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SUBJ/(U) USINDOPACOM FORCE HEALTH PROTECTION FOR POLIO IN PAPUA NEW GUINEA (PNG) 

PAAUZYUW RUICAAA4649 2850425-UUUU--RUICAAA.

ZNR UUUUU ZDH ZUI RUEOMCG4065 2850427

REF/A/DOD/DOC/09 OCT 2004// 

REF/B/USINDOPACOM/MSG/260322Z SEP 2018// 

REF/C/DOD/DOC/28 DEC 2009//

REF/D/DOD/DOC/08 FEB 2012//

REF/E/DOD/DOC/ 17 JUL 2017//

NARR/REF A IS DODD 6200.04 "FORCE HEALTH PROTECTION" OF 09 OCT 2004 CERTIFIED CURRENT AS 

OF 23 APR 2007. REF B IS “USINDOPACOM FY19 FORCE HEALTH PROTECTION GUIDANCE FOR 

USINDOPACOM AOR” MESSAGE OF 26 SEP 2018. REF C IS DODD 4500.54E “DOD FOREIGN CLEARANCE 

PROGRAM” OF 28 DEC 2009 INCORPORATING CHANGE 1 EFFECTIVE 24 MAY 2017. REF D IS DODD 
UNCLASSIFIED 

UNCLASSIFIED 2

6490.02E “COMPREHENSIVE HEALTH SURVEILLANCE” OF 08 FEB 2012 INCORPORATING CHANGE 2

EFFECTIVE 28 AUGUST, 2017. REF E IS “ARMED FORCES REPORTABLE MEDICAL EVENTS GUIDELINES AND 

CASE DEFINITIONS” OF 17 JUL 2017 AVAILABLE AT: HTTPS: (DOUBLE

SLASH)HEALTH.MIL/REFERENCE-CENTER/PUBLICATIONS/2017/07/17/ARMED-FORCES-REPORTABLEMEDICAL-EVENTS-GUIDELINES. 

1. (U) THIS MESSAGE IS FOR ALL FORCES LOCATED WITHIN THE USINDOPACOM AREA OF 

RESPONSIBILITY (AOR). PER REFERENCES (A) THROUGH (C), SERVICE MEMBERS MUST COMPLY WITH ALL 

DOD TRAVEL GUIDANCE. THE U.S. CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) ASSIGNED 

ALERT LEVEL 2 "PRACTICE ENHANCED PRECAUTIONS" STATUS AND ISSUED A TRAVEL NOTICE RELATING 

TO THE POLIO OUTBREAK IN PAPUA NEW GUINEA (PNG) AT HTTPS:(DOUBLE

SLASH)WWWNC.CDC.GOV/TRAVEL/NOTICES/ALERT/POLIO-PAPUA-NEW-GUINEA. THE CDC ISSUED THIS 

NOTICE DUE TO THE ONGOING OUTBREAK CAUSED BY CIRCULATING VACCINE-DERIVED POLIOVIRUS.

2. (U) BACKGROUND: POLIO IS A HIGHLY INFECTIOUS, BUT VACCINE-PREVENTABLE DISEASE THAT 

CAUSES SEVERE PARALYSIS. POLIO IS SPREAD BY CONSUMING FOOD OR WATER THAT HAS BEEN 

CONTAMINATED WITH FECES FROM INFECTED INDIVIDUALS. THERE HAVE BEEN NO CASES OF POLIO IN 

THE UNITED STATES SINCE 1979 DUE TO THE U.S.’S CHILDHOOD VACCINATION PROGRAM AND 

SANITATION INFRASTRUCTURE. AGGRESSIVE GLOBAL IMMUNIZATION CAMPAIGNS HAVE ALMOST 

ERADICATED POLIO FROM THE WORLD. HOWEVER, SOME COUNTRIES USE A LIVE VACCINE WHICH 

POSES A POTENTIAL RISK THAT THE VACCINE CAN MUTATE AND CAUSE DISEASE.

3. (U) RISK ASSESSMENT/OUTBREAK: AS OF 16 OCTOBER, PAPUA NEW GUINEA’S NATIONAL 

DEPARTMENT OF HEALTH HAS REPORTED A TOTAL OF EIGHTEEN (18) CASES OF POLIO SINCE APRIL 

2018. THESE CASES HAVE OCCURRED THROUGHOUT THE COUNTRY TO INCLUDE THE PNG HIGHLANDS 

AND THE CAPITOL, PORT MORESBY. THIS OUTBREAK REFLECTS THE SUB-STANDARD WATER AND 

SANITATION PRACTICES AND THE POOR IMMUNIZATION RATES FOR THEIR LOCAL POPULATION. IN 

JULY, THE CDC AND WORLD HEALTH ORGANIZATION (WHO) RELEASED TRAVEL NOTICES ADVISING THAT 

TRAVELERS SHOULD BE ADEQUATELY PROTECTED AND IMMUNIZED AGAINST POLIO. IN RESPONSE TO 

THIS OUTBREAK, PNG HAS LAUNCHED A LARGE-SCALE IMMUNIZATION CAMPAIGN. 

4. (U) PREVENTION: THE MOST EFFECTIVE WAY TO PREVENT INFECTION IS TO ENSURE ALL TRAVELERS 

TO PNG ARE ADEQUATELY VACCINATED. CDC RELEASED UPDATED COUNTRY-SPECIFIC 

RECOMMENDATIONS FOR SHORT- AND LONG-TERM TRAVELERS IN JULY 2018 WHICH IS LOCATED AT: 

HTTPS://WWWNC.CDC.GOV/TRAVEL/NEWS-ANNOUNCEMENTS/POLIO-GUIDANCE-NEWREQUIREMENTS. 

