New York City officials have detected polio in the city’s sewage and confirmed that at least one person recently carried the virus in the city.
Surveillance of the virus was launched after a confirmed case was found near Rockland County last month. Orange County sewage monitoring — also just outside the city’s Bronx borough — has also detected at least two polio samples since June.
Officials have warned there could be hundreds – possibly – thousands of undiagnosed cases across the state. Since the majority of cases are either asymptomatic or very mild, it is likely that a large majority will go undetected.
In response, the Centers for Disease Control and Prevention (CDC) dispatched a team to Rockland County earlier this week to investigate the outbreak and help vaccinate the local community. Both Rockland and Orange County have only 60 percent of residents vaccinated — some of the lowest rates in the state.
The Big Apple has an 86 percent vaccination rate, still well below the 95 percent threshold deemed necessary to avoid a large-scale outbreak.
While a polio incidence in America’s largest city may be startling, a vaccinated person is not considered at risk. Many Americans have had to get vaccinated to go to school, and no booster is needed. More than 90 percent of the US population has received the polio vaccine.
New York City officials have detected a case of polio in the city’s sewage, meaning at least one person in the city is carrying the devastating virus. A case of the virus was previously confirmed in Rockland County, and Orange County sewage monitoring also found a case
Common symptoms of polio include high temperature, extreme tiredness, headache, vomiting, stiff neck, and muscle aches
“The risk to New Yorkers is real, but the defense is so simple — get the polio vaccine,” said Dr. Ashwin Vasan, the city’s health commissioner, in a statement.
“As polio circulates in our communities, there is simply nothing more important than vaccinating our children to protect them from this virus and if you are an unvaccinated or under-vaccinated adult please make a decision to get the vaccine now.
“Polio is completely preventable and its resurgence should prompt us all to act.”
Officials did not confirm when the sample was taken. It is also not possible to determine whether it was a question of a city visitor or a resident.
Polio: Once the most feared disease in America, it has now become a rarity
Polio is a serious viral infection that used to be widespread around the world.
The virus lives in the throat and intestines for up to six weeks, with patients being most contagious seven to 10 days before and after symptoms appear.
But it can spread to the spinal cord, causing muscle weakness and paralysis.
The virus is more common in infants and young children and occurs in poor sanitation conditions.
how deadly is it
Most people show no signs of infection at all, but about 1 in 20 people have mild symptoms, such as fever, muscle weakness, headache, nausea, and vomiting.
About 1 in 50 patients develop severe muscle pain and stiffness in the neck and back.
Less than 1% of polio cases result in paralysis and one in 10 deaths.
Of those who develop symptoms, these usually appear three to 21 days after infection and include:
- High temperature
- Sore throat
- headache
- stomach pain
- Muscle cramp
- nausea and vomiting
How is it spreading?
People can get polio from airborne droplets when someone coughs or sneezes, or when they come into contact with an infected person’s feces.
This includes food, water, clothing or toys.
Are there different tribes?
There are three strains of “wild” polio that have been largely eradicated in Europe, America, Southeast Asia, and the western Pacific.
Types 2 and 3 have been eliminated thanks to a mass global vaccination campaign, with the last cases detected in 1999 and 2012, respectively.
The remaining wild type 1 polio remains endemic in only two countries, Afghanistan and Pakistan.
Wild polio has been eradicated from almost every country in the world thanks to vaccines.
But global introduction has created new types of strains known as vaccine-derived polioviruses.
These are strains that were originally used in live vaccines but spread through the community and evolved to behave more like the wild version.
Does polio still exist in the US?
The last case of human-to-human transmission in the US was in 1979, which was also the last wild case of polio.
Since then, however, there have been several dozen cases of vaccine-derived poliovirus, although these were one-off cases with no onward transmission.
Am I vaccinated against polio?
Since 2000, Americans have been offered the inactivated polio vaccine (IPV).
It is given in four doses, with the first vaccination given at two months of age. It is also given at ages four, six to 18 months, and four to six years.
Uptake has declined slightly but is still above 90 percent nationwide.
There are concerns that vaccination hesitancy has increased during the Covid crisis as misinformation has been spread about vaccinations against the virus and school closures.
The polio case found in Rockland earlier this year came as a shock. It was the first case detected in the nation in over a decade and could potentially be the first case transmitted in the US since before the turn of the century.
It was found in a man in his 20s who had a severe case with symptoms including paralysis.
The man was hospitalized but returned home to recover. His current situation is unknown.
His polio case was from a vaccine-induced strain. This form of polio came about as a result of the oral polio vaccine, which provides a person with a live form of the virus.
In some cases, the recipient may be infected. Because of this, it is no longer used in America, although some developing countries still use it.
Officials have not confirmed whether they know if the virus found in sewage samples in the area came from the vaccine-borne or wild strains of the virus.
However, just the discovery of one case put the officials on high alert.
“Based on past polio outbreaks, New Yorkers should know that for every observed case of paralytic polio, there may be hundreds of other people infected,” said Dr. Mary Bassett, the state’s health commissioner, earlier this week.
“In conjunction with the latest findings on wastewater, the Department is treating the individual case of polio as just the tip of the iceberg with a much larger potential spread.”
A local Rockland official said this week actual case numbers in the Empire state are likely in the thousands.
“There’s not just a polio case when you see a paralysis case. The incidence of paralytic polio is less than one percent,” said Dr. Rockland County Health Commissioner Patricia Schnabel Ruppert told the BBC.
“Most cases are asymptomatic or mildly symptomatic, and these symptoms are often overlooked.
“So there are hundreds, maybe even thousands, of cases that have occurred for us to see a paralytic case.”
The CDC has also been active in Rockland, sending a team to investigate the circumstances surrounding the polio case and to increase immunization rates in the county.
According to official figures, only about 60 percent of Rockland County residents are vaccinated against polio. This is an astonishingly low figure, well below the 95 percent threshold set by the World Health Organization to prevent an outbreak.
New York City has a much higher score at 86 percent, still well below the 95 percent threshold.
Once the most feared disease in the United States, polio caused panic in the 1940s.
Parents feared letting their children play outside — especially in the summer when the virus was more prevalent — and public health officials quarantined homes and even entire cities where it was detected.
It was responsible for more than 15,000 cases of paralysis and hundreds of deaths each year.
But in the mid-1950s, the country began rolling out poliovirus vaccines to prevent the disease.
By 1979, the United States declared the virus eliminated. There has been no known transmission on US soil since then.
The vaccine has also been rolled out globally, with the virus pushed back to just a few countries.
It is now only known to circulate in Pakistan and Afghanistan. The WHO warns that as long as it continues to spread there, it remains a threat to the world.
But in recent years – as the virus has faded from national memory – vaccination rates in the United States have slowed.
Latest figures show that about 92.6 percent of Americans will be vaccinated against polio by their second birthday.
The CDC recommends that all children should receive the polio vaccine.
It is given as four injections into the leg or arm, with the first dose being given at two months of age, the second at four months of age, the third between the ages of six and 18 months, and the last dose between the ages of four and administered for six years.
The vaccine is highly effective, 99 percent of children are protected from the disease for life.