“The first case of paralytic polio in the United States in nearly 10 years in an unvaccinated adult and the presence of poliovirus in sewage detected in New York urgently reminds us of the importance of vaccination. People who are not fully vaccinated against polio are at risk of infection and paralysis “. This is the warning launched by the US CDCs, centers for disease control and prevention, in a report that takes stock of the polio situation and the public health response implemented. The first red light officially turns on July 18, when the New York State Department of Health notifies the CDC of the detection of type 2 poliovirus in samples from an unvaccinated young man from Rockland County, NYC, who he had experienced fever, neck stiffness, gastrointestinal symptoms and limb weakness. Prior to this case, the last poliovirus detection in a person in the United States was in 2013, in an immunocompromised child who received the oral vaccine in India and then immigrated to the United States. Almost a decade later, the new case. The patient was admitted to hospital in June with possible acute flaccid myelitis, basically sudden paralysis. Vaccine-derived poliovirus type 2 was detected in fecal samples obtained on days 11 and 12 after the initial onset of symptoms. And this is where the second alarm bell goes on: the presence of type 2 poliovirus was intercepted in the wastewater of the patient’s county of residence and in neighboring Orange County up to 25 days earlier (from samples originally collected for monitoring Sars-CoV-2) and 41 days after the onset of the patient’s symptoms. The last case of polio caused by wild poliovirus in the United States occurred in 1979, and the WHO region of the Americas was declared polio-free, with formalization by the World Health Organization, in 1994. The one described in the report is the second. identification of a community transmission of the poliovirus in the United States since 1979. The previous one dates back to 2005 (vaccine-derived poliovirus type 1). “The occurrence of this case, combined with the identification of the poliovirus also in the wastewater of nearby Orange County, underscores the importance of maintaining high vaccination coverage to prevent paralytic poliomyelitis in people of all ages”, warn the CDC. . “Unvaccinated people in the United States remain at continued risk of paralytic polio if they are exposed to wild or vaccine-derived poliovirus.” Therefore “all people in the United States should stay up to date on the recommended vaccination against the poliovirus”. As for the patient with paralytic polio, he was transferred 16 days after the onset of symptoms to a rehabilitation facility with ongoing flaccid weakness of the lower limbs. Based on the typical incubation period for paralytic poliomyelitis, exposure to the virus may have occurred 7 to 21 days before the onset of paralysis. The epidemiological investigation revealed that the patient attended a large gathering 8 days before the onset of symptoms, while he had not traveled abroad during the alleged exposure period. No other noteworthy potential exposures have been identified, explain the CDC experts. According to the New York State Immunization Information System, 3-dose polio vaccination coverage among infants and toddlers under 24 months in Rockland County was 67.0% in July 2020 and dropped to 60.3% by August 2022. On July 22, the County Department of Health committed to launching a campaign to catch up on vaccinations. But the short-term increase recorded in the administrations was not enough to raise the covers. “Low vaccination coverage in the patient’s county of residence indicates that the community is at risk of further cases of paralytic polio,” the CDC warns. “Even a single case of paralytic polio represents a public health emergency in the United States. Vaccination plays a role. pivotal role. During the Covid pandemic, routine immunization services were disrupted, leading to a decline in coverage and leaving many communities at risk of preventable disease outbreaks. “
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