Category: 8. Health

Right now, global funding for humanitarian aid is facing unprecedented cuts. In 2024 alone, there was a staggering $25 billion shortfall between the funds needed for United Nations appeals and the contributions received.

In a major setback to global humanitarian efforts, in early 2025 the U.S. State Department—once the world’s largest aid donor—terminated more than 10,000 foreign aid grants and contracts. This has had far-reaching consequences, including the disruption of many lifesaving vaccination programs.

These cuts come at a time when millions of children in conflict and crisis-affected areas already lack access to critical immunizations, remaining at risk simply because national health systems can’t reach them.

The funding crisis deepens 

Recent policy shifts have impacted vaccination funding around the world, including those led by Gavi, the Vaccine Alliance. 

Infectious disease outbreaks cost an estimated $60 billion per year globally. These outbreaks know no borders and can impact us all. In contrast, disease prevention through vaccination and routine immunization, particularly when delivered by frontline actors, have proven to be highly effective.

The impact of aid cuts on immunization

Of the 13 countries the IRC has identified as the most affected by global aid cuts, 10 rank among the bottom 20 globally for measles immunization rates, highlighting a critical gap in disease prevention. This issue is even more alarming as climate change continues to heighten the risks of infectious diseases, further compromising global health efforts.

Due to these funding cuts, 300 IRC-supported health facilities have closed or are at risk of closing. 

The IRC provides about 4.3 million services for communicable diseases around the world—1.7 of these services are delivered to children under 5. These services are essential for preventing and controlling outbreaks in vulnerable communities. Critical immunization programs in Burkina Faso, Nigeria, and Afghanistan are all facing the threat of closure.

A global health security threat

“Preparing for the next pandemic starts by investing where outbreaks begin,” says Dr. Mesfin Teklu Tessema, Senior Director of Health at the IRC. “Global health security is not a luxury. It is a strategic imperative—one that demands sustained, coordinated investment.”

Cutting vital immunization programs – as well as primary healthcare services- increases the risk of infectious disease outbreaks that could impact everyone. Without prevention and treatment efforts, diseases are more likely to spread unchecked, mutate and become harder to control.

With 21 million children around the world currently under-immunized, reaching these underserved communities is critical to preventing outbreaks that threaten both regional and global health security.

The IRC’s solution: Access to life-saving vaccines for children in missed communities

The IRC is committed to ensuring children receive a full schedule of life-saving vaccines, making immunization a cornerstone of its child health programs. In 2024 alone, over 700,000 children under the age of one were protected against vaccine-preventable diseases by receiving their third dose of the diphtheria, tetanus, and pertussis (DTP) vaccine. This vital protection allows these children to grow up healthier and free from the threat of preventable illnesses.

To expand access to essential healthcare, including immunizations, the IRC has implemented strategic initiatives designed to maximize the impact of its efforts. These programs focus on reaching children in some of the world’s most fragile and conflict-affected regions, ensuring even the most vulnerable populations can access the care they need. 

In 2022, the IRC launched the Reaching Every Child in Humanitarian Settings (REACH) project in partnership with Gavi, the Vaccine Alliance. The aim: leverage the IRC’s unique humanitarian expertise to ensure that even the hardest-to-reach children receive the full national schedule of vaccines. 

Using flexible methods like mobile clinics, local community teams, and mapping tools, our teams are able to reach people in places where the government health system can’t work properly because of conflict, danger, or climate-related problems.

Since its launch, the REACH consortium has enabled health workers to administer over 13 million vaccine doses to children across the Horn of Africa, with recent extension into Chad and Nigeria.

An IRC nurse, Nancy, attends to Selina Naoi’s* child, Maria*, during an IRC community outreach program in Turkan, Kenya.

Photo: Billy Mutai for the IRC

Reaching children at the last mile

Using flexible and evidence-based interventions enables us to reach more children with essential vaccines, while ensuring maximum impact per dollar spent. Training and supporting community health workers with local knowledge is central to this approach. In 2024, the IRC supported 15,800 community health workers to help ensure more children are protected by lifesaving vaccines.

In South Sudan, we worked with community health workers and local leaders to raise awareness about vaccines for diseases like polio, measles and diphtheria. Community health workers were also empowered to share community feedback with health officials and help combat misinformation. 

IRC staff in South Sudan traverse through a flooded village to reach children with vaccinations in Koch County.

