Study: Public Health Response to Paralytic Polio in an Unvaccinated Person and Detection of Polio Virus in Sewage — New York, June–August 2022. Image Credit: Maryna Olyak/Shutterstock On July 18, 2022, the New York State Department of Health (NYSDOH) reported the identification of poliovirus type 2 in stool samples collected from an unvaccinated, immunocompetent young person residing in Rockland County, New York who presented with acute loose weakness. The patient reported symptoms of fever, gastrointestinal problems, neck stiffness, and limb weakness. The patient was subsequently admitted to hospital with possible acute flaccid myelitis (AFM). However, laboratory results detected vaccine-derived poliovirus type 2 (VDPV2) in stool samples collected 11 and 12 days after symptom onset. To date, Sabin-like type 2 polioviruses have been detected in the patient’s area of residence up to 25 days before and 41 days after the patient’s date of symptom onset.
Case findings
In June 2022, a young person who was not vaccinated against polio presented with a five-day history of fever, back and abdominal pain, neck stiffness, constipation, and two days of bilateral lower extremity weakness. The patient visited the emergency department and was admitted to the hospital with suspected AFM. The patient was subsequently transferred to a rehabilitation unit approximately 16 days after the initial onset of symptoms with persistent flaccid lower extremity weakness. Nasopharyngeal or oropharyngeal swabs and cerebrospinal fluid samples collected from the patient tested negative for human parevirus, enteroviruses, as well as common respiratory pathogens and encephalitis viruses (RT-PCR). In addition, sequencing and RT-PCR of stool samples performed by the NYSDOH laboratory detected poliovirus type 2. Samples tested at the Centers for Disease Control and Prevention (CDC) further confirmed the presence of poliovirus type 2. Further sequencing also identified the virus as VDVP2, which differed from the Sabin 2 vaccine strain, suggesting that transmission of the virus had been occurring for up to a year. However, the location of the transmission is not known.
Public health response
NYSDOH, CDC, and local health authorities investigated and responded to notification of the positive VDVP2 sample on July 18, 2022. On July 22, 2022, a NYSDOH advisory was issued to increase awareness among health care providers and improve detection of potentially infected individuals . Wastewater from Rockland and other New York counties was tested to assess vaccination coverage in the patient’s local community. Authorities also provided inactivated polio vaccine (IPV) to eligible vaccination providers and operated vaccination clinics throughout Rockland County. Enhanced surveillance was conducted for persons under investigation (PUI) who met clinical criteria and resided or traveled to certain counties, neighborhoods in New York, or other countries beginning May 1, 2022. By August 10, 2022, three additional persons were categorized as PUI. However, the samples provided by the PUIs tested negative for the polio virus. In addition, through August 10, 2022, 260 wastewater samples were collected from treatment plants in Orange and Rockland counties and tested for poliovirus. Of these, 8% tested RT-PCR positive for poliovirus, including 13 and eight samples from Rockland and Orange counties, respectively. Specifically, 20 sewage samples taken from May to July were genetically linked to the virus from the patient’s stool sample. In addition, an additional sample was identified in April from Orange County that had poliovirus type 2. Authorities also initiated additional public health and clinical surveillance activities to detect the presence of symptomatic nonparalytic infection or more severe symptoms along with asymptomatic infections in counties with poliovirus positive sewage findings. The Rockland County Health Department also began a countywide vaccination program on July 22, 2022. The present study highlighted the risk of contracting poliomyelitis among unvaccinated individuals. The researchers believe that citizens should be informed about the proposed IPV vaccination program to combat the virus.
title: “Investigation Of A Case Of Paralytic Poliomyelitis In An Unvaccinated Person Klmat” ShowToc: true date: “2022-11-11” author: “Cody Wascher”
Study: Public Health Response to Paralytic Polio in an Unvaccinated Person and Detection of Polio Virus in Sewage — New York, June–August 2022. Image Credit: Maryna Olyak/Shutterstock On July 18, 2022, the New York State Department of Health (NYSDOH) reported the identification of poliovirus type 2 in stool samples collected from an unvaccinated, immunocompetent young person residing in Rockland County, New York who presented with acute loose weakness. The patient reported symptoms of fever, gastrointestinal problems, neck stiffness, and limb weakness. The patient was subsequently admitted to hospital with possible acute flaccid myelitis (AFM). However, laboratory results detected vaccine-derived poliovirus type 2 (VDPV2) in stool samples collected 11 and 12 days after symptom onset. To date, Sabin-like type 2 polioviruses have been detected in the patient’s area of residence up to 25 days before and 41 days after the patient’s date of symptom onset.
