Polio Outbreaks — Precision Vaccinations - Precision Vaccinations

Polio Outbreaks 2022

Polio outbreaks in 2022 have been confirmed in non-endemic countries in Africa, Asia, Europe, and New York by the U.S. CDC. In addition, in recent years, the polio-endemic countries of Afghanistan and Pakistan often report new outbreaks, according to the Global Polio Eradication Initiative (GPEI). This interactive timeline traces the history of polio outbreaks from 1580 B.C. to 2022.

The World Health Organization (WHO), the UK Health Services Agency, the European CDC, and the U.S. NIH say polio is a vaccine-preventable disease.

Polio Cases 2022

In the USA, the State of New York and the CDC confirmed a poliovirus type 2 infection on July 14, 2022, in Rockland Country, NY. The patient was hospitalized with possible acute flaccid myelitis (AFM). The last polio case caused by wild poliovirus occurred in the USA during 1979.

Worldwide, as of August 9, 2022, the ECDC reported about 19 cases of polio due to wild poliovirus type 1 (WPV1) and 223 cases due to circulating vaccine-derived poliovirus (cVDPV) had been reported this year. In 2022, vaccine-derived poliovirus type 2 (cVDPV) cases have been reported in 15 countries, with 93% of the cases attributed to cVDPV2. The continuing circulation of WPV1 in Pakistan and Afghanistan and the detection of four WPV1 cases in Mozambique in 2022 genetically linked to a strain from Pakistan show that there is still a risk of poliovirus being exported to other countries.

Poliovirus Detection

Poliovirus is very contagious, spreads through person-to-person contact, and lives in an infected person's throat and intestines. Poliovirus is hard to detect when relying on clinical symptoms in humans, says The BMJ. According to CDC information updated on August 11, 2022, about 25% of people infected with poliovirus will experience symptoms such as Fatigue, Fever, Headache, Stiffness, Muscle or stomach pain, Nausea, or sore throat. 

Poliovirus in Wastewater

On August 2, 2022, the peer-review journal Nature published 'Wastewater monitoring comes of age.' While not every pathogen is reliably shed in feces, estimating case counts based on RNA or DNA concentrations in wastewater remains a work in progress.' Between February and July 2022, a total of 116 poliovirus type 2 (PV2) isolates were identified in 19 sewage samples collected in London, United Kingdom. And in Israel, wastewater near Jerusalem. 

Polio Israel

The Israeli Ministry of Health announced on March 10, 2022, that following two confirmations, it was expanding the investigation of sewage sample collection in Jerusalem and in additional centers around Israel. The International Health Regulations National Focal Point for Israel notified WHO of the detection of the cVDPV3 virus isolated from an acute flaccid paralysis case in the country on March 7, 2022. The Israeli Ministry of Health, under guidance from the Consultant Committee on Poliovirus, resolved to launch a nationwide vaccine operation in April 2022 for additional vaccination against polio for over 2 million children aged six weeks until 17 years. In July 2022, Dr. Sharon Alroy-Preis, the Health Ministry's public health chief, stated to the JPost, 'The poliovirus outbreak has largely been overcome and is under control. And no poliovirus was found in the country's sewage in July 2022.' 

In 2013-2014, Israel detected WPV1 in wastewater samples in its southern regions. And The Lancet reported that between 2005 and 2013, Israel discontinued the administration of the live polio vaccine.

Polio London

The UK Health Security Agency (UKHSA) declared a "national incident" in June 2022 after poliovirus was detected in London sewage. Detection of the current poliovirus since February 2022, and genetic sequencing showing its ongoing evolution, indicate likely circulation in the community, reported The BMJ. In the UK, poliovirus was detected through a surveillance program led by the National Institute of Biological Standards and Control. Some of the vaccine-derived poliovirus type 2 isolates found in the UK were genetically linked to a polio case reported in July 2022 from lower New York, as well as to environmental samples collected in New York and Greater Jerusalem, Israel.

Polio New York

The New York State Department of Health (NYSDOH) confirmed on August 26, 2022, that New York State (Rockland, Orange, Sullivan) and NYC Health confirmed poliovirus was detected in sewage, suggesting likely local circulation of the virus. The percentage of children aged six months to 5 years who received three doses of polio vaccine in New York City as of June 30, 2022, is about 86%, with Williamsburg (11206) being the lowest at 56%. On August 12, 2022, NYC leaders confirmed that all eligible children and adults should be vaccinated against polio.

Polio Vaccines - U.S. FDA Approved

The U.S. CDC's website stated on August 16, 2022, that 'for best protection, children should get multiple doses of polio vaccine. For polio vaccination recommendations for adults, see Polio Vaccination: What Everyone Should Know. Two types of vaccines can prevent polio: Inactivated poliovirus vaccine (IPV) and the Oral poliovirus vaccine (OPV). 