Photo: International Rescue Committee

How can you support vital vaccine programs?

Now, more than ever, your support is urgently needed to help humanitarian organizations continue to deliver lifesaving services. 

The new era of reduced aid will bring difficult decisions. But by investing in IRC’s Primary Healthcare Programs that deliver immunization services that center proven interventions, empower local responders, and implement smart financing strategies, we can ensure that available resources have the maximum impact for those most in need.

With collective action, we can prevent this funding crisis from becoming an era of unprecedented suffering and instead set a path toward sustainable relief and long-term resilience for the world’s most vulnerable populations.

Donate: Financial contributions are key for trusted organizations like the IRC that prevent, treat and contain infectious diseases. Your donation can empower our work in the U.S. and more than 40 countries worldwide.

Get connected: Follow our Instagram, LinkedIn, Facebook, and Bluesky accounts.

Stay informed: Subscribe to IRC alerts to get the latest on our programming and learn more about how you can make a difference.

Our continued commitment to delivering vital health care

Every child deserves the right to health care and protection, regardless of crisis. But due to aid cuts, vulnerable children who are relying on humanitarian aid to survive, could be left with nothing. This is a matter of life or death.

With over 90 years of experience, the IRC knows how to push through tough times by focusing on what matters most—helping those in crisis, working hand-in-hand with communities and treating people with dignity. Our commitment to supporting the hardest-to-reach communities with lifesaving immunization will not waver.

*Names changed for privacy reasons.

It’s common for patients to schedule an office visit due to symptoms like shortness of breath from doing regular tasks, feeling heart palpitations, experiencing mild chest pain, or feeling weak or unusually tired. 

During your assessment, if you determine that the patient has an irregular heartbeat, a family history of cardiac conditions, or believe further testing is warranted, realize that a patient could be fearful of cardiac testing. To ease the concerns of your patients, it’s important to explain how such testing can diagnose the reason they aren’t feeling quite right and how their treatment team can help them feel better.

Start With the Why 

Leaving the trusted environment of a primary care office can be daunting for patients, particularly for those who haven’t had cardiac testing before. But explaining why you’re suggesting the tests can help a patient understand. 

“The most important step would be to explain how cardiac testing can be important in order to screen for issues before they become serious,” said David Weininger Cohen, MD, a cardiologist with the Leonard M. Miller School of Medicine at the University of Miami in Florida.

He also suggested recounting what symptoms patients are experiencing and how specific tests can investigate what’s causing them. Also, explaining that some symptoms may not even be tied to cardiac issues could be another strategy to demonstrate the importance of further testing.

“For instance, chest pain is a symptom that becomes a common reason for visits. Most people usually associate chest pain with heart issues, but there are a lot of structures in the chest that can cause pain, not just the heart — cartilage, esophagus, sometimes part of the stomach, skin, and even nerve endings,” he said. “Ultimately, cardiac testing is important because it allows the physician to discriminate between cardiac and non-cardiac causes for the patient’s symptoms.”

In addition, reassuring your patients that these experts can diagnose potential issues may also ease their worries, so articulate how such cardiac tests are performed in a controlled environment with trained staff that can anticipate issues and respond quickly if something goes wrong, Weininger Cohen added. 

Understand Patients Are Fearful of Test Results

Some patients are afraid of the results as much as the test. 

“In those cases, I like to reinforce why the test is necessary and why we’re doing it,” said Weininger Cohen. “Additionally, I sometimes go through the possible scenarios depending on the results of each test.” Knowing what lies ahead, depending on what the test shows, can sometimes be reassuring — you’re showing patients you know exactly what the next steps would be. 

Treat Fears Patient by Patient

Although there are some general practice strategies to ease fear regarding cardiac testing, personalizing your approach is also important. 

“The best way to tackle fear of cardiac testing would be to ask the patient exactly what they’re afraid of,” said Weininger Cohen. Some patients are going to be afraid of having pain or discomfort during the test. Some patients are afraid of what the results may be, and some patients are afraid of possible complications. 

“Usually, the best way to approach the topic is to explain the reason for the test and then address the specific fear the patient has,” he specified.

For example, the best way to describe an EKG would be to explain that it is a test that is trying to capture the electrical activity of the heart. To achieve that, the person performing it is putting sensors on different parts of the patient’s body to detect the heart’s electrical current from different points, he said. Emphasizing that the test is painless, and that it’s just capturing the natural electrical activity of the heart, should put patients at ease. 

