New York City officials have detected polio in the city’s sewage, confirming that at least one person has recently contracted the virus in the city.
Surveillance for the virus began after a confirmed case was found near Rockland County last month. Sewage monitoring in Orange County — also just outside the Bronx borough — has also turned up at least two polio samples since June.
Officials warned there could be hundreds — potentially thousands — of undiagnosed cases circulating around the state. Because most cases are either asymptomatic or very mild, it is likely that the vast majority will go undetected.
In response, the Centers for Disease Control and Prevention (CDC) sent a team to Rockland County earlier this week to investigate the outbreak and help vaccinate the local community. Both Rockland and Orange County have vaccinated only 60 percent of residents, one of the lowest rates in the state.
New York City officials have discovered 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’s wastewater watchdog also found a case
Common symptoms of polio include high temperatures, extreme fatigue, headaches, vomiting, stiff neck and muscle aches
The Big Apple has a vaccination coverage rate of 86 percent, still well below the 95 percent threshold considered necessary to prevent a widespread outbreak.
While a polio outbreak in America’s largest city can be scary, a vaccinated person is not considered at risk. Many Americans had to be vaccinated in order to go to school, and no booster shots are necessary. More than 90 percent of the American population has received the polio vaccine.
“The risk to New Yorkers is real, but the defense is so simple – get vaccinated against polio,” said Dr. Ashwin Vasan, City Health Commissioner.
“With polio circulating 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 incompletely vaccinated adult, please choose to get the vaccine now.
“Polio is completely preventable and its reappearance should be a call to action for all of us.”
Officials have not confirmed when the sample was taken. It is also impossible to find out whether it was a person visiting the city or a resident.
Polio: Once the most feared disease in America, now a rarity
Polio is a serious viral infection that used to be common around the world.
The virus lives in the throat and intestines for up to six weeks, with patients being most infectious from seven to 10 days before and after the onset of symptoms.
However, it can spread to the spinal cord and cause muscle weakness and paralysis.
The virus is more common in infants and young children and occurs in conditions of poor hygiene.
How deadly is that?
Most people show no signs of infection, but about one in 20 people have minor symptoms such as fever, muscle weakness, headache, nausea and vomiting.
About one in 50 patients will develop severe muscle pain and stiffness in the neck and back.
Less than one percent of polio cases result in paralysis, and one in 10 of these results in death.
For those who do develop symptoms, they usually appear three to 21 days after infection and include:
- High temperature
- Sore throat
- Abdominal pain
- Muscle pain
- Nausea and vomiting
How does it spread?
People can catch polio through airborne droplets when someone coughs or sneezes, or when they come into contact with the feces of an infected person.
This includes food, water, clothes or toys.
Are there different tribes?
There are three strains of “wild” polio that have been largely eradicated throughout Europe, the Americas, Southeast Asia, and the Western Pacific.
Types 2 and 3 have been eliminated thanks to a worldwide mass vaccination campaign, with the last cases detected in 1999 and 2012, respectively.
The remaining wild polio type 1 remains endemic in only two countries, Afghanistan and Pakistan.
Thanks to vaccines, wild polio has been eliminated in almost all countries of the world.
However, global introduction has spawned new types of strains known as vaccine-derived polioviruses.
These are strains that were originally used in live vaccines but have spread into the community and evolved to behave more like the wild version.
Is polio still in the US?
The last case of human-to-human transmission in the US was in 1979, which was also the last case of wild polio.
Since then, however, there have been several dozen cases of vaccine-derived poliovirus, although these were isolated cases, with no further transmission.
Am I vaccinated against polio?
Inactivated polio vaccine (IPV) has been offered to Americans since 2000.
It is given in four doses, with the first jab at the age of two months. It is also given at the ages of four, six to 18 months and four to six years.
Income has fallen slightly, but remains above 90 percent nationally.
There are fears that reluctance to vaccinate during the Covid crisis has increased due to the spread of misinformation about the virus and school closures.
A case of polio found earlier this year in Rockland was a shock. It was the first case detected in the country in more than a decade and could potentially be the first US-transmitted case 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 case of polio was a vaccine-induced strain. This form of polio emerged as a result of the oral polio vaccine, which delivers a live form of the virus to humans.
In some cases, the recipient may be infected. For this reason, it is no longer used in America, although some developing countries still use it.
Officials have not confirmed whether they know whether the virus found in sewage samples in the area came from vaccine-induced or wild strains of the virus.
However, the mere discovery of a single case put officials on high alert.
“Based on previous polio outbreaks, New Yorkers should know that for every observed case of paralytic polio, there may be hundreds of other people infected,” Dr. Mary Bassett, the state’s health commissioner, said earlier this week.
“Coupled with the latest knowledge about sewage, the Department considers the single case of polio to be the tip of the iceberg of a much larger potential spread.”
A local Rockland official said this week that the true number of cases in the Empire State is likely in the thousands.
“It’s not just one case of polio when you see a paralytic case. The incidence of paralytic polio is less than one percent,” Rockland County Health Commissioner Dr. Patricia Schnabel Ruppert told the BBC.
“Most cases are asymptomatic or mildly symptomatic and we often miss these symptoms.
“So there are hundreds, maybe thousands of cases that have happened for us to see a paralytic case.”
The CDC also got involved in Rockland, sending a team to investigate the circumstances of the polio case and increase vaccination coverage in the county.
According to official figures, only about 60 percent of Rockland County residents are vaccinated against polio by their second birthday. That’s a staggeringly low number that falls far short of the 95 percent threshold set by the World Health Organization to prevent an outbreak.
New York City has a much higher number – 86 percent – still short of the 95 percent mark.
Polio was once the most feared disease in the US, causing panic in the 1940s.
Parents were afraid to let their children play outside — especially in the summer, when the virus seemed to be more common — and public health officials imposed quarantines on households and even entire cities where it was spotted.
It was responsible for more than 15,000 paralysis and hundreds of deaths each year.
However, in the mid-1950s, the country began introducing polio vaccines to prevent the disease.
In 1979, the United States declared that the virus had been eliminated. Since then, there has been no known transmission on American soil.
The vaccine has also been rolled out globally, with the virus pushed back to just a few countries.
It is now known to be in circulation only in Pakistan and Afghanistan. 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 receded from national memory — vaccination rates in the United States have slowed.
The latest data shows that about 92.6 percent of Americans are now vaccinated against polio by their second birthday.
The CDC recommends that all children receive the polio vaccine.
It is given as four doses in the leg or arm, with the first dose given at two months of age, the second at four months, the third between six and 18 months and the last dose between four and six years.
The vaccine is highly effective, 99 percent of children receive lifelong protection against the disease.