原文链接：
http://www.who.int/ith/vaccines/2007_routine_use/en/index11.html
谷歌翻译：
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脊髓灰质炎
疾病
脊髓灰质炎是一种疾病的中枢神经系统所造成的三个密切相关的肠病毒，脊髓灰质炎病毒类型1 ， 2及3 。该病毒的传播主要是由粪便-口腔的路线，虽然罕见的爆发所造成的污染的食物或水有发生。之后，病毒进入口，原发部位的感染是肠，虽然该病毒还可以发现在咽。脊髓灰质炎是也被称为“小儿麻痹” ，因为它最常见的引起的瘫痪在婴幼儿在会前疫苗的时代，在工业化国家。在发展中国家， 60-70 ％的病例，目前发生在儿童3岁以下和90 ％的儿童在5岁以下。由此造成的瘫痪是永久性的，虽然有些功能恢复是可能的。有没有治愈。
发生
已取得重大进展对全球根除小儿麻痹症。超过125个国家流行脊髓灰质炎在1988年到2006年，只有四个国家-阿富汗，印度，尼日利亚和巴基斯坦（见地图） ，其中野生脊髓灰质炎病毒传播从未中断-仍是风土病。一些以前无脊髓灰质炎的国家已受到野生病毒输入已导致在随后的爆发，例如纳米比亚-流行的国家，为游客-在2 0 06年夏天。直到所有的国家都终止野生脊髓灰质炎病毒传播，所有地区仍然是高风险的进口，甚至重新建立的地方性传播。
风险，为旅客
后果脊髓灰质炎感染是危及生命或瘫痪。感染和瘫痪，可能会发生在非免疫的个人和是绝不限于婴儿。受感染的旅客烈性载体传输和可能的恢复，该病毒到了无脊髓灰质炎区，现在世界各地的贫穷是附近。直到疾病已认证为消除全球范围内，风险获取脊髓灰质炎（为旅客受感染的地区） ，以及转口感染无脊髓灰质炎的地区（旅客所携带的来自疫区的） ，依然存在。旅客和从流行的国家，应该得到充分的保护，注射疫苗。
疫苗
所有旅客和从脊髓灰质炎感染的地区，应直至目前为止，与疫苗接种脊髓灰质炎根据国家免疫政策。有两种类型的疫苗：灭活（ ipv ） ，这是给予注射，口服（口服脊髓灰质炎疫苗） 。口服脊髓灰质炎疫苗组成的三种类型的活减毒的脊髓灰质炎病毒。由于成本低和易于管理的疫苗和优势，赋予肠道免疫功能，口服脊髓灰质炎疫苗一直是疫苗的选择，控制脊髓灰质炎疫情在许多国家。在极少数情况下（ 2-4案件每100万，每年出生的婴儿）口服脊髓灰质炎疫苗的原因疫苗相关麻痹性脊髓灰质炎（ vapp ） 。风险vapp高与第一剂口服脊髓灰质炎疫苗比与随后的剂量。 vapp是较为常见的在个人谁是免疫功能低下，为谁ipv是疫苗的选择。
大多数工业化国家使用ipv ，无论是作为唯一的脊髓灰质炎疫苗，或在附表结合口服脊髓灰质炎疫苗。虽然ipv抑制咽排泄的野生脊髓灰质炎病毒，这种疫苗仅提供有限度的影响在减少肠道排泄的脊髓灰质炎病毒。为unvaccinated年龄较大的儿童和成人，第二剂是由于1-2个月，第三次6-12个月后，首次剂量。一支强心针，剂量是建议后4-6年。 ipv亦是疫苗的选择，为旅客没有历史的口服脊髓灰质炎疫苗的使用，以及为免疫功能低下的个人和他们的接触和家庭成员。
对于那些谁已收到三个或更多剂量的口服脊髓灰质炎疫苗，在过去，可取的做法是提供另一种剂量脊髓灰质炎疫苗作为一个曾经只有大剂量那些前往流行地区的世界。任何unimmunized个人有意前往这些地区需要一个完整的过程中的疫苗。国家不同，在推荐ipv或口服脊髓灰质炎疫苗，在这种情况下：利用ipv ，就是任何的风险vapp是可以避免的，但这种疫苗是更加昂贵，并且可能无法防止粪便排泄病毒。
在以限制的进一步国际传播野生脊髓灰质炎病毒，以无脊髓灰质炎的地区，旅客从受感染的国家或地区应该有一个充分的过程中对脊髓灰质炎疫苗接种前离开他们居住的国家，最低一剂量的口服脊髓灰质炎疫苗之前离境。一些无脊髓灰质炎的国家也可能要求旅客从流行国家要接种了预防脊髓灰质炎疫苗，以取得入境签证。
Poliomyelitis
Disease
Poliomyelitis is a disease of the central nervous system caused by three closely related enteroviruses, poliovirus types 1, 2 and 3. The virus is spread predominantly by the faecal–oral route, although rare outbreaks caused by contaminated food or water have occurred. After the virus enters the mouth, the primary site of infection is the intestine, although the virus can also be found in the pharynx. Poliomyelitis is also known as “infantile paralysis” because it most frequently caused paralysis in infants and young children in the pre-vaccine era in industrialized countries. In developing countries, 60–70% of cases currently occur in children under 3 years of age and 90% in children under 5 years of age. The resulting paralysis is permanent, although some recovery of function is possible. There is no cure.
