This month, the Centers for Disease Control (CDC) updated its global warning about polio, releasing a list of 39 countries where Americans should "practice enhanced precautions."
On the list are some surprising European nations (Finland, Germany, Poland, Spain, the United Kingdom), major safari destinations (Kenya and Tanzania), and such tourist magnets as Egypt and Indonesia.
Countries that appear on the list aren't necessarily dealing with outbreaks. The United Kingdom, for example, reports it hasn't found a case of polio that was contracted within its borders for more than 40 years—but it has found traces of the virus in London sewage water, which suggests someone carried it into the country on their travels.
That's enough for the CDC to encourage caution. The CDC is suggesting that American travelers be "up to date on their routine polio vaccinations."
Which begs the question: How does one do that?
How to check your immunity from polio
Two words: titer test.
This is a blood test that measures the levels of antibodies in the blood for such diseases as measles, chickenpox, mumps, hepatitis, Covid-19, and yes, polio.
In many cases, a prior vaccination, which many of us had when we were young, will result in a high level of protective antibodies against these diseases, and that protection will be revealed by the titer test.
But if you haven't had a polio vaccine since childhood—or if you don't know if you even had the vaccine as a kid—the test will show whether your antibody levels are sufficient to visit countries with higher polio risks.
Titer tests require a simple blood draw (usually from the arm) and take just a few business days to process.
With measles becoming more of a problem in the United States, it's probably a good idea to ask for results for that, as well as polio.
Titer tests for polio can usually be arranged through your doctor, but if you're not going through insurance, bloodwork lab companies such as Quest Diagnostics can often arrange one for about $200.
If a titer test reveals that you have insufficient levels of the poliovirus antibody, despite having once been vaccinated, a simple booster dose should be enough to keep you safe and give you lifetime immunity, according to the CDC.
What happens if you contract polio
Polio is not as common as it once was, but it still isn't a disease to be taken lightly, and it can spread from person to person via something as small as a cough. (U.S. President Franklin D. Roosevelt is thought to have contracted polio while visiting a Boy Scout camp as an adult in New York State.)
The vast majority of people who contract polio experience no symptoms or they exhibit manageable ones such as passing headaches, a short-lived fever, or pain and stiffness in the neck, arms, or legs.
But 1% of polio infections cause paralysis of a limb (a leg is most common, as FDR experienced) or, in the worst cases, paralysis of the muscles used in breathing, which can lead to death, according to the Mayo Clinic.
The Mayo Clinic notes that decades after an initial bout with polio, some get Post-Polio Syndrome, which can result in "progressive muscle or joint weakness and pain; fatigue; muscle wasting; breathing or swallowing problem; sleep-related breathing disorders, such as sleep apnea; and lowered tolerance of cold temperatures."
Vaccinations are proven to dramatically reduce the risk of illness if you are exposed to a disease.
Rather than risk joining a new wave of infections, ask your doctor for a titer test or arrange one through a health provider such as CVS or Quest Diagnostics.