Poliovirus Discovered in New York City

Poliovirus Emerging Once Again - Should Our Seniors Be Concerned?

by Don Drake, Connelly Law Offices, Ltd.

Polio campaign of the 1950s

Once one of the most feared viruses in the United States, polio was considered eliminated from this country for some forty years. But early this summer, the poliovirus was found in wastewaters of New York City, London, and Jerusalem, sparking concerns about the return of this disease.

New York City health officials reported that the virus was found in wastewater, and in Rockland County in June, a young man was diagnosed with this disease. "We have many clients who remember the polio outbreaks of the early 1950s," said certified elder law Attorney RJ Connelly III. "Prior to the introduction of the Salk vaccine, there were thousands of cases of paralysis caused by this disease annually. There is no cure for the virus, but there are vaccines, one of which, ironically, could be the genesis of this current polio concern as the wild form of the disease has almost disappeared globally."

Afghanistan and Pakistan are now the only countries where the highly infectious wild form of polio, spread mainly through contact with fecal matter, remains endemic. But this year, imported cases were also found in Malawi and Mozambique, the first in those countries since the 1990s.

Let's not get ahead of ourselves, this is not an epidemic or crisis at this time and there is little chance it will become one, but it is a cause for concern that needs to be monitored by authorities. "It's hard to figure out whether it's a good thing that those from our current generation don't know what polio is, or if it's a bad thing because not being aware means we haven't taken lessons from our history seriously," said Attorney Connelly.

Ad put out by Britain's Health Services, reminiscent of the early 1950s polio outbreaks

What Is Polio

Polio, or poliomyelitis, is a disabling and life-threatening disease caused by the poliovirus. The virus spreads from person to person and can infect a person’s spinal cord, causing paralysis. A small number of people with the poliovirus infection will develop other, more serious symptoms that affect the brain and spinal cord:

  • Meningitis (infection of the covering of the spinal cord and/or brain) occurs in about 1–5 out of 100 people with poliovirus infection, depending on the virus type.

  • Paralysis (can’t move parts of the body) or weakness in the arms, legs, or both occurs in about 1 out of 200 people to 1 in 2000 people, depending on the virus type.

Those who remember the polio outbreaks of the 1950s will speak about those with paralyzed body parts which led to death for two out of ten per hundred people who suffered some form of paralysis. In the outbreak of 1916, health workers in New York City would remove children from their homes and even playgrounds if they exhibited symptoms and placed them in a sanitarium. A frightening response to a horrific disease.

Dr. Jonas Salk

When the outbreak of the 1950s occurred, the number of polio cases peaked in 1952 at around 60,000 which resulted in 3,145 deaths. Many of those who survived ended up with some form of paralysis, forcing them to use crutches, leg braces, wheelchairs or be treated in an iron lung, a large tank respirator that would pull air in and out of the lungs, allowing them to breathe. In 1955, a vaccine developed by Jonas Salk and his team at the University of Pittsburgh put an end to this disease.

Zofia's Story

In my own childhood memory about polio, I grew close to a woman from Poland who arrived in the United States as Nazi forces invaded her native country. After the death of her child on her trip to the United States, she contracted polio and shared her story about her journey with me in the late 1960s.

I woke up one morning and was unable to get out of my bed. When I did not show up at work that night, my friends came looking for me. When they found me, I was unable to move, paralyzed on my left side. They called for help, and I was taken to the local hospital, first in New Jersey and then transferred to New York City where I was diagnosed with polio.

The thing I remembered the most was being moved outside into the frigid winter night because for some reason, they thought that cold helped with the symptoms, but it didn’t. It was bone-chilling cold, and I couldn’t get up to walk inside so I lay there and listened to the street noises and tried to imagine it was summer. I went through this again and again.

After a month in the ward, I started getting letters from church members which made me feel better, but I was by myself in New York. It was a big place, a lonely place. My sister, who had come over about a year after me, was living in Pittsburgh with a family we knew from Warsaw. Any contact with her was sparse at best.

I initially began to feel better but without warning, things got worse, and my breathing began to suffer. Not only was I paralyzed on one side but now I felt like I had just run one hundred miles and continued to run. After a few days, my doctor came in and told me I would need oxygen and suddenly I was moved from the ward that was busy into critical care with a respirator strapped on my face which was bothersome. Then they came in with the news that I would be put into an "iron lung." I had no idea what that was at the time, but I learned really quickly.

