To the Editor: In July 2007, an Australian traveler imported polio from Pakistan to Australia (1). He was a 22-year-old man who had im-migrated to Australia and had traveled to his country of origin (Pakistan) to visit friends and relatives. Pakistan is one of 4 countries (Afghanistan, In-dia, Nigeria, Pakistan) where polio is still endemic. A diagnosis of polio was made shortly after his return to Aus-tralia. Australia was certifi ed as polio-free in 2000. Australia will not be the last industrialized country affected by importation of polio. All countries are at risk until polio has been completely eradicated.Between 2003 and 2006, polio was imported by travelers (e.g., refu-gees, pilgrims, traders) to 24 polio-free countries (2). The origin of these im-portations was largely the 4 countries where polio transmission was never completely interrupted. The importa-tions resulted in about 1,400 second-ary cases (2). The resurgence of polio by international spread was a setback to the Global Polio Eradication Initia-tive that had successfully decreased the number of polio-affected countries to only 9 in 2002.The revised International Health Regulations, IHR (2005) (3), entered into legal force on June 15, 2007. These regulations provide the legal framework for coordination of the international effort to reduce or pre-vent international spread of diseases of public health concern. IHR (2005) (2) lists polio as one of the diseases of public health emergencies of interna-tional concern. Preventing importa-tion of polio into polio-free countries is therefore a test case for the revised International Health Regulations (4). Compared to the previous IHR (1969), IHR (2005) has moved away from the defi nition of fi xed maximum mea-sures relating to specifi c diseases and instead focuses on the issuance of con-text-specifi c recommendations, made either on a temporary emergency ba-sis (a temporary recommendation) or routinely for established ongoing risks of disease spread (a standing recom-mendation).
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