How Can You Best Describe an Echocardiogram? 

Most patients understand what an ultrasound is, so advising patients that an echocardiogram is simply an ultrasound study of the heart can calm fears. It may also be helpful to share that in some cases, ultrasounds use enhancing agents, referred to as contrast, to get a look at the different structures of the heart, he said. 

Some patients could be concerned about radiation. 

“Both tests are radiation free, and this is something that some patients are very interested in knowing before proceeding, especially if they have been previously exposed to radiation through other diagnostic imaging tests or radiotherapy for cancer treatment,” Weininger Cohen said. Taking the time to explain both an echocardiogram and an EKG can help your patients understand what to expect and reduce worry and the fear of the unknown.

What to Tell Patients Before Referring to a Cardiologist

Referring a patient to a specialist like a cardiologist could cause fear. So explain why you’re taking this step. 

“Telling a patient why they need to see a heart expert and how they will add to their overall care can be a helpful first step,” said Mustafa M. Ahmed, MD, a cardiologist and professor of medicine, who’s also vice chief of research of the Division of Cardiovascular Medicine and medical director of the Mechanical Circulatory Support Program at the University of Florida in Gainesville. “Assuring them that they won’t be losing their primary care doctor, but gaining a specialist to consult with both them and the primary care team, is often a good way to frame expectations.”

Lifestyle Tweaks You Might Suggest 

In the context of your discussions with patients regarding their symptoms and recommendations for cardiac testing, Ahmed suggested expressing how diet and exercise, as a part of overall lifestyle changes, can be the most impactful way to prevent heart disease. 

“Gentle guidance and step-by-step encouragement are often helpful,” he said. 

Also, involving other family members and friends in that journey is another strategy. This may include taking walks, preparing meals together, or embracing a healthier mindset overall.

Testing practices during and after the COVID-19 pandemic were found to have significant implications on the post-pandemic understanding of respiratory diseases, according to a study published in the Journal of Infection and Public Health.¹ Because of increased COVID-19 testing for healthy individuals, researchers uncovered a potential for overdiagnosis of infectious diseases including respiratory syncytial virus (RSV), influenza, and invasive pneumococcal disease.

“RSV is a major cause of infant hospitalizations, while influenza tends to affect toddlers and school-aged children more commonly,” wrote authors of the study. “Bacterial infections, though less frequent, remain a concern. Especially, children with complex chronic diseases are more susceptible to invasive infections caused by Streptococcus Pneumonia, known as invasive pneumococcal disease, which is a severe and potentially life-threatening condition.”

Indeed, researchers’ understanding of how respiratory diseases interact with one another was crucial during times like the COVID-19 pandemic. Even more important for pediatric patients, major pandemic-level events have been found to significantly impact epidemiology patterns of respiratory diseases.²

READ MORE: ACIP Votes to Expand RSV Vaccine Recommendation to Include Adults 50 Years and Older

Along with older adults over 65, children too are deemed at risk of contracting respiratory illnesses; a risk that was significantly increased during the COVID-19 pandemic. According to BMC Pulmonary Medicine, rhinovirus/enterovirus and RSV were the most prominent among children during the COVID-19 era.³

Many researchers and health care professionals are aware of the complex interplay between various respiratory viruses and how they are manifested in children. However, researchers of the current study wanted to place the focus on the pandemic and the non-pharmaceutical interventions (NPIs) that came from it.

“A potential consequence of these interventions has been the phenomenon known as ‘immunity debt,’ which refers to the reduction in population immunity due to lack of exposure to common pathogens during the pandemic,” continued the authors.¹ “The concept of immunity debt has been hypothesized to explain the post-pandemic surge in respiratory infections, and the focus of this study is to present empirical data scrutinizing and quantifying these patterns.”

Focusing on the 3 aforementioned respiratory diseases, researchers’ goal was to explore the overall impact NPIs that emerged during the pandemic had on RSV, influenza, and invasive pneumococcal disease. They conducted a national, population-based analysis of children in Denmark over a 10-year period lasting from 2012 to 2022.

Throughout the time period, researchers scanned microbiology tests and hospital contacts for infection rates and testing patterns before, during, and after the pandemic. All participants included in the study were born in Denmark and between 0 and 17 years old during the study period.