The IPV protects against both wild-type polio and this weakened poliovirus strain. For details and age groups, refer to the ACIP IPV catch-up vaccine table. And the oral vaccine contains a weakened strain of the poliovirus that has changed over time and now behaves similarly to a wild-type polio infection. The OPV can lead to vaccine-derived poliovirus, which can enter the blood and paralyze an unvaccinated person and is not offered in the USA.

The IPOL IPV vaccine is indicated for active immunization of infants (as young as six weeks), children, and adults to prevent poliomyelitis caused by poliovirus types 1, 2, and 3.

Kinrix is indicated for active immunization against diphtheria, tetanus, pertussis, and poliomyelitis as the fifth dose in diphtheria, tetanus, and acellular pertussis (DTaP) vaccine series and the fourth dose in the IPV series in children 4 through 6 years of age whose previous DTaP vaccine doses have been with Infanrix and/or Pediarix for the first three doses and Infanrix for the fourth dose.

Pediarix is a vaccine for active immunization against diphtheria, tetanus, pertussis, and infection caused by all known subtypes of hepatitis B virus and poliomyelitis. 

Pentacel is a multi-vaccine consisting of Diphtheria, Tetanus Toxoids, and Acellular Pertussis Adsorbed and Inactivated Poliovirus (DTaP-IPV) component as well as an ActHIB® vaccine component.

Quadracel vaccine is indicated for active immunization against diphtheria, tetanus, pertussis, and poliomyelitis.

Sabin IPV vaccine is indicated to prevent the Wild Polio Virus in the hope of completely eradicating the disease.

Polio Vaccine Price

The U.S. CDC confirmed the Vaccines For Children program is a federally funded program that provides IPV vaccines and medicines at no cost to children to children who might not otherwise be vaccinated because of their inability to pay. For people in the USA not covered by health insurance, a polio booster typically costs about $100. For example, pharmacies may charge about $100 for an IPV polio booster shot. The U.S. CDC Vaccine Price List was updated on July 1, 2022.

This UNICEF table provides an overview of Oral polio vaccine prices contracted with suppliers. And additional polio vaccine prices and discount information are available at InstantRx™.

Polio Vaccination: What Everyone Should Know

The U.S. CDC urges everyone who is not fully vaccinated to complete the polio vaccination series as soon as possible. The CDC recommends that children get four doses of a polio vaccine. And adults who completed their polio vaccination but who are at increased risk of coming in contact with poliovirus (see below) may receive one lifetime IPV booster. 

And the CDC defined acute flaccid paralysis (AFP) in 2004 as "anyone under 15 years of age with acute onset of focal weakness or paralysis (including GBS) or any person with paralytic illness at any age when polio suspected, characterized by flaccid (reduced tone), without other obvious causes. The adoption of the global polio eradication goal in 1988 required the implementation of AFP surveillance in all countries and territories.

Post-Polio Syndrome

As polio survivors progress through life, a significant proportion develops neurological symptoms known as Post-Polio Syndrome (PPS), says the U.S. NIH. Characterized by new, gradual, and progressive muscle weakness and wasting, difficulty swallowing, joint or muscle pain, and general fatigue after being stable for many years, the non-contagious PPS typically develops 15 to 40 years after people have recovered from polio. 

The first medical reports of PPS appeared in France in 1875. Further research published in the 1950s identified significant damage to nerve cells within the spinal cord. However, as the UK-based Polio Survivors Network concludes, PPS has no set pattern of nerve damage. Additional clinical and diagnostic information about poliovirus infection is posted by the U.S. CDC as of August 10, 2022.

Polio Outbreak News 2022

September 1, 2022 - The U.S. CDC is investigating a case of poliomyelitis, or paralytic polio, in New York state. During a COCA Call, presenters will discuss the history of polio in the USA. CDC staff will also review clinical aspects of poliovirus infection, how to report suspected cases and recommendations for polio vaccination in the USA.

August 28, 2022 - National Geographic published: Why polio is making a comeback.

August 26, 2022 - The New York State Department of Health confirmed today that sequencing analysis performed by CDC has now detected poliovirus in four samples from Sullivan County, two collected in July and two collected in August, which are genetically linked to the case of paralytic polio previously identified in Rockland County. Already, poliovirus had been identified in samples collected in Rockland County, Orange County, and NYC, the types of poliovirus that can cause paralysis in humans.

August 26, 2022 - The Yale School of Medicine published: Is Polio Making a Comeback?

August 25, 2022 - The JAMA Network published a Perspective: What Physicians Need to Know About the Polio Resurgence in New York State.

August 23, 2022 - In the state of Michigan, 31% of children ages 19 to 35 months are overdue for routine vaccinations, including polio. "You really want to have a large number of people vaccinated, so diseases don't start circulating," says Dennis Cunningham, M.D., medical director of infection control and prevention at Henry Ford Health.

August 22, 2022 - With Poliovirus in Wastewater, Should We Get Boosted?