Occurrence
Significant progress has been made towards global eradication of poliomyelitis. More than 125 countries were endemic for polio in 1988; by 2006, only four countries – Afghanistan, India, Nigeria and Pakistan (see map), where wild poliovirus transmission has never been interrupted – remained endemic. A number of previously polio-free countries have been affected by wild-virus importation that has resulted in subsequent outbreaks, e.g. Namibia – a popular country for tourists – in the summer of 2006. Until all countries have stopped wild poliovirus transmission, all areas remain at high risk of importations and even of the re-establishment of endemic transmission.
Risk for travellers
The consequences of polio infection are life-threatening or crippling. Infection and paralysis may occur in non-immune individuals and are by no means confined to infants. Infected travellers are potent vectors for transmission and possible reintroduction of the virus into polio-free zones, now that worldwide eradication is near. Until the disease has been certified as eradicated globally, the risks of acquiring polio (for travellers to infected areas), and of re-infection of polio-free areas (by travellers from infected areas), remain. Travellers to and from endemic countries should be fully protected by vaccination.
Vaccine
All travellers to and from polio-infected areas should be up to date with vaccination against poliomyelitis according to national immunization policy. There are two types of vaccine: inactivated (IPV), which is given by injection, and oral (OPV). OPV is composed of the three types of live attenuated polioviruses. Because of the low cost and ease of administration of the vaccine and its superiority in conferring intestinal immunity, OPV has been the vaccine of choice for controlling epidemic poliomyelitis in many countries. On very rare occasions (2–4 cases per million births per year) OPV causes vaccine-associated paralytic poliomyelitis (VAPP). The risk of VAPP is higher with the first dose of OPV than with subsequent doses. VAPP is more common in individuals who are immunocompromised, for whom IPV is the vaccine of choice.
Most industrialized countries use IPV, either as the sole vaccine against poliomyelitis or in schedules combined with OPV. Although IPV suppresses pharyngeal excretion of wild poliovirus, this vaccine has only limited effects in reducing intestinal excretion of poliovirus. For unvaccinated older children and adults, the second dose is given 1–2 months, and the third 6–12 months, after the first dose. A booster dose is recommended after 4–6 years. IPV is also the vaccine of choice for travellers with no history of OPV use, as well as for immunocompromised individuals and their contacts and family members.
For those who have received three or more doses of OPV in the past, it is advisable to offer another dose of polio vaccine as a once-only dose to those travelling to endemic areas of the world. Any unimmunized individuals intending to travel to such areas require a complete course of vaccine. Countries differ in recommending IPV or OPV in these circumstances: the advantage of IPV is that any risk of VAPP is avoided, but this vaccine is more expensive and may not prevent faecal excretion of the virus.
In order to limit further international spread of wild poliovirus to polio-free areas, travellers from an infected country or area should have a full course of vaccination against polio before leaving their country of residence, with a minimum one dose of OPV before departure. Some polio-free countries may also require travellers from endemic countries to be immunized against polio in order to obtain an entry visa..
