ISLAMABAD - After being slapped with recommendation of travel restrictions by the World Health Organisation (WHO), Pakistani government has woken up to the threat and taking special measures to contain the poliovirus.

Country’s failure to stem the spread of polio triggered global emergency health measures on Monday, with the WHO recommending all residents must show proof of vaccination before they can leave the country.

The travel restrictions also apply to Syria and Cameroon, which along with Pakistan are seen as posing the greatest risk of exporting the crippling virus and undermining a UN plan to eradicate it by 2018. The emergency measures came on the recommendation of the International Health Emergency Committee held in Geneva.

Being one of the three states currently exporting poliovirus the travellers from Pakistan will have to produce International Certificate of Vaccination or Prophylaxis of previous 4 weeks to 12 months to serve as proof of vaccination. Earlier, India had imposed restrictions on Pakistani travellers for being one the three polio endemic countries.

The WHO recommendations call upon Pakistan to ensure that those undertaking urgent travel within 4 weeks, who have not received a dose of Oral Polio Vaccine (OPV) or inactivated poliovirus vaccine (IPV) in the previous four weeks to 12 months, receive a dose of polio vaccine at least by the time of departure as this will still be beneficial, particularly for frequent travellers.

In the wake of polio related travel restrictions recommended by the Emergency Committee, Minister of National Health Services, Regulations and Coordination Saira Afzal Tarar has convened emergency meeting of all provincial ministers tomorrow (Wednesday) to discuss the introduction of special measures to allay concerns of the international community and prevent of exportation of poliovirus from Pakistan.

According to officials, special measures will include establishing mandatory immunisation counters on all airports, borders crossings and seaports for all travellers. And for this, airport/port health officers across the country working under the ministry would be tasked to ensure the availability of vaccine and health personnel to administer the vaccine. Directions will be issued to Expanded Programme on Immunisation manager to ensure uninterrupted availability of vaccines at the airports/seaports.

“We were not expecting such restrictions but since the meetings of the International Health Regulations Emergency Committee were going on and the officials representing Pakistan faced lot of pressure, we had sensed that the body might recommend some strict measures owing to international pressure,” maintained Minister Saira Afzal.

“The best option would be vaccinating the passengers at the airport departure where polio vaccination cards would be issued to the passengers. Human resource and vaccines would have to be worked out for the purpose,” the minister said. “It would be most practical as people often have to fly in emergencies.”

Since health is a provincial subject so all the provinces would have to take decisions with mutual consensus to deal with the situation for which a special meeting had been called this week to decide on special measures, she said.

Pakistan is in the spotlight as the only country with endemic polio that saw cases rise last year. Its caseload rose to 93 from 58 in 2012, accounting for more than a fifth of the 417 cases globally in 2013. In first four months of 2014 the country has reported 59 cases, the highest number of polio cases reported in quarter of a year since 2000. Of these, 46 were reporter from Federally Administered Tribal Areas, 9 from Khyber Pakhtunkhwa and 4 from Sindh.

According to WHO officials, though the country has escaped a complete travel ban and internal travel restrictions but if the country fails to implement the recommended measures it may draw the wrath of the international health agency.

The Emergency Committee convened by the WHO Director-General Dr Margaret Chan under the IHR was held by teleconference on April 28-29 in Geneva. Members of the committee and expert advisors met on both days of the meeting and discussed the situation with the representatives of the affected states including Afghanistan, Cameroon, Equatorial Guinea, Ethiopia, Israel, Nigeria, Pakistan, Somalia and the Syrian Arab Republic.

The Emergency Committee stated that Pakistan, Cameroon, and the Syrian Arab Republic pose the greatest risk of further wild poliovirus exportations in 2014. These three countries will be monitored for six months and if they continue to export the virus and fail to initiate high quality eradication activities in all infected and high risk areas, the recommended measures could be maintained for next 12 months. It has also recommended these states to officially declare, if not already done, at the level of head of state or government, that the interruption of poliovirus transmission is a national public health emergency.

During the 2014 low transmission season there has already been international spread of wild poliovirus from 3 of the 10 states that are currently infected: in central Asia (from Pakistan to Afghanistan), in the Middle East (Syrian Arab Republic to Iraq) and in Central Africa (Cameroon to Equatorial Guinea), said the WHO statement.

The overriding priority for all polio-infected states must be to interrupt wild poliovirus transmission within their borders as rapidly as possible through the immediate and full application in all geographic areas of the polio eradication strategies, specifically: supplementary immunisation campaigns with oral poliovirus vaccine (OPV), surveillance for poliovirus, and routine immunisation, emphasised the statement.