Dear USET/USET SPF Family,
In July of 2022, a case of paralytic polio was reported in a young adult who was unvaccinated for polio in Rockland County in southern New York State. This was the first case of paralytic polio in the United States in many years. Recently, poliovirus has been found in the wastewater in New York City and several counties in southern New York. This current case is concerning, especially because the virus has been found in wastewater, indicating some community spread. About 75% of people who are infected with polio have no symptoms; about 25% will have a non-specific viral illness. Less than 1% of infected people will develop paralysis.
Polio is caused by the poliovirus, an enterovirus that inflicted widespread illness and death around the world prior to the availability of a vaccine developed in the 1950’s. Before the vaccine was introduced, many people suffered paralysis from polio, including President Franklin D. Roosevelt. Thanks to strong vaccination campaigns, polio was eradicated in the United States by 1979. Though Polio appears to have been eliminated in the US, infections still occur in a few places in the world, leading to the occasional imported case.
Vaccination with the currently available Polio vaccine confers a high degree of long-lasting immunity. In addition, the vaccine is considered very safe when administered appropriately, with mild to no side effects generally noted. It is given as part of routine childhood immunization. Unfortunately, vaccination rates in this country have declined in recent years; the current reported rate of polio vaccination in New York is 79%. The average rate of polio vaccination in Nashville Area Tribal Nations is currently 75.8%. Only 20% of Tribal Nations have a rate above 90%.
Anyone who has not received a primary series of polio vaccine is at risk for developing paralytic disease if they become infected with the poliovirus. Therefore, this is an excellent opportunity to review the immunization rates in your community, and to make an effort to reach out to those who are not up to date.
Medical providers should be aware of the possibility of paralytic polio and should consider it in the differential diagnosis of anyone with sudden onset weakness in the extremities.
The CDC website has some excellent materials for clinicians and for patient education:
For general polio information: https://www.cdc.gov/polio/what-is-polio/index.htm
For clinicians, including how to report suspected cases: https://www.cdc.gov/polio/what-is-polio/hcp.html
For clinicians, a 1 hour continuing education video: Webinar Thursday, September 1, 2022 - Polio in New York: How to Recognize and Report Polio, and Reinforce Routine Childhood Polio Vaccination (cdc.gov)
For vaccine information: https://www.cdc.gov/vaccines/vpd/polio/index.html
For patient education: https://www.cdc.gov/vaccines/parents/diseases/polio.html?CDC_AA_refVal=https%3A%2F%2Fwcms-wp.cdc.gov%2Fvaccines%2Fparents%2Fdiseases%2Fchild%2Fpolio.html
As always, staff members of the USET are available to help you with any questions. If you have any questions, please reach out to firstname.lastname@example.org