August 19, 2022 - New York Department of Health HEALTH ADVISORY: Update #2 Regarding Poliovirus in New York State: All children, adolescents, and adults who are unvaccinated or under-vaccinated should be brought up to date with all routine CDC-recommended IPV doses. This is particularly important and urgent if they live, work, attend school, or have frequent social interactions with communities in Rockland and Orange Counties.

August 19, 2022 - The U.S. CDC published: Public Health Response to a Case of Paralytic Poliomyelitis in an Unvaccinated Person and Detection of Poliovirus in Wastewater — New York, June–August 2022. Twenty specimens from wastewater samples collected during May, June, and July were genetically linked to viruses from the patient's stool samples. This case highlights the risk for paralytic disease among unvaccinated persons.

August 16, 2022 - The U.S. CDC issued an MMWR - Public Health Response to a Case of Paralytic Poliomyelitis in an Unvaccinated Person and Detection of Poliovirus in Wastewater — New York, June–August 2022. Among tested samples, 21 (8%) yielded positive poliovirus results using RT-PCR and partial genome sequencing, including 13 from Rockland County and eight from Orange County. The detection of VDPV2 genetically linked to the virus from the patient and in wastewater specimens from two counties in New York State over the course of ≥2 months indicates community transmission and ongoing risk for paralysis in unvaccinated persons.

August 15, 2022 - GAVI reported: Post-Polio Syndrome - Decades after recovering from polio, some survivors are developing progressive muscle weakness and fatigue that can severely impair their quality of life.

August 12, 2022 - Poliovirus Confirmed in NYC's wastewater by the New York State Department of Health. and NYC Health issued: 2022 Health Alert #20: Update on Poliovirus in New York City.

August 11, 2022 - The Rockland County, NY Health Department will offer a polio vaccination clinic in Spring Valley on August 17, 2022. The Health Department also offers polio vaccinations at 50 Sanatorium Road in Pomona on Mondays and Wednesdays.

August 10, 2022 - The UKHSA confirmed a total of 116 PV2 isolates had been identified in 19 sewage samples collected in London, England, between February and July 2022. Most are vaccine-like viruses, and only a few have sufficient mutations to be classified as vaccine-derived poliovirus. And the Joint Committee on Vaccination and Immunisation advised that a targeted IPV booster dose should be offered to all children between the ages of 1 and 9 in London boroughs.

August 10, 2022 - According to the Global Polio Eradication Initiative, the Democratic Republic of the Congo, Mozambique, and Yemen reported more polio cases this week.

August 8, 2022 - Global Polio Eradication Initiative: Short report on type 2 poliovirus detected in the USA, Israel, and the UK.

August 7, 2022 - NBC4 News NY reported - The "CDC continues to collaborate with the New York State Department of Health to investigate their recent polio case, including ongoing testing of wastewater samples to monitor for poliovirus and deploying a small team to New York to assist on the ground with the investigation and vaccination efforts," a spokesperson confirmed. The polio virus has now been found in seven different wastewater samples in two adjacent counties north of New York City.

August 4, 2022 - "Based on earlier polio outbreaks, New Yorkers should know that for every one case of paralytic polio observed, there may be hundreds of other people infected," State Health Commissioner Dr. Mary T. Bassett said. HEALTH ADVISORY #1: Update Regarding Poliomyelitis in Rockland County, New York State.

July 29, 2022 - The Global Polio Eradication Initiative has been informed of a case of paralytic polio (type 2 VDPV) in an unvaccinated individual in Rockland County, NY. Following the detection, the Global Polio Laboratory Network has confirmed that the VDPV2 isolated from the case is genetically linked to two Sabin-like type 2 isolates collected from environmental samples in early June 2022 in both New York and Israel, as well as to the recently-detected VDPV2 from environmental samples in London, UK. 

July 26, 2022 - The Rockland County Department of Health vaccinated 71 people against polio at the County's first two clinics in response to a case of polio in a resident.

July 22, 2022 - New York State issued HEALTH ADVISORY: Poliomyelitis Case in Rockland County, New York State.

July 13, 2022 - Israel's Ministry of Health published updated polio vaccination guidelines #6.

July 3, 2022 - Israel's Operation Two Drops polio vaccine program reached over two million children.

June 22, 2022 - London residents are shedding the type 2 poliovirus strain in their feces.

June 22, 2022 - Israel is providing live attenuated poliovirus vaccines as part of student health services.

April 29, 2022 - Morbidity and vaccination campaign against the polio virus in Israel.

April 2, 2022 - Israel reports potentially eight polio cases in 2022.

March 15, 2022 - The Israeli Ministry of Health, under guidance from the Consultant Committee on Poliovirus, launched a nationwide vaccine operation, 'Two-Drops,' for supplementary vaccination against polio for children.

September 2021 - Getting a Fair Shot: Progress and Disparities in Early Childhood Vaccination in New York State. The lowest regional rates of early childhood vaccination coverage were consistently found in the Lower Hudson and Long Island regions (in 2020, 54% and 59%, respectively.

The Global Polio Eradication Initiative publishes polio vaccine and outbreak news.