Polio Risk Returns to London and Lower New York
The poliovirus has been surprisingly confirmed in non-endemic communities over the past month, thanks to innovative wastewater surveillance systems. The advantage of wastewater sampling is that it captures the waste contributions of society without divulging individual identities.
A total of 116 PV2 isolates have been identified in 19 sewage samples collected in London, England, between February and July 5, 2022. Most are vaccine-like viruses; only a few have sufficient mutations to be classified as vaccine-derived poliovirus (VDPV2).
VDPV2 is of more significant concern as it behaves more like naturally occurring 'wild' polio and may, on rare occasions, lead to cases of paralysis in unvaccinated individuals, says the U.K. Health Security Agency (UKHSA).
However, the polio risk in England may be greater than currently known.
The UKHSA has already increased sewage surveillance.
A further 15 sites in London will start sewage sampling in mid-August, and about 15 sites will be stood up nationally to determine if poliovirus is spreading outside of London.
And in New York State, following the identification of poliovirus in wastewater samples in Rockland County, the virus has now also been detected in wastewater samples from June and July 2022, in two geographically different locations in Orange County and July samples from Rockland County.
N.Y. State Health Commissioner Dr. Mary T. Bassett stated in a press release on August 4, 2022, "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."
"As we learn more, what we know is clear: the danger of polio is present in N.Y. today."
"We must meet this moment by ensuring that adults, including pregnant people, and young children by two months of age are up to date with their immunization."
According to recent polio vaccination data, several N.Y. communities have substandard polio vaccination rates.
For example, the polio vaccination rate in the Williamsburg section of Brooklyn is below 60% as of June 30, 2022.
To reduce the risk to children and adults, both London, England, and the southern counties of New York have recently launched polio vaccination programs.
The UKHSA announced on August 10, 2022, that about 900,000 children in various areas of London are being offered primary and booster polio vaccinations.
Dr. Vanessa Saliba, a Consultant Epidemiologist at UKHSA, commented, 'No polio cases have been reported. But we know the areas in London where the poliovirus is being transmitted have some of the lowest vaccination rates.'
'It is vital parents ensure their children are fully vaccinated for their age.'
'Following the Joint Committee on Vaccination and Immunisation's advice, all children aged 1 to 9 years in London need to have a polio vaccine now – whether an extra booster dose or just to catch up with their routine vaccinations.'
'This may also help stop the poliovirus from spreading further.'
And in Rockland and Orange Counties of New York, free polio vaccination clinics are available to all residents as of August 11, 2022.
In the USA, the U.S. FDA has approved various combination vaccines that offer polio protection.
The individual IPOL vaccine is indicated for active immunization of infants (as young as six weeks), children, and adults to prevent poliomyelitis caused by poliovirus types 1, 2, and 3.
These polio vaccines are generally available at health clinics and local pharmacies in the USA.
In 2021, more than 372 million children were vaccinated multiple times in 30 countries, using more than one billion oral polio vaccines.
To alert international travelers of their potential poliovirus risks, the CDC's latest travel advisory stated on July 29, 2022, Before any international travel, anyone unvaccinated, incompletely vaccinated, or with an unknown polio vaccination status should complete the routine polio vaccine series.
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