Singapore has confirmed an imported case of vaccine-associated paralytic poliomyelitis, involving a 5-month-old Indonesian girl. The Ministry of Health (MOH) announced the case on February 7, emphasizing there is a low risk of community transmission due to the protocols in place. The infant, who arrived in Singapore on January 26, was immediately admitted to the National University Hospital (NUH) for treatment.
The young patient had been facing fever, acute floppiness, and paralysis of her lower limbs since December 2024 while in Indonesia. Prior to the onset of these symptoms, she had received one dose of oral polio vaccine (OPV) and one dose of inactivated polio vaccine (IPV) in her home country. Medical experts have determined that she is immunocompromised, which increases her vulnerability to rare adverse events such as vaccine-associated paralytic poliomyelitis.
“Our findings so far indicate low risk of community transmission. The case was conveyed directly to NUH upon arrival in Singapore and isolated upon admission. She was also placed under the appropriate infection prevention and control precautions to prevent further spread once suspected of poliomyelitis infection,” – MOH
Upon arrival, the patient was isolated and placed under stringent infection control measures to prevent any potential spread. MOH stated that three close contacts, including family members or caregivers, have been quarantined as a precaution.
“Currently three close contacts, who are family members or caregivers of the case, have been quarantined as a precautionary measure.” – MOH
Vaccine-associated paralytic poliomyelitis is a rare occurrence where an individual develops paralytic polio after receiving OPV, which contains live attenuated poliovirus. In contrast, the IPV used in vaccinations does not contain live virus, eliminating the risk of such adverse events. The risk associated with OPV is notably higher for immunocompromised individuals, for whom IPV is recommended.
“Vaccine-associated paralytic poliomyelitis is an extremely rare adverse event that occurs when an individual develops paralytic polio after receiving OPV. The risk is higher for immunocompromised persons, for whom IPV is recommended instead of OPV.” – MOH
Singapore's National Childhood Immunisation Schedule (NCIS) includes five doses of the polio vaccine, with infants receiving IPV at two months, four months, and six months old. These vaccinations are provided free of charge for Singaporean children, ensuring high coverage and contributing to the country's polio-free status.
“As the IPV does not contain live virus, it carries no risk of vaccine-associated paralytic poliomyelitis. Vaccinations in the NCIS are available free to all Singaporean children at Community Health Assist Scheme General Practitioner clinics and polyclinics,” – MOH
Singapore maintains its polio-free status through high vaccination coverage, rigorous hygiene standards, and a robust surveillance system designed to detect any potential cases of poliomyelitis promptly.
“Singapore has maintained our polio-free status by continuing high polio vaccination coverage, high standards of environmental hygiene and sanitation, and having an established surveillance system in place to detect possible cases of poliomyelitis.” – MOH
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