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ASPartOfMe
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21 Jul 2022, 6:00 pm

Polio case confirmed in New York state, health-care providers told to look for more infections

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The New York State Health Department confirmed a case of polio on Thursday, the first known infection in the U.S. in nearly a decade.

A resident of Rockland County, a suburb of New York City, tested positive for polio, according to the state health department. The Centers for Disease Control and Prevention confirmed the infection.

The individual was an unvaccinated adult who experienced significant symptoms, including paralysis, and had to be hospitalized, according to the New York State Health Department.

Health-care providers should look for additional polio cases, state health officials said. The chain of infection that resulted in the New York case is believed to have originated outside the U.S.

No cases of polio have originated in the U.S. since 1979, according to the CDC. The last known case of polio in the U.S. was in 2013. The case in Rockland County is the first time New York state has confirmed an infection since 1990, when there were two cases.

The polio strain the individual caught, known as revertant Sabin type 2 virus, suggests the chain of infection began with someone who received the oral polio vaccine, according to the state health department. The oral polio vaccine contains a mild virus strain that is still able to replicate, which means people who receive it can spread the virus to others.

The oral polio vaccine is no longer administered in the U.S., which suggests the chain of transmission began abroad, according to New York health officials. The U.S. uses an inactivated polio vaccine that is administered as a shot in the leg or arm. This vaccine uses a non-replicating virus strain so people who receive it cannot spread the virus to others.

The CDC recommends that all children receive the polio vaccine. New York state requires that all children receive the shot before they start school. State Health Commissioner Dr. Mary Bassett encouraged recommended that people who are not vaccinated against polio get the vaccine.

Polio is highly contagious and often begins with symptoms similar to the flu such as fatigue, fever, headache, muscle pain, vomiting and stiffness. Symptoms can take as long as 30 days to develop, which means people who haven’t fallen ill yet can still spread the virus to others.

In rare cases, polio can cause paralysis and death. The virus caused widespread fear in the 1940s before vaccines were available, with more than 35,000 people becoming disabled from polio every year, according to the CDC. At the time, many parents were afraid to let their children play outside during the summer when transmission peaked.


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21 Jul 2022, 10:23 pm

Nice.

New diseases. And now old classics are making a comeback.



auntblabby
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21 Jul 2022, 11:44 pm

i hope today's treatments for polio are more than the iron lung.



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22 Jul 2022, 12:23 am

I can already hear the anti vaxxers shoving their heads into the sand.



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22 Jul 2022, 12:55 am

auntblabby wrote:
i hope today's treatments for polio are more than the iron lung.


Polio is nearly always very minor. Only a tiny portion of cases would require an iron lung.

Before the vaccine, polio was so common that just about everyone would have it by the time they were 6 or 7 years old. In the vast majority of cases it would be so mild that symptoms were minimal and might not even be noticed.



ASPartOfMe
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01 Aug 2022, 9:38 pm

Polio found in N.Y.’s Rockland County wastewater following first confirmed U.S. case in almost a decade

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Polio was discovered in wastewater samples from a Rockland County sewage treatment plant dating back to early June, state officials announced Monday.

The wastewater testing began last week, shortly after the county recorded the first case of the life-threatening virus in the U.S. since 2013.

Going back over sewage samples already collected for COVID-19 testing, state officials worked with the federal Centers for Disease Control and Prevention and the international Global Polio Laboratory Network to determine that the virus found in Rockland is genetically linked to a strain recorded in Jerusalem.

“Further investigations – both genetic and epidemiological – are ongoing to determine possible spread of the virus and potential risk associated with these various isolates detected from different locations around the world,” the Global Polio Eradication Initiative said in a statement.

Areas with lower vaccination rates can see the virus spread quickly because those infected can transmit it even if they aren’t sick.

Symptoms, which can be mild and flulike, can take up to 30 days to appear.

The variant recorded in Rockland as well as Israel is linked to a vaccine used across much of the world, but no longer utilized in the U.S. The oral vaccine uses weakened live viruses that prompt the immune system to create protective antibodies.

However, the weakened strains can occasionally spread among the unvaccinated and, often in areas with poor sanitation systems and the absence of clean drinking water, genetically revert to a form that can cause paralysis.

State officials note that Rockland County currently has a polio vaccination rate of 60.5% among 2-year-olds compared with the statewide average of 79.1%.

Rockland was the epicenter of a measles outbreak back in 2018 and 2019 that saw the now rare viral infection spread largely among children in the Orthodox Jewish communities whose parents refused to get them vaccinated.

That outbreak led New York lawmakers to put an end to vaccination exemptions based on religious beliefs.


