An unvaccinated person in New York State’s Rockland County developed paralysis from a polio infection, emphasizing the need to target vaccination efforts to vulnerable communities
The first case of polio in the U.S. since 2013 has shaken New York State, particularly because it occurred in an area where many people are not vaccinated against the disease.
A polio outbreak may be harder to spot than measles: much like COVID, many polio cases are asymptomatic. Only one in four people who catch the virus develop coldlike symptoms—which likely would not be suspected to be polio—and only one in 200 infected people develop paralysis. Scientists in London who routinely monitor the city’s wastewater for pathogens also found polio in its sewage this year.
Even polio-free countries need to realize they’re not risk-free, Bandyopadhyay says. “We’ve known all along that a virus like polio is essentially a plane ride away as long as it is still there in some corner of the world,” he says. In 2000 this risk, which results in about 1,000 polio cases around the world each year, prompted the U.S. to exclusively switch to IPV, which cannot become reactivated. But because IPV does not spread to others, unvaccinated people in countries that use it have no immunity at all. Nevertheless, people who have received this injectable vaccine can still acquire and carry the poliovirus and spread it to others, despite having no symptoms themselves.
As a result, the world has seen about 2,500 more cases of vaccine-derived polio since 2016 than public health experts had expected. And in 2020 the WHO granted emergency authorization to a new oral polio vaccine that does not reactivate because it is more resistant to mutations. Over the past two years, tens of millions of children in Africa have received the new vaccine.
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