Following the discovery of vaccine-derived poliovirus type 2 in sewage in north and east London, the Joint Committee on Vaccination and Immunization (JCVI) reported that a vaccine directed against inactivated poliomyelitis (IPV) should be offered a booster dose to all children aged 1–9 years in all boroughs of London.
This will ensure a high level of protection against paralysis and help reduce the spread of the virus.
Nationally, the overall risk of paralytic poliomyelitis is considered low because most people are protected from it by vaccination.
Many countries around the world provide an additional dose of polio-containing vaccine as part of their childhood vaccination schedule. Parents will be contacted by NHS London when it is their child’s turn to come for a booster or booster dose of polio – parents should take up the offer as soon as possible.
The program will begin in affected areas, where poliovirus has been detected and vaccination rates are low. This will be followed by a rapid rollout to all districts.
This booster dose comes in addition to the NHS’s childhood vaccination up-to-date campaign in London, where childhood vaccination uptake is lower than in the rest of the country. It is important that all children aged 1 to 9 years, even if they are up to date with their vaccinations, accept this vaccine when offered to further strengthen their protection against poliovirus.
Following the findings earlier this year of poliovirus type 2 (PV2) collected at the Beckton Wastewater Treatment Works, subsequent sampling by the UK Health Safety Agency (UKHSA) and the Medicines and Health Products Regulatory Agency (MHRA) has now identified at least one positive sample of poliovirus, currently present in parts of the following districts:
- Waltham Forest
Sampling has also detected the virus in lower concentrations and frequency in areas adjacent to the Beckton catchment to the south (immediately below the Thames) and to the east of Beckton. However, it is unclear whether the virus has become established in these areas or whether the detections are due to people from the affected area visiting these neighboring areas.
The level of poliovirus found and the high genetic diversity among the PV2 isolates suggests that there is some level of transmission of the virus in these neighborhoods that may spread to adjacent areas. This suggests that transmission has gone beyond a narrow network of a few individuals.
A total of 116 PV2 isolates have been identified in 19 sewage samples collected in London between February 8 and July 5 this year, but most are vaccine-like viruses and only a few have enough mutations to be classified as to vaccine-derived poliovirus (VDPV2).
VDPV2 is more worrisome because it behaves more like naturally occurring “wild” polio and can, on rare occasions, cause cases of paralysis in unvaccinated individuals.
UKHSA is working closely with health agencies in New York and Israel along with the World Health Organization to investigate links between the poliovirus detected in London and recent incidents of polio in these 2 other countries.
Dr. Vanessa Saliba, Epidemiologist Consultant of UKHSAsaid:
No cases of polio have been reported and for the majority of the population, which is fully vaccinated, the risk is low. But we know that areas of London where polio is transmitted have some of the lowest vaccination rates. This is why the virus is spreading in these communities and putting those residents who are not fully vaccinated at greater risk.
Polio is a serious infection that can cause paralysis, but nationally the overall risk is considered low because most people are protected by vaccination. The last case of polio in the UK was in 1984, but decades before the polio vaccination program was introduced around 8,000 people would be paralyzed each year.
It is critical that parents ensure their children are fully vaccinated for their age. following JCVI advice that all children aged 1-9 in London should receive a dose of polio vaccine now, either as an extra booster dose or simply to catch up with their routine vaccinations. It will ensure a high level of protection against paralysis. This can also help stop the spread of the virus.
Jane Clegg, NHS Chief Nurse in London, said:
Although most Londoners are protected from polio, the NHS will be contacting parents of eligible children aged 1-9 shortly to offer them an extra dose to ensure they get the maximum virus protection.
We are already contacting parents and carers of children who are not up to date with their routine vaccinations, who can now book a catch-up appointment with their GP and for anyone who is unsure your child’s vaccination status, you can check it. his Red Book.
UKHSAworking with MHRAhas already increased monitoring of sewage to assess the extent of the spread of the virus and are currently sampling 8 sites across London.
A further 15 sites in London will start sewage sampling in mid-August, and 10 to 15 sites will be rolled out nationally to determine whether poliovirus is spreading outside of London.
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