4.A. (U) CDC RECOMMENDS ALL TRAVELERS TO PNG BE FULLY VACCINATED AGAINST POLIO WITH TWO 

VACCINE DOSES DURING CHILDHOOD. ADULTS WHO HAVE BEEN FULLY VACCINATED AND ARE SHORTTERM TRAVELERS TO PNG (LESS THAN 4 WEEKS), SHOULD RECEIVE A SINGLE LIFETIME ADULT BOOSTER 

DOSE OF POLIO VACCINE (FOR A TOTAL OF 3 LIFETIME DOSES). DOD SERVICE MEMBERS SHALL HAVE 

THEIR MEDICAL/IMMUNIZATION RECORDS REVIEWED TO ENSURE AT LEAST 1 POLIO SHOT HAS BEEN 

ADMINISTERED (AND RECORDED) DURING THEIR ADULTHOOD.

4.B (U) LONG-TERM TRAVELERS TO PNG (4 WEEKS OR MORE), SHALL OBTAIN A POLIO IMMUNIZATION 

PRIOR TO ARRIVING IN COUNTRY (REGARDLESS OF THE NUMBER OF PREVIOUS VACCINES), TO COMPLY 

WITH CDC AND WHO GUIDANCE. THIS WILL ENSURE THAT TRAVELERS HAVE ADEQUATE PROTECTION 

WHILE IN COUNTRY AND WILL ENSURE THAT THEY DO NOT EXPORT POLIO UPON THEIR DEPARTURE. 

PROOF OF POLIO VACCINE ADMINISTRATION WITHIN THE PREVIOUS 12 MONTHS MAY BE REQUIRED 

WHEN DEPARTING FROM THE POLIO-AFFECTED COUNTRY. 

4.C (U) TRAVELERS WHO ARE UNCERTAIN AS TO THE EXPECTED DURATION OF THEIR STAY IN PNG SHALL 

COMPLY WITH PARAGRAPH 4B AND RECEIVE A POLIO IMMUNIZATION PRIOR TO ARRIVAL IN PNG.

4.D (U) BOTH SHORT- AND LONG-TERM TRAVELERS TO PNG SHALL HAVE POLIO VACCINATION HISTORY 

DOCUMENTED ON THE CDC YELLOW CARD (CDC FORM 731). THE CDC YELLOW CARD IS THE ONLY 
UNCLASSIFIED 

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AUTHORIZED AND INTERNATIONALLY-RECOGNIZED DOCUMENTATION. CLINICS CAN OBTAIN CDC 

YELLOW CARDS (FORM 731) FROM THE U.S. GOVERNMENT PRINTING OFFICE 

(HTTP:(DOUBLESLASH)BOOKSTORE.GPO.GOV). 

5. (U) COMMANDERS WILL ENSURE SERVICE MEMBERS AND DOD CIVILIANS TRAVELING TO PNG, 

WHETHER ON DUTY OR IN A LEAVE STATUS, ARE AWARE OF THESE TRAVEL NOTICES AND ARE 

COMPLIANT WITH ALL FORCE HEALTH PROTECTION RECOMMENDATIONS. IN ANTICIPATION OF 

MILITARY MISSIONS IN SUPPORT OF ASIA-PACIFIC ECONOMIC COOPERATION (APEC) FORUM TO BE 

HELD IN NOVEMBER 2018, MISSION PLANNERS NEED TO IDENTIFY WHICH UNITS/MISSIONS MAY BE IN 

COUNTRY MORE THAN 4 WEEKS AND BE AWARE THAT CIRCUMSTANCES REQUIRING POLIO 

VACCINATION AND DOCUMENTATION MAY CHANGE IF THE POLIO SITUATION WORSENS. 

6. (U) EVOLVING THREAT: THE POLIO THREAT IN PNG IS EVOLVING AND PREDICTED TO REMAIN A 

CONCERN FOR THE FORESEEABLE FUTURE. BE AWARE THAT CIRCUMSTANCES REQUIRING POLIO 

VACCINATION AND DOCUMENTATION MAY CHANGE IF THE POLIO SITUATION WORSENS. 

7. (U) REPORTING: REF (D) MANDATES THE REPORTING OF SIGNIFICANT INFECTIOUS DISEASES. CASE 

DEFINITIONS AND REPORTING INSTRUCTIONS ARE LOCATED IN REF (E).

8. (U) PUBLIC AFFAIRS GUIDANCE: THE PA POSTURE IS RESPONSE TO QUERY. THE CDC HAS THE OVERALL 

LEAD FOR COMMUNICATIONS REGARDING POLIO. MEDIA AND GENERAL INQUIRIES ABOUT THIS 

MESSAGE SHOULD BE DIRECTED TO USINDOPACOM PUBLIC AFFAIRS AT 808-477-1342.

9. (U) THIS MESSAGE MAY BE MODIFIED AS INFORMATION BECOMES AVAILABLE.

10. (U) POC, INDOPACOM SURGEONS OFFICE, JOC-MED.PACOM(AT)NAVY.MIL; 808-477-7885.

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Received from AUTODIN 260003Z Oct 18

Classification: UNCLASSIFIED