New York state health officials issued a more urgent call on Thursday for unvaccinated children and adults to get inoculated against polio, citing new evidence of "potential community spread" of the debilitating virus.
The polio virus has now been found in seven wastewater samples in Rockland and Orange counties, which are next to each other and north of New York City.
So far, one person has tested positive for polio: an unvaccinated adult in Rockland County who had paralysis due to the virus.
"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," Mary Bassett, MD, the state health commissioner, said in the statement.
"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," she said. "As we learn more, what we do know is clear: the danger of polio is present in New York today."
The polio patient in Rockland County is the first person known to be infected with the polio virus in the U.S. in nearly a decade, according to The Associated Press.
Since the polio virus was found in wastewater samples in Rockland County in early June, the virus has also been found in wastewater samples from June and July in two locations in Orange County, as well as in July samples from Rockland County.
The CDC found three positive samples in Rockland County and four positive samples in Orange County. Are all genetically linked to the case of polio in the Rockland County resident who had paralysis.
"These findings provide further evidence of local — not international — transmission of a polio virus that can cause paralysis and potential community spread," the announcement said.
But the latest environmental findings don't mean that the Rockland County resident was the source of the transmission, state health officials said. New York health officials are working with international, national, and local public health authorities to find the origin of the virus.
On Monday, New York health officials said in another announcement that the Global Polio Laboratory Network, which includes the CDC and World Health Organization, confirmed that the Rockland County case is genetically linked to samples from greater Jerusalem as well as environmental samples in London.
On Thursday, state health officials urged New Yorkers who are unvaccinated — including children who are 2 months or older, pregnant people, and those who haven't completed their polio vaccine series previously — to get the shot right away. Unvaccinated people who live, work, attend school, or visit Rockland County, Orange County, and the greater New York metropolitan area face the highest risk of exposure right now, health officials said.
Under New York health guidelines for school-age children, most children are already vaccinated, the alert said. New Yorkers who aren't sure about their vaccination status should contact a health care provider to get vaccinated or receive a booster.
As of Aug. 1, Rockland County has a polio vaccination rate of about 60%, and Orange County has a polio vaccination rate of about 59%, as compared with a statewide average of 79%, among children who have received three polio vaccinations before their second birthday.
"This unprecedented circulation of polio in our community from a devastating disease that was eradicated from the United States in 1979 must be stopped," Patricia Schnabel Ruppert, DO, the Rockland County health commissioner, said in the statement.
"Any unvaccinated children and adults should receive a first polio immunization immediately," she said. "The Rockland County Department of Health is here to help residents receive vaccinations."
Her department is offering the polio vaccine at immunization clinics, either by appointment or during certain hours. Residents can visit the department's polio information page to learn more and book an appointment.
Polio is a life-threatening disease that is highly contagious. The virus can spread from person to person, and people can pass it to others even if they aren't sick. New York health officials expressed "high concern" about the spread of the disease by people without symptoms after the case of polio that caused paralysis.
Symptoms of polio, which can be mild and flu-like, can take up to 30 days to appear. During that time, an infected person can shed the virus to others. Some polio cases can result in paralysis or death, with about 5% to 10% of paralysis cases ending in death due to disabled breathing muscles.
There is no cure for polio, but it is preventable through immunization, health officials said. Under CDC guidelines, all children should receive four doses of the polio vaccine, with the first dose given at 6 weeks through 2 months, followed by the second at 4 months, the third at 6 to 18 months, and the final dose between ages 4 and 6.
Adults who are unvaccinated or are unsure if they have been immunized should receive three doses. Those who have received one or two doses should get the remaining one or two doses, regardless of how long it has been since the earlier doses.
Adults who have a higher risk of exposure to the polio virus and who previously completed a routine series of polio vaccine can receive one lifetime booster dose.
In Orange County, the wastewater samples that identified the polio virus were first collected from city wastewater treatment plants for COVID-19 testing.
"It is concerning that polio, a disease that has been largely eradicated through vaccination, is now circulating in our community, especially given the low rates of vaccination for this debilitating disease in certain areas of our county," Irina Gelman, PhD, the Orange County health commissioner, said in the statement.
"I urge all unvaccinated Orange County residents to get vaccinated as soon as medically feasible," she said.
New York State Department of Health: "Urging Immunization, State Department of Health Updates New Yorkers on Polio Detected in New York State," "State Department of Health Updates New Yorkers on Polio in New York State."
The Associated Press: "Polio fears rise in New York amid possible community spread."
Rockland County Department of Health: "Polio information."
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Cite this: Polio in New York Linked to Potential Community Spread - Medscape - Aug 05, 2022.