Post by Atticus Pizzaballa on Aug 6, 2022 9:13:29 GMT -5
'Tip of the iceberg': How state health officials are setting off alarms over polio
State, national and local health officials say recent wastewater testing leads them to believe polio is circulating in the Hudson Valley, linking it to a case of paralytic polio in Rockland County.
Two New York state health officials made clear this week that this significant health challenge needs everyone’s attention.
“This is a very alarming and urgent situation. This has not happened since we eradicated polio in the United States in 1979,” said Dr. Eli Rosenberg, New York State Department of Health deputy director of science for the Office of Public Health.
The work health officials are now doing – ongoing wastewater testing and preventive vaccination – help measure and simultaneously prevent spread of a very contagious virus.
“When we see only one case, that’s kind of the tip of the iceberg,” said Dr. Emily Lutterloh, state health department director of the Division of Epidemiology. “And we really need to see how big that iceberg is.”
The Rockland County case developed in someone who had never been vaccinated. But the polio strain was derived through a type of oral live-virus vaccine that hasn’t been used in the U.S. for decades.
That means the Rockland County patient likely caught polio somehow formed in a person who had the oral polio vaccine recently in another country. A rare complication occurred that allowed the virus to shed in the person who received the oral vaccine, releasing copies of the vaccine from their body.
Although only one case has been detected so far, U.S. Centers for Disease Control and Prevention officials said that tests indicted the likelihood of more people shedding the virus in their stool. "These individuals might have no symptoms or only mild symptoms, such as a sore throat and fever, but they can unknowingly still spread polio to those who are not protected by vaccination," a statement from the CDC said.
The CDC has deployed a small team to help with surveillance and vaccination in the Hudson Valley.
The Rockland patient, only identified by Rockland officials as a young adult, developed paralysis – a hallmark outcome for the virus – but health officials have not said if it that condition was permanent. They only are saying the patient is a young adult, and would not provide further information on where that person lived or gender.
Indications of 'community spread'
The polio strain found in the patient’s sample and in local wastewater testing has been found in wastewater in London and around Jerusalem. Orange County health officials reported Wednesday that wastewater samples at two sites had detected polio. On Thursday, the state health department reported July wastewater testing also revealed the virus.
State officials said that the samples in Orange and Rockland are genetically linked to each other and to the case found in the Rockland patient. However, health officials said, "the latest environmental findings do not indicate that the individual identified in Rockland County was the source of the transmission, and case investigation into the origin of the virus is ongoing."
The Rockland patient had not traveled out of the country. There was no information about travel to Orange County.
3 shots over 7 months: How to catch up on polio vaccination
“These environmental findings – which further indicate potential community spread – in addition to the paralytic polio case identified among a Rockland County resident, underscore the urgency of every New York adult and child getting immunized against polio, especially those in the greater New York metropolitan area,” said Samantha Fuld, spokesperson for the New York State Department of Health.
Concern about 'cases we're not seeing'
Transmission to the Rockland patient could have been directly from the person who took the oral polio vaccine, or through several people who may have been unvaccinated and asymptomatic.
“We don’t know and I don’t even think it’s possible to know that,” Rosenberg said. “We certainly are concerned there has been transmission in the Rockland County and New York.”
Dr. Eli Rosenberg, New York State Department of Health deputy director of science for the Office of Public Health.
Public health officials have said that a paralytic polio case likely means there are more, possibly hundreds, of asymptomatic polio cases in the area. “We see one paralytic case, that most certainly means there are many," Rosenberg said.
Prior to the polio vaccine’s introduction in 1955, summer waves of polio would sicken thousands. Children were most at risk and would be hospitalized for months on end, in iron lungs, or worse.
“It was a very different situation back then,” Lutterloh said. Prior to vaccine availability, it was a disease of younger children who may have not had exposure to the virus so had no immunity. “Nowadays, anyone who hasn’t been immunized is at risk.”
The inactive polio vaccine, used exclusively in the U.S. since 2000, is considered highly effective at preventing paralysis and other forms of severe illness. That's why, health officials say, the best way to keep New York polio-free is to maintain high immunity across the population through vaccination.