Case findings
In June 2022, a young person who was not vaccinated against polio presented with a five-day history of fever, back and abdominal pain, neck stiffness, constipation, and two days of bilateral lower extremity weakness. The patient visited the emergency department and was admitted to the hospital with suspected AFM. The patient was subsequently transferred to a rehabilitation unit approximately 16 days after the initial onset of symptoms with persistent flaccid lower extremity weakness. Nasopharyngeal or oropharyngeal swabs and cerebrospinal fluid samples collected from the patient tested negative for human parevirus, enteroviruses, as well as common respiratory pathogens and encephalitis viruses (RT-PCR). In addition, sequencing and RT-PCR of stool samples performed by the NYSDOH laboratory detected poliovirus type 2. Samples tested at the Centers for Disease Control and Prevention (CDC) further confirmed the presence of poliovirus type 2. Further sequencing also identified the virus as VDVP2, which differed from the Sabin 2 vaccine strain, suggesting that transmission of the virus had been occurring for up to a year. However, the location of the transmission is not known.
Public health response
NYSDOH, CDC, and local health authorities investigated and responded to notification of the positive VDVP2 sample on July 18, 2022. On July 22, 2022, a NYSDOH advisory was issued to increase awareness among health care providers and improve detection of potentially infected individuals . Wastewater from Rockland and other New York counties was tested to assess vaccination coverage in the patient’s local community. Authorities also provided inactivated polio vaccine (IPV) to eligible vaccination providers and operated vaccination clinics throughout Rockland County. Enhanced surveillance was conducted for persons under investigation (PUI) who met clinical criteria and resided or traveled to certain counties, neighborhoods in New York, or other countries beginning May 1, 2022. By August 10, 2022, three additional persons were categorized as PUI. However, the samples provided by the PUIs tested negative for the polio virus. In addition, through August 10, 2022, 260 wastewater samples were collected from treatment plants in Orange and Rockland counties and tested for poliovirus. Of these, 8% tested RT-PCR positive for poliovirus, including 13 and eight samples from Rockland and Orange counties, respectively. Specifically, 20 sewage samples taken from May to July were genetically linked to the virus from the patient’s stool sample. In addition, an additional sample was identified in April from Orange County that had poliovirus type 2. Authorities also initiated additional public health and clinical surveillance activities to detect the presence of symptomatic nonparalytic infection or more severe symptoms along with asymptomatic infections in counties with poliovirus positive sewage findings. The Rockland County Health Department also began a countywide vaccination program on July 22, 2022. The present study highlighted the risk of contracting poliomyelitis among unvaccinated individuals. The researchers believe that citizens should be informed about the proposed IPV vaccination program to combat the virus.
title: “Investigation Of A Case Of Paralytic Poliomyelitis In An Unvaccinated Person Klmat” ShowToc: true date: “2022-11-21” author: “Mark Shorter”
Study: Public Health Response to Paralytic Polio in an Unvaccinated Person and Detection of Polio Virus in Sewage — New York, June–August 2022. Image Credit: Maryna Olyak/Shutterstock On July 18, 2022, the New York State Department of Health (NYSDOH) reported the identification of poliovirus type 2 in stool samples collected from an unvaccinated, immunocompetent young person residing in Rockland County, New York who presented with acute loose weakness. The patient reported symptoms of fever, gastrointestinal problems, neck stiffness, and limb weakness. The patient was subsequently admitted to hospital with possible acute flaccid myelitis (AFM). However, laboratory results detected vaccine-derived poliovirus type 2 (VDPV2) in stool samples collected 11 and 12 days after symptom onset. To date, Sabin-like type 2 polioviruses have been detected in the patient’s area of residence up to 25 days before and 41 days after the patient’s date of symptom onset.
Case findings
In June 2022, a young person who was not vaccinated against polio presented with a five-day history of fever, back and abdominal pain, neck stiffness, constipation, and two days of bilateral lower extremity weakness. The patient visited the emergency department and was admitted to the hospital with suspected AFM. The patient was subsequently transferred to a rehabilitation unit approximately 16 days after the initial onset of symptoms with persistent flaccid lower extremity weakness. Nasopharyngeal or oropharyngeal swabs and cerebrospinal fluid samples collected from the patient tested negative for human parevirus, enteroviruses, as well as common respiratory pathogens and encephalitis viruses (RT-PCR). In addition, sequencing and RT-PCR of stool samples performed by the NYSDOH laboratory detected poliovirus type 2. Samples tested at the Centers for Disease Control and Prevention (CDC) further confirmed the presence of poliovirus type 2. Further sequencing also identified the virus as VDVP2, which differed from the Sabin 2 vaccine strain, suggesting that transmission of the virus had been occurring for up to a year. However, the location of the transmission is not known.
