The CDC has updated its global travel advisory for polio, urging Americans to take additional precautions when visiting more than two dozen countries.
The agency revised its Level 2 travel notices for 29 nations, including the European destinations Germany and the United Kingdom. Travelers to these countries are advised to “practice enhanced precautions.”
“The international destinations have circulating poliovirus,” the CDC said. The list includes countries where poliovirus has been identified in people or environmental samples within the past 13 months.
Polio is a highly contagious virus transmitted through respiratory droplets and contact with feces. It attacks the nervous system and often produces no symptoms, but serious infections can cause muscle weakness and stiffness, spasms, difficulty swallowing and paralysis throughout the body.
In severe cases, polio can paralyze the lungs and other muscles needed for breathing, potentially resulting in death.
In Germany, poliovirus has been found in wastewater samples from several locations, including Munich, Mainz, Frankfurt and Cologne.
Wild poliovirus was also detected in a Hamburg wastewater sample in October 2025. Testing indicated that the virus was similar to a strain circulating in Afghanistan.
In the United Kingdom, poliovirus was detected in wastewater samples from London earlier this year.
The CDC has updated its Level 2 travel advisories for 29 countries, including Germany and the United Kingdom. Munich’s 2026 Oktoberfest is pictured above.
The countries covered by the advisory are Afghanistan, Algeria, Angola, Benin, Cameroon, Central African Republic, Chad, Côte d’Ivoire, Democratic Republic of the Congo, Djibouti, Ethiopia, Germany, Israel, Laos, Malawi, Mali, Namibia, Niger, Nigeria, Pakistan, Papua New Guinea, Somalia, South Sudan, Sudan, Tanzania, Togo, United Kingdom, Yemen and Zambia.
The CDC did not say how many human polio cases, if any, had been reported in the countries included on the list.
Polio was eradicated in the United States in 1979, a little more than 20 years after the polio vaccine was introduced. Only sporadic cases have been reported in the country since then.
The polio vaccine is part of routine childhood immunization schedules in Germany and the United Kingdom, although vaccination is less widespread in many African countries.
The vaccine uses an inactivated form of poliovirus and is 99 to 100 percent effective. In the United States, children receive four doses at two months, four months, six to 18 months and four to six years of age. Completing the series provides lifelong protection.
The latest CDC figures indicate that 92.5 percent of US children have received at least three doses of the polio vaccine.
The CDC says the Global Polio Eradication Initiative, launched in 1988, has reduced polio cases worldwide by 99 percent. Vaccination has also prevented an estimated 20 million cases of paralysis among children.
As part of the updated advisory, the CDC urged travelers to ensure they are current on polio vaccinations and to complete the full vaccine series. The agency also said they should consider receiving a single booster dose during their lifetime.
Frequent hand washing was also recommended to help reduce the risk of spreading poliovirus.
Poliovirus attacks nerve cells in the spinal cord and brainstem. Infected people can transmit it through droplets released by coughing or sneezing, as well as through fecal contamination.
The map above shows the countries covered by the updated CDC Level 2 travel advisory.
While about nine in ten people with polio do not develop symptoms, around five percent report mild flu-like symptoms such as fever, headache, muscle aches, sore throat, nausea and vomiting. This is called ‘abortive polio.’
Around one percent of patients develop nonparalytic polio, which causes more severe flu-like symptoms, neck and spine stiffness, decreased reflexes and muscle weakness.
Nonparalytic polio can progress to paralytic polio, the most serious form of the disease. It leads to intense pain, extreme sensitivity to touch, tingling sensations, muscle spasms or twitching and paralysis.
Paralytic polio can affect any limb or organ, but if it spreads to the lungs, it could lead to deadly breathing issues.
The CDC said in its advisory: ‘Polio can be fatal if the muscles used for breathing are paralyzed or if there is an infection of the brain.’
The last confirmed case of polio in the US was in 2022 in an unvaccinated adult from Rockland County, New York, just outside of New York City.
The unidentified individual reported a fever, stiff neck, constipation and back and abdominal pain.
