Dropping vaccine rates, misinformation, and wastewater systems–here is what you need to know about the polio outbreak.
With the first vaccine created in 1955 by Dr. Jonas Salk, the virus was declared eradicated from the United States in 1979, and “globally eradicated” in October 2019. However, a state of emergency was declared in New York after the virus was found in the state’s Orange, Rockland, Sullivan, and Nassau County. Though the poliovirus is highly infectious, causes permanent paralysis, and is sometimes even fatal, polio vaccination rates are severely low with Orange County at 58%, Rockland County at 60%, Sullivan County at 62%, and Nassau County at 79%. The state’s vaccination campaign is to have a statewide vaccination rate of 90%. After a frenzy of COVID-19’s “unprecedented times” and “Mask Up, New York!”, our normal, typical, precedented times had just seemed to arrive. But with the findings of the poliovirus in the state’s wastewater, along with the recent outbreak of monkeypox, some New Yorkers worry that we will yet again revert back to March 13th, 2020.
Nassau County resident Inaya Chadha stated, “I believe that the Polio outbreak is a major issue that should be brought to attention by more people. This is incredibly hazardous and unsafe, with the tests of polio in wastewater coming back positive. Those that are not entirely up to date with necessary vaccinations are at serious risk, which worries my family and I. Another outbreak such as COVID-19 should not be happening again.”
However, Dr. Shauna Zorich, formerly a preventive medicine officer for the Air Force and now a full time clinical assistant professor at the University at Buffalo, says, “This is not going to be something like COVID or even something like monkeypox where when COVID started, no one had immunity, and so it spread very quickly. With monkeypox, the same thing. No one had any immunity to monkeypox, except for maybe some people that have received the smallpox vaccine.” She added that “most people are adequately vaccinated. As those that are not, they are the ones that are at risk.”
In an interview with Her Campus Buffalo, she explained that the virus is transmitted “typically via what we call the fecal oral route, meaning that someone inadvertently ingests the feces of another individual.” She adds that this can happen if “individuals are not using proper hand hygiene. This can be especially seen in areas where there’s not good sanitation systems set up.”
Individuals contracting polio can develop flu-like symptoms, and sometimes may even lead to paralysis. Zorich states that, “about 75% won’t experience any symptoms, where about 25% will experience flu-like symptoms, but then you have a very small percentage, less than 1%, that will experience paralysis as a result of the polio infection.” Zorich mentions when there is paralysis of the diaphragm, there is a higher risk of fatality as the individual’s breathing apparatus becomes compromised due to the infection. She adds that though in some cases paralysis is permanent, some are able to reverse the paralysis with physical therapy.
Zorich tells those that are vaccinated not to worry, but called the findings “a public health emergency.” Having been declared eradicated within the United States over four decades ago, it is concerning for both experts and the public, with Zorich calling it “an active problem”, especially with New York’s dropping vaccination rates. Majority of experts have pointed to this decrease in vaccination rates as a primary reason for the return of polio. According to Zorich, “if you have low vaccination levels, then you’re going to have more people that are at risk of becoming infected and then experiencing poliomyelitis.”
“If you have low vaccination levels, then you’re going to have more people that are at risk of becoming infected and then experiencing poliomyelitis.”
Dr. Shauna Zorich
Zorich says there is likely “a combination” of reasons in dropping vaccination rates such as the COVID-19 pandemic’s disruption of vaccination programs,” as well as the popularization of “anti-vaccine sentiment.”
Samiha Ahmed, a graduate from the University of Maryland who received her Masters in Public Health and has conducted research on vaccine misinformation, agrees saying that the return of polio as well as other diseases that were previously eradicated is a result of the lack of vaccination. Ahmed says this occurs as there are pockets of the population that no longer have immunity to these diseases. Ahmed states that low income communities that do not have access to resources to get vaccinated and “communities that are feeding on misinformation and not getting vaccinated” are the most at risk.
Zorich urges that in order for families and individuals to stay safe, they must prioritize vaccination and to contact their providers if they do not have the series of vaccines completed. She says that for individuals and families that are vaccinated, “their risk is almost zero.” She adds that, “the risk is never zero, but the risk is so low because the vaccine is very effective. That we could somehow become infected by drinking water, but we’re not coming in contact with the wastewater, that water is going to be treated, so that risk isn’t there. But what it does mean is that there are people in those communities that are shedding poliovirus.”
Zorich believes that New York is taking the right steps and that calling for a state of emergency was “appropriate.” She argues that doing this will aid in “diverting resources to where they need to go in order to deal with the case of polio that was identified, and also can allow other types of personnel to administer the polio vaccine.” Though Ahmed agrees that New York has been taking the appropriate action, she argues that it is important for the state to implement outreach within immigrant communities and implement programs for non-English language speakers. She adds that, “New York City, it’s a city of immigrants, so there’s a lot of people who don’t speak English, a lot of people who have just gotten to this country and have no idea what’s going on.”
Though experts have stated that a large outbreak of the virus in wealthy nations is unlikely, the same cannot be said for developing nations. In countries where there is a lack of and poorly structured wastewater treatment systems, the risk of a larger scale polio outbreak is much more likely.
Zorich mentions that it is a major issue for countries “where people don’t have potable water to drink” and “don’t have clean and safe water.” Ahmed adds that though “it’s hard to determine specific names” in terms of which countries are at the highest risk due to our increasingly globalized world as well as some countries that had still been previously dealing with polio cases, she states that lower middle income countries are the most at risk, however that “goes for all sorts of communicable diseases” as she states that most of these countries do not have the proper infrastructure to regulate hygiene and supporting efficient wastewater systems.