In December 2019, acute poliomyelitis was confirmed in a 3-month-old infant in Tuaran, a town in Sabah state, Borneo, Malaysia. It was the first confirmed case in Malaysia since 1992, and Malaysia had been declared polio-free in 2000. The child reportedly had a fever and muscle weakness, and although in stable condition, required assistance to breathe. Testing of the virus indicated that it was related to the strain that had appeared in the Philippines. Local officials said the strain originated from a weakened virus used in an oral vaccine that was then excreted in feces and spread into the unvaccinated population through unsanitary conditions. It was reported that 23 of 199 children in the local community had not received the polio vaccine.