After an 18-month-old boy was diagnosed with polio, Australian parents planning holidays in Indonesia have been warned to ensure babies and toddlers have been vaccinated for polio.
This is Indonesia's first case of the killer disease in a decade and has prompted an emergency reaction from the World Health Organization (WHO), which plans to urgently vaccinate 5.2million Javanese children under five.
The boy was diagnosed with the paralysing and highly infectious disease at a village in western Java.
The first round of vaccinations should begin in 10 to 14 days, and will be followed by a second round a fortnight later, says Brent Burkholder, an immunisation and vaccine expert with WHO's southeast Asian regional office.
Dr Burkholder says he is concerned because polio has not been in Indonesia since 1995 and the vaccination rate is about 90per cent, he says until this case, India was the only country in the region with a problem.
No cases of polio have been reported in Australia since 1974 but parents visiting Indonesia are advised to check young children had been vaccinated and immunisations are up to date. He said it would probably take 60 days before it was known what level of residual paralysis the Javanese boy would be forced to live with.
Australia's National Health and Medical Research Council recommends children receive the polio vaccine at two, four and six months of age, and again at four years.
Dr Burkholder said the 5.2million Indonesian children would be given an Indonesian-made oral vaccine that would not harm those already immunised. Genetic sequencing had established that the polio came from Saudi Arabia, where several people from the boy's village had recently worked.
Since 2003, 15 countries have reported polio cases, after a boycott of the vaccine in Nigeria.
The virus, mainly affects children under five, and attacks the nervous system, it can cause total paralysis in hours. It enters through the mouth and multiplies in the intestine and the initial symptoms are fever, fatigue, headache, vomiting, stiffness in the neck and pain in the limbs.