#17,005
Although it is more of a technicality than breaking news, yesterday the CDC acknowledged that the United States meets the WHO criteria for circulating vaccine-derived poliovirus (cVDPV), meaning the poliovirus continues to transmit in the counties in and around New York City.
Last July, in New York State DOH: Rockland County Reports A Polio Case, we looked at the first domestic case of polio in nearly a decade, involving a resident of Rockland County, which is a suburb of New York City.Analysis shows this case to be due to a vaccine-derived poliovirus (VDPV), a rare downside to using the oral polio vaccine (OPV), which has been discontinued in most western countries for the past 20+ years.
Since then environmental testing has found the poliovirus present in the wastewater treatment plants of at least four counties in New York State (Rockland, Sullivan, Orange & Nassau), indicative of continued community spread of the virus.
While most people in United State are fully protected by the polio vaccine, there are some adults who were never fully vaccinated along with quite a few very young children yet to be vaccinated - who are still at risk from the virus.
While the vast majority (75%) of those infected will have no symptoms (but will shed the virus for weeks) - and most others will have mild `flu-like' symptoms - for something less than 1 in every 100 infections, serious, often permanent paralysis can occur.
Complicating matters, last week the CDC put the nation's doctors on alert due to a rise in EV-D68, a non-polio enterovirus that can produce Acute Flaccid Myelitis (AFM) in children, a form of limb weakness/paralysis remarkably similar to that produced by the poliovirus.
The CDC's full statement follows:
United States confirmed as country with circulating vaccine-derived poliovirus
Media Statement
For Immediate Release: Tuesday, September 13, 2022
Contact: Media Relations
(404) 639-3286
CDC today announced that polioviruses found in New York, both from the case of paralytic polio in an unvaccinated adult in Rockland County and in several wastewater samples from communities near the patient’s residence, meet the World Health Organization (WHO)’s criteria for circulating vaccine-derived poliovirus (cVDPV) – meaning that poliovirus continues to be transmitted in Rockland County, NY, and surrounding areas.
CDC is working closely with WHO, the Pan American Health Organization (PAHO), and other international public health partner organizations. As previously reported, the virus’ genetic sequences from the patient from Rockland County, NY, and wastewater specimens collected in New York have been linked to wastewater samples in Jerusalem, Israel, and London, UK, indicating community transmission. The viral sequences from the patient and from three wastewater specimens had enough genetic changes to meet the definition of a vaccine-derived poliovirus (VDPV).
These two things – one individual with VDPV and at least one detection of a related VDPV in an environmental sample – meet WHO’s definition of cVDPV, and CDC submitted this data to WHO for inclusion on its list of countries with cVDPV. There are global recommendations for countries with cVDPV2 outbreaks to protect people from polio, and the United States is taking all appropriate actions to prevent new cases of paralysis.
The United States now joins a list of about 30 other countries where cVDPVs have been identified. Circulating vaccine-derived poliovirus occurs when local immunity to poliovirus is low enough to allow prolonged transmission of the original weakened virus in the oral polio vaccine. As the virus circulates and more genetic changes occur, the virus can regain its ability to infect the central nervous system and cause paralysis. It’s important to note that cVDPVs are not caused by a child receiving the polio vaccine. Oral polio vaccine has not been used or licensed in the U.S. since 2000 but continues to be used in some countries.
“Polio vaccination is the safest and best way to fight this debilitating disease and it is imperative that people in these communities who are unvaccinated get up to date on polio vaccination right away,” said Dr. José R. Romero, Director of CDC’s National Center for Immunization and Respiratory Diseases. “We cannot emphasize enough that polio is a dangerous disease for which there is no cure.”
It’s important to note that no additional cases of polio have been reported in the United States at this time, and today’s update does not impact the current CDC recommendations for polio vaccination for children or adults.
CDC continues to support New York State Department of Health’s investigation through ongoing testing of wastewater to better understand the possible spread of the virus and through supporting vaccination efforts in the affected communities. Last week, the New York State Governor issued an Executive Order declaring a State Disaster Emergency. While no additional polio cases have been found, this action helps the state expand vaccination efforts and surveillance. Improving vaccination coverage is the key to preventing additional cases of paralytic polio in the United States.