“The outcomes of interest were the occurrences of tests for 3 different pathogens, specifically RSV, influenza virus, and pneumococcus,” they wrote.¹ “Testing for COVID-19 was also included to provide context within the study period. Testing patterns were described based on both the absolute number of tests performed and the percentage of positive tests.”

Researchers included a total of 1,790,464 unique individuals in the final analysis.

Overall, COVID-19 restrictions and lockdowns led to decreased cases of respiratory diseases. Once those lockdowns were lifted, respiratory infections experienced a resurgence. With COVID-19 emerging at this time as a notable respiratory illness alongside RSV, the flu, and pneumococcus, testing for respiratory pathogens noticeably increased among children in Denmark.

“The NPIs for COVID-19 not only limited the spread of the targeted virus but also substantially decreased the incidence of RSV, influenza, and pneumococcus,” wrote the authors.¹ “The subsequent lifting of restrictions led to a notable resurgence of these infections, likely attributable to immunity debt arising from reduced pathogen circulation.”

With further evidence regarding immunity debt uncovered, studies like this are constantly being conducted to further the knowledge of health care professionals and their understanding of COVID-19. Like many of the ongoing studies regarding COVID-19’s impact on health care and respiratory health, evidence from the current study can now be used to inform future policy regarding respiratory viruses, infectious diseases, and how they interact with each other among children.

“Our study comprehensively described the impact of behavioral changes and immunity debt on infectious disease epidemiology,” concluded the authors.¹ “The rising number of tests among healthy children contributes to ongoing discussions regarding overdiagnosis and the implications for health care policy.”

READ MORE: Respiratory Resource Center

Ready to impress your pharmacy colleagues with the latest drug information, industry trends, and patient care tips? Sign up today for our free Drug Topics newsletter.

References

1. Jensen A, Stensballe LG. Impact of COVID-19 on testing, positive cases, patient characteristics, and hospital contacts for respiratory syncytial virus, influenza, and pneumococcus in Danish children. J Infect Public Health. 2025;18(2):102660. https://doi.org/10.1016/j.jiph.2025.102660

2. Dallmeyer LK, Schüz ML, Fragkou PC, et al. Epidemiology of respiratory viruses among children during the SARS-CoV-2 pandemic: a systematic review and meta-analysis. IJID. 2023;138:10-18. https://doi.org/10.1016/j.ijid.2023.10.023

3. Khales P, Razizadeh MH, Ghorbani S, et al. Prevalence of respiratory viruses in children with respiratory tract infections during the COVID-19 pandemic era: a systematic review and meta-analysis. BMC Pulm Med. 2025;25. https://doi.org/10.1186/s12890-025-03587-z

Corticosteroids, a commonly prescribed medication to alleviate cancer-related symptoms for non-small cell lung cancer patients treated with immunotherapy, are the main reason certain immunotherapies may fail in treating the disease, according to new research by Keck Medicine of USC. 

The study, published today in Cancer Research Communications, showed that high doses of steroids, when given before and/or during a specific type of immunotherapy, caused patients’ tumors to shrink less than those of patients not on steroids. Those patients also did not live as long. 

Steroids were the biggest predictor of why certain immunotherapies may not be effective, even when considering multiple other factors such as stage and progression of the disease.”

Fumito Ito, MD, PhD, Keck Medicine oncologist and immunologist, lead author of the research

Additionally, researchers believe they have found the mechanism behind why steroids and some immunotherapies may not mix. 

“Our findings reveal that steroids stop the body’s natural cancer-fighting cells, T-cells, from maturing. This makes them unable to attack the cancer as vigorously as they usually would, leading to worse outcomes for patients,” said Ito, who is also a member and co-leader of the translational and clinical sciences research program at USC Norris Comprehensive Cancer Center. “While other research has indicated steroids may negatively impact immunotherapy’s efficacy, we are one of the first to pinpoint a probable cause and effect.” 

Ito and his colleagues also discovered that steroids blocked circulating biomarkers in the body – bits of cells in the bloodstream that signal when cancer is progressing so oncologists can adjust the patient’s treatment. 

“Without the presence of circulating biomarkers to inform our decisions, oncologists cannot treat the cancer as effectively and patients may miss out on the best treatment for their cancer,” said Ito. 

