New York City health officials announced last week that they detected polio in wastewater, suggesting that the dangerous virus is silently spreading within the nation’s most populous metropolis. The spotting happened about a month after nearby Rockland County became the first American locale in nearly a decade to report a symptomatic case of polio. The virus is also cruising through sewage in Orange County, which sits next to Rockland in the Hudson Valley.
For decades, the country hasn’t had to worry about community transmission of polio. Thanks to childhood vaccination, most people in the U.S. have been protected for 70 years, and homegrown outbreaks were eliminated from both North and South America by 1994.
It would be easy to fret now — especially with the news coming on the heels of more than two years of COVID-19 and a summer of monkeypox. But a slew of health researchers told Gothamist that it isn’t time to panic. Only a single symptomatic case has been identified in New York so far. But a new vaccination push is warranted, given that some cracks have emerged in our collective defenses.
“If we start getting three or four or five random cases in New York City, then I would definitely be looking for my vaccine schedule and make sure I've been vaccinated,” said Dr. David Buchholz, a pediatrician and the senior founding medical director for primary care at Columbia University Irving Medical Center.
Polio is almost exclusively a threat to the unvaccinated — and based on current immunization rates, many neighborhoods in New York City and counties statewide are below the levels needed to keep the virus from thriving among youngsters, the most vulnerable age group.
The threat was more severe in the 1940s and 1950s, when the virus killed thousands of Americans each year and paralyzed scores more. The afflicted were mostly children, but included adults like President Franklin D. Roosevelt. Back then, the polio virus, which primarily spreads via fecal matter, contaminated water in swimming pools and even drinking fountains. Many of those threats are long gone in high-income nations due to vaccination and public infrastructure such as water treatment.
“Are we going to see the numbers we saw in the '50s or in the '40s?” asked Dr. Perry Halkitis, dean of the Rutgers School of Public Health. “Unlikely.”
But some technological gaps remain in understanding our collective public health. Most New Yorkers, for example, will have an easier time checking their order history on Uber Eats than finding their childhood vaccination records.
“Over the course of your lifetime, particularly if we're thinking about immunizations you might have received as a child, you've moved around to a lot of different organizations,” said Dr. Julia Adler-Milstein, a professor of medicine at the University of California San Francisco who directs its Center for Clinical Informatics and Improvement Research. “That means that your history is fragmented in all those different places that you've been.”
It’s also unclear how many New York residents might be carrying polio right now because wastewater surveillance cannot reveal such information.
Right now, the methods can simply tell the presence or absence of polio, stated Syracuse University epidemiologist Dr. David Larsen, who helps manage the New York state wastewater surveillance network, via email. “There needs to be further development to estimate trends in transmission.”
So for any New Yorker who can’t find their vaccine documents, who has a young kid at home who hasn’t completed their vaccine schedule, or who simply wants to know if they might be at risk if an epidemic emerges, here’s a guide to facing a polio outbreak in 2022 — just in case.
Click "listen" in the player to hear a guide to finding your old vaccination records, and visit Gothamist to get answers to some frequently asked questions about polio in New York.