Urging Immunization and Warning of Expanding Community Spread, State Department of Health Updates New Yorkers On Polio In New York State

Poliovirus Now Detected in Four Wastewater Samples Collected in July and August in Sullivan County, Linked to Paralytic Polio Case Previously Identified in an Unvaccinated Individual in Rockland County

Wastewater Samples in Rockland County, Orange County, and New York City Had Already Provided Additional Evidence of Local Transmission and Circulating Polio That Can Cause Paralysis

Adults and Children Urged to Get Immunized and Stay Up to Date with Polio Immunizations

Albany, N.Y. (August 26, 2022) – Urging immunization and warning of expanding community spread, the New York State Department of Health (NYSDOH) today updated New Yorkers on poliovirus in New York State. Sequencing analysis performed by CDC has now detected poliovirus in four samples from Sullivan County, two collected in July and two collected in August, which are genetically-linked to the case of paralytic polio previously identified in Rockland County. Already, poliovirus had been identified in samples collected in Rockland County, Orange County, and New York City. All samples reported are samples of concern, meaning they are types of poliovirus that can cause paralysis in humans.

"One New Yorker paralyzed by polio is already too many, and I do not want to see another paralytic case," State Health Commissioner Dr. Mary T. Bassett said. "The polio in New York today is an imminent threat to all adults and children who are unvaccinated or not up to date with their polio immunizations. Every New Yorker, parent, guardian, and pediatrician must do everything possible to ensure they, their children, and their patients are protected against this dangerous, debilitating disease through safe and effective vaccination."

To protect adults and children against paralytic disease, every adult and child must get immunized against polio and stay up to date with polio immunizations.

All New Yorkers who are unvaccinated, including children by 2 months of age, those who are pregnant, and people who have not completed their polio vaccine series previously, should get immunized right away. Unvaccinated New Yorkers or those not up to date with vaccinations who live, work, go to school in, or visit Rockland County, Orange County, New York City, and Sullivan County are at the highest risk of contracting paralytic disease. While there is no cure for polio, it is preventable through safe and effective immunization.

Nancy McGraw, MPH, Public Health Director of Sullivan County Department of Public Health said: "There is no cure for polio, but it can be prevented with safe and effective vaccination which has been available for a very long time in the U.S. to eliminate the disease. Polio is among the top preventable diseases, and we have the ability to stop this in its tracks as long as people take the importance of immunizations seriously."

Joshua A. Potosek, Sullivan County Manager said: "Sullivan County is taking all reasonable steps to monitor the situation and keep the people of the County safe. We urge parents and adults to be vigilant and aware of their vaccination status, because polio is a disease that can be eliminated through vaccination."

Following the identification of a case of paralytic polio among an unvaccinated individual in Rockland County, NYSDOH, in partnership with local health authorities and the Centers for Disease Control and Prevention (CDC), launched wastewater surveillance, a tool to check for signs of the virus in sewage water in Rockland County and the surrounding areas.

NYSDOH continues to conduct case investigation, aggressively assess spread, and ensure prevention measures, particularly vaccine and immunization clinics, are in place – as the best way to keep New Yorkers polio-free is to maintain high immunity across the population through vaccination. The inactivated polio vaccine (IPV), the only vaccine available in the United States, is at least 99 percent effective at preventing disease among people who get all the recommended doses.

Individuals infected with polio shed virus in their stool. Wastewater samples are based on water from our sewage system, which collects and treats feces flushed down the toilet. Health officials use this surveillance for evidence of where and when the virus is spreading in communities, though it does not provide quantitative information about who or how many people or households may be infected. New Yorkers should know that wastewater collected in sewer systems cannot be a source of infection or transmission for the general public, and it does not contaminate drinking or tap water.

Polio is a serious and life-threatening disease. Spread from person-to-person, polio is very contagious, and an individual can transmit the virus even if they aren't sick. Asymptomatic spread is a high concern among health officials, particularly following the identification of a paralytic, symptomatic polio case. Based on evidence from earlier polio outbreaks, health officials estimate that for every one case of paralytic polio observed, there may be hundreds of other people infected.

Polio is very contagious, and a person can spread the virus even if they aren't sick or experiencing symptoms. The polio virus enters the body through the mouth, usually from hands contaminated with the stool of an infected person. Respiratory and oral-to-oral transmission through saliva may also occur. In addition to immunization to prevent disease, New Yorkers should know that handwashing with soap is important, as alcohol-based sanitizers do not work on some types of germs, like polio.

According to CDC, 70 percent of people infected with polio experience no symptoms, and 25 percent experience mild or flu-like symptoms that may be mistaken for many other illnesses. About 1 in 100 individuals will develop severe disease, including permanent paralysis. Of those paralyzed, 2-10 percent die when their breathing muscles become immobilized.

NYSDOH has increased communication to healthcare providers, stressing the importance of testing and the on-time administration of the polio vaccine among their patients. In accordance with CDC:

• All children should get four doses of the polio vaccine, with the first dose given at 6 weeks through 2 months of age, followed by one dose given at 4 months of age, 6 through 18 months old, and 4 through 6 years old.
• People who are unvaccinated or are unsure if they have been immunized should receive a total of 3 doses, if they are starting the vaccine series after age 4.
• Adults who have only had 1 or 2 doses of the polio vaccine in the past should get the remaining 1 or 2 doses – it does not matter how long it has been since the earlier doses.

A core component of CDC's childhood immunization schedule and required by NYSDOH for all school-aged children, most children are already vaccinated. New Yorkers who are unsure of their or their child's vaccination status should reach out to a healthcare provider right away. As of August 1, 2022, Rockland County has a polio vaccination rate of 60.34 percent, Orange County has a polio vaccination rate of 58.68 percent, and Sullivan County has a polio vaccination rate of 62.33 percent, compared to the statewide average of 78.96 percent, among children who have received 3 polio immunizations before their second birthday.* A rate of well over 90 percent is NYSDOH's goal. NYSDOH has also engaged community-based organizations in the affected areas to partner on outreach, disseminating education about the virus, the safe, protective nature of the well-established immunization, and the gravity of the current situation.

New Yorkers can learn more about polio and polio immunization here. Information about wastewater surveillance and results is available here.

Polio vaccination rates by county are available here.

About New York State Polio Vaccination Rates

*Based on data calculated from August 1, 2022 from the New York State Immunization Information System (NYSIIS), polio vaccination rates include all New York counties, with the exception of New York City. The rate is calculated based on data of children who have received 3 polio immunizations before their second birthday, reported their residency as the State of New York, provided their New York State county of residence, and have at least one immunization or have an upstate New York State birth record. As of January 8, 2008, all healthcare providers in New York State are required to report all immunizations administered to people less than 19 years of age, along with the person's immunization histories, to NYSDOH using NYSIIS. New York City maintains their own non-COVID-19 immunization records through the Citywide Immunization Registry (CIR).