Mary Wilson
Well-known member
Early Release / August 16, 2022 / 71
DOI: http://dx.doi.org/10.15585/mmwr.mm7133e2
Ruth Link-Gelles, PhD[SUP]1[/SUP]; Emily Lutterloh, MD[SUP]2[/SUP][SUP],3[/SUP]; Patricia Schnabel Ruppert, DO[SUP]4[/SUP]; P. Bryon Backenson, MS[SUP]2[/SUP][SUP],3[/SUP]; Kirsten St. George, PhD[SUP]5[/SUP][SUP],6[/SUP]; Eli S. Rosenberg, PhD[SUP]2[/SUP][SUP],3[/SUP]; Bridget J. Anderson, PhD[SUP]2[/SUP]; Meghan Fuschino, MS[SUP]5[/SUP]; Michael Popowich[SUP]5[/SUP]; Chitra Punjabi, MD[SUP]4[/SUP]; Maria Souto, MPH[SUP]4[/SUP]; Kevin McKay, MPH[SUP]4[/SUP]; Samuel Rulli[SUP]4[/SUP]; Tabassum Insaf, PhD[SUP]2[/SUP]; Dustin Hill, PhD[SUP]7[/SUP]; Jessica Kumar, DO[SUP]2[/SUP]; Irina Gelman, DPM[SUP]8[/SUP]; Jaume Jorba, PhD[SUP]1[/SUP]; Terry Fei Fan Ng, PhD[SUP]1[/SUP]; Nancy Gerloff, PhD[SUP]1[/SUP]; Nina B. Masters, PhD[SUP]1[/SUP]; Adriana Lopez, MHS[SUP]1[/SUP]; Kathleen Dooling, MD[SUP]1[/SUP]; Shannon Stokley, DrPH[SUP]1[/SUP]; Sarah Kidd, MD[SUP]1[/SUP]; M. Steven Oberste, PhD[SUP]1[/SUP]; Janell Routh, MD[SUP]1[/SUP]; 2022 U.S. Poliovirus Response Team
Summary
What is already known about this topic?
Sustained poliovirus transmission has been eliminated from the United States for approximately 40 years; vaccines are highly effective in preventing paralysis after exposure.
What is added by this report?
In June 2022, poliovirus was confirmed in an unvaccinated immunocompetent adult resident of New York hospitalized with flaccid lower limb weakness. Vaccine-derived poliovirus type 2 was isolated from the patient and identified from wastewater samples in two neighboring New York counties.
What are the implications for public health practice?
Unvaccinated persons in the United States remain at risk for paralytic poliomyelitis if they are exposed to either wild or vaccine-derived poliovirus; all persons in the United States should stay up to date on recommended poliovirus vaccination.
On July 18, 2022, the New York State Department of Health (NYSDOH) notified CDC of detection of poliovirus type 2 in stool specimens from an unvaccinated immunocompetent young adult from Rockland County, New York, who was experiencing acute flaccid weakness. The patient initially experienced fever, neck stiffness, gastrointestinal symptoms, and limb weakness. The patient was hospitalized with possible acute flaccid myelitis (AFM). Vaccine-derived poliovirus type 2 (VDPV2) was detected in stool specimens obtained on days 11 and 12 after initial symptom onset. To date, related Sabin-like type 2 polioviruses have been detected in wastewater* in the patient’s county of residence and in neighboring Orange County up to 25 days before (from samples originally collected for SARS-CoV-2 wastewater monitoring) and 41 days after the patient’s symptom onset. The last U.S. case of polio caused by wild poliovirus occurred in 1979, and the World Health Organization Region of the Americas was declared polio-free in 1994. This report describes the second identification of community transmission of poliovirus in the United States since 1979; the previous instance, in 2005, was a type 1 VDPV (1). The occurrence of this case, combined with the identification of poliovirus in wastewater in neighboring Orange County, underscores the importance of maintaining high vaccination coverage to prevent paralytic polio in persons of all ages.
