By Isabel Andaya, Guest Contributor
Poliomyelitis, colloquially known as “polio,” is a life-threatening disease caused by poliovirus. A majority of those affected by the virus show no visible symptoms, while a handful of people may experience flu-like symptoms such as fever, nausea, sore throat, and the like. An even smaller population might develop more severe signs (meningitis, leg and arm weakness, and paralysis) that can affect the brain and spinal cord.
Polio History
A timeline outlined by Mayo Clinic illustrates the history of polio epidemics and the impact that vaccines had on the virus. Before the creation of a vaccine against polio, numerous outbreaks and cases occurred between the years 1948 and 1955. With the development of the first polio vaccine in 1955 and the second vaccine in 1961, cases steadily began to subside. Following this, polio was considered to be fully eliminated in both North and South America in 1994. Variants WPV2 and WPV3 were declared eradicated worldwide in 2015 and 2019, respectively.
Polio cases have reduced by over 99% since eradication efforts were pushed by the World Health Organization (WHO) in 1988. The World Health Assembly, alongside healthcare giants Rotary International, the Centers for Disease Control and Prevention (CDC), and UNICEF, launched the Global Polio Eradication Initiative (GPEI) in the same year.
The New York Case
Although the decline of polio gave the public a sense of peace and calm, six reported cases of polio in 2021 and one case in 2022 raised concerns for a possible re-emerging outbreak. As stated by WHO, “As long as a single child remains infected, children in all countries are at risk of contracting polio. Failure to eradicate polio from these last remaining strongholds could result in a global resurgence of the disease” (July 2022).
Is this singular case enough to spark fear in the hearts of many? As reported by State Health Commissioner Dr. Mary T. Bassett, “The detection of poliovirus in wastewater samples in New York City is alarming, but not surprising” (August 2022). Because of the past epidemics, the CDC still recommends that non-vaccinated individuals complete their polio vaccinations in order to suppress the spread of the virus and minimize potential symptoms.
The New York State Department of Health (NYSDOH) and the New York City Department of Health and Mental Hygiene (NYCDOHMH) detected poliovirus in New York sewage samples collected during May, June, and July of 2022. This suggests that the source of the virus within New York could be the reason for the current concerns.
Following these findings was the recent polio case; a Rockland County resident of New York was diagnosed with paralytic polio on the 21st of July, 2022. According to New York State’s government site, Rockland County’s vaccination rate is just over 60%. As the NYSDOH urges residents to get vaccinated, Rockland County’s 60.34% vaccination rate is falling behind the state-wide average rate of 78.96%.
Polio Prevention
While polio cannot be completely “cured,” it can be prevented by implementing certain measures. The two currently available vaccines for poliovirus, oral (OPV) and inactivated (IPV), are tried-and-true; they are effective when both are fully implemented within a population “depending on local epidemiological and programmatic circumstances” (WHO, July 2022). As per the CDC’s guidelines, it is advised that children receive four doses of the polio vaccine. Most adults in the U.S. have been vaccinated as children, so they are already protected.
According to GPEI, “It is vital that all countries . . . strengthen surveillance in order to rapidly detect any new virus importation and to facilitate a rapid response. Countries, territories, and areas should also maintain uniformly high routine immunization coverage . . . to protect children from polio and to minimize the consequences of any new virus being introduced” (July 2022).
Dr. Bassett, as previously mentioned, stated that “[t]he best way to keep adults and children polio-free is through safe and effective immunization–New Yorkers’ greatest protection against the worst outcomes of polio, including permanent paralysis and even death.”
“The risk to New Yorkers is real but the defense is so simple–get vaccinated against polio,” said Health Commissioner Dr. Ashwin Vasan. “[T]here is simply nothing more essential than vaccinating our children to protect them from this virus . . . Polio is entirely preventable and its reappearance should be a call to action for all of us.”
The NYSDOH and NYCDOHMH, in partnership with the CDC, will continue to actively survey New York and surrounding cities’ sewage and wastewater to further prevent the spread of poliovirus.
The “Polio Endgame and Legacy”
Created by GPEI, the polio Post-Certification Strategy (PCS) aims to confirm the eradication of polio internationally after global certification. It was initially developed as a strategic and comprehensive way to define standards used to “sustain a polio-free world” (GPEI). The goals of PCS include the containment of poliovirus, the removal of OPV (replaced with IPV only), and rapid detect-and-respond measures.
Does the New York case signify the onset of a polio outbreak? Officials’ responses suggest this is highly unlikely as long as people make an effort to get vaccinated. While poliovirus is here to stay for now, it is ultimately up to individuals to vaccinate their children.
Isabel Andaya is a Health Science student at California State University, Sacramento.
Disclaimer: The information and opinions on this site do not include legal advice or the advice of a licensed healthcare provider.