Following sewage testing positive in Brooklyn and Queens, New York Governor Kathy Hochul has prolonged the state of emergency established in response to the spread of the poliovirus.
According to Hochul, the state disaster emergency would continue at least through November 8 in order to support regional initiatives to increase the polio vaccination rate.
The sewage sample from Brooklyn and Queens that tested positive on Tuesday was genetically related to the virus that paralyzed an adult who was unvaccinated in Rockland County over the summer, according to a statement from the New York State Department of Health.
The only confirmed case of paralysis in the United States to date is an unvaccinated adult from Rockland County, but state health officials have warned that there are probably hundreds of people spreading the virus asymptomatically.
“These findings put an alarming exclamation point on what we have already observed: unvaccinated people are at a real and unnecessary risk,” New York State Health Commissioner Dr. Mary Bassett and New York City Health Commissioner Dr. Ashwin Vasan said in a joint statement.
A total of 70 sewage samples have tested positive for poliovirus in the New York City metropolitan area so far, according to New York state health officials. The virus has been detected in sewage from Kings, Nassau, Orange, Queens, Rockland, and Sullivan counties.
More than 28,000 doses of polio vaccine have been administered since July in Rockland, Orange, Sullivan and Nassau countries, according to state health officials.
Most people are vaccinated against polio as children and are not at risk, but New York has been struggling with low immunization rates in some communities for years.
In Rockland County, the vaccination rate for children under age two dropped from 67% in 2020 to 60% in 2022, according to the Centers for Disease Control and Prevention. In some areas of Rockland, only 37% of kids in this age group are up to date on their vaccine.
State, national, and global health authorities believe the poliovirus found in New York originated from a country that still uses the oral polio vaccine. The oral vaccine uses a live virus that in rare circumstances can mutate and cause disease.
The U.S. stopped using the oral vaccine more than 20 years ago. It now administers an inactivated vaccine that contains killed virus that cannot mutate. The inactivated vaccine is highly effective at preventing disease but does not stop transmission of the virus.
MORE INFORMATION ABOUT POLIO VIRUS
What is Poliovirus
Poliomyelitis (polio) is a highly infectious viral disease that largely affects children under 5 years of age. The virus is transmitted by person-to-person spread mainly through the faecal-oral route or, less frequently, by a common vehicle (e.g. contaminated water or food) and multiplies in the intestine, from where it can invade the nervous system and cause paralysis.
History of Poliovirus
In the early 20th century, polio was one of the most feared diseases in industrialized countries, paralysing hundreds of thousands of children every year. Soon after the introduction of effective vaccines in the 1950s and 1960s however, polio was brought under control and practically eliminated as a public health problem in these countries.
It took somewhat longer for polio to be recognized as a major problem in developing countries. Lameness surveys during the 1970s revealed that the disease was also prevalent in developing countries. As a result, during the 1970s routine immunization was introduced worldwide as part of national immunization programmes, helping to control the disease in many developing countries.
Rotary International launched a global effort to immunize the world’s children against polio in 1985 followed by the establishment of the Global Polio Eradication Initiative (GPEI) in 1988. When the GPEI started, polio paralysed more than 1000 children worldwide every day. Since then, more than 2.5 billion children have been immunized against polio thanks to the cooperation of more than 200 countries and 20 million volunteers.
Today, wild poliovirus continues to circulate in only two countries, and global incidence of polio cases has decreased by 99%.
There has also been success in eradicating certain strains of the virus; of the three types of wild polioviruses (WPVs), the last case of type 2 was reported in 1999 and its eradication was declared in September 2015; the most recent case of type 3 dates to November 2012 and this strain was declared as globally eradicated in October 2019.
How does Polio spread?
- Poliovirus is very contagious and spreads through person-to-person contact.
- It lives in an infected person’s throat and intestines.
- It can contaminate food and water in unsanitary conditions.
Poliovirus only infects people. It enters the body through the mouth. It spreads through:
- Contact with the feces (poop) of an infected person
- Droplets from a sneeze or cough of an infected person (less common)
You can get infected with poliovirus if:
- You have picked up minute pieces of feces on your hands, and you touch your mouth.
- You put in your mouth objects like toys that are contaminated with feces.
An infected person can spread the virus to others immediately before and up to 2 weeks after symptoms appear.
- The virus can live in an infected person’s intestines for many weeks. It can contaminate food and water in unsanitary conditions.
- People who don’t have symptoms can still pass the virus to others and make them sick.
What are the symptoms of polio?
Between 70% and 95% of people infected with poliovirus don’t have symptoms. Of those with symptoms, most people have the mildest form (abortive poliomyelitis) with flu-like and intestinal symptoms. Paralytic polio causes the most serious symptoms, including paralysis.
Symptoms of abortive poliomyelitis
Abortive poliomyelitis symptoms are similar to many other illnesses. They start three to seven days after getting infected and last a few days. Symptoms of abortive poliomyelitis include:
- Fatigue.
- Fever.
- Headache.
- Vomiting.
- Diarrhea or constipation.
- Sore throat.
Symptoms of non-paralytic poliomyelitis
Non-paralytic poliomyelitis starts with the same symptoms as abortive poliomyelitis. Additional symptoms start within a few days, including:
- Neck stiffness.
- Pain or pins-and-needles feeling in your arms and legs.
- Severe headache.
- Sensitivity to light (photophobia).
Symptoms of paralytic poliomyelitis
Paralytic poliomyelitis starts out with symptoms similar to abortive poliomyelitis or non-paralytic poliomyelitis. Additional symptoms can appear days or weeks later, including:
- Sensitivity to touch.
- Muscle spasms.
In addition:
- Spinal poliomyelitis makes it so you can’t move your arms or legs or both (paralysis).
- Bulbar poliomyelitis makes it hard to breathe, swallow and speak.
- Bulbospinal poliomyelitis has symptoms of both spinal and bulbar polio.
Symptoms of polioencephalitis
You can have symptoms of polioencephalitis on their own or along with flu-like symptoms. Symptoms include:
You can have symptoms of polioencephalitis on their own or along with flu-like symptoms. Symptoms include:
- Extreme tiredness (fatigue).
- Anxiety.
- Trouble focusing.
- Seizures.
How is polio treated?
There are no specific medications to treat polio. If you have paralytic polio, you’ll receive physical therapy. If your breathing muscles are weakened or paralyzed, you’ll need mechanical ventilation, a machine that helps you breathe.
You might be able to improve your symptoms by:
- Drinking fluids (such as water, juice and broth).
- Using heat packs to help muscle aches.
- Taking pain relievers, such as ibuprofen (Advil®, Motrin®).
- Doing physical therapy and any exercise recommended by your healthcare provider.
- Getting plenty of rest.
By: Cabunagan, Jeberly C., Dahay, Arsha Nichole Y., Diez, Prich Jayrald S., Santacera, Ian Jori G.
References
Polio: Causes, Symptoms & Vaccine Schedule. (n.d.). Cleveland Clinic. Retrieved October 24, 2022, from https://my.clevelandclinic.org/health/diseases/15655-polio
GPEI-History of Polio. (n.d.). Retrieved October 24, 2022, from https://polioeradication.org/polio-today/history-of-polio/
Kimball, S. (2022, October 11). Poliovirus found in Brooklyn and Queens sewage, New York health officials say. CNBC. Retrieved October 24, 2022, from https://www.cnbc.com/2022/10/11/poliovirus-found-in-brooklyn-and-queens-sewage-samples-new-york-health-officials-say.html
