March 30, 2023

New York has recorded one case of polio but has found additional polio virus samples in state wastewater, prompting Governor Kathy Hochul to declare a public health emergency last week.

Federal health officials fear the additional positive samples and positive samples found in places like London mean more cases may be circulating — a threat to low-vaccination communities.

Most polio infections are asymptomatic, although as many as 1 in 200 people can become paralyzed. According to the CDC. While only one case of paralysis has been reported, senior Biden health officials worry that because the virus is often symptom-free or has mild flu-like symptoms, it is far more common than officials can detect.

“It could put the public at risk,” said one person familiar with the talks, adding that any government response could be thwarted if it is unable to reliably track the movement of the virus.

The National Security Council did not respond to a request for comment.

At NSC meetings, Biden health officials tried out how to increase polio vaccinations, such as the best ways to communicate the importance of vaccination to local leaders, including religious leaders. CDC Director Rochelle Walensky, in consultation with the New York Department of Health, recently sent a letter to communities across the state highlighting the effectiveness of polio vaccination. The letter has been translated into Yiddish, Haitian Creole and Spanish, a CDC spokesperson said.

The New York State Department of Health is also deploying officials to work with local community leaders to convince people who are hesitant about the vaccine, especially those living in counties where wastewater samples have come back positive, to sign up for the injection.

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Lawrence Gostin, a professor of public health law at Georgetown University, said polio and Covid-19 both demonstrate what can happen when there is “backlash against vaccinations.”

“You’ve seen it with polio because the outbreaks have happened in communities that are hesitant to get vaccines.” he said. “From a public health perspective, we’re in trouble.”

According to CDC data, about 92 percent of children in the U.S. have been vaccinated against polio. However, there are areas across the country with lower rates, including in Rockland County, where rates in some zip codes are as low as 37 percent for children under age 2.

Federal officials have also debated whether the CDC should begin monitoring wastewater for poliovirus in other states. A CDC spokesperson said the agency only regularly tests samples in New York. It also tested several samples from Connecticut and New Jersey — all of which were negative.

“Poliovirus testing is not a formal part of the National Wastewater Surveillance Program at this time,” the spokesperson said in a statement. “Expansion into new diseases, such as poliovirus, can take time and resources to ensure reliable, actionable data.”

The CDC also said the agency has been working with local clinicians and religious leaders on vaccination efforts that have led to a “significant increase” among children receiving polio shots.

Some top health officials have argued that the government needs to do more to detect the virus and prepare for its possible spread in the community, especially after it was overrun by monkeypox. They have called on the CDC to step up its wastewater monitoring for the virus, one of the senior officials said.

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Several health departments across the country are also interested in testing their wastewater. Officials said they are beginning to develop plans with the CDC to test in the coming months.

Neither the Houston Health Department nor the Colorado Department of Public Health and Environment — the two health departments that awarded CDC grants earlier this month to establish a National Wastewater Surveillance System Center of Excellence — test sewer samples for polio virus. However, spokespersons from both departments said talks are underway about starting testing.

“We are working closely with CDPHE and the CDC to develop and evaluate wastewater assays for other pathogens of public health importance,” said Corinne Lengsfeld, senior vice provost for research and graduate education at the University of Denver, who works on Colorado’s wastewater efforts. . “Polio is on our development list, but we are not ready for it yet.”

The California Department of Health told POLITICO it is monitoring polio through reports from health care providers and labs and that it is “working with academic partners to explore options for wastewater testing.”

Kimberly Thompson, a polio expert and president of Kid Risk, a nonprofit devoted to public health issues, said the value of wastewater monitoring by public health authorities may be greatest in low polio vaccinated communities, including New York’s Hasidic Jewish community. Amish communities, minority populations without access to care, and communities with significant populations of people who are anti-vaccine.

“Despite the ‘test everything’ culture that emerged during Covid-19, testing purely for testing has a real cost and does not necessarily lead to actionable information,” Thompson said. “As schools begin and immunization efforts to catch up with those missed during the pandemic are still underway, prioritizing communication about the risks of paralysis for all unvaccinated individuals and ensuring school admission requirements effective to raise polio immunization will likely be the priorities for most public health. authorities.”

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