The European region was declared polio-free in June 2002. While there have been no cases of polio in humans, the detection of the poliovirus in wastewater samples in several European countries highlights the importance of maintaining high vaccination rates and high quality surveillance.
Thanks to vaccination, global rates of polio – which can cause paralysis, breathing difficulties and sometimes death – have fallen by 99% over the past thirty years. The disease is now ‘endemic’ in just two countries: Afghanistan and Pakistan. This means the disease continues to occur in those countries, threatening a worldwide push to end polio.
The immediate risk of a polio outbreak in Europe is considered to be low, but experts warn against complacency. Between September and December 2024, Finland, Germany, Poland, Spain and the United Kingdom reported detections of circulating vaccine-derived poliovirus type 2 (cVDPV2) in sewage samples. This is the first time cVDPV2 has been detected in EU/EEA countries from environmental surveillance, the European Centre for Disease Prevention and Control (ECDC) said last week.
‘Europe has been polio-free for more than 20 years. We have to remain vigilant, maintain high vaccination rates and close any vaccination gaps that exist to prevent any return of this serious disease,” said Pamela Rendi-Wagner, ECDC Director.
Although the majority of EU/EEA countries report vaccination coverage above 90% at the national level, local and regional data show lower rates in some areas. Only 39% of reporting districts reached 90% vaccination coverage. According to ECDC estimates, around 600,000 children aged 12–23 months may not have received a full primary polio vaccination course in 2022 and 2023.The ECDC is calling for immunisation catch-up campaigns targeting individuals with incomplete or unknown vaccination status, particularly in areas of low coverage or where environmental sampling has detected the virus. Additionally, authorities are advised to maintain adequate stocks of inactivated polio vaccine (IPV).
In November, the World Health Organization (WHO) European office specified that areas reporting poliovirus in wastewater samples include Barcelona, Warsaw, Cologne, Bonn, Hamburg and Munich. In December, Finnish authorities said the virus was reported in the Tampere region. In the UK, London, Leeds and Worthing have detected poliovirus.
The detected virus is genetically linked to a strain that emerged in Nigeria and is circulating in north and west Africa.
Robb Butler, Director of the Division of Communicable Diseases, Environment and Health at WHO/Europe said the countries that detected and reported poliovirus should be commended for their vigilance.
‘WHO continues to support national and local public health authorities in their investigations and monitoring of the situation, including identification of any potential subnational immunity gaps that may need to be addressed,’ he added. ‘Vaccination of every vulnerable child is essential to ensure that the virus cannot lead to lifelong paralysis or even death.’
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