Looking for viruses, finding polio
Surveillance remains an important part of the fight against polio spread. The Rockland County case was discovered by the state’s ongoing request for providers to send specimens to the state when there is any case of polio-like illnesses. A medical provider sent the specimen and the Wadsworth Laboratory ran tests for suspected causes, including a non-polio enterovirus, and discovered the paralytic polio.
“The goal was not specifically to pick up polio,” Lutterloh said. “The goal was to pick up any viruses that could cause problems.”
State health officials were integral to fighting a measles outbreak that centered on Rockland County in 2018-2019.
Lutterloh said, though, the hurdles in tracking down the spread are different in the two viruses.
Measles typically has a very short incubation period, and cases almost always present with symptoms, particularly a characteristic rash. “They get infected, they get sick,” Lutterloh said.
Polio is different. According to the World Health Organization, up to 90% of people infected with polio experience no or mild symptoms. So many don’t have any idea they could shed the virus.
Health officials have repeatedly expressed concern that people may not understand the damage waves of polio would bring in the early 20th century.
"Many Americans don’t remember the era of iron lungs and leg braces, and the devastation associated with this crippling and potentially fatal infectious disease – and that’s due to widespread vaccination," said Dr. José R. Romero, director of CDC’s National Center for Immunization and Respiratory Diseases. "We have brought polio to the brink of extinction and cannot let it regain a toehold in our communities. Even one case of polio in the U.S. is too many.”
Want all the Rockland news delivered to your inbox? Subscribe to the Rockland Angle. the county's newsletter delivered via email every Monday evening. Find subscriber information here.
www.uticaod.com/story/news/health/2022/08/05/polio-case-wastewater-tests-alarm-new-york-state-health-officials/65391301007/?utm_source=uticaod-DailyBriefing&utm_medium=email&utm_campaign=daily_briefing&utm_term=list_article_thumb&utm_content=NOBD-NEWYORK-UTICA-NLETTER65
COVID and all its mutations, Monkeypox, Polio what's next!
State, national and local health officials say recent wastewater testing leads them to believe polio is circulating in the Hudson Valley, linking it to a case of paralytic polio in Rockland County.
Two New York state health officials made clear this week that this significant health challenge needs everyone’s attention.
“This is a very alarming and urgent situation. This has not happened since we eradicated polio in the United States in 1979,” said Dr. Eli Rosenberg, New York State Department of Health deputy director of science for the Office of Public Health.
The work health officials are now doing – ongoing wastewater testing and preventive vaccination – help measure and simultaneously prevent spread of a very contagious virus.
“When we see only one case, that’s kind of the tip of the iceberg,” said Dr. Emily Lutterloh, state health department director of the Division of Epidemiology. “And we really need to see how big that iceberg is.”
The Rockland County case developed in someone who had never been vaccinated. But the polio strain was derived through a type of oral live-virus vaccine that hasn’t been used in the U.S. for decades.
That means the Rockland County patient likely caught polio somehow formed in a person who had the oral polio vaccine recently in another country. A rare complication occurred that allowed the virus to shed in the person who received the oral vaccine, releasing copies of the vaccine from their body.
Although only one case has been detected so far, U.S. Centers for Disease Control and Prevention officials said that tests indicted the likelihood of more people shedding the virus in their stool. "These individuals might have no symptoms or only mild symptoms, such as a sore throat and fever, but they can unknowingly still spread polio to those who are not protected by vaccination," a statement from the CDC said.
The CDC has deployed a small team to help with surveillance and vaccination in the Hudson Valley.
The Rockland patient, only identified by Rockland officials as a young adult, developed paralysis – a hallmark outcome for the virus – but health officials have not said if it that condition was permanent. They only are saying the patient is a young adult, and would not provide further information on where that person lived or gender.
Indications of 'community spread'
The polio strain found in the patient’s sample and in local wastewater testing has been found in wastewater in London and around Jerusalem. Orange County health officials reported Wednesday that wastewater samples at two sites had detected polio. On Thursday, the state health department reported July wastewater testing also revealed the virus.
