New York Takes New Steps To Fight Polio

NEW YORK — New York State is taking more steps to address evidence of circulating poliovirus in the Hudson Valley, Long Island and New York City, including an official declaration of "imminent threat to public health" to make more support for local health departments possible.

There is no cure for polio, also known as infantile paralysis. Anyone who has not been vaccinated against the virus, once a global scourge, is at risk. Polio affects the nervous system. It is very contagious and can be spread by someone even if they aren't sick or experiencing symptoms, which range from mild flu-like symptoms to paralysis and death. People who are carrying the virus shed it in their stools.

A young Rockland County adult who had not traveled abroad was diagnosed with polio in July after becoming paralyzed. Since then, local, state and federal health officials have repeatedly found poliovirus circulating in the wastewater systems in Rockland, Orange, Sullivan and Nassau counties plus parts of New York City.

This newest declaration expands funding and resources to support local health departments in establishing immunization clinics, deploying vaccine to health care partners, and conducting outreach to unvaccinated and under-vaccinated New Yorkers.

It enables localities to claim reimbursement for poliovirus response activities undertaken from July 21 through Dec. 31.

New York State Health Commissioner Dr. Mary T. Bassett made the declaration Wednesday.

"Working daily with local county health departments, our partners at CDC, and trusted leaders, the Department is working effectively to increase childhood and community vaccination rates in counties where the virus has been detected," she said. "Thanks to long-established school immunization requirements, the vast majority of adults, and most children, are fully vaccinated against polio. Our focus remains on ensuring the on-time administration of polio vaccination among young children and catching kids and adults up who are unimmunized and under-immunized in the affected areas. That work continues at full force."

State officials hope to increase immunization rates particularly among children and in the areas where poliovirus is circulating.

The State Health Department launched wastewater surveillance in July, a tool to check for signs of the virus in sewage water in communities. Sequence analysis from the Centers for Disease Control and Prevention has since found repeated evidence of poliovirus in samples collected from Rockland, Orange and Sullivan counties as well as detected in samples collected from New York City and Nassau County.

The state has focused its efforts in areas where the threat is concentrated, which includes where there is repeated detection, and where there is a relatively low percentage of children that have completed their three-dose polio regimen by the age of 2 — Rockland, Orange, and Sullivan counties.

As of Aug. 1, the polio vaccination rate statewide was 78.96 percent. The counties with the lowest polio vaccination rates in the state were Orange, with 58.68 percent; Rockland, with 60.34 percent; Sullivan, with 62.33 percent; and Yates, with 53.77 percent. Nassau's vaccination rate is above the state average, at 79.15 percent.

Rockland has been a center of vaccine resistance in recent years. A 2018-19 measles outbreak there infected 312 people. In July, anti-vaxxers commenting on the county's social media pages derided officials' efforts to encourage polio vaccination.

Local health departments continue wastewater monitoring, clinical surveillance, and vaccine administration, working with the state health department.

They are also conducting education and outreach in communities where the virus has been detected to spread greater awareness and encourage vaccination, particularly to parents and guardians of young children, state officials said.

From July 21 to Sept. 25, roughly 26,000 polio vaccine doses have been administered to children 18 years and younger in Rockland, Orange, Sullivan, and Nassau counties — a 26 percent increase compared to the same time period in 2021, state officials said.

Earlier this month, Gov. Kathy Hochul declared a State Disaster Emergency to aggressively tackle any potential spread of the poliovirus. That increased the availability of resources to protect New Yorkers against paralytic disease.

An executive order expanded the network of polio vaccine administrators by allowing emergency medical services workers, midwives, and pharmacists to administer vaccines and authorize physicians and certified nurse practitioners to issue non-patient specific standing orders for polio vaccines.

While the state used to only require vaccinations of those 18 and under be reported into the New York State Immunization Information System, under the executive order, all health care providers must report polio vaccinations for people 19 and older to NYSIIS as well. That enables the agency and local health departments to focus vaccination activities where they are needed most and provides them yet another datapoint to understand the level of protection against polio in communities.

Polio vaccines provide durable protection, and the inactivated polio vaccine, the only vaccine available in the U.S., protects 99 to 100 percent of people against disease who receive all recommended doses. The Rockland County resident now paralyzed from polio was unvaccinated, officials said.

Polio vaccination has long been part of a nationwide recommended immunization schedule and New York State's requirements to attend school. Most adults and many children in New York State are already vaccinated.

Parents and guardians with children 17 years of age or younger who are unvaccinated or not up to date with their polio immunizations should immediately make sure their children get up to date with all recommended doses.

This is particularly urgent if they live, work, attend school, or have frequent social interactions with communities where poliovirus has been repeatedly detected in wastewater, which includes Rockland, Orange, and Sullivan counties.

As of Sept. 23, sequencing analysis by the Centers for Disease Control and Prevention (CDC) confirmed the presence of poliovirus in a total of 69 positive samples of concern:

• Of the 69 positive samples of concern, 62 samples have been found to be genetically linked to the individual case of paralytic polio among a Rockland County resident.
• Of the 62 samples, 37 samples were collected in Rockland County, 16 samples were collected in Orange County, 8 samples were collected in Sullivan County, and 1 sample was collected in Nassau County.
• Of the 37 samples identified in Rockland County, 2 were collected in May, 3 were collected in June, 9 were collected in July, 21 were collected in August, and 2 were collected in September.
• Of the 16 samples identified in Orange County, 2 were collected in June, 5 were collected in July, 6 in August, and 3 were collected in September.
• Of the 8 samples identified in Sullivan County, 2 were collected in July, 5 were collected in August, and 1 was collected in September.
• The sample identified in Nassau County was collected in August.
• 7 positive samples of concern, 1 collected in April from Orange County and 2 collected in June and 4 collected in July from New York City have also been identified. While at this time, these samples have not been genetically linked to the individual case in Rockland County, sequencing analysis characterizes these samples as either a live-vaccine-derived poliovirus (1, collected in New York City in July) or variants of the revertant polio Sabin type 2 poliovirus (6, 3 collected in July and 2 collected in June in New York City; 1 collected in April in Orange County). Both of these types of polioviruses can cause illness, including paralysis, in humans.

In the United States, live-virus vaccines have not been given since 2000. Inactivated poliovirus vaccine (IPV) is the only polio vaccine used in the United States in the past two decades.

IPV does not contain any live virus, and it cannot cause polio. It is given in either the arm or the leg depending on the patient's age. It is critical to get all recommended doses, specially for unvaccinated or under-vaccinated New Yorkers who live or work in areas with repeated poliovirus detection and are at increased risk of exposure.

New York adults outside of these areas who are unvaccinated, unsure of their vaccination status, or not up to date with vaccinations should consult with a health care provider. If vaccination is recommended and a provider does not have doses on hand, New Yorkers should contact their local health department.

SEE ALSO:

• NY Confirms 1st Case Of Polio In U.S. Since 2013
• 379 Polio Vaccines Given In Rockland After Resident Left Paralyzed
• More Poliovirus Found In Hudson Valley, NYC Wastewater
• Polio Detected In Nassau County Wastewater
  
• U.S. Polio Case Sparks Alarm: How Worried Should You Be?
• 'Tip Of The Iceberg': More Polio Virus Detected In The HV
  
• Rockland Polio Strain Matches Virus Samples In London, Jerusalem
• No Polio Detected In NJ Yet, But Testing To Ramp Up