Two competing medications 

The study examined the effect of steroids on a type of immunotherapy known as immune checkpoint inhibitors (ICIs). ICIs help the body’s immune system fight cancer by blocking proteins that prevent T-cells from attacking cancer cells. ICIs are often used to treat non-small cell lung cancer, the most common form of lung cancer. 

Steroids are often prescribed to alleviate symptoms of the cancer or treatments given for a variety of reasons, such as fatigue and vomiting, or more serious side effects like brain swelling and lung inflammation. Steroids suppress the immune system, which reduces the inflammation that can cause these conditions. 

How the studies were conducted 

Ito and fellow researchers retrospectively studied the medical records of 277 patients with Stage II-IV non-small cell lung cancer who were treated with ICIs alone or in combination with other therapies. They compared outcomes (tumor shrinkage and survival rate) between patients prescribed steroids and those who were not at three centers, including USC Norris Comprehensive Cancer Center. 

They analyzed up to eight years of data to determine that steroids were the sole factor impeding the effectiveness of the immunotherapy. 

They also determined that the T-cells of significant numbers of patients on steroids were not fully matured and launched a preclinical study using mice to observe the effects of steroids on ICI therapy in real time. This mouse model study led to the discovery that steroids given before/during immunotherapy inhibit T-cells from fully maturing. 

The future of steroids 

While the Keck Medicine research indicates steroids can interfere with ICIs, Ito acknowledges that for some patients, steroids may be necessary to manage their cancer-related symptoms. 

“We know that steroids will continue to play an important role in lung cancer care, but it is important to understand their potential limitations,” said Ito. “Each patient should talk to their oncologist to make sure they have the best possible care plan tailored to their specific needs.” 

He hopes this research will lead to more studies examining the effect of steroids on immunotherapy so oncologists can make fully informed decisions that will best benefit their patients. 

Other study authors include Keck Medicine medical oncologists Jorge Nieva, MD and Robert Hsu, MD. 

The study was supported with grants from the National Cancer Institute, P30CA016056 (RPCCC), P30CA014089 (USC), K08CA197966, R01CA255240, R01CA272827 (F. Ito), R01CA188900, R01CA267690 (B.H. Segal) as well as the Department of Defense Lung Cancer Research Program and the Uehara Memorial Foundation. 

Editor’s Note:
The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians, but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please email us at ccsuggestions@medscape.com with the subject line “Case Challenge Suggestion.” We look forward to hearing from you.

Background and Initial Presentation

A 35-year-old man with a history of two prior spontaneous pneumothoraxes — both managed conservatively — presents to the emergency department with new-onset chest pain and lightheadedness. The pain is described as sudden, intense, and exacerbated by deep breathing. He indicates that it is located in the center of the chest. He denies dyspnea or leg swelling and has no other complaints. When asked, he says this pain is different from his pneumothorax pain, mainly because it is in the center of his chest.

Physical Examination and Workup

Vital signs are within normal limits, except for a pulse > 120 bpm. Physical examination reveals diminished breath sounds on the left hemithorax. There are no rales or wheezes and no leg edema.

Highlights:

• Mosquitoes that carry pathogens often develop resistance to insecticides.
• Biopesticides offer an ecologically friendly way to control the pests and mitigate resistance, but options are limited.
• Researchers recently identified bacteria in Crete that produce metabolites that quickly kill mosquito larvae in lab tests.
• The compounds might be useful for the development of new biopesticides, though developing the right formulations and delivery method remains a challenge.

Washington, D.C.-Mosquito-borne diseases kill more than 700,000 people every year, according to the World Health Organization, and the mosquitos that spread the disease are difficult to control. Most species have developed resistance to all major classes of synthetic insecticides, many of which pose both environmental and health risks.

Biopesticides, derived from living organisms, may mitigate chemical insecticide resistance and offer an environmentally friendly way forward. This week in Applied and Environmental Microbiology, researchers report that bacterial isolates collected from the Mediterranean island of Crete act as insecticides against Culex pipiens molestus mosquitoes, which can transmit human pathogens such as West Nile virus and Rift Valley fever virus. In lab tests, extracts containing metabolites produced by 3 of the isolates killed 100% of mosquito larvae within 24 hours of exposure.