State officials said that the samples in Orange and Rockland are genetically linked to each other and to the case found in the Rockland patient. However, health officials said, "the latest environmental findings do not indicate that the individual identified in Rockland County was the source of the transmission, and case investigation into the origin of the virus is ongoing."
The Rockland patient had not traveled out of the country. There was no information about travel to Orange County.
3 shots over 7 months: How to catch up on polio vaccination
“These environmental findings – which further indicate potential community spread – in addition to the paralytic polio case identified among a Rockland County resident, underscore the urgency of every New York adult and child getting immunized against polio, especially those in the greater New York metropolitan area,” said Samantha Fuld, spokesperson for the New York State Department of Health.
Concern about 'cases we're not seeing'
Transmission to the Rockland patient could have been directly from the person who took the oral polio vaccine, or through several people who may have been unvaccinated and asymptomatic.
“We don’t know and I don’t even think it’s possible to know that,” Rosenberg said. “We certainly are concerned there has been transmission in the Rockland County and New York.”
Dr. Eli Rosenberg, New York State Department of Health deputy director of science for the Office of Public Health.
Public health officials have said that a paralytic polio case likely means there are more, possibly hundreds, of asymptomatic polio cases in the area. “We see one paralytic case, that most certainly means there are many," Rosenberg said.
Prior to the polio vaccine’s introduction in 1955, summer waves of polio would sicken thousands. Children were most at risk and would be hospitalized for months on end, in iron lungs, or worse.
“It was a very different situation back then,” Lutterloh said. Prior to vaccine availability, it was a disease of younger children who may have not had exposure to the virus so had no immunity. “Nowadays, anyone who hasn’t been immunized is at risk.”
The inactive polio vaccine, used exclusively in the U.S. since 2000, is considered highly effective at preventing paralysis and other forms of severe illness. That's why, health officials say, the best way to keep New York polio-free is to maintain high immunity across the population through vaccination.
Looking for viruses, finding polio
Surveillance remains an important part of the fight against polio spread. The Rockland County case was discovered by the state’s ongoing request for providers to send specimens to the state when there is any case of polio-like illnesses. A medical provider sent the specimen and the Wadsworth Laboratory ran tests for suspected causes, including a non-polio enterovirus, and discovered the paralytic polio.
“The goal was not specifically to pick up polio,” Lutterloh said. “The goal was to pick up any viruses that could cause problems.”
State health officials were integral to fighting a measles outbreak that centered on Rockland County in 2018-2019.
Lutterloh said, though, the hurdles in tracking down the spread are different in the two viruses.
Measles typically has a very short incubation period, and cases almost always present with symptoms, particularly a characteristic rash. “They get infected, they get sick,” Lutterloh said.
Polio is different. According to the World Health Organization, up to 90% of people infected with polio experience no or mild symptoms. So many don’t have any idea they could shed the virus.
Health officials have repeatedly expressed concern that people may not understand the damage waves of polio would bring in the early 20th century.
"Many Americans don’t remember the era of iron lungs and leg braces, and the devastation associated with this crippling and potentially fatal infectious disease – and that’s due to widespread vaccination," said Dr. José R. Romero, director of CDC’s National Center for Immunization and Respiratory Diseases. "We have brought polio to the brink of extinction and cannot let it regain a toehold in our communities. Even one case of polio in the U.S. is too many.”
Want all the Rockland news delivered to your inbox? Subscribe to the Rockland Angle. the county's newsletter delivered via email every Monday evening. Find subscriber information here.
www.uticaod.com/story/news/health/2022/08/05/polio-case-wastewater-tests-alarm-new-york-state-health-officials/65391301007/?utm_source=uticaod-DailyBriefing&utm_medium=email&utm_campaign=daily_briefing&utm_term=list_article_thumb&utm_content=NOBD-NEWYORK-UTICA-NLETTER65
COVID and all its mutations, Monkeypox, Polio what's next!