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02 Aug 2022, 7:14 am

Most cases of polio are mild, yes….but enough cases weren’t mild for it to become a public health disaster.

Polio is returning because of vaccine hesitancy. What’s next? Diphtheria, smallpox?



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02 Aug 2022, 7:24 am

It’s scary. There are several anti-vaxxers in my family.


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12 Aug 2022, 2:16 am

Polio booster vaccine to be offered to children in London after more virus found in sewage water

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British health authorities say they will offer a polio booster vaccine to children aged 1 to 9 in London, after finding evidence the virus has been spreading in multiple regions of the capital, despite not confirming any cases of the paralytic disease in people.

In a statement on Wednesday, Britain's Health Security Agency said it had detected polio viruses derived from the oral polio vaccine in sewage water from eight boroughs of London, but had not identified any cases.

Its analysis of the virus samples suggested "transmission has gone beyond a close network of a few individuals" but that it had not found anyone infected with the virus. According to the World Health Organization, only one in 200 polio infections leads to paralysis; most people don't show any symptoms.

The agency said it was working closely with health authorities in the U.S. and Israel and WHO to investigate the links between polio viruses detected in those two countries.

"We know the areas in London where the poliovirus is being transmitted have some of the lowest vaccination rates," said Dr. Vanessa Saliba, a consultant epidemiologist at the U.K. Health Security Agency. "This is why the virus is spreading in these communities and puts those residents not fully vaccinated at greater risk."

Polio is a disease often spread in water that mostly affects children under 5. It has mostly been wiped out from developed countries, but outbreaks remain in Pakistan, Afghanistan and parts of Africa. Initial symptoms include fever, fatigue, headache, vomiting, and muscle stiffness. Among people paralyzed by the disease, death can occur in up to 10% of cases when their breathing muscles become paralyzed.

In rare cases, the live virus contained in the oral polio vaccine used in the global effort to eradicate the disease can mutate into new forms potent enough to trigger new outbreaks. The vaccination booster effort in London will use injected polio vaccines that do not carry that risk.


'Silent' spread of polio in New York drives CDC to consider additional vaccinations for some people
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A polio case identified in New York last month is "just the very, very tip of the iceberg" and an indication there "must be several hundred cases in the community circulating," a senior official with the US Centers for Disease Control and Prevention told CNN on Wednesday.

The case was found In Rockland County, which has a stunningly low polio vaccination rate. Dr. José Romero, director of the CDC's National Center for Immunization and Respiratory Diseases, noted that the majority of people with polio don't have symptoms and so can spread the virus without knowing it.

"There are a number of individuals in the community that have been infected with poliovirus. They are shedding the virus," he said. "The spread is always a possibility because the spread is going to be silent."

A team of CDC disease detectives traveled last week from agency headquarters in Atlanta to Rockland County, and they are "quite nervous" that polio "could mushroom out of control very quickly and we could have a crisis on our hands," said a community health leader who has met with the team.

"They are -- what is the opposite of cautiously optimistic?" said another community leader, an expert in vaccine education, who has also met with the CDC team in Rockland County. Both leaders requested anonymity because they are not authorized to speak publicly.

Polio can cause incurable paralysis and death, but most people in the US are protected, thanks to vaccination. Others, however, may be vulnerable to the virus for a variety of reasons.

Unvaccinated and undervaccinated people are vulnerable, and polio vaccination rates in Rockland County and neighboring Orange County, just north of New York City, are about 60%, compared with 93% nationwide. Immune-compromised people can be vulnerable even if they are fully vaccinated.

Romero said the CDC is considering a variety of options to protect people from polio, including offering children in the area an extra shot of the vaccine, as UK health authorities are doing now in London, or recommending extra doses to certain groups of adults.

"We're looking into all aspects of how to deal with this. At this point, we don't have a definitive answer," he said.

The virus has also been detected in sewage in Rockland County and neighboring Orange County. The positive samples were genetically linked to the individual case, but no other cases in the US have been reported.

About 3 in 4 people infected with polio don't have symptoms, but they're still capable of spreading the virus to others, according to the CDC. Among the rest, most have symptoms such as a sore throat or headache that could easily be overlooked or confused with other illnesses. Only a relatively small number, about 1 in 200 infected people, become paralyzed. A few of those who are paralyzed die because they can't breathe.

In the late 1940s, polio outbreaks disabled an average of more than 35,000 people a year in the US. A vaccination campaign started in 1955, and cases quickly plummeted. Today, a full round of childhood polio vaccinations -- four doses between 2 months old and 6 years old -- is at least 99% effective, according to the CDC.

But in recent decades, some small groups have not vaccinated their children against the virus. One of them is within the ultraorthodox Jewish community in New York, including in Rockland County.