Those metabolites might guide the development of biopesticides with minimal ecological side effects, the researchers noted. “They degrade more quickly in the environment and therefore don’t accumulate, and they often don’t kill such a wide range of different insect species as chemical insecticides,” said George Dimopoulos, Ph.D., a molecular entomologist and microbiologist at Johns Hopkins University in Baltimore and at the Institute of Molecular Biology and Biotechnology (IMBB) in Crete. He co-led the new study, conducted in Crete, together with molecular biologist John Vontas, Ph.D., at the IMBB.

Dimopoulos’ research focuses on mosquitoes that transmit human pathogens, and over the past 15 years his group has found microbes that produce metabolites that interfere with the pathogens that cause malaria and dengue, and some bacteria that can kill mosquitoes. More recently, they have been investigating mosquito-killing bacteria in the Mediterranean region as part of the MicroBioPest project, funded by the European Union.

For the new work, they collected 186 samples from 65 locations across Crete. The samples included topsoil, soil from around plant roots, plant tissues, water samples and dead insects. They then exposed C. pipiens molestus larvae to water solutions containing some of the most promising isolates found in the samples. More than 100 of the isolates killed all the mosquito larvae within 7 days, and 37 of those killed the larvae within 3 days. Those 37 isolates represented 20 genera, many of which have not previously been identified as potential biopesticides, said Dimopoulos.

Further analyses showed that the rapid-acting bacteria killed the larvae not through infection but through the production of compounds like proteins and metabolites. This is promising, Dimopoulos noted, because it suggests that an insecticide based on these bacteria would not depend on the microbes staying alive. The findings have implications not only for controlling mosquitoes, but also as safe biopesticides to use for controlling agricultural pests.

The researchers have now begun studying the chemical nature of those insecticidal molecules more closely and identifying whether they are proteins or metabolites. They’re also mapping out the spectrum of pesticidal activity demonstrated by the bacteria, including screening the isolates against other strains of pathogen-bearing mosquitoes and agricultural pest insects.

Biopesticides often degrade quickly and require multiple applications, Dimopoulos said, and finding the right way to formulate and deliver the compounds will be a challenge in the future. The new study represents the discovery phase.

“It’s now entering the basic science phase to understand the molecules’ chemical structures and modes of action, and then we’ll shift to a more applied path, really aiming at prototype product development,” he said. “There is a major push toward developing ecologically friendly insecticides.”

According to the health departments of various countries, a cluster of vaccine-derived poliovirus type 2 (cVDPV2) has been detected in wastewater samples collected in Europe.

As of July 7, 2025, the European Centre for Disease Prevention and Control (ECDC) says these countries include, but are not limited to, the United Kingdom, Finland, Germany, Spain, and Poland.

Specifically, Germany has reported detections of cVDPV2 in multiple environmental samples throughout 2024 and the first half of 2025.

In 2024, a strain of variant poliovirus originating from Nigeria was repeatedly detected in wastewater samples from Hamburg, Berlin, Munich, Frankfurt, Stuttgart, Dresden, Cologne, Düsseldorf, and Bonn. 

In 2025, detections have been from Dresden during weeks 17, 19, 21, and 23, Mainz during weeks 15 and 19, Munich during weeks 21, 22, and 23, and Stuttgart during week 21.

The cluster exhibits a degree of genomic diversity that more strongly supports the hypothesis of multiple introductions than a single introduction with local transmission within the EU.

However, the large geographical spread in the EU/EEA, the fact that detections occurred over several months, and the identification of specific genetic sub-clusters suggest at least some degree of local transmission.

Fortunately, no cases of poliomyelitis have been reported in Europe. 

The last indigenous case of polio in Germany was in 1990.

Given the presence of non-vaccinated or under-vaccinated population groups in European countries, and the fact that poliomyelitis has not been eradicated globally, the risk of the virus being reintroduced into Europe remains, affirms the ECDC.

To alert international travelers visiting Europe during the summer of 2020, the U.S. CDC’s Level 2 – Practice Enhanced Precautions, Travel Health Advisory identifies 41 countries at risk for poliovirus detections.

According to the CDC, travelers to Germany are at increased risk of exposure to poliovirus.

The CDC recommends that adults who have previously completed the routine polio vaccine series and are traveling to any destination listed may receive a single, lifetime booster dose of polio vaccine. Polio vaccination services are offered at most health clinics and travel pharmacies in the United States.