An overhead view of an NYC sewer cover
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  • New York Governor Kathy Hochul has declared a state of emergency due to polio.
  • Officials say the polio disease could be circulating among unvaccinated individuals, with hundreds of cases unaccounted for.
  • According to experts, vaccination against the disease is crucial to preventing severe illness and minimizing the spread.

New York Governor Kathy Hochul declared a state of emergency on September 9 over concerns that polio could be spreading in the state.

The poliovirus has been detected in the wastewater of multiple New York counties in recent weeks, suggesting a community spread among unvaccinated people, officials announced on Friday.

The virus causes polio, a disease that could lead to paralysis in the arms and legs and may result in death.

Earlier this summer the New York State Department of Health (NYSDOH) and the New York City Department of Health and Mental Hygiene (NYCDOHMH) provided sewage samples to the Centers for Disease Control and Prevention (CDC), which identified the presence of the poliovirus.

Using wastewater detection, state health offiicals have identified at least 57 samples in multiple New York counties that tested positive for the virus.

Hundreds of polio cases may be unaccounted for

The state of emergency will allow EMTs, pharmacists, and midwives among other groups to provide polio vaccinations. It also requires healthcare providers to send polio vaccination data to the state.

According to officials, hundreds of polio cases may be circulating among unvaccinated New Yorkers. As New York City officials scramble to meet the demand for monkeypox vaccinations and adjust to the CDC’s new COVID-19 guidelines, residents are grappling with an additional public health threat, the Associated Press reports

“​​For every one case of paralytic polio identified, hundreds more may be undetected, State Health Commissioner Dr. Mary T. Bassett said in an earlier statement. “The detection of poliovirus in wastewater samples in New York City is alarming, but not surprising.” 

Bassett added that the NY State Health Department is “responding urgently” at local and federal levels and “aggressively assessing” the spread of the disease. Health officials did not specify where in the five boroughs the virus was detected.

Until recently, polio hadn’t been detected in the United States in nearly a decade. On July 21, an unvaccinated man in Rockland County developed paralysis after contracting the virus. 

Officials and health experts encourage vaccination

Poliovirus spreads through saliva or fecal matter — but is preventable with vaccination. As such, New York officials are urging unvaccinated individuals, including children, to get immunized against polio as soon as possible. 

 “The risk to New Yorkers is real but the defense is so simple – get vaccinated against polio,” Health Commissioner Dr. Ashwin Vasan said in an earlier statement statement. 

“With polio circulating in our communities there is simply nothing more essential than vaccinating our children to protect them from this virus, and if you’re an unvaccinated or incompletely vaccinated adult, please choose now to get the vaccine. Polio is entirely preventable and its reappearance should be a call to action for all of us.” Vasan noted.

What new parents should know

Infants can be vaccinated against polio as soon as six weeks of age. Prior to that point, newborns are well protected by the maternal transfer of antibodies, according to Dr. Zachary Hoy, pediatric infectious disease specialist at Pediatrix Nashville Pediatric Infectious Disease. 

“If the mother of the infant has been vaccinated, the infant would not be at increased risk,” Hoy said. 

Who is at risk

Immunocompromised people, including those on medications and chemotherapy that impacts antibody production, are at a heightened risk. 

Because polio is spread via fecal-oral transmission, frequent handwashing can help prevent the spread of poliovirus, Hoy said.

Other than regular hand washing and getting vaccinated, Hoy says there are no specific precautions that immunocompromised people should take at this time.  

Loved ones of at-risk groups should ensure they are up to date with their polio vaccinations and ensure their children are on schedule for their childhood vaccinations, which includes the polio shot. 

Dr. Monica Gandhi, MPH, professor of medicine at the University of California, San Francisco, said the polio vaccine is very effective at preventing illness. 

“We know that the initial polio vaccine protects individuals from severe disease for a long time, possibly a lifetime although individuals vary,” Gandhi said.

“The only people who need to worry are those who are unvaccinated because vaccines are extremely protective against the severe forms of polio, like the vaccines with COVID. Children are most at risk of paralytic polio so it is imperative to catch up to childhood vaccines as there were setbacks during COVID-19.”

Gandhi noted that while vaccines prevent disease, they may not always prevent all spread, as with the COVID-19 vaccine.

“However, unlike with COVID-19, since we usually only screen for polio if someone has symptoms, we know very clearly that vaccination does prevent the development of polio symptoms,” Gandhi added.

Could there be a polio outbreak?

The CDC recommends that children receive 4 doses of the polio vaccine for the best protection.

Older research from 2005 shows that the polio vaccine generates strong and durable T cell immunity against polio, and durable memory B cells, Gandhi noted.

Most adults in the United States were vaccinated against polio as young children, but in some areas, vaccine rates for today’s children could be improved upon.

The New York Times reports the overall vaccination rate for polio among children 5 and under in New York City is 86%. But in other parts of the city, less than two-thirds of children 5 and under are fully vaccinated against polio, which has health officials concerned. 

In addition, the CDC recommends a one-time inactivated polio vaccine booster shot for adults who may be exposed to the virus in regions like New York, where the disease may currently be spreading.

“Boosters are generally recommended for immunocompromised patients and this may be the group that is targeted for a polio booster during this time (the U.K. is considering this for young children),” Gandhi said.

“I do not think there will be an outbreak of paralytic polio (symptomatic disease) with such high rates of vaccination in the U.S. if we can catch up. I think our efforts should focus on vaccinating those who have never had a primary polio vaccine series such as children who missed their childhood vaccines during COVID as well as those (like this young man) who are adults and not yet vaccinated.”

Takeaway

Polio was detected for the second time in a month in the state of New York, this time in city wastewater.

According to officials, detecting the poliovirus in sewage could indicate a community spread among unvaccinated people.

While it’s possible to contract polio even if you’re vaccinated, it’s unlikely you’d experience severe symptoms.

Health experts say that a polio outbreak is unlikely in the U.S., where vaccine levels remain relatively high. That’s why unvaccinated individuals, especially those living in New York, are being urged by city officials to get vaccinated against polio as soon as possible.

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