Officials Say Polio Has Been Detected in New York City Sewage

Polio outbreaks caused frequent panic attacks decades ago, until a vaccine was developed and the disease was largely eradicated. Then, on Friday, New York City health authorities announced that they had found the virus in wastewater samples, suggesting polio may be circulating again in the city.

Parents of young children wonder – perhaps for the first time in their lives, and generally for the first time in generations – how worried they must be about polio.

Anabela Borges, a designer who lives in the Crown Heights neighborhood of Brooklyn, says she has friends whose kids probably aren’t vaccinated. Following Friday’s announcement, she said she plans to “make her friends know.”

Ms Borges said she hopes her 7-month-old daughter, Ava, is old enough to receive three of the four recommended childhood shots, enough in the regimen to be protected. “Polyopia is really dangerous for kids like her,” Ms Borges said as she and her daughter’s nanny took Ava for a walk in her stroller.

In New York City, the overall polio vaccination rate among children 5 years of age and younger is 86 percent, and most adults in the United States was vaccinated against polio as a child. However, in some city ZIP codes, less than Two-thirds of children 5 years old and younger have received at least three doses, a number that worries health officials.

The state Department of Health said in a statement that the discovery of the virus underscored “the urgency of every New York adult and child to be immunized, especially those in the major metropolitan area of ​​New York.” New York.”

The announcement comes three weeks after a man in Rockland County, NY, north of the city, was diagnosed with polio. leaving him with paralysis. Officials now say polio has circulated in county wastewater since May.

“The risk to New Yorkers is real, but prevention is simple – get vaccinated against polio,” said Dr. Ashwin Vasan, New York City health commissioner. “With polio circulating in our community, nothing is more essential than immunizing our children to protect them from this virus, and if you are an unvaccinated adult or incomplete vaccination, please choose to vaccinate now.”

The spread of the virus poses a danger to unvaccinated people, but three doses of current vaccines provide at least 99% protection from severe illness. Children too young to be fully immunized are also vulnerable, as are children whose parents refuse to immunize them or allow them to be vaccinated.

Health officials are concerned that the discovery of polio in New York City’s sewage could herald other cases of polio.

“Without a relatively large vaccine drive, I think it’s very likely that they will be one or more cases” in the city, said Dr. Jay Varma, an epidemiologist and former deputy health commissioner for the city. city.

Vaccination rates across the city have fallen amid the pandemic, as paediatrician visits have been postponed, and the spread of vaccine misinformation has increased. Even before Covid arrived, vaccination rate because some viruses are preventable in some neighborhoods low enough to worry health officials.

Although effective at preventing polio, the vaccines used in the United States in recent decades have been less effective in limiting transmission. People who have been vaccinated can still carry and shed the virus, even if they do not have the infection or have no symptoms.

According to epidemiologists, that could mean the virus is unlikely to be killed off quickly, further clarifying why vaccination is important for protection, a state Department of Health spokesman said. .

Many people infected with polio do not develop symptoms, but some people will have a fever or nausea. Dr. Bernard Camins, an infectious diseases specialist and medical director of infection prevention for the Mount Sinai Health System, urges doctors to pay attention to those symptoms and consider ordering polio testing. paralysis in patients who are not fully immunized.

About 4% of people infected with the virus develop viral meningitis, and about 1 in 200 will become paralyzed, according to health authorities.

“The problem,” Dr. Camins said, “is that if you have one case of paralysis, there can be hundreds of other people who are either asymptomatic or have symptoms that are unlikely to be identified as polio.”

The polio virus has was previously found in wastewater samples from the Rockland and Orange Countiesbut Friday’s announcement is the first indication of its presence in New York City.

Neither the city nor the state health departments provided details on where in the five counties the virus was detected in the wastewater. State officials said six “Positive samples of interest” were identified in municipal wastewater, two collected in June and four in July.

The last case of polio was found in the United States before one in Rockland County in 2013.

Before the polio vaccine was first introduced in the 1950s, the virus was a source of fear, especially in the summer months, when outbreaks are most common. Cities close swimming pools as a precautionary tactic, and some parents keep their children in the house.

