New York state health officials on Thursday stepped up efforts to get people who are not immune to polio vaccinated “immediately,” saying the state’s one confirmed case of the disease may be the “tip of the iceberg” of many a wider threat.
The emergency call came as officials said polio was found in sewage samples taken at multiple locations and at different times in two counties north of New York, potentially signaling the spread of the disease in the community.
“Based on past polio outbreaks, New Yorkers should know that for every observed case of paralytic polio, there may be hundreds of other infected people,” Dr. Mary T. Bassett, the state’s health commissioner, said in a statement. .
“Combined with the recent findings about the sewage,” added Dr. Bassett, “the department is treating the single case of polio as just the tip of the iceberg of a much larger potential spread.”
Polio is caused by the poliovirus, and children under the age of 5 are at the greatest risk of contracting it, but anyone who has not been vaccinated is at risk. Polio is highly contagious, usually spreading from person to person when someone comes into contact with the feces of an infected person and then touches their mouth.
The fight against polio
The highly contagious virus was one of the most feared diseases until the 1950s, when the first vaccine was developed.
Many cases are asymptomatic and some can cause flu-like symptoms, but the disease, also known as poliomyelitis, can be debilitating and even life-threatening. There is no treatment.
Paralysis is a rare outcome, but before vaccines were widely available in the 1950s, polio outbreaks caused more than 15,000 cases of paralysis annually.
Last month, a case of polio — the first reported in the United States in nearly a decade — was identified in an unvaccinated elderly man in Rockland County. No cases have occurred in the United States since 1979.
State and county health officials said the infection in Rockland County was transmitted by someone who received an oral polio vaccine that has not been administered in the United States since 2000.
The virus circulating in New York may have originated outside the United States, where an oral vaccine is still administered, officials said. The oral vaccine contains a weakened virus. It is safe, but if the vaccine-derived virus circulates in a community, it can infect unvaccinated people and spread the disease.
In announcing the case, officials stressed that the infected person was no longer contagious and said their efforts would focus on increasing vaccination rates and determining whether anyone else may have been affected.
Officials said polio was found in Rockland County sewage samples taken in June, before the polio case was confirmed. They said Thursday that evidence of the disease was also found in sewage samples taken in June and July from two “geographically distinct” parts of Orange County, which borders Rockland.
“The findings,” the state health department said in a news release, “provide further evidence of local, rather than international, transmission of the polio virus.”
There is no indication that the infected Rockland County man was the source of the polio found in the sewage samples, officials said. The investigation into the origin of the virus continues.
Because widespread vaccination has proven to be an effective prevention strategy, areas with low immunization rates may be at particular risk of an outbreak.
In both Rockland and Orange counties, about 60 percent of 2-year-olds received all three doses of the polio vaccine, according to state data — significantly lower than the 80 percent rate in the rest of the state, excluding New York. (To achieve herd immunity against polio, the target vaccination rate is 80 percent, according to the World Health Organization.)
Most adults in the United States do not need to be vaccinated against polio because they were most likely immunized as children, although some may be eligible for booster shots if they have an increased risk of exposure.
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