The polio virus is resurfacing in rich economies, exposing gaps in immunization

The polio virus is resurfacing in rich economies, exposing gaps in immunization

Public health authorities in rich economies are scrambling to prevent the return of polio, after the virus has resurfaced in several countries where it had been wiped out.

New York City health officials said Friday they detected polio in samples taken from the sewer system. Last month, a man in suburban New York was diagnosed with the first US case since 2013.

In London, health officials said this week they would offer polio vaccine boosters to hundreds of thousands of children after the virus was detected in London’s sewage. Israel previously identified its first cases since 1988 and there has been a surge in war-torn Ukraine, where health services are under severe strain.

The situation is raising concerns that vaccines and global conflicts could allow a disease that was on the brink of global eradication to make a comeback.

For much of the 20th century, poliomyelitis, which is short for poliomyelitis, was one of the most feared childhood diseases, killing and incapacitating tens of thousands of people each year. But the development of vaccines in the 1950s and a global campaign against the disease that began in 1988 reduced the number of infections to just 175 cases in 2019 and reduced the number of countries where it is endemic to two: Pakistan and Afghanistan.

But its resurgence in Europe and the United States, along with the disruption of vaccination programs due to the Covid-19 pandemic and war in places like Ukraine and Afghanistan, has public health officials they sound the alarm

“There has been a huge drop in routine immunization coverage globally as countries were engaged in the response to the Covid-19 pandemic. If you scratch the surface, this shows the vulnerability of immunization systems of countries,” said Siddhartha Datta, the World Health Organization’s regional adviser for vaccine-preventable diseases in the European region.

Last month, the WHO and Unicef ​​released data showing the biggest sustained drop in childhood vaccines in three decades, with at least 25 million babies missing out on life-saving shots by 2021. A just under 7 million children missed their third dose of polio vaccine last year when compared to 2019, before the coronavirus pandemic.

New York health officials warned Friday that hundreds of people had already contracted the virus after a July 21 diagnosis of polio in an unvaccinated man who developed paralysis in Rockland County, about 30 miles north- west of New York City.

The suburban county has one of the lowest immunization rates in the US. Authorities have set up vaccination centers, distributed leaflets urging people to get shots and are considering offering polio booster shots to boost people’s immunity.

Dr. Mary Leahy, chief executive of Bon Secours Charity Health System, one of Rockland’s largest hospital groups, said the virus had likely infected many people without their knowledge because three-quarters of people with infections have no symptoms .

“They have polio, but they are walking and they don’t know they have it. Only 25% develop flu-like symptoms. . . less than 1 percent go on to develop paralysis.”

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Genetic studies of the New York case have linked it to polio viruses in Israel and London, suggesting links across borders. The viruses detected are examples of vaccine-derived poliomyelitis, which is a strain related to the live, weakened poliovirus contained in the oral polio vaccine. They can cause disease and paralysis if allowed to circulate in populations with unvaccinated people long enough and then mutate.

Rockland County has a 60 percent vaccination rate for two-year-olds, well below the state average of 78 percent. WHO says 95% vaccination coverage is required to provide herd immunity.

Rockland is home to a large and growing Orthodox Jewish population. Dorrit Reiss, a law professor at the University of California, Hastings College of Law, said the Orthodox community in the Rockland area had been actively sought by national anti-vaccine campaigns, which have organized rallies and distributed leaflets raising fears about immunization.

“There is nothing in Judaism that is against vaccines, but some specific Orthodox Jewish communities have concerns. They live a closed life in multi-generational homes with large numbers of children, so in a very real sense it is an area vulnerable to an outbreak,” he said.

Local tensions over vaccination remain high after a measles outbreak in 2018 and 2019 infected hundreds of people, centered on the ultra-Orthodox community of Rockland.

The New York Jewish Week and other local publications have reported that the man who contracted polio in Rockland is Orthodox, though local health officials have not confirmed this because of concerns about stigmatizing the community.

A New York state senator also last month identified the infected polio patient as an Orthodox Jew and alleged that some private Jewish schools had a history of failing to meet vaccination requirements. He later retracted his statement after objections from Jewish groups.

“One thing about this case of polio is that it’s in Rockland Country, which had a massive outbreak of measles two years ago, so that suggests there are questions about the vaccine,” said Dr. Marny Eulberg, a retired doctor and polio survivor who has studied the disease for decades. .

“This is a problem because these days many young parents have not seen polio, it is not part of their consciousness. And the reality is that once you have polio, the treatment now is no better than it was in the 1950s: so the best answer is to get vaccinated.”

Health providers in Rockland say fears about polio are causing some previously hesitant people to come forward for vaccinations.

“We’ve seen a mother who was anti-vaccine and didn’t give other vaccines, who took her two children for the polio vaccine, because the paralysis scares her,” said Amanda Salzman, director of communications for Refuah Health in Rockland .

Salzman said the clinic has administered nearly 500 polio shots so far, out of a total of 2,000 countywide.

Health experts say the latest cases demonstrate the need to monitor vaccination efforts and for governments to support global polio eradication efforts. This program is seeking $4.6 billion in funding to complete vaccination efforts in Afghanistan and Pakistan.

“There is a great need to identify funding,” said Dr. Jay Wenger, who directs a polio eradication program at the Bill & Melinda Gates Foundation. “The importance of achieving this is that we won’t have these episodes of the virus in New York, in London or anywhere else.”

Additional reporting by Donato Paolo Mancini in London

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