October 3, 2022
a viral recurrence
Many of us are old enough to remember the excitement of our parents when the new polio vaccine was developed in the 50’s. Polio causes a paralytic disease, killing many because the muscles for breathing stop working. Polio also caused weakness in other muscles, leaving people in wheelchairs.Some people recover fully, others do not. Fear of polio kept swimming pools closed. My uncle had polio leaving him with a weak left arm. My mother worried about her children, taking my brothers and I to get vaccinated as soon as the vaccines were available. The relief was palpable.
Over the years, we lost our fear of polio because the vaccines were so effective. Only developing countries without access to good vaccines still suffered from it. Experts had hope it could be eradicated.
Are any of you old enough to remember the sugar cubes we took that had drops of the vaccine on them? It seemed like a good idea at the time.
But we learned that polio vaccines are complicated. The first vaccine was a shot, then an oral immunization was developed. It seemed more effective because it made antibodies in the gut to prevent absorption of the polio virus.
The problem was the oral vaccine was made from “attenuated” polio viruses, which were weakened versions of the original. Immunity developed in the immunized person but the weakened virus was still able to reproduce in the gut. Since it is transmitted by “fecal oral route”, unimmunized family members would occasionally get infected, especially if immunocomprised. This is known as “vaccine-derived polio virus.”
The CDC stopped recommending oral polio vaccine years ago in 2000 because of this. The only cases in the US were these “vaccine derived polio virus cases.” Many other countries continue to use the oral polio vaccine.
Now Polio is circulating again, especially in New York State with documented cases in communities with low immunization rates. The initial cases uncovered were “vaccine derived”, brought from another country.
Wastewater testing for viruses is becoming a useful tool for public health officials to assess spread of viruses. We have seen it be used with SARS-CoV-2 the virus that causes COVID.
Polio virus was detected in wastewater in NYC as early as April which means it is continuing to spread and be an issue for the unimmunized. New York State has declared it a Public Health Emergency. Children and adults are encouraged to complete their immunization series. High risk groups in New York are advised to get a Polio booster shot (not the oral dose) for protection.
So frustrating, so needless. Vaccine fear and misinformation causing more harm.
Most of us were vaccinated as kids. So far, since the outbreak is still isolated to one area, the vaccine recommendations for most of us has not changed. The CDC still recommends getting one polio booster shot if you are going to travel extensively in certain developing countries. The CDC’s travel site is full of helpful information if you are planning travel to any country.
Spread the word vaccines are good.
https://www.seattletimes.com/life/ask-a-doctor-why-are-so-many-viruses-popping-up-again/
https://www.washingtonpost.com/world/interactive/2022/polio-vaccine-history-photo-video/
https://www.cdc.gov/vaccines/vpd/polio/index.html
https://www.medpagetoday.com/special-reports/exclusives/100397 polio circulating
https://www.seattletimes.com/nation-world/community-spread-of-polio-prompts-cdc-wastewater-surveillance/
https://www.health.ny.gov/press/releases/2022/2022-09-09_polio_immunization.htm
https://wwwnc.cdc.gov/travel/