Last month, the first case of polio was reported in the United States in nearly a decade. The New York State Department of Health (NYSDOH) and the Rockland County Department of Health announced that an unvaccinated New York state resident was hospitalized for paralytic polio — and that an official investigation was underway to determine how the polio was contracted and who may have been exposed.
Following the investigation, the NYSDOH and the New York City Department of Health and Mental Hygiene (NYCDOHMH) informed the public on Aug. 12 that poliovirus had been detected in New York City sewage.
“For every one case of paralytic polio identified, hundreds more may be undetected,” State Health Commissioner Dr. Mary T. Bassett said in a statement. “The detection of poliovirus in wastewater samples in New York City is alarming, but not surprising. Already, the State Health Department — working with local and federal partners — is responding urgently, continuing case investigation and aggressively assessing spread. The best way to keep adults and children polio-free is through safe and effective immunization — New Yorkers’ greatest protection against the worst outcomes of polio, including permanent paralysis and even death.”
The unvaccinated are the most at risk, says infectious-disease expert Amesh Adalja, MD, senior scholar at the Johns Hopkins University Center for Health Security. The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) report that we are experiencing the “largest sustained decline in childhood vaccinations in approximately 30 years.” Compared to 2019, 6.7 million more children missed the third dose of polio vaccine this year. “Inadequate coverage levels have already resulted in avoidable outbreaks of measles and polio in the past 12 months,” the WHO and UNICEF report.
So what can be done to protect yourself and your little ones? To learn more about polio, how it spreads, and information on polio vaccination, read on.
Polio is a serious and potentially disabling disease caused by the poliovirus, according to the CDC. It is highly contagious and spreads through person-to-person contact via coughing, sneezing, and exposure to feces, contaminated food, or water, per the Mayo Clinic.
In most cases, people who have polio do not experience symptoms or even realize they are infected. Others will experience flu-like symptoms for up to 10 days. According to the Mayo Clinic, symptoms may include fever, sore throat, headache, pain or stiffness in the arms and legs, muscle weakness, vomiting, back or neck pain and stiffness, and fatigue.
In rare cases, people will develop paralytic polio, which can lead to permanent or temporary paralysis, disability, bone deformities, and death. In the care of paralytic polio, patients will experience the same flu-like symptoms as nonparalytic polio, in addition to loss of reflexes, severe muscle aches or weakness, and flaccid paralysis (floppy limbs).
Polio was declared eliminated (not eradicated) in the US in 1979 after decades-long vaccination efforts. In the 1950s, polio outbreaks caused more than 15,000 cases of paralysis each year, the CDC says. When vaccinations were introduced in the US, first in 1955 and again in 1963, the number of polio cases fell to fewer than 10 in the 1970s. But growing antivax sentiments have led to outbreaks of vaccine-preventable illnesses, polio included. Dr. José R. Romero, director of the Centers for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases, called the recent spread “sobering” and noted that “it’s likely that there are many people infected with polio and shedding the virus in these communities. This is also an urgent and living reminder of the importance of vaccination,” according to the Associated Press.
Poliovirus spreads through person-to-person contact. It is a “fecal oral spread virus that in rare cases can damage the spinal cord to the point that paralysis ensues,” Dr. Adalja explains. The virus lives in an infected person’s throat and intestines, according to the CDC. And it can also “contaminate food and water in unsanitary conditions.” An infected person can spread the virus within two weeks before and after symptoms arise. Infected people who are asymptomatic can also pass along the virus.
There is no cure for polio; the only way to prevent contracting it is through vaccination, Dr. Adalja says.
In the United States, there is only one vaccine currently in use: inactivated polio vaccine (IPV), given via a shot in the arm or leg. “It is a universal vaccine and is highly effective,” Dr. Adalja says. The CDC recommends children get the vaccine as part of routine childhood vaccinations. Currently, there are four doses of the polio vaccine, given at 2 months, 4 months, 6-18 months, and 4-6 years of age.
If adults did not get any or all of the four polio vaccination doses, they may not be properly protected against polio. In this case, the CDC states that adults without complete vaccination should get IPV or complete their IPV doses. If you’re not sure if you’ve received the full vaccination against polio, or if you’ve been vaccinated at all, the CDC has a list of contacts to help you track down your medical records.
“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,” New York City Health Commissioner Dr. Ashwin Vasa said in a statement. “Polio is entirely preventable and its reappearance should be a call to action for all of us.”
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