MEMO: Polio

TO: Health care professionals in the Niagara region

FROM: Vaccine Preventable Disease (VPD) program, Niagara Region Public Health

REFERENCE: Polio

DATE: August 30, 2022

Polio, or poliomyelitis, is a contagious infectious disease caused by the poliovirus. It is transmitted from person to person mainly by contact with secretions or feces of an infected person. Due to vaccination efforts, Canada has been polio free since 1994.

A case of polio was identified in Rockland Country, New York a month ago. Wastewater surveillance in Rockland County also detected poliovirus in samples, though no other cases have been identified to date. The poliovirus detected in this case was vaccine-derived, meaning that it was caused by a weakened but live poliovirus in oral polio vaccine (OPV) that has mutated and been able to spread to unvaccinated individuals. OPV is no longer used in Canada; since 1996, polio vaccination in Canada has relied on inactivated polio vaccine (IPV). Vaccine-derived polioviruses are generally less virulent than wild-type poliovirus. Only two countries in the world still have endemic wild-type poliovirus: Afghanistan and Pakistan.

The risk to the Canadian public from polio remains very low at this time.

Health Care Provider Action

Though the risk is low, Niagara Region Public Health encourages residents to stay up-to-date with vaccinations. For polio, a person is considered up-to-date if they had three doses of polio-containing vaccine, with at least one dose administered over the age of four years (provided at the correct intervals). If a person has received a full primary series, they do not require booster doses.

Patients 18 years of age and older who are up-to-date with their vaccinations and traveling to high-risk areas where poliovirus is known or suspected to be circulating are eligible to receive a single lifetime booster dose, as per Ontario’s Publicly Funded Immunization Schedules.

Refer to the Committee to Advise on Tropical Medicine and Travel (CATMAT) and the World Health Organization’s map of Global Polio Cases to assess risk. Note that the United States is not currently considered a high-risk country for polio.
Select the most appropriate vaccine (i.e., IPV or Tdap-IPV), based on the patient’s vaccination status
If a patient meets the high-risk criteria for IPV eligibility (page 8 of Ontario’s Publicly Funded Immunization Schedules), complete and submit the General Vaccine Order Form to Public Health. If your patient requires further travel vaccine consultation, refer them to a travel medicine clinic.

As a reminder, polio is a designated Disease of Public Health Significance (DOPHS) under the Health Protection and Promotion Act (HPPA). To report a DOPHS, contact the Infectious Disease Program:

905-688-8248 at ext. 7330 or
Toll free at 1-888-505-6074
Emergency after-hours: 905-984-3690

For More Information

Call the Vaccine Preventable Disease program at 905-688-8248 or 1-888-505-6074 ext. 7396.
Poliomyelitis vaccine: Canadian Immunization Guide - Canada.ca
Appendix 1 - Case Definitions and Disease-Specific Information: Poliomyelitis, Acute - Ministry of Health
Poliomyelitis (Polio): For health Professionals - Government of Canada