Polio in New York – An Infectious Disease Doctor Explains



The first incidence of polio in the United States since 2013 was reported by New York state health officials on July 21, 2022. The American resident, who has paralysis and weakened muscles, was not immunized.

Prior to the development of secure and reliable vaccinations in the middle of the 20th century, polio was a frequent cause of childhood paralysis. Polio has nearly been eliminated as a result of international immunization initiatives. Only 13 endemic wild poliovirus infections have been recorded globally so far in 2022.

According to reports, a kind of polio that the New York patient developed can be linked to the live but weakened poliovirus used in the oral polio vaccination. Since 2000, the United States has not employed this particular vaccination. Health experts said the virus that was infecting the male patient most likely came from a country where oral vaccinations are still used.

Specialist in infectious diseases and head of the Polio Research Committee for the World Health Organization is William Petri. Here, he describes vaccine-derived poliovirus and explains why it cannot be brought on by the inactivated polio vaccination now used in the United States.                                                          
What are the two polio vaccination types?

The pathogen is introduced to your body in a safe manner via vaccinations. The aim is to prepare your immune system to combat the actual germ should you ever come into contact with it.

The oral polio vaccine, which was created by Albert Sabin, involves a live but attenuated poliovirus that is ingested in the form of a sugar cube or droplet. The virus is weakened, or attenuated, so that it can no longer spread illness.

Jonas Salk was the man behind the creation of the injection-based polio vaccine. Dead, inactive virus is present.

Children in the US receive the inactivated polio vaccination at ages 2, 4, and 6. It offers almost total defense against paralytic polio.

How is polio caused by the live vaccine?

The oral vaccine's weakened live virus can't really spread illness. The weakened virus is still eliminated in the feces since the vaccination is administered orally. A person who has received the vaccination might then pass it on to their close contacts. Long-term transmission of the weakened virus can lead it to evolve and recover its power to paralyze people.

People in areas with poor sanitation and low vaccination rates can then contract the modified virus, which can cause illness and even paralysis.

Thankfully, this is a rather uncommon event. Less than 800 instances of vaccine-derived polio have been documented since 2000, despite more than 10 billion doses of the oral polio vaccine having been given.

The present New York patient apparently came into contact with a mutant poliovirus after receiving a vaccine abroad. Routine surveillance discovered vaccine-derived poliovirus in London's sewage system earlier this summer, but there have been no cases there.

Given this danger, why use the oral vaccination anywhere?

The fact that the weakened live virus can spread throughout the population once oral vaccination recipients pass it in their stools is beneficial. It can help to promote immunity even in persons who weren't directly vaccinated by using a feces-to-oral route. Compared to inactivated polio vaccinations, the oral polio vaccine is also less expensive and simpler to administer.

The live virus vaccination is more effective than the inactivated virus vaccine at preventing the spread of wild poliovirus, which is the most significant benefit. Polio has been completely eradicated in the Americas, Europe, and Africa thanks alone to the live oral vaccination. It is safe to discontinue using the oral live vaccination after polio has been eradicated from a continent and switch entirely to the inactivated vaccine, which does protect patients from illness and does not carry the small risk of vaccine-derived paralytic polio.

The older live-virus vaccination has been replaced by a newer, safer oral polio vaccine that has been genetically modified to not mutate. Thus, even this incredibly rare polio vaccine side effect should soon be history.

Two of the three polioviruses have been eliminated as a result of the enormous worldwide effort. Now that all but one wild poliovirus 1 have been eradicated, the globe is close to doing so (WPV1).

Only Pakistan and Afghanistan still have endemic polio today; Pakistan has 12 paralytic polio cases this year alone, while Afghanistan has only one. Two cases that were brought into Africa from abroad are being controlled by extra vaccination drives.

When the world is free of wild poliovirus, vaccination campaigns may be able to switch to the inactivated polio vaccine, removing the possibility of any polio cases arising from vaccines in the future.

William Petri,  University of Virginia

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