Polio: A Modern Case Study
Dr. Jonas Salk administers the polio vaccine he developed in his Pittsburgh laboratory
A young American adult male unvaccinated against poliomyelitis recently travels to Hungary and Poland. Upon returning home to Rockland County, N.Y., he develops sudden weakness and then paralysis in his lower extremities. The man is hospitalized, and testing reveals the first confirmed case of polio in the United States since 2013. (It’s been more than 40 years (1979) since the last homegrown (not imported) case of polio occurred in the U.S.). Prognosis for a full recovery remains unclear.
Rockland County is known for vaccine resistance and refusal among members of its ultra-Orthodox Jewish community. In 2018 and 2019, the county was at the epicenter of a well-publicized measles outbreak. Last week’s news from this New York City suburb about this one man’s experience should remind everyone of the importance for keeping children and adults up-to-date on immunizations.
Poliomyelitis is a highly contagious enteroviral infection caused by ingesting water or food contaminated with the virus. According to the Centers for Disease Control and Prevention, three out of four infected individuals have no symptoms, so they go undetected but are a threat to spread the virus to other susceptible community members. About 25% of people infected with poliovirus develop flu-like symptoms — fever, sore throat, fatigue, headache, and abdominal pain — and then fully recover on their own within 2-5 days. Less than 1% of people infected with poliovirus go on to develop “poliomyelitis,” a disease affecting the brain and spinal cord. Symptoms of muscle weakness and paralysis can lead to respiratory failure and death, and permanent physical disability in survivors.
There is no cure for paralytic polio. Vaccines are the best defense against a once-common and still-menacing disease.
Infectious disease experts believe the Rockland County man was not infected with a “wild” or natural type of poliovirus. Rather, a weaker or “attenuated” version of the virus — probably spread by an infant or child in another country who had received a live, oral polio vaccine — appears to be the culprit.
While extremely rare, transmission of vaccine-induced polio can happen and is a big reason why most developed countries switched from the live oral vaccine (OPV) to the inactivated injected form of the vaccine (IPV) in the 1990s. Both types of polio vaccines have been highly effective in eliminating the risk of polio worldwide, from about 350,000 cases in 1988 to 33 in 2018. (Only Afghanistan and Pakistan are still considered “polio-endemic countries.)
In 1955, Dr. Jonas Salk and his team of researchers at the University of Pittsburgh developed and began administering the first effective polio vaccine. 67 years later, Dr. Salk’s son warns Jesse Bunch that the news from Rockland County is a reminder “that children unvaccinated for polio could be at risk.”
But Dr. [Peter] Salk, who serves as president of the Jonas Salk Legacy Foundation in La Jolla, Calif., and is a visiting professor at Pitt, said that the virus is still a threat to populations in other countries. When U.S. citizens unvaccinated against polio travel abroad, there’s always the threat that they could bring the virus home.
Dr. Salk warned that populations across the world were increasingly at risk. However, vaccine disinformation rose during the COVID-19 pandemic and the chaotic nature of remote learning led some parents to forgo vaccinating their children — children who weren’t going into the classroom and therefore not required to be vaccinated by some kindergarten programs.
“This is a bit of a warning bell, in saying ‘Hey guys, wake up here,’” Dr. Salk said of the Rockland County case. “Whether it’s one case, or whether this turns out to be more, we just need to keep our awareness of the fact that the world is not an isolated place.”
The start of school is a month away. If your child is due for vaccines, please call your pediatrician’s office to schedule a convenient time to get them. In addition to the usual vaccines included in the 2022 Child and Adolescent Immunization Schedule, the COVID-19 vaccine is strongly recommended for everyone 6 months and older.
Read more about polio on The PediaBlog here, here, here, and here.
source http://www.thepediablog.com/2022/07/26/polio-a-modern-case-study/
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