Polio is back — how worried should Americans be?


New York’s governor declared a state of emergency after well being officers detected poliovirus in sewage from 5 counties – proof that the illness is spreading. The declaration additionally follows the U.S. Centers for Disease Control and Prevention’s report of an unvaccinated particular person in Rockland County, New York, who was recognized with polio this summer time — the primary case recognized within the United States in practically a decade.

Understandably, these occasions have raised many questions: Why should one case of polio fear officers? What does it imply to seek out poliovirus in sewage? Who should be involved about contracting the illness? If somebody acquired the vaccine years in the past, are they nonetheless protected now?

To study extra about this illness that most individuals alive right now have by no means skilled, I interviewed CNN medical analyst Dr. Liana Wen is an emergency doctor and professor of well being coverage and administration on the George Washington University Milken Institute School of Public Health. He is additionally the creator of Lifelines: A Doctor’s Journey within the Battle for Public Health.

CNN: So there’s been just one documented case of polio-related paralysis in New York. Why is an incident of concern to well being officers?

Dr. Liana Wen: “Even a single case of polio represents a public well being emergency within the United States,” the CDC stated in an August report. This is for 2 primary causes.

First, poliomyelitis is a illness that may have very severe penalties. At its peak within the Forties and Fifties, polio paralyzed tens of hundreds of kids every year. Thousands of individuals have died from the virus.

This modified with the introduction of extremely efficient vaccines – greater than 99% efficient in defending in opposition to polio. Thanks to mass vaccination campaigns, the final case of wild-type polio occurred in 1979, and it was thought-about eradicated within the United States. The recurrence of such a illness, which might have such severe penalties, is an amazing hazard.

Second, a case of paralysis may be the tip of a big iceberg. Most instances of polio an infection are asymptomatic and don’t trigger paralysis. Symptoms – which might embrace fatigue, fever and diarrhea – are gentle and may resemble different viruses. Public well being officers concern that many extra individuals have polio and are unknowingly spreading it.

This is particularly alarming as a result of in Rockland County, the place polio was not too long ago recognized, polio vaccination is solely 60%. Vaccination charges are as little as 37% in some areas of the county. These numbers are effectively under the edge wanted for herd immunity and imply that there are various individuals within the area who’re susceptible to polio an infection and probably extreme penalties.

CNN: What does it imply that polio was discovered within the sewage of 5 counties, together with New York?

Wen: Finding poliovirus in sewage means one in all two issues: there are people who find themselves actively contaminated with polio who’re spreading the virus, or the virus sign could also be from individuals who have not too long ago obtained polio vaccine (OPV). OPV is not given within the United States – since 2000, the model used within the US is inactivated polio vaccine (IPV), which is injected – however different nations nonetheless use OPV, and vacationers from these locations could also be spilled. vaccine-derived virus.

On August 25, wastewater samples were taken from a laboratory at Queens College in New York.

In uncommon instances, a weakened virus from individuals who have obtained OPV may cause paralysis in unvaccinated individuals – a significant cause why OPV is not used within the US.

Another concern was {that a} sewage pattern from Nassau County on Long Island was genetically linked to polio instances present in Rockland County. (The two counties should not contiguous, however reasonably inside 40 miles of one another.) This is additional proof of the group’s broad unfold.

CNN: How do individuals get polio?

Wen: Poliomyelitis is an infectious illness that may be transmitted in varied methods. The primary route is fecal-oral, that is, somebody can get polio if they arrive into contact with the feces of an contaminated particular person. This can occur, particularly in kids, by placing issues of their mouths, similar to toys which were contaminated with feces.

Polio will also be unfold by the respiratory tract, similar to when an contaminated particular person coughs or sneezes and the droplets get into your mouth. Vaccinated individuals can nonetheless get polio and cross it on to others, however they’re very effectively shielded from extreme illness.

CNN: Should New Yorkers be worried about getting polio?

Wen: Again, individuals who have been vaccinated in opposition to polio are very effectively protected in opposition to paralysis and should not be involved at this level. It’s vital to notice that whereas IPV is superb at stopping the worst potential penalties of the illness, individuals who obtain the vaccine can nonetheless grow to be carriers of polio and cross it on to others. Those prone to extreme issues embrace those that are unvaccinated and those that should not totally vaccinated, together with younger kids underneath 6 years of age who haven’t accomplished the polio vaccine sequence.

CNN: How many polio vaccines should somebody get?

Wen: The CDC recommends that kids obtain 4 doses of IPV. The first is for two months, the second for 4 months, the third for six to 18 months, and the fourth for 4 to six years.

Adults who’ve by no means been vaccinated in opposition to polio should obtain three doses of IPV. The first should be given as early as doable, the second to 2 months after, and the third 6 to 12 months after the second.

CNN: If somebody acquired the vaccine years in the past, are they nonetheless protected? Who should obtain polio vaccine?

Wen: Protection in opposition to extreme illness stays robust for a few years after immunization; it is believed to final a lifetime. There is no want for extra doses for individuals who have obtained extra vaccinations.

However, if somebody has not accomplished the preliminary sequence of vaccines, they should obtain the remaining doses. Some totally vaccinated people may obtain a further lifetime BTI booster underneath sure circumstances, similar to direct contact with suspected polio or well being care employees who’re at excessive danger of contact with individuals with the illness.

CNN: What if you do not know for those who’ve been vaccinated? Say you do not bear in mind getting the vaccine and it has been years. Is there a blood take a look at to verify each methods?

Wen: You can verify together with your main care physician’s workplace or state well being division to see if they’ve data of your immunizations. If they do not and you don’t have any different approach to verify—for instance, by asking your mother and father or different family or caregivers—you should discuss to your well being care supplier about getting the complete polio vaccine sequence now. There is no blood take a look at that may precisely decide whether or not you’ve gotten been totally vaccinated in opposition to polio.

CNN: What for those who or somebody in your loved ones hasn’t been vaccinated in opposition to polio?

Wen: People who haven’t obtained any dose or should not totally vaccinated should instantly obtain the entire polio vaccine sequence. This is particularly vital in the event that they reside in or round Rockland County, New York, however actually everybody should be updated with their immunizations.

Decades in the past, so many kids have been completely paralyzed and even died from polio. This should not occur once more, as a result of now we have efficient vaccines that may stop the intense penalties of the illness.


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