Polio case in New York linked to traces of virus found in UK and Israel — ProPublica

Public health officials’ international hunt for clues in the polio case that paralyzed a New York man has revealed an important one: The virus that infected him matches the genetic fingerprint of poliovirus found in sewage samples taken in London and the Jerusalem area on Friday, officials from the Centers for Disease Control and Prevention and the World Health Organization told ProPublica.

It is not yet clear how the virus moved from place to place or where it first got to.

“This is still under investigation,” Oliver Rosenbauer, communications manager for WHO’s Global Polio Eradication Initiative, said in an email.

The search for answers in countries thousands of miles apart shows how viruses can spread across the world. Poliomyelitis is highly contagious, and since the majority of infections cause no symptoms, it can circulate silently in communities where there is no routine surveillance.

ProPublica reported Tuesday that US public health agencies have generally not tested sewage for polio, relying on high vaccination rates to protect Americans from the disease, but there are signs of cracks. in this shield, here and abroad.

Waiting for patients to show up with symptoms can be perilous: by the time there is a case of paralysis, 100 to 1,000 infections may have occurred, according to public health experts. New York health officials only began filtering sewage after the case was identified.

The New York case was the first in the United States in nearly a decade. It was discovered after a young man from Rockland County, a northwest New York suburb, sought medical treatment in June for weakness and paralysis. He had not been vaccinated against poliomyelitis. It was July when tests confirmed he had polio.

Genetic sequencing confirmed he had what is called vaccine-derived polio. This type of polio is linked to an oral polio vaccine that has not been used in the United States since 2000. The oral vaccine, still used in other parts of the world, relies on weakened polio viruses to trigger the immune system and create protective antibodies. . In rare cases, when weakened viruses circulate in people who have not been vaccinated or who are underimmunized, they can revert to a form that can make unvaccinated people sick.

Public health officials said traces of poliovirus found in sewage samples in early June in Rockland County and greater Jerusalem were still too weak to cause paralytic polio. It’s unclear where the virus evolved, becoming potent enough to cause illness in the Rockland County patient.

A Rockland County Health Department spokeswoman said she could not confirm whether the man had traveled to London or Jerusalem this year.

Another mystery in the case is that, like the US, the UK has not used the oral polio vaccine for years. Instead, both use only an injectable vaccine that contains inactivated viruses and cannot cause vaccine-derived polio. Although Israel uses the oral polio vaccine, the version it uses does not contain the strain of polio, known as Type 2, which was found in sewage samples or which infected the man from New York.

New York officials say they are now testing both stored sewage samples, which were collected as part of the COVID-19 tracking effort, and newer samples for signs of poliomyelitis.

While high vaccination rates in the United States have staved off the risk of polio, some communities have much lower vaccination rates than the country as a whole. Rockland County in 2018 and 2019 grappled with a protracted outbreak of measles — also vaccine-preventable — that was concentrated in its Orthodox Jewish community. Some news agencies have reported that the man paralyzed by polio is a member of this community.

Most Americans aren’t old enough to remember, but in the first half of the 20th century, poliomyelitis ranked among the nation’s most feared diseases. It primarily victimized young children, attacking their spinal cord, brainstem, or both, and left thousands with irreversible paralysis. After the first vaccine was approved in 1955, cases in the United States dropped precipitously within a few years.

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