'Tip of the iceberg': New York health officials raise alarms over possible polio spread

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New York state health officials say wastewater testing leads them to believe polio is circulating in parts of the state, linking it to a case of paralytic polio in Rockland County.

Two New York state health officials said the health challenge needs everyone’s attention.

“This is a very alarming and urgent situation. This has not happened since we eradicated polio in the United States in 1979,” said Dr. Eli Rosenberg, New York State Department of Health deputy director of science for the Office of Public Health.

The work health officials are now doing – wastewater testing and preventive vaccination – help measure and simultaneously prevent spread of a very contagious virus.

“When we see only one case, that’s kind of the tip of the iceberg,” said Dr. Emily Lutterloh, state health department director of the Division of Epidemiology. “And we really need to see how big that iceberg is.”

The Rockland County case developed in someone who had never been vaccinated. But the polio strain was derived through a type of oral live-virus vaccine that hasn’t been used in the U.S. for decades.

That means the Rockland County patient likely caught polio that somehow formed in a person who had the oral polio vaccine recently in another country. A rare complication occurred that allowed the virus to shed in the person who received the oral vaccine, releasing copies of the vaccine from their body.

The Rockland patient, identified by officials only as a young adult, developed paralysis – a hallmark outcome for the virus – but health officials have not said if that condition was permanent.

Rockland County is about 40 miles north of New York City.

Wastewater shows indications of 'community spread'

The polio strain found in the patient’s sample and in local wastewater testing has been found in wastewater in London and around Jerusalem. Orange County, New York health officials reported Wednesday that wastewater samples at two sites had detected polio. On Thursday, the state health department reported July wastewater testing also revealed the virus.

State officials said the samples in Orange and Rockland counties are genetically linked to each other and to the case found in the Rockland patient. However, health officials said, "the latest environmental findings do not indicate that the individual identified in Rockland County was the source of the transmission, and case investigation into the origin of the virus is ongoing."

The Rockland patient had not traveled out of the country. There was no information about travel to Orange County.

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“These environmental findings – which further indicate potential community spread – in addition to the paralytic polio case identified among a Rockland County resident, underscore the urgency of every New York adult and child getting immunized against polio, especially those in the greater New York metropolitan area,” said Samantha Fuld, spokesperson for the New York State Department of Health.

Concern about 'cases we're not seeing'

Transmission to the Rockland patient could have been directly from the person who took the oral polio vaccine, or through several people who may have been unvaccinated and asymptomatic.

“We don’t know and I don’t even think it’s possible to know that,” Rosenberg said. “We certainly are concerned there has been transmission in the Rockland County and New York.”

Public health officials have said a paralytic polio case likely means there are more, possibly hundreds, of asymptomatic polio cases in the area.

“We see one paralytic case, that most certainly means there are many," Rosenberg said.

Before the polio vaccine was introduced in 1955, summer waves of polio would sicken thousands.

The inactive polio vaccine, used exclusively in the U.S. since 2000, is considered highly effective at preventing paralysis and other forms of severe illness.

This article originally appeared on Rockland/Westchester Journal News: New York polio case, wastewater tests worry health officials