Health officials have detected polio in the wastewater in New York City, a development that portends community spread of the virus in a densely populated part of America that suffered greatly from COVID-19 and is the epicenter of the monkeypox outbreak.
State and city health officials said sewage samples sent to the Centers for Disease Control and Prevention confirmed the presence of the virus, which can cause paralysis and death.
Health departments identified one case of vaccine-derived poliovirus in Rockland County, New York, last month but the samples suggest the virus could be pinging around the Big Apple, too.
Officials said they are working aggressively to assess the extent of the spread of the virus. They fear the pathogen will afflict people who are unvaccinated or not up to date on their shots.
“For every one case of paralytic polio identified, hundreds more may be undetected,” said state Health Commissioner Mary T. Bassett. “The detection of poliovirus in wastewater samples in New York City is alarming, but not surprising.”
City Health Commissioner Ashwin Vasan said polio poses a real risk to New Yorkers but “the defense is so simple.”
“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,” he said. “Polio is entirely preventable and its reappearance should be a call to action for all of us.”
Polio is highly contagious and was a devastating disease in the early 20th century before the vaccine arrived. There is a wild type that is only endemic to Afghanistan and Pakistan, though it was detected in Mozambique earlier this year.
But the CDC said the case in New York was a vaccine-derived poliovirus, or VDPV, in an unvaccinated person.
A VDPV is a strain related to the weakened live poliovirus in the Sabin vaccine, also known as the oral polio vaccine (OPV), that in rare instances can prey upon under-vaccinated or immunodeficient populations and revert to a form that causes illness.
The OPV vaccine is no longer licensed in the U.S. though it is used in other parts of the world.
The U.S. has been giving children the inactivated poliovirus vaccine (IPV) since 2000.
Children typically get a course of four shots for polio between 2 months old and 6 years old. Some groups, including some in the orthodox Jewish community in Rockland County, have resisted vaccination, sparking calls for an information campaign.
City officials said vaccination rates are lagging in parts of the city. About 86% of city children ages 6 months to 5 years have received three doses, meaning 14% are not up to date, and neighborhoods in Brooklyn have vaccination rates below 70%.
Some people who contract polio don’t feel any symptoms, prompting increased worry about the silent spread of the virus.
New York is already struggling to contain the monkeypox virus that, while rarely fatal, features a painful rash and lesions. The Empire State accounts for about a fifth of the 10,700-plus cases recorded in the U.S. as a number of countries battle the virus for the first time outside of Africa, where the virus is endemic.
New York City was also the epicenter of COVID-19 during the first months of the pandemic in 2020, with the eerie sound of ambulances filling city streets and hospitals forced to create makeshift morgues.
Officials on Friday warned that polio can cause permanent paralysis of the arms and legs and might be fatal because of paralysis in the muscles that are used to breathe or swallow.
They said most people infected with the virus do not have any symptoms, though some feel flu-like symptoms such as sore throat, fever, fatigue, nausea and stomach pain.
Beyond New York, officials in London have detected the polio virus in wastewater, adding to the alarm around the discovery.
Disease fighters are considering different steps to fight a potential outbreak, including whether extra doses are needed for certain persons who aren’t up to date on vaccination. U.K. officials started offering boosters in the London area.