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Things to know about polio vaccines, symptoms and more

The New York State Department of Health warned Thursday of the “potential spread” of polio after a case of paralysis detected in an unvaccinated young adult in the last month.

Paralytic cases of polio are rare, approximately represented 1 in 200 infections According to the World Health Organization, the discovery of a single case indicates the presence of many more. The New York City Department of Health also detected polio in sewage samples from two different counties, Orange and Rockland, in both June and July – another sign of community transmission.

“Based on past polio outbreaks, New Yorkers should know that for every case of paralytic polio observed, hundreds of other people may be infected,” said New York State Health Commissioner Dr. Mary Basset said in a statement on Thursday.

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“In conjunction with the latest findings on wastewater, the Department is treating the individual case of polio as just the tip of the iceberg with a much larger potential spread,” she added.

The Department of Health recommends that all New Yorkers who have not received a polio vaccine, including infants and pregnant women, get vaccinated immediately.

How polio spreads and how well vaccines protect against the disease.

What is polio?

Polio is a highly contagious disease caused by the poliovirus. The disease was eradicated in the United States in 1979, and the country has not seen a case of domestically acquired wild polio since. The latest New York patient was infected with vaccine-associated polio, a strain linked to the live virus of an oral polio vaccine not administered in the United States.

“[For] Public health people everywhere, like me, this makes us cry,” said Lynelle Phillips, assistant professor at the University of Missouri School of Health Professions and board chair of the Missouri Immunization Coalition.

“Hopefully this is just an abnormal situation and we can bring it under control,” she said. “But my heart breaks for this person who has flaccid paralysis due to a completely preventable disease.”

About 72% of those infected with polio have no visible symptoms, according to the Centers for Disease Control and Prevention. Another 25% may develop flu-like symptoms such as a sore throat, fatigue, fever, nausea, headache or stomach ache, which usually subside after a few days.

In rare cases, the virus can enter the nervous system and cause meningitis (swelling of the lining of the brain and spinal cord), paraesthesia (tingling in the legs), or irreversible paralysis, usually on one side of the body.

“It’s a double-humped disease. It starts out as mild illness, with cold symptoms, a sore throat and things like that. Then the patient usually gets better for a day or so and the paralysis sets in,” said Walter Orenstein, associate director of the Emory Vaccine Center.

People with paralysis often lose the ability to move an arm or leg, he said.

Between 2% and 10% of cases of paralytic polio are fatal because the virus can destroy the nerves that control breathing.

How is polio spread?

Polio spreads primarily through contact with an infected person’s feces, although in rarer cases people can transmit the virus through droplets from coughing or sneezing.

“In general, people don’t have good hand hygiene and so it spreads from person to person,” said Vincent Racaniello, professor of microbiology and immunology at Columbia University.

People with asymptomatic or mild cases are the main drivers of transmission, he said, as they are most likely to participate in social interactions and their cases are more common overall. But anyone with polio can shed the virus and potentially be contagious.

Racaniello said it’s likely the poliovirus has been circulating in US sewage for some time, although no cases have been detected.

“I think this virus has been in our sewers for many, many years,” he said.

However, as the U.S. disinfects and chlorinates its water systems, people are more likely to be exposed at home or in high-risk community settings such as prisons or nursing homes, Phillips said.

How well do polio vaccines work?

The US offers a range of four doses of an inactivated poliovirus vaccine. The CDC recommends that people get their first dose at 2 months of age, followed by single doses at 4 months of age and between 6 and 18 months, and a booster dose at between 4 and 6 years of age.

The vaccine is not required federally, but all 50 states and the District of Columbia require it for students entering kindergarten.

From 2019 almost 93% of US children had received three or more doses of the polio vaccine by age 2, according to the CDC. Vaccination rates in Rockland County and Orange County in New York are far lower: about 60% in the same age group.

“We rarely see a problem except in communities that are under-vaccinated,” Racaniello said. “For the general population, I don’t think it’s a problem if you’re vaccinated.”

According to CDC, 99% of the children Those who receive the recommended doses of polio are protected from disease, but protection takes weeks to build up. Racaniello estimates that people have 50% to 60% protection two weeks after receiving the first dose. The second dose should increase that protection to 90%, followed by 99% after three doses, experts said.

Racaniello said the vaccine was designed to prevent people from getting sick, rather than preventing the virus from entering our cells. But Orenstein said vaccines could still stave off some infections and help reduce transmission.

According to the New York State Health Department, vaccinated people should be protected for life said Thursday that vaccinated adults who are at increased risk of polio can receive a booster dose.

“The prevailing notion has always been that vaccine immunity is lifelong,” Racaniello said. “I got my polio shot in the ’60s and I think I’m still protected.”

But Phillips said it’s hard to say how strong the vaccine’s protection remains over time because the US hasn’t seen many polio cases in recent decades.

“We couldn’t really test if it’s lifetime immunity because we didn’t have polio around,” she said. “Unfortunately, we now have the opportunity to test that.”

https://www.nbcnews.com/health/health-news/know-polio-vaccines-symptoms-rcna41713 Things to know about polio vaccines, symptoms and more

Fry Electronics Team

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