The "iron lung"

As scared as I was about the “iron lung”, it actually was quite comfortable at first. The respirator that was strapped tightly on my face was removed and I was lying flat on my back with the machine helping me breathe. It was quite relaxing except for the fact that you couldn’t see what was going on around you. There was a mirror on the front so you could see behind you and a frame that a book or newspaper would go into, but it wouldn’t do you any good if there was no one to turn the pages and believe me, there was plenty to do for the nurses as it seemed there were new patients coming in every few minutes for treatment.

The lung reminded me of an oven and me being on a cookie tray. They would slide me in and out like a roast chicken. Underneath me was the pump for the machine and you could feel the vibrations of the motor running. It would take a breath for you and then you will feel a bump as the air escapes. But I got used to it.

Having food was another challenge, however. Because your body was inside the machine and your head was outside, swallowing became a chore. Because the machine was pulling your diaphragm in and out, you learned to swallow in rhythm with the lung. It was a strange dance I did with the machine, but it was a partner that saved my life. On the sides of the lung were portholes so the therapists could reach in and do the therapy needed on the muscles and joints.

I remember people feeling sorry for me, asking me how I could take being locked up in a machine all day, not being able to have my freedom. But I told them that I was thankful to have had this chance. If I had stayed in Europe, I may not have been alive much less had a chance for life thanks to a machine like that. Overall, I considered myself incredibly lucky...”

The Rockland County Case in 2022

This June, a young man from Rockland County, New York, went to the local hospital's emergency room. He reported having a fever, stiff neck, back pain, and constipation. His legs, he told the doctors, were weak, to the point that he struggled to stand. Initially, the doctors suspected an inflammation of the spinal cord, called acute flaccid myelitis, due to a viral infection. After a lab workup, it was discovered that he had poliomyelitis, a shocking diagnosis given the fact that since the turn of the century, just three known cases of the virus have occurred in the United States. This diagnosis caused health officials in Rockland County to test the wastewater where they found that the poliovirus had been present since May.

Children with polio in the 1950s

About the Virus

The CDC reports that there are three wild types of polioviruses (WPV) – type 1, type 2, and type 3. According to their website, "people need to be protected against all three types of the virus in order to prevent polio disease and the polio vaccination is the best protection. Type 2 wild poliovirus was declared eradicated in September 2015, with the last virus detected in India in 1999. Type 3 wild poliovirus was declared eradicated in October 2019. It was last detected in November 2012. Only type 1 wild poliovirus remains. There are two vaccines used to protect against polio disease, oral polio vaccine and inactivated poliovirus vaccine."

Vaccine Derived Polio - The Current Culprit?

There is another form of polio that can spread within communities: circulating vaccine-derived poliovirus, or cVDPV. While cVDPVs are rare, they have been increasing in recent years due to low immunization rates within communities. cVDPV type 2 (cVDPV2) is the most prevalent, with 959 cases occurring globally in 2020.

The oral polio vaccine

The oral polio vaccine (OPV) that has brought the wild poliovirus to the brink of eradication has many benefits: the live attenuated (weakened) vaccine virus provides better immunity in the gut, which is where polio replicates. After children are vaccinated, they shed the virus in their feces for a few weeks. In under-vaccinated communities, this can then spread and mutate back to a harmful version of the virus.

"This type of polio [vaccine derived] really poses little risk to populations that have high vaccine rates," said Attorney Connelly. "But in communities with low rates of vaccinations, such as newly arriving immigrants or those who do not trust vaccines, this virus can spread and even cause the paralytic form of the disease." Because of these concerns, there is a move afoot to phase out the oral vaccines that contain the live virus that is ending up in the wastewater systems.

Should Seniors Be Concerned?

Obviously, the re-emergence of poliovirus should not be ignored, but the good news is that childhood polio vaccine numbers are still high, approaching 93%. But in areas where those numbers are lower, there is cause for concern. So, what about adults and seniors who have been vaccinated as kids, will they need boosters? According to the CDC, this is not necessary. The only adults or seniors who may need a booster are those who travel to countries where polio is active or ones providing care to a polio patient.

"This news on the heels of the COVID pandemic is proving to be frightening to a lot of people, and understandably so," said Attorney Connelly. "But given the fact that the vaccination rates continue to be so high among children is a reason for optimism. Plus, the phasing out of the live virus vaccine will put an end to the vaccine-derived type of polio. Getting your children vaccinated against this virus is the best and safest way to alleviate any fears you may have."

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