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How Worried FOR ANYONE WHO IS About New Reports on Polio?

By Dennis Thompson

HealthDay Reporter

MONDAY, Aug. 15, 2022 (HealthDay News) — Poliovirus detected in NEW YORK wastewater the other day put public health officials on high alert, since it indicates the potentially paralyzing virus is circulating widely in your community.

But infectious disease experts say there is no need for groups of fully vaccinated children to panic.

“The inactivated polio vaccine is section of the standard childhood immunization schedule, so for some families, it certainly shouldn’t be a problem,” said Dr. Gail Shust, a pediatric infectious diseases specialist at NYU Langone Hassenfeld Children’s Hospital in NEW YORK. “It is an exceptionally effective vaccine.”

At this time, there’s also you don’t need to look for a polio booster for a completely vaccinated child or adult, she added.

“For kids who’ve been through the standard vaccination schedule in the usa, there’s zero reason behind them to obtain a booster,” Shust said.

Instead, concern ought to be centered on communities with clusters of unvaccinated children and adults, because those will be the people at an increased risk for polio, experts say.

A man in Rockland County, N.Y. — about 45 minutes northwest of the Bronx — was diagnosed in late July with the initial case of paralytic polio identified in the usa in nearly ten years.

Subsequently, poliovirus was detected in the sewage of both Rockland County and neighboring Orange County, indicating community transmission of the herpes virus.

Polio can result in permanent paralysis of the legs and arms. It also could be fatal if paralysis occurs in muscles used to breathe or swallow.

About 1 in 25 people infected with poliovirus are certain to get viral meningitis, and about 1 in 200 become paralyzed.

“Many people who get badly infected with poliovirus, they’re asymptomatic,” Shust said. “It’s possible you can find other cases that haven’t been diagnosed and you can find more folks infected than we’re alert to.”

Children should receive at the very least three doses of polio vaccine by 18 months old, with a fourth dose delivered between ages 4 and 6, based on the U.S. Centers for Disease Control and Prevention.

NY state health officials said they’re particularly concerned by neighborhoods where less than 70% of children between six months and 5 years have received at the very least three doses of polio vaccine.

About 86% of NEW YORK kids have gotten all three doses, however in Rockland County the rate is merely over 60%, and in Orange County the rate is merely under 59%, state health officials said.

Statewide, nearly 79% of children have obtained three doses by their second birthday, officials said.

Poliovirus also offers been identified in London’s wastewater, and health officials in britain have decided to provide polio vaccine boosters to children.

“They’re beginning to do this in London. We haven’t said that that’s necessary,” said Dr. William Schaffner, medical director of the Bethesda, Md.-based National Foundation for Infectious Diseases.

“The only real time we’ve given boosters during the past is when somebody who was vaccinated as a kid then made a decision to happen to be some developing country where there is plenty of polio, and we said, OK, to be on the safe side, to be prudent, we’ll offer you a booster prior to going,” Schaffner said. “It wasn’t really regarded as necessary, nonetheless it was a prudent, extra, easy, safe move to make.”

Poliovirus lives in the digestive tract and will be transmitted through stool, so wastewater surveillance is really a logical solution to track it, said Vincent Racaniello, a professor of microbiology and immunology at Columbia University in NEW YORK.

“These viruses likely have experienced the sewage for a long time,” he said. “We’ve just never looked for them, and today we began to look for this reason case. And I’d say the more we look, we will find it all around the U.S., especially in major cities.”

These strains of poliovirus likely entered america from people far away who’ve had the oral polio vaccine, Racaniello and Schaffner said.

The oral vaccine was the initial developed and easy and simple to administer, so it’s still used within the World Health Organization’s polio eradication efforts around the world, professionals said. But, Racaniello said, it’s an infectious vaccine, meaning it includes a weakened version of the herpes virus itself.

It reproduces in your intestines, and you also shed it — that is the virus in the sewage,” he said. “That virus gets around quickly, and it could cause polio despite the fact that it is a vaccine virus. After it passes through the human gut, it could reacquire the opportunity to cause polio.”

AMERICA stopped utilizing the oral vaccine in 2000, following the U.S. Preventive Services Task Force decided that the chance of a good few incidental cases of polio was too great, Schaffner said.

“Every year we’d about 4 million births and we’d somewhere within six and 10 cases of vaccine-associated poliomyelitis,” he said. “We were giving an extremely few children and adults paralysis utilizing the oral vaccine.”

The U.S. now exclusively runs on the four-dose inactivated polio vaccine.

The herpes virus is killed. There is no possibility it could multiply. It cannot mutate. It cannot cause paralysis,” Schaffner said. “But being an inactivated viral vaccine, it must get by needle and syringe, that is more cumbersome and somewhat more expensive and, needless to say, added to the amount of inoculations small children were consistently getting, which didn’t make moms too happy.”

Schaffner said it’s “notable” that vaccine-related poliovirus is circulating in the usa.

“We wouldn’t have expected it to be widely disseminated, so we’re just finding there’s a lot more intercontinental transmission of the oral polio vaccine viruses than we thought,” Schaffner said.

“In the event that you had asked me before this case, I’d have said that unless somebody has just gone abroad or had a visitor from abroad, you wouldn’t think it is here because we’re not using [the oral vaccine] in the usa,” Schaffner added. “But we might be considered a smaller global community even than I thought.”

The only real true protection is vaccination, and Racaniello hopes that wastewater surveillance data can help persuade the vaccine-hesitant to go on and obtain jabs.

“Maybe they thought there is no poliovirus in the U.S., right? And they also say I won’t need to get vaccinated,” Racaniello said. “Therefore now we are able to show them that there surely is. In fact, I believe we ought to do more surveillance of wastewater and show people, look, it’s atlanta divorce attorneys major metropolitan city. You better get vaccinated.”

More info

The U.S. Centers for Disease Control and Prevention has more about polio.

SOURCES: Gail Shust, MD, pediatric infectious diseases specialist, NYU Langone Hassenfeld Children’s Hospital, NEW YORK; William Schaffner, MD, medical director, National Foundation for Infectious Diseases, Bethesda, Md.; Vincent Racaniello, PhD, Higgins Professor, Department of Microbiology and Immunology, Columbia University, NEW YORK

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