Much of the rest of the religious Jewish community in Rockland County has rallied around efforts to educate the "outliers" who refuse to vaccinate, the community health leader said.

"This is a silent killer, like carbon monoxide, and we don't know when it will hit us," she said.

The vaccine educator said the CDC team has been intent on learning the best ways to communicate with members of this community, who tend not to use the internet and instead get a lot of their information from the messaging platform WhatsApp as well as community newspapers.

This week, Rockland County and local health-care providers distributed an infographic in several languages, including Yiddish, that announced, "Polio is spreading in Rockland County."

Dr. Mary Leahy, CEO of the largest health-care provider in Rockland County, Bon Secours Charity Health System, a member of WMCHealth, has attended meetings with the CDC and said that to get people who are not vaccinating their children against polio to understand the severity of the disease, "I turn to the grandparents and the great-grandparents who actually lived through the days of polio in the '40s and '50s."


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12 Aug 2022, 6:03 am

I do not want to be inoculated with a booster vaccine for polio! I want that sugar cube I heard about :)



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12 Aug 2022, 12:07 pm

Poliovirus detected in wastewater samples in New York City, health officials say

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Poliovirus has been detected in wastewater samples in New York City, suggesting likely local circulation of the virus, according to state and local health officials.

The officials underscore the urgency of staying up to date with polio immunizations, specifically those in the greater NY metro area.

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

Officials say routine vaccine coverage has fallen among New York City children since 2019, noting only 86.2% of NYC children between the ages of 6 months and 5 years old have received three doses of the polio vaccine, meaning nearly 14% are not fully protected.


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21 Aug 2022, 4:54 pm

Should You Get A Polio Vaccine Booster? Here’s How To Decide

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Didn’t think you’d have “Decide whether to get the polio vaccine booster as an adult” on your 2022 List of Things to Do, did you? After all, wasn’t the U.S. declared polio-free back in 1979 years after the polio vaccine had become part of routine childhood vaccinations? But then again, you probably didn’t expect to have “Read about how the poliovirus has re-appeared again in U.S.” on your 2022 list either.

Well, the re-appearance of the poliovirus in the U.S. has many people now double-checking whether they got vaccinated against polio as a child and wondering whether they need a booster as an adult.

Upon closer reflection, is this return really that much of a surprise? There’s a thing called cause-and-effect in nature. The World Health Organization (WHO) declared measles eliminated from the U.S. in 2000 due to successful vaccination efforts. But then after years of some personalities, politicians, and purposely anonymous social media accounts peppering people with unscientific anti-vaccination messages, what did you think would happen?

If you either can’t verify this or know for sure that you didn’t get vaccinated against polio, you can always get three doses of the IPV as an adult. Once you’ve gotten the first dose, you have to wait one to two months to get the second dose, and then another six to 12 months to get the third dose. As an adult, the IPV is as easy as one, two, three.

If you indeed got the four-dose series as child, that in theory should give you lifetime protection. It’s in theory because while studies have suggested that protection can last for decades, they haven’t yet specifically determined whether such protection will last lifelong for everyone. So, yes, it is possible that your protection after getting vaccinated as a child may wane a bit at some point as an adult.

That’s the rationale behind the CDC’s current recommendation that as an adult who was vaccinated as a child you don’t need a adult booster unless you are “at increased risk of exposure to poliovirus.” Now, you may ask what exactly would put you at increased risk of exposure to the poliovirus? Certainly, if you plan on going snorkeling in New York’s wastewater where they recently found the poliovirus, you could be at increased risk. The same would apply if you have close contact with anyone who may be infected with the poliovirus or handle the poliovirus in any way. Therefore, it’s a good idea to get boosted if you work in healthcare or a laboratory where any jar, test tube, or other container happens to have the word “polio” on it.

The CDC also recommends getting a booster if “You are traveling to a country where the risk of getting polio is greater.” This includes Afghanistan and Pakistan, where polio remains endemic. Of course, nowadays you may ask whether New York or other parts of the U.S. represent a place “where the risk of getting polio is greater.” This may seem tricky since the actual number and distribution of currently infected people are not known. Health departments just don’t have the resources track such numbers. That’s what happens when the country invests so little in public health infrastructure.

Nonetheless, right now, there’s probably no need to get an adult booster unless you are a healthcare worker, a laboratory worker handling polio specimens, traveling to a country where polio is still more widespread that the U.S., or otherwise may be around someone who has a good chance of being infected. At the same time, there’s no real harm in getting an adult booster.


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21 Aug 2022, 9:12 pm

A horrible visit from an old friend, I see.