In 1916, polio kills 6,000 people in the United States and leaves behind at least 21,000 others – mostly children – are permanently disabled. More than a third of the deaths were in New York City, outbreak site leading to the slow opening of public schools.

An outbreak in 1952 paralyzed more than 20,000 people, and leaving many children in iron lungs. The first effective vaccine appeared soon after, and the virus began to regress.

Today have only two countries, Pakistan and Afghanistanpolio place is an endemic species. It has been preserved in the rest of the world through the widespread use of vaccines.

Cases appear outside of those two countries, with some occasional cases, as a result of oral vaccines used in many parts of the world. Oral vaccines use a live but weakened virus. It is safe, but a person who receives it can spread the weakened virus to others. Only inactivated polio vaccine has been used in the United States since 2000.

The CDC recommends that children get four doses, with the last shot being given between the ages of 4 and 6.

Captain Derek Ehrhardt, epidemiologist and polio eradication incident manager for the Centers for Disease Control and Prevention, said: The polio virus is just another problem elsewhere.

The virus lives mainly in a person’s throat and intestines and most widely spread through contact with feces.

If the attenuated virus used in the oral vaccine circulates widely enough in communities with low vaccination rates or replicates in people with compromised immune systems, it can turn toxic form can cause paralysis, according to the CDC

Such outbreaks of “vaccine-derived polio virus” have occurs in many countries In recent years. Open drains and contaminated drinking water can help accelerate the spread.

Health authorities believe that the polio virus was introduced to New York by a vaccinated person living in another country, or by an unvaccinated person people with vaccine-induced polio while abroad.

Officials say the virus detected in two counties north of New York City is genetic link Vaccine-derived viruses collected from this year’s samples in Jerusalem, as well as sewage samples in London, have led to a new polio vaccination campaign there.

As of Friday, the CDC has confirmed the presence of polio virus in 20 wastewater samples in Rockland and Orange Counties, all of which are genetically related to the polio case in Rockland County residents. The districts are next to each other.

Of the 20 samples, two were collected in May, three in June and eight in July from Rockland County; two were collected in June and five in July in Orange County.

Irina Gelman, Orange County health commissioner, said officials are assuming that each positive sample collected in her county indicates a separate person has had the virus locally, but she added that she is awaiting further genetic analysis from the CDC to be sure.

Health officials believe hundreds of people in the area could be infected, she said. Estimates based on the number of people typically needing to be infected with the virus to have a single case of polio, combined with the global increase in vaccine-associated polio cases and coverage rates. Vaccine coverage is very low in parts of New York.

“Part of me still hopes that’s not the case,” she said.

“We are really working on a perfect storm scenario,” she added. “We have low immunization rates in Orange County for vaccine-preventable diseases, especially in our group of children.”

The only confirmed case of polio to date has been a 20-year-old male, an Orthodox Jewish resident of Rockland County, according to several local officials. Orange and Rockland counties are both home to large numbers of ultra-Orthodox Jews, and Anti-vaccination sentiment has spread among some in that community.

An outbreak of measles in 2019 also focuses on those in the ultra-Orthodox community, although vaccine misinformation and low vaccination rates are also found more widely, Dr. Gelman said.

According to the state Department of Health, immunization rates in Rockland and Orange Counties are far below what is needed to stop the spread of the virus. Among 2-year-olds, about 60 percent of children in both counties received all three recommended polio shots, state data shows, compared with 79 percent statewide.

Tired of Covid and spooked by the recent appearance of monkeypox, New Yorkers thought they had switched to a third virus on Friday, as they wondered if they were fully vaccinated. enough and whether their protection lasts for decades.

Gregory Ludd, 46, of Crown Heights, a porter, has six children. They are always up to date on their vaccinations, he said.

“I’m scared of it because we haven’t really heard of polio going on since we were little, little kids,” he said. “But all you can do is, you put your trust in God and just hope it doesn’t happen to your child.”

Lola Fadulu contribution report.