Case Findings
In June 2022, a young adult with a 5-day history of low-grade fever, neck stiffness, back and abdominal pain, constipation, and 2 days of bilateral lower extremity weakness visited an emergency department and was subsequently hospitalized with suspected AFM; the patient was unvaccinated against polio (Figure). ...
https://www.cdc.gov/mmwr/volumes/71/wr/mm7133e2.htm?s_cid=mm7133e2_x#suggestedcitation
DOI: http://dx.doi.org/10.15585/mmwr.mm7133e2
Ruth Link-Gelles, PhD[SUP]1[/SUP]; Emily Lutterloh, MD[SUP]2[/SUP][SUP],3[/SUP]; Patricia Schnabel Ruppert, DO[SUP]4[/SUP]; P. Bryon Backenson, MS[SUP]2[/SUP][SUP],3[/SUP]; Kirsten St. George, PhD[SUP]5[/SUP][SUP],6[/SUP]; Eli S. Rosenberg, PhD[SUP]2[/SUP][SUP],3[/SUP]; Bridget J. Anderson, PhD[SUP]2[/SUP]; Meghan Fuschino, MS[SUP]5[/SUP]; Michael Popowich[SUP]5[/SUP]; Chitra Punjabi, MD[SUP]4[/SUP]; Maria Souto, MPH[SUP]4[/SUP]; Kevin McKay, MPH[SUP]4[/SUP]; Samuel Rulli[SUP]4[/SUP]; Tabassum Insaf, PhD[SUP]2[/SUP]; Dustin Hill, PhD[SUP]7[/SUP]; Jessica Kumar, DO[SUP]2[/SUP]; Irina Gelman, DPM[SUP]8[/SUP]; Jaume Jorba, PhD[SUP]1[/SUP]; Terry Fei Fan Ng, PhD[SUP]1[/SUP]; Nancy Gerloff, PhD[SUP]1[/SUP]; Nina B. Masters, PhD[SUP]1[/SUP]; Adriana Lopez, MHS[SUP]1[/SUP]; Kathleen Dooling, MD[SUP]1[/SUP]; Shannon Stokley, DrPH[SUP]1[/SUP]; Sarah Kidd, MD[SUP]1[/SUP]; M. Steven Oberste, PhD[SUP]1[/SUP]; Janell Routh, MD[SUP]1[/SUP]; 2022 U.S. Poliovirus Response Team
Summary
What is already known about this topic?
Sustained poliovirus transmission has been eliminated from the United States for approximately 40 years; vaccines are highly effective in preventing paralysis after exposure.
What is added by this report?
In June 2022, poliovirus was confirmed in an unvaccinated immunocompetent adult resident of New York hospitalized with flaccid lower limb weakness. Vaccine-derived poliovirus type 2 was isolated from the patient and identified from wastewater samples in two neighboring New York counties.
What are the implications for public health practice?
Unvaccinated persons in the United States remain at risk for paralytic poliomyelitis if they are exposed to either wild or vaccine-derived poliovirus; all persons in the United States should stay up to date on recommended poliovirus vaccination.
On July 18, 2022, the New York State Department of Health (NYSDOH) notified CDC of detection of poliovirus type 2 in stool specimens from an unvaccinated immunocompetent young adult from Rockland County, New York, who was experiencing acute flaccid weakness. The patient initially experienced fever, neck stiffness, gastrointestinal symptoms, and limb weakness. The patient was hospitalized with possible acute flaccid myelitis (AFM). Vaccine-derived poliovirus type 2 (VDPV2) was detected in stool specimens obtained on days 11 and 12 after initial symptom onset. To date, related Sabin-like type 2 polioviruses have been detected in wastewater* in the patient’s county of residence and in neighboring Orange County up to 25 days before (from samples originally collected for SARS-CoV-2 wastewater monitoring) and 41 days after the patient’s symptom onset. The last U.S. case of polio caused by wild poliovirus occurred in 1979, and the World Health Organization Region of the Americas was declared polio-free in 1994. This report describes the second identification of community transmission of poliovirus in the United States since 1979; the previous instance, in 2005, was a type 1 VDPV (1). The occurrence of this case, combined with the identification of poliovirus in wastewater in neighboring Orange County, underscores the importance of maintaining high vaccination coverage to prevent paralytic polio in persons of all ages.
Case Findings
In June 2022, a young adult with a 5-day history of low-grade fever, neck stiffness, back and abdominal pain, constipation, and 2 days of bilateral lower extremity weakness visited an emergency department and was subsequently hospitalized with suspected AFM; the patient was unvaccinated against polio (Figure). ...
https://www.cdc.gov/mmwr/volumes/71/wr/mm7133e2.htm?s_cid=mm7133e2_x#suggestedcitation
