The case of a young man paralyzed by polio in New York is not simply a surprise. It was shocking. The last time polio was diagnosed in New York state was in 1990. However, the virus has also now been found in sewage samples in Rockland County, Orange County and New York City. As monitoring continues, we’ll learn more, but what we know is enough. We have circulating polio virus that can cause paralysis in these communities. Polio in New York today is an imminent threat.
Unlike Covid-19, polio is not a new disease. Once a source of terror during the summer months, the virus seems to have entered the history books. Successful vaccination campaigns in the 1950s meant that wild poliovirus was declared eliminated in the United States in 1979, and from the Americas in 1994.
Today, polio is endemic only amid political turmoil in Afghanistan and Pakistan, although Malawi and Mozambique reported cases in the past seven months. Wealthy countries with surveillance systems are put on high alert. On August 10, UK Health Security Agency announced it will give a booster dose to children in London because a polio virus has been found in sewage, seeking to prevent a human tragedy from happening here.
During a conversation, my colleague and friend Jane Cardosa, a Malaysian virologist, calmly noted: “In our part of the world, a case of polio is breaking out.” The New York state case was not an accident of chance, a freak accident or a government conspiracy. And it’s not surprising that we only have one paralyzed person. Many people don’t know that about 70 percent of people with polio have no symptoms. About 25 percent infected people have mild or flu-like symptoms – headache, fatigue, fever, stiffness, muscle aches, nausea, sore throat – all of which can be mistaken for many other illnesses. Less than 1 percent of those infected are paralyzed. Among the paralyzed, 2 to 10 percent die when their breathing muscles are immobilized. On this virus we simply cannot play the odds.
The greatest danger is for unvaccinated adults and children. While you may think you and your child are up to date with the polio vaccine, now is the time for all adults, including those who are pregnant, to make sure this is true.
The answer is simple, although the solution is not so easy. Vaccination rates are too low in too many places, and unvaccinated and unvaccinated individuals are often clustered together. About 60 percent of 2-year-olds in Rockland and Orange Counties completed the initial three-dose regimen. The goal is more than 90 percent coverage, and on-time immunization of young children is what we want. Vaccinated people have a virtual wall against paralysis and can shed less virus if they are infected. Community spread is the driving force behind the emergence of polio strains.
Up-to-date polio immunization is a mandatory requirement for school-age children. But more and earlier vaccinations are needed. The biggest barrier is vaccine resistance, which has grown tremendously. Yes, many people have lost faith in the government, and public health departments have shouldered the brunt. Some people believe they can protect themselves and their families by going against the advice of public health experts and bypassing state-mandated vaccination programs.
The problem is not just those who are against. Today, health departments fight not only infectious diseases but also misinformation campaigns designed to wage the war against vaccines. During the 2018-19 New York State measles outbreak, Report shows that highly targeted misinformation is meant to sow doubt about vaccines in outbreak communities. According to a study conducted by Kaiser Family Foundation by November 2021, 78% of adults said they had heard at least one in eight false claims about Covid-19 or vaccines and worse, they believed the statement to be true or were unsure whether it was true or false . The bad guys with clever marketing lures target their victims public.
Polio, like other recent viral threats, exposes social fissures. It is still not understood that government performs essential functions that individuals and families cannot do alone: It protects our air, water, and food. It prevents the spread. A damaging cycle will continue as under-resourced health departments are unable to solicit the kind of response the public seeks, further diminishing trust. Budgets and policies can expand in response to a crisis, only to shrink as it passes. When public health authorities responded, it was too little, too late. Damage has been done, suffering has ensued, and faith in the institutions people need has been devastated.
This is our position. The emergence of new pathogens such as Covid-19 or the unusual manifestations of viruses recently identified in the US, such as monkeypox, will only be the beginning. Polio, an ancient plague, may return. The good news is that we can change this grim scenario.
Currently, the New York State Department of Health – in coordination with local and national health authorities – is working tirelessly. Together, we are investigating the incident, assessing the spread, and communicating openly and honestly. Promoting immunization is the goal of our public health response. To achieve success, local healthcare providers, community-based organizations and trusted leaders are encouraged to join us.
We must re-convince America that innovation in science, like space, and our medical advances – whether the rate at which vaccinations can be developed or the deployment of those proven proved to be safe and effective – must be a source of great consolation and pride, never a political football. There are many reasons, whether individually or in groups, that some people fear vaccines more than the diseases they protect against. Therefore, we must address all concerns. The result means that public health is more, not less, integrated into our daily activities, school lessons, and national sense while taking into account the nuances and community-based standards. Public health is the safety of the community, and we must start investing in it.
I hope fervently that one day we will declare that, like smallpox, polio has been eradicated. Disappear as a source of disease for humans. Global obliteration is still within reach. If we go there, it’s because of the vaccine. Childhood vaccinations will be the hero of the story.
