Polio epidemics caused periodic panic decades ago until a vaccine was developed and the disease was largely eradicated. Then on Friday, New York City health officials announced they had found the virus in a wastewater sample.
Parents of young children find themselves wondering, perhaps for the first time in their lives, how much they should be concerned about polio, collectively for generations.
Designer Annabella Borges, who lives in Brooklyn’s Crown Heights neighborhood, said her friends have children who probably haven’t been vaccinated. said.
Borges hopes her 7-month-old daughter, Ava, will be vaccinated when she is old enough to receive three of the four recommended injections for children. said there is. “Polio is really dangerous for a baby like her,” said Borges, who took Ava for a walk in a stroller with her daughter’s nanny.
In New York City, the overall polio vaccination coverage for children under the age of five is 86%, and most adults in the United States were vaccinated against polio during childhood. nevertheless, Postal codes for some cities, less Two-thirds of children under the age of five have received at least three doses of vaccine, a figure that worries health officials.
In a statement, the state health department said the discovery of the virus underscored “the urgency for all adults and children in New York to be vaccinated, especially those in the greater New York area.”
The announcement comes three weeks after a man in Rockland County, New York, north of the city, was diagnosed with a case of polio that left him paralyzed. says from May.
“The risk to New Yorkers is real, but the defense is very simple: Get vaccinated against polio,” New York City Health Commissioner Dr. Ashwin Bassan said in a statement. “With polio prevalent in our communities, nothing is more important than vaccinating children to protect them from this virus. If you are an unvaccinated adult, please choose to get vaccinated now.”
The spread of the virus poses risks to unvaccinated people, but 3 doses of the current vaccine offers at least 99% protection against severe illness. Children who are too young to be fully immunized or whose parents have refused or delayed vaccination are equally vulnerable.
Health officials fear the detection of polio in New York City’s wastewater may precede other cases of paralytic polio.
This highly contagious virus was one of the most feared diseases until the 1950s, when the first vaccine was developed.
Dr. Jay Varma, an epidemiologist and former deputy city health director, said, “I think it’s very likely that we’ll have one or more cases in the city without a relatively large-scale vaccine push.
Citywide vaccination coverage has declined amid the pandemic as visits to pediatricians have been postponed and the spread of vaccine misinformation has accelerated. Even before Covid arrived, vaccination rate Low preventable virus coverage in some areas worried health officials.
Although effective in preventing paralysis, the vaccines used in the United States in recent decades are less effective in limiting transmission. People who have been vaccinated can carry and shed the virus without infection or symptoms.
Epidemiologists say that could mean the virus is difficult to eradicate quickly, further highlighting why vaccination is so important for protection.
Many people with polio have no symptoms, but some have a fever or feel nauseousDr. Bernard Cummins, an infectious disease expert and medical director of infection prevention at Mount Sinai Health System, said it’s important to be aware of these symptoms and to request polio testing for patients who are not fully vaccinated. urged doctors to consider
About 4% of people who get the virus develop viral meningitis, and about 1 in 200 become paralyzed, according to health officials.
“The problem is that if you have one case of paralysis, there can be hundreds of people who have no symptoms or symptoms that are difficult to identify as polio,” Cummins said.
The poliovirus had previously been found in wastewater samples from Rockland and Orange counties, but Friday’s announcement was the first sign of its presence in New York City.
Neither the city nor state health departments provided details on where in the five districts the virus was detected in wastewater.government official said 6 “Positive samples of concern” were identified in the city’s wastewater, with two taken in June and four in July.
The last case of polio in the United States was in 2013, before it was found in Rockland County.
Before the polio vaccine was first introduced in the 1950s, the virus was a source of fear, especially during the summer months when outbreaks were most common.Cities closed pools as a precaution, and some parents their kids indoor.
1916, polio 6,000 dead in US, leaving at least 21,000 more — most of them children — have permanent disabilities. More than a third of his deaths occurred in New York City, place of occurrence Delayed opening of public schools.
The 1952 epidemic paralyzed more than 20,000 people, left many children with an iron lung. The first effective vaccine appeared soon after and the virus began to recede.
Currently, there are only two countries where polio is endemic: Pakistan and Afghanistan. It has been kept at bay in the rest of the world through widespread use of vaccines.
There is a regularity of cases occurring outside of these two countries as a result of the oral vaccine used in much of the world. Oral vaccines use live, attenuated viruses. Although safe, those who receive it can spread the weakened virus to others.Only inactivated polio vaccines have been used in the United States since 2000.
CDC recommends 4 doses with the final injection between the ages of 4 and 6.
“What we are seeing is a wake-up call for those who thought the poliovirus was just another problem,” said Capt. Derek Erhardt, an epidemiologist and polio eradication incident manager at the Centers for Disease Control and Prevention. I’m here.
The virus lives mainly in the human throat and intestines, most commonly spread Through contact with faeces.
If the attenuated virus used in oral vaccines circulates sufficiently widely in communities with low vaccination coverage or replicates in people with compromised immune systems, May mutate to be pathogenic Forms that can cause paralysis, according to the CDC
Such outbreaks of “circulating vaccine-derived poliovirus” have occurred in many countries in recent years. Open sewers and contaminated drinking water can help hasten the spread.
Health officials believe the poliovirus was brought to New York by someone who received a live virus vaccine in another country. or by an unvaccinated person Persons infected with vaccine-derived polio abroad.
Officials say the virus detected in two counties upstate New York City genetically linked Vaccine-derived viruses collected from samples in Jerusalem this year, and wastewater samples that led to a new polio vaccination campaign in London.
As of Friday, the CDC confirmed the presence of poliovirus in 20 wastewater samples from Rockland and Orange counties. All of these are genetically linked to paralytic polio cases in Rockland County residents. The counties are next to each other.
Of the 20 samples, 2 were collected in May, 3 in June, and 8 in July from Rockland County. Two were collected in June and five in Orange County in July.
Orange County Health Commissioner Dr. Irina Gelman said officials assumed each positive sample collected in her county was indicative of a different person who had the virus locally. He added that he is awaiting further genetic analysis from the CDC to be certain.
Health officials believe hundreds of people in the area may be infected, she said. This estimate, combined with the global increase in vaccine-derived polio cases and very low vaccination coverage in parts of New York, is likely due to the number of cases of paralytic polio that typically occur in her one case. based on how many people need to get the virus.
“Part of me still wishes it wasn’t,” she said.
“We are working on the perfect storm scenario,” she added. “Orange County has low immunization coverage for vaccine-preventable diseases, especially the pediatric population.”
According to multiple local officials, the confirmed polio case so far was in a 20-year-old ultra-Orthodox Jew living in Rockland County. Orange and Rockland counties are home to large numbers of ultra-Orthodox Jews, and anti-vaccine sentiment is widespread in some of those communities.
Measles outbreaks in 2019 were also concentrated among people in the ultra-Orthodox community, but vaccine misinformation and low vaccination coverage are also more widespread, Dr Gelman said.
Vaccination rates in Rockland and Orange counties are well below the levels needed to prevent the spread of the virus, according to the state health department. For 2-year-olds, approximately 60% of children in both counties received all three recommended polio immunizations, compared with 79% statewide, according to state data.
Fed up with the novel coronavirus and unnerved by the recent monkeypox outbreak, New Yorkers’ thoughts turned to a third virus on Friday.
Crown Heights resident Gregory Ladd, 46, works as a porter and has six children. They are up to date on vaccinations, he said.
“I’m scared of it because we were probably young kids and we never really heard about the polio outbreak,” he said. , I just hope it doesn’t happen to my child.”
Laura Fadulcontributed to the report.