican Republic (1). Of these, 11 (92%) case-patients were aged <6 years (range: 9 months--14 years), and the date of paralysis onset of the last case was January 2, 2001. All case-patients were inadequately vaccinated or unvaccinated. In Haiti, one confirmed polio case attributed to vaccine-derived type 1 poliovirus was reported in an unvaccinated child aged 2 years with paralysis onset on August 30, 2000. As of February 21, 33 acute flaccid paralysis (AFP) cases from the Dominican Republic and three AFP cases from Haiti were pending final classification.

Extensive control efforts are under way. The Dominican Republic held nationwide mass vaccination campaigns with oral poliovirus vaccine (OPV) in December 2000 and February 2001, with a third round planned for April 2001. All children aged <5 years are being targeted, with approximately 1.2 million OPV doses given in the first campaign. AFP surveillance has been strengthened with intensification of active case-finding and weekly reporting. Haiti has initiated regional OPV campaigns to be conducted approximately every 2 months.

Travelers to the Dominican Republic and Haiti who are not vaccinated adequately are at risk for polio. All travelers should be vaccinated against polio according to national vaccination policies (2)*.

Reported by: Ministry of Health, Pan American Health Organization, Santo Domingo, Dominican Republic. Ministry of Health, Pan American Health Organization, Port-au-Prince, Haiti. Caribbean Epidemiology Center Laboratory, Pan American Health Organization, Trinidad and Tobago. Div of Vaccines and Immunization, Pan American Health Organization, Washington, DC. Respiratory and Enteric Viruses Br, Div of Viral and Rickettsial Diseases, National Center for Infectious Diseases; Vaccine Preventable Disease Eradication Div, National Immunization Program, CDC.

References

  1. CDC. Outbreak of poliomyelitis---Dominican Republic and Haiti, 2000. MMWR 2000;49:1094--103.
  2. CDC. Poliomyelitis prevention in the United States: updated recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2000;49(no. RR-5).

* Recommendations for children in the United States include a 4-dose vaccination series with inactivated poliovirus vaccine (IPV) at ages 2, 4, 6--18 months, and 4--6 years. Unvaccinated adults should receive three doses of IPV, the first two doses at intervals of 4--8 weeks and the third dose 6--12 months after the second. If three doses cannot be administered within the recommended intervals before protection is needed, alternative schedules are proposed. For incompletely vaccinated persons, additional IPV doses are recommended to complete a series. Booster doses of IPV may be considered for persons who previously have completed a primary series of polio vaccination and who may be traveling to areas where polio is endemic.



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