On July 21, 2022, the New York State Department of Health alerted the public to a confirmed case of paralytic polio an unvaccinated Rockland County man. Wastewater monitoring conducted by the DOH and the New York City Department of Health and Mental Hygiene (NYCDOHMH) detected the presence of the virus in New York City, Rockland and Orange Counties, according to an August 12 press release, suggesting that the virus, which can lead to paralysis and death, in rare cases, has been circulating once again.
Polio infections were a once a driver of widespread panic: in the early 1950s, outbreaks caused more than 15,000 cases of paralysis per year according to the Centers for Disease Control and Prevention (CDC). A vaccine became available in 1955 and the US was declared free from the disease in 1979. Unfortunately, the COVID-19 pandemic has significantly set back national and global immunization efforts and prevention programs made over the past several decades, and unvaccinated communities are at risk for the disease.
Who is at risk for polio?
Children and adults who aren’t vaccinated for polio are at risk for infection.
What are the symptoms of polio?
Polio is a viral infection and highly contagious. It is carried in the nose and throat for a few weeks when someone is infected. It can also be spread through infected stool. Polio can live for many weeks in the gastrointestinal (G.I.) tract. Thorough handwashing after using the bathroom and before meals is essential for prevention.
The majority of polio cases have no or mild symptoms, including fever, headache and nausea, which resolve after a few days. A minority of cases, maybe 3% - 4%, may progress and cause meningitis; in less than 1% of cases, polio can cause paralysis. Those with no symptoms can still spread the virus.
Is there a test to diagnose polio?
Yes. Your physician can test for polio through specimens from the throat, stool and occasionally the cerebrospinal fluid (CSF).
Is the polio vaccine safe for children?
Yes. The inactivated polio vaccine (IPV), the only polio vaccine given in the US since 2000, is a safe and effective vaccine with few side effects. It may cause a mild fever and irritation, as well as pain, redness and swelling at the injection site (the leg or arm, depending on the patient’s age). It is often given in combination with other routine childhood vaccines in the same syringe.
When is the polio vaccine given?
The polio vaccine is typically given to children in a four-dose series as part of the regular vaccine schedule recommended by the CDC at ages 2 months, 4 months, 6-18 months and 4-6 years, but adults who were not vaccinated at all or completely as children should get the IPV vaccine to be protected from polio. For adults who have never been vaccinated, IPV is given in three doses: the second dose is 1-2 months following the first, and the third dose 6-12 months after the second.
Adults should get a lifetime booster dose of IPV if:
- They are traveling to countries with a high risk of exposure to polio
- They work in a healthcare setting treating patients who could have polio or a laboratory setting with specimens that might contain polio
Vaccination is strongly recommended to protect children and adults from the polio virus and to prevent it from spreading, and the good news is that overall vaccination rates in the US are high: 93% of kindergarteners had been vaccinated ahead of the 2020-2021 school year, according to the CDC.
To make an appointment to speak with a physician or schedule a vaccination for you or your child, call 914-849-MyMD.
Neritan Mani, MD, MBA, FHM is the Associate Medical Director at White Plains Hospital.