Thanks to the widespread vaccination, the United States declared polio to be eradicated in 1979. Until now, 1979 was the last time that natural transmission of polio happened domestically. The recent identification of a polio outbreak is a shock to communities and the world and now has become another concern that employers will need to factor into safety protocols. Is polio back to the United States officially? Here is what you need to know.
Polio Cases in the USA:
A case of paralytic polio in Rockland County, New York was confirmed by Rockland County Department of Health and the New York State Department of Health (NYSDOH) on July 21, 2022. Genetic sequencing indicates a case of revertant polio Sabin type 2 virus, suggesting the source of transmission may be from an individual who received the active oral polio vaccine (OPV) outside of the United States. No activated polio vaccines are administered in the U.S.
On August 1st, 2022. the NYSDOH reported ongoing wastewater surveillance showing the presence of polio in samples from Rockland County in early June. The sequencing from these samples matched samples sequenced in Jerusalem, Israel and in London, U.K. These samples match the sequence from the confirmed paralytic case in Rockland County.
On August 4, 2022, NYSDOH reported wastewater surveillance found polio in samples from June and July in two distinct locations in Orange County, NY, as well as in new July samples from Rockland County. CDC sequencing of the samples suggests that 7 of these samples are linked to the individual paralytic case from Rockland County, which indicates that local community transmission is occurring.
In the Aug 4th release, NY State Health Commissioner Dr. Mary T. Bassett said, “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 . . .with the latest wastewater findings, the Department is treating the single case of polio as just the tip of the iceberg of much greater potential spread.”
Rockland County and Orange County are promoting polio vaccines and boosters to all residents. Most children are vaccinated as it is a school prerequisite, but as of August 1, 2022, Rockland County’s polio vaccination rate was 60.34 percent and Orange County’s was 58.68 percent.
On August 7, 2022 the CDC confirmed they’ve sent a team to Rockland County to support investigative and vaccination efforts.
Why the Polio Outbreak is a Concern
The recent polio outbreak within US borders is a specific concern because it once caused widespread panic and can do so again. It is also a concern because it was once eradicated (through vaccination), but now it is back.
Also, evidence gathered during past polio outbreaks shows that for every paralytic polio case, hundreds of other individuals can potentially be exposed and infected.
Is There a Cure for Polio?
There is no cure for polio. Three doses of the inactivated polio vaccine (IPV) (used in the U.S. since 2000) protect 99 of 100 children against all three polio serotypes. The virus enters the body via fecal-oral or oral-oral transmission. It is shed through nasal/oral secretions for 1-2 weeks but can be shed in the stool for several weeks after infection. 70% of cases are asymptomatic; in the remaining 30%, most experience mild, flu-like symptoms. Asymptomatic individuals do shed the virus. Nonparalytic aseptic meningitis occurs in 1% to 5% of polio infections in children. <1% of children develop flaccid paralysis. Adolescents and adults are more likely to have worse symptoms and a higher risk of paralysis. In nonparalytic polio, the incubation period is 3-6 days, whereas for paralytic polio incubation is 7-21 days. The case fatality rate for paralytic polio is 2-5% in children, and 15-30% in adolescents and adults. [Source: CDC]
How Can It Affect Workplace Health and Safety?
As with other life-threatening viruses, including COVID-19, polio can negatively affect workplace health and safety.
The first essential thing employers need to know is that it is highly contagious and can spread easily from individual to individual. Polio is spread by sneezing or coughing and contamination with the feces of an infected individual.
An employee can transmit the polio virus even if they are asymptomatic. Also, since symptoms may take up to thirty days to show, the individual may be shedding the virus to others before realizing they have those symptoms. As a result, the workplace can become a hotbed of virus transmission.
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Dr. Cherry is the Chief Medical Officer for Axiom Medical. He is an energetic physician executive with a passionate focus on health, human performance, and prevention. He is dual board certified in Occupational/Environmental Medicine and Preventive Medicine/Public Health. He is a distinguished fellow within the American College of Occupational & Environmental Medicine.