New York declares a polio emergency to extend immunization charges

New York Gov. Kathy Hochul on Friday declared a state of emergency for polio in a bid to boost immunization rates in the state amid more evidence the virus is spreading in communities.

The poliovirus has now been detected in sewage samples from four counties in the New York metropolitan area, as well as in the city itself. The counties are Rockland, Orange, Sullivan and the newest Nassau.

According to state health officials, the samples tested positive for the poliovirus, which can cause paralysis in humans. Unvaccinated individuals who live, work, go to school or attend school in Orange, Rockland, Nassau, New York City and Sullivan are at the highest risk for paralysis, officials said.

New York began sanitation monitoring after an unvaccinated adult contracted polio and became paralyzed in Rockland County in July, the first known infection in the United States in nearly a decade.

The emergency declaration will expand the network of vaccine administrators to include pharmacists, midwives and emergency responders to increase vaccination coverage in areas where it has slipped.

New York Health Commissioner Dr. Mary Bassett called on unvaccinated people to get vaccinated immediately. Individuals and families who are unsure of their immunization status should contact a health care provider, clinic, or the county health department to make sure they are up to date on their immunizations.

“With polio, we just can’t play the dice,” Bassett said. “I urge New Yorkers not to take any chances at all. The polio vaccine is safe and effective – it protects almost all people from the disease who get the recommended doses.”

Polio vaccination coverage is appallingly low in some New York boroughs. The vaccination rate is 60% in Rockland, 58% in Orange, 62% in Sullivan and 79% in Nassau, according to the Health Department. The national average for polio vaccination is about 79%.

According to the health department, the aim of the vaccination campaign is to significantly increase the vaccination coverage nationwide to over 90%.

Some New Yorkers should be cheered up

Some New Yorkers who have completed their vaccination series should receive a single lifetime booster shot, health officials said. These people include people who may have been in contact with a person who is infected or suspected to be infected with poliovirus, or members of the infected person’s household.

Health care workers should also get a booster shot if they work in areas where poliovirus has been detected and they may be handling samples or treating patients who may have polio. People who may be exposed to sewage as a result of their jobs should also consider a booster, health officials said.

All children should receive four doses of the polio vaccine. The first dose is given between 6 weeks and 2 months of age, the second dose at 4 months of age, the third at 6 to 18 months of age and the fourth dose at 4 to 6 years of age.

Adults who have only received one or two doses should receive the remaining one or two. Health officials said it didn’t matter how long it had been since the first doses.

How the polio virus spreads

Polio spreads between people when the virus enters the mouth, typically through hands contaminated with an infected person’s stool. The virus often spreads unnoticed, as 70% of those infected show no symptoms. About 25% of those infected develop mild flu-like symptoms.

One in 100 infected people develops a serious illness such as permanent paralysis. Polio is fatal in 2% to 10% of people with paralysis because the muscles used to breathe are immobilized.

The chain of transmission that brought polio to New York is believed to have originated from someone overseas who received the oral polio vaccine. The oral vaccine uses a weakened form of the virus that still replicates. In rare cases, the virus used in the vaccine can mutate, become virulent and spread to others.

The US stopped using the oral vaccine more than two decades ago. It now uses a vaccine that’s given as a shot, which inactivates the virus, meaning it doesn’t replicate and mutate. Although this vaccine is very effective at preventing disease, it does not block transmission of the virus.

The oral polio vaccine can block the transmission of the naturally occurring poliovirus, but carries the risk that the strain used in the vaccine will mutate and become virulent, leading to the spread of the so-called vaccine-derived poliovirus.

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