Polio found in New York City wastewater

New York City officials have detected polio in the city’s wastewater, confirming at least one person carried the virus in the city recently.

Surveillance for the virus was initiated after a confirmed case was found nearby Rockland County last month. Wastewater surveillance in Orange County – also just outside the city’s Bronx borough – also detected at least two polio samples since June.

Officials have warned that there could be hundreds – potentially – thousands of undiagnosed cases circulating around the state. Because a majority of cases are either asymptomatic or very mild it is likely that a vast majority are going undetected.

In response, the Centers for Disease Control and Prevention (CDC) deployed a team to Rockland County earlier this week to investigate the outbreak and help vaccinate the local community. Both Rockland and Orange counties have only vaccinated 60 percent of residents – some of the lowest rates in the state.

The Big Apple has a vaccination rate of 86 percent, still far below the threshold of 95 percent considered necessary to avoid a widescale outbreak. 

While an incidence of polio in America’s largest city may be terrifying, a vaccinated person is not considered to be in danger. Many Americans had to be vaccinated in order to go to school, and there is no booster necessary. More than 90 percent of the U.S. population has received the polio vaccine.

New York City officials have detected a case of polio in the city’s wastewater, meaning that at least one person in the city is carrying the devastating virus. A case of the virus was previously confirmed in Rockland County, and wastewater surveillance in Orange county also found a case

Common symptoms of polio include high temperatures, extreme fatigue, headaches, vomiting, stiff neck and muscle pain

Common symptoms of polio include high temperatures, extreme fatigue, headaches, vomiting, stiff neck and muscle pain

‘The risk to New Yorkers is real but the defense is so simple — get vaccinated against polio,’ Dr Ashwin Vasan, the City’s health commissioner, said in a statement. 

‘With polio circulating in our communities there is simply nothing more essential than vaccinating our children to protect them from this virus, and if you’re an unvaccinated or incompletely vaccinated adult, please choose now to get the vaccine. 

‘Polio is entirely preventable and its reappearance should be a call to action for all of us.’ 

Officials did not confirm when the sample was collected. There is also no way to tell whether it was a person visiting the city or a resident.

Polio: Once the most feared disease in America that has now become a rarity

Polio is a serious viral infection that used to be common all over the world.

The virus lives in the throat and intestines for up to six weeks, with patients most infectious from seven to 10 days before and after the onset of symptoms. 

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 under conditions of poor hygiene.

How deadly is it? 

Most people show no signs of infection at all but about one in 20 people have minor symptoms such as fever, muscle weakness, headache, nausea and vomiting. 

Around one in 50 patients develop severe muscle pain and stiffness in the neck and back. 

Less than one per cent of polio cases result in paralysis and one in 10 of those result in death.

Of those who develop symptoms, these tend to appear three-to-21 days after infection and include:

  • High temperature
  • Sore throat
  • Headache
  • Abdominal pain
  • Aching muscles
  • Nausea and vomiting

How does it spread?

People can catch polio via droplets in the air when someone coughs or sneezes, or if they come into contacted with the feces of an infected person.

This includes food, water, clothing or toys.

Are there different strains?

There are three strains of ‘wild’ polio, which has been largely eradicated throughout Europe, the Americas, Southeast Asia and the Western Pacific.

Types 2 and 3 were eliminated thanks to a global mass vaccine campaign, with the last cases detected in 1999 and 2012 respectively.

The remaining, type 1, wild polio remains endemic in only two countries, Afghanistan and Pakistan.

Wild polio has been eliminated in almost every country in the world thanks to vaccines.

But the global rollout has spawned new types of strains known as vaccine-derived polioviruses.

These are strains that were initially used in live vaccines but spilled out into the community and evolved to behave more like the wild version. 

Is polio still around in the U.S.?

The last case of person-to-person transmission in the U.S. was in 1979, which was also marked the last wild polio case. 

But there have been several dozen cases of vaccine-derived polioviruses since, although they have been one-offs, with no onward transmission.

Am I vaccinated against polio?

Americans have been offered the inactivated polio vaccine (IPV) since 2000.

It is given as four doses, with the first jab at two months old. It is also administered at four, six to 18 months, and four to six years old.

Uptake has fallen slightly but remains above 90 percent nationally. 

There are concerns vaccine hesitancy has risen during the Covid crisis due to misinformation spread about jabs for that 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 U.S.-borne case since before the turn of the century.

It was found in a man in his 20s who experienced a severe case, with his symptoms including paralysis.

The man was hospitalized, though did return home for recovery. His current situation is unknown.

His polio case was of a vaccine-induced strain. This form of polio emerged as a result of the oral polio vaccine, which delivers a person a live form of the virus.

In some cases, the recipient can be infected. For this reason it is no longer used in America, though some developing nation’s still do use it.

Officials have not confirmed whether they know if the virus found in wastewater samples in the area are of the vaccine-induced or wild strains of the virus.

Just the detection of the one case alone put officials on high alert, though.

‘Based on earlier polio outbreaks, New Yorkers should know that for every one case of paralytic polio observed, there may be hundreds of other people infected,’ Dr Mary Bassett, the state’s health commissioner said earlier this week.

‘Coupled with the latest wastewater findings, the Department is treating the single case of polio as just the tip of the iceberg of much greater potential spread.’

A local Rockland official said this week that the real case figures in the Empire state are likely in the thousands.

‘There isn’t just one case of polio if you see a paralytic case. The incidence of paralytic polio is less than one percent,’ Dr Patricia Schnabel Ruppert, health commissioner for Rockland County, told BBC.

‘Most cases are asymptomatic or mildly symptomatic, and those symptoms are often missed.

‘So there are hundreds, perhaps even thousands of cases that have occurred in order for us to see a paralytic case.’

The CDC has gotten involved in Rockland as well, sending a team to investigate the circumstances surrounding the polio case and boost the vaccination rates in the county.

According to official data, only around 60 percent of Rockland county residents are vaccinated for polio by their second birthday. This is a staggering low figure that falls well short of the 95 percent threshold set by the World Health Organization to prevent an outbreak.

New York City has a much higher figure – at 86 percent – still falls well short of the 95 percent threshold.

Polio was once the most feared disease in the U.S., sparking panic throughout the 1940s.

Parents were left afraid to let their children play outside — particularly in summer when the virus appeared to be more common —, and public health officials would impose quarantines on homes and even whole towns where it was spotted.

It was behind more than 15,000 paralyses every year, and hundreds of deaths.

But in the mid-1950s the country began rolling out poliovirus vaccines to prevent the disease.

By 1979, the United States declared the virus had been eliminated. There has been no known transmission on U.S. soil since.

The vaccine was also rolled out globally, with the virus pushed back to just a few countries.

It is now only known to be circulating 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 retreated from the national memory — vaccination rates have slowed in the United States.

Latest figures show now about 92.6 percent of Americans are vaccinated against polio by their second birthday.

The CDC recommends that all children should get the polio vaccine.

It is given as four shots in the leg or arm, with the first given at two months old, the second at four months, the third between six and 18 months and the final dose between four and six years old.

The vaccine is highly effective, with 99 percent of children receiving life-long protection against the disease.

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