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30 Aug 2022, 11:25 pm

Poliovirus outbreak expands in NY: Third county has vaccination rate of 62%

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A third county in New York with a low vaccination rate has detected poliovirus in its wastewater, suggesting that spread of the dangerous virus is expanding, which continues to pose a significant threat to anyone unvaccinated.

Wastewater sampling in Sullivan County detected poliovirus twice in July and twice in August, the New York State Health Department announced. Genetic sequencing determined that the positive samples are linked to the case of paralytic polio reported from Rockland County in July, which was genetically linked to viruses circulating in London and Israel.
Sullivan County joins nearby Rockland County, Orange County, and New York City in having poliovirus detected in sewage. At least 13 sewage samples from Rockland and eight from Orange have tested positive since April. The three counties are all in a northwest-pointing line from New York City, along the state's southern border. Earlier this month, New York City also announced finding poliovirus in wastewater surveillance

All three counties have low vaccination rates against polio, the state's health department notes.

For now, I am actually optimistic. The whole summer traditionally peak polio season has gone by with only one reported case. That means the people that had polio were asymptomatic or were mild enough to be thought of as something else. After all these decades the vaccines still seem to be providing near total herd immunity.


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09 Sep 2022, 4:21 pm

New York governor declares state disaster emergency amid circulating poliovirus evidence, samples found in 5 counties

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New York Governor Kathy Hochul declared a state disaster emergency amid evidence of circulating poliovirus, a move that will increase the availability of resources including expanding the network of polio vaccine administrators, state health officials said.

Sequence analysis of wastewater surveillance from the Centers for Disease Control and Prevention found poliovirus samples in Nassau County, bringing the total to 5 counties -- Rockland County, Orange County, Sullivan County, New York City, and now, Nassau County.
The August sample from Nassau County on Long Island has been genetically linked to the case identified in Rockland county -- showing further evidence of expanding community spread.

All samples are "samples of concern," -- essentially, types of poliovirus that can cause paralysis in humans.
"Bolstering the immunization drive, the E.O. (executive order) immediately expands the network of polio vaccine administrators with the addition of EMS workers, midwives, and pharmacists and authorizes physicians and certified nurse practitioners to issue non-patient specific standing orders for polio vaccines," the release from DHS said.

The executive order also requires health care providers to give polio immunization data to the state health department to help focus vaccination efforts where they are most needed.


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27 Sep 2022, 1:13 pm

https://www.cbsnews.com/news/polio-cases-wastewater-testing-vaccinations-stall-in-new-york/

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Health authorities in New York's Rockland County say they have seen the pace of their emergency polio vaccination effort stall in recent weeks, amid fierce opposition from anti-vaccine groups

Authorities are concerned polio could now be spreading undetected more widely around the country, especially in communities with low vaccination rates.

"We have a lot of infiltration of especially our insular community in Rockland by the anti-vaxxers, and we are now working to supersede them as best we can. It's going to be very, very difficult," Rockland County's chief medical officer Patricia Schnabel Ruppert said last week at a meeting of the federal National Vaccine Advisory Committee.

Schnabel Ruppert said authorities have faced a deluge of nightly robocalls and death threats, aimed at curtailing efforts by staff and leaders in the county's religious communities supporting the polio vaccination effort. Vaccination rates are especially low in local ultra-Orthodox Jewish communities.

With help from state and federal health agencies, county residents have been blanketed with pleas for polio vaccinations through the outreach and letters. The county is also stepping up "school and daycare audits" in search of unvaccinated children, Schnabel Ruppert added.

"It's unfortunate that we haven't sustained that level of increased immunization in the areas that we need. We have a lot more work to do," she said.

Samantha Fuld, a spokesperson for New York state's health department, said 11,328 doses of vaccine have been administered to children across

Many of the positive samples collected from sewer systems, except for those collected from New York City's Coney Island neighborhood, have been genetically linked to the virus in Rockland County. That case also shares genetic ties to virus samples collected abroad in the United Kingdom and Israel.

Concerns over undetected cases have spurred the CDC to begin working with health departments to expand their National Wastewater Surveillance System — currently used to help track monkeypox and COVID-19 — to search for polio as well.

New Jersey's health department said it has already been working with the CDC to test wastewater for polio. Samples collected through August from a handful of sites have tested negative so far.

The health departments for California, Colorado, Chicago, Los Angeles, Michigan, Minnesota, and Ohio said they are also in talks with federal health authorities about potentially expanding their wastewater surveillance, pending guidance from the CDC.

A handful of state health departments – Indiana, Missouri, Pennsylvania and Texas – told CBS News they were not planning to launch polio wastewater surveillance efforts with the CDC.


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