The Register Citizen (Torrington, CT)
N.Y. reports first new case of polio since 2013
“Wild” polio was declared eradicated in the United States in 1979 following an extensive, nationwide vaccination campaign. The last reported cases in Connecticut were documented in 1972. That year there were 11 cases.
The first case of polio detected in the United States since 2013 was announced last week, but local and state officials are not yet expressing concern about what it could mean for Connecticut.
The case was detected at a hospital in Rockland County, New York. The patient was a young adult who was admitted to the hospital about a month ago with muscle weakness and mild paralysis.
“Rockland County Department of Health was notified Monday evening that an unvaccinated adult in Rockland county is confirmed to have polio,” said Rockland health commissioner Dr. Patricia Schnabel in a press conference Thursday. “We stress that those who are fully vaccinated with the three dose series are at very low risk.”
Local health officials report that the patient is no longer contagious and has been released to their family for care. Health officials are conducting a contact tracing investigation to determine the origin of the infection and assess community exposure risk.
“The county health department is surveying the family and the close contacts of the family to assess what risk there may be to the community,” said Beth Cefalu, Rockland County Health Department spokesperson, “We’re doing what we can but it’s still early days.”
So far the Conneticuit Department of Public Health has stated that they are not involved with the contact tracing effort. And official from the nearby health department in Stamford also confirmed they are not yet involved in any contact tracing efforts.
“Our Department would be notified either directly or via CTDPH of any contacts residing in Stamford,” said Jody BishopPullan, director of health for the Stamford health department. “We are concerned with any infectious disease particularly among those who are unvaccinated.”
Polio is a serious viral infection that causes no symptoms in 95% of people. The remaining five percent have sore throat, nausea, vomiting, fever and meningitis. Roughly 2% of infected people develop paralysis which is often fatal. Polio is shed through the intestine and is usually spread through accidental ingestion of fecal-contaminated water, like at a public swimming pool. Symptoms can take up to 30 days to appear.
“Wild” polio was declared eradicated in the United States in 1979 following an extensive, nationwide vaccination campaign. The last reported cases in Connecticut were documented in 1972. That year there were 11 cases.
Occasionally travelers to the United States have brought polio cases with them. The previous case of polio was detected in an Indian infant who had moved to San Antonio with their parents. That infant died of polio.
The Rockland case had not recently traveled outside the United States, according to local health officials.
The Wadsworth Center, the state health department laboratory, and the Centers for Disease Control and Prevention sequenced the poliovirus and found that it was a revertant polio Sabin type two virus. Revertant strains sometimes, but rarely, emerge from oral poliovirus vaccines which are made with live-attenuated poliovirus. In areas with low polio vaccination rates, revertant poliovirus can cause sporadic outbreaks.
“What we’re talking about with this case is that it is not a wild strain of polio,” said Dr. Patricia Shnabel, the health director in Rockland County, “The case is a strain used in an oral polio vaccine that reverted or regained its virulance . ... Obviously we do not use that in this country anymore but many countries around the world do.”
The United States, and many industrialized countries, no longer use the oral polio vaccine. Since 2000, the US has used inactivated poliovirus vaccine which cannot revert to an infectious form.
Because the Rockland case was caused by a revertant poliovirus this points to a chain of transmission from someone who received polio vaccine outside the United States.
In the Untied States children are routinely vaccinated against polio. Federal officials recommend four doses to be given at two months, four months and between six to 18 months of age with a booster between the ages of four and six. Connecticut requires only three doses before the age of 18 months.
Due to the pandemic many children missed scheduled vaccinations. According to data from the state health department between the 2017-2018 and 2020-2021 school years polio vaccination rates among all students fell from 96.7% to 95.3% on average. While that’s still very high it still points to many children missing their scheduled vaccinations.
“We want shots into arms for those who need it,” said Dr. Shnabel. “We looking for those who did not complete their series, be it adult or child.”
Dr. Shnabel said that the federal government had sent 300 doses of inactivated polio vaccine to top off their stocks.
A walk-in clinic is scheduled for Monday from 1 to 4 p.m. at 50 Sanatorium Road in Pomona, N.Y. The clinic welcomes anyone who is unvaccinated — including those who are pregnant — has not completed their polio vaccine series, or are concerned they have might have been exposed.