Public health response
NYSDOH, CDC, and local health authorities investigated and responded to notification of the positive VDVP2 sample on July 18, 2022. On July 22, 2022, a NYSDOH advisory was issued to increase awareness among health care providers and improve detection of potentially infected individuals . Wastewater from Rockland and other New York counties was tested to assess vaccination coverage in the patient’s local community. Authorities also provided inactivated polio vaccine (IPV) to eligible vaccination providers and operated vaccination clinics throughout Rockland County. Enhanced surveillance was conducted for persons under investigation (PUI) who met clinical criteria and resided or traveled to certain counties, neighborhoods in New York, or other countries beginning May 1, 2022. By August 10, 2022, three additional persons were categorized as PUI. However, the samples provided by the PUIs tested negative for the polio virus. In addition, through August 10, 2022, 260 wastewater samples were collected from treatment plants in Orange and Rockland counties and tested for poliovirus. Of these, 8% tested RT-PCR positive for poliovirus, including 13 and eight samples from Rockland and Orange counties, respectively. Specifically, 20 sewage samples taken from May to July were genetically linked to the virus from the patient’s stool sample. In addition, an additional sample was identified in April from Orange County that had poliovirus type 2. Authorities also initiated additional public health and clinical surveillance activities to detect the presence of symptomatic nonparalytic infection or more severe symptoms along with asymptomatic infections in counties with poliovirus positive sewage findings. The Rockland County Health Department also began a countywide vaccination program on July 22, 2022. The present study highlighted the risk of contracting poliomyelitis among unvaccinated individuals. The researchers believe that citizens should be informed about the proposed IPV vaccination program to combat the virus.
title: “Investigation Of A Case Of Paralytic Poliomyelitis In An Unvaccinated Person Klmat” ShowToc: true date: “2022-11-25” author: “Nancy Bertrand”
Study: Public Health Response to Paralytic Polio in an Unvaccinated Person and Detection of Polio Virus in Sewage — New York, June–August 2022. Image Credit: Maryna Olyak/Shutterstock On July 18, 2022, the New York State Department of Health (NYSDOH) reported the identification of poliovirus type 2 in stool samples collected from an unvaccinated, immunocompetent young person residing in Rockland County, New York who presented with acute loose weakness. The patient reported symptoms of fever, gastrointestinal problems, neck stiffness, and limb weakness. The patient was subsequently admitted to hospital with possible acute flaccid myelitis (AFM). However, laboratory results detected vaccine-derived poliovirus type 2 (VDPV2) in stool samples collected 11 and 12 days after symptom onset. To date, Sabin-like type 2 polioviruses have been detected in the patient’s area of residence up to 25 days before and 41 days after the patient’s date of symptom onset.
Case findings
In June 2022, a young person who was not vaccinated against polio presented with a five-day history of fever, back and abdominal pain, neck stiffness, constipation, and two days of bilateral lower extremity weakness. The patient visited the emergency department and was admitted to the hospital with suspected AFM. The patient was subsequently transferred to a rehabilitation unit approximately 16 days after the initial onset of symptoms with persistent flaccid lower extremity weakness. Nasopharyngeal or oropharyngeal swabs and cerebrospinal fluid samples collected from the patient tested negative for human parevirus, enteroviruses, as well as common respiratory pathogens and encephalitis viruses (RT-PCR). In addition, sequencing and RT-PCR of stool samples performed by the NYSDOH laboratory detected poliovirus type 2. Samples tested at the Centers for Disease Control and Prevention (CDC) further confirmed the presence of poliovirus type 2. Further sequencing also identified the virus as VDVP2, which differed from the Sabin 2 vaccine strain, suggesting that transmission of the virus had been occurring for up to a year. However, the location of the transmission is not known.
Public health response
NYSDOH, CDC, and local health authorities investigated and responded to notification of the positive VDVP2 sample on July 18, 2022. On July 22, 2022, a NYSDOH advisory was issued to increase awareness among health care providers and improve detection of potentially infected individuals . Wastewater from Rockland and other New York counties was tested to assess vaccination coverage in the patient’s local community. Authorities also provided inactivated polio vaccine (IPV) to eligible vaccination providers and operated vaccination clinics throughout Rockland County. Enhanced surveillance was conducted for persons under investigation (PUI) who met clinical criteria and resided or traveled to certain counties, neighborhoods in New York, or other countries beginning May 1, 2022. By August 10, 2022, three additional persons were categorized as PUI. However, the samples provided by the PUIs tested negative for the polio virus. In addition, through August 10, 2022, 260 wastewater samples were collected from treatment plants in Orange and Rockland counties and tested for poliovirus. Of these, 8% tested RT-PCR positive for poliovirus, including 13 and eight samples from Rockland and Orange counties, respectively. Specifically, 20 sewage samples taken from May to July were genetically linked to the virus from the patient’s stool sample. In addition, an additional sample was identified in April from Orange County that had poliovirus type 2. Authorities also initiated additional public health and clinical surveillance activities to detect the presence of symptomatic nonparalytic infection or more severe symptoms along with asymptomatic infections in counties with poliovirus positive sewage findings. The Rockland County Health Department also began a countywide vaccination program on July 22, 2022. The present study highlighted the risk of contracting poliomyelitis among unvaccinated individuals. The researchers believe that citizens should be informed about the proposed IPV vaccination program to combat the virus.
