NY Declares State of Emergency Following Polio Detection

Expanding response efforts and urging immunization, the New York State Department of Health (NYSDOH) updated New Yorkers on polio in New York State. With evidence of circulating poliovirus, Governor Kathy Hochul recently issued an Executive Order declaring a State Disaster Emergency, increasing the availability of resources to protect New Yorkers against paralytic disease.

Bolstering the immunization drive, the E.O. immediately expands the network of polio vaccine administrators with the addition of EMS workers, midwives, and pharmacists and authorizes physicians and certified nurse practitioners to issue non-patient specific standing orders for polio vaccines. The E.O. also requires healthcare providers to send polio immunization data to the New York State Department of Health (NYSDOH) through the New York State Immunization Information System (NYSIIS), enabling NYSDOH and local health departments to focus vaccination activities where they are needed most and have yet another datapoint to understand the level of protection against polio in communities.

"On polio, we simply cannot roll the dice," says State Health Commissioner Dr. Mary T. Bassett. "If you or your child are unvaccinated or not up to date with vaccinations, the risk of paralytic disease is real. I urge New Yorkers to not accept any risk at all. Polio immunization is safe and effective – protecting nearly all people against disease who receive the recommended doses. Do not wait to vaccinate. If you are unsure of you or your families' vaccination status, contact a healthcare provider, clinic, or local county health department to make sure you and your loved ones receive all recommended doses."

Following the identification of a case of paralytic polio in an unvaccinated individual in Rockland County, NYSDOH launched wastewater surveillance — a tool to check for signs of the virus in sewage water in communities – as people infected with poliovirus shed virus in their stool. Sequence analysis from the Centers for Disease Control and Prevention (CDC) has found poliovirus in samples collected from Rockland County, Orange County, Sullivan County, New York City, and now, Nassau County. The sample collected in August from Nassau County has been genetically linked to the case of paralytic polio previously identified in Rockland County, further evidence of expanding community spread. All samples reported are samples of concern, meaning they are types of poliovirus that can cause paralysis in humans.

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 immunizations who live, work, go to school in, or visit Rockland County, Orange County, New York City, Sullivan County, and Nassau County are at the highest risk of contracting paralytic disease.

The inactivated polio vaccine (IPV), the only vaccine available in the United States, is safe, and contains no live virus. It protects 99 – 100 percent of people who get all recommended doses. In accordance with CDC, the polio immunization schedule by age is as follows:

• All children should get 4 doses of the polio vaccine. The first dose should be 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 starting the polio immunization series after 4 years of age who are unvaccinated or are unsure if they have been immunized should receive a total of 3 doses.

• 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.

• In addition, adults who live or work in the areas where poliovirus has been detected (Rockland County, Orange County, New York City, Sullivan County, and Nassau County) and don't believe they are vaccinated should get vaccinated.

At this time, the following New Yorkers who have previously completed their polio vaccine series should receive one lifetime booster dose of IPV:

• Individuals who will or might have close contact with a person known or suspected to be infected with poliovirus or such person's household members or other close contacts.

• Healthcare providers working in areas where poliovirus has been detected (Rockland County, Orange County, Sullivan County, New York City, or Nassau County) who might handle specimens that might contain polioviruses or who treat patients who might have polio (e.g., urgent care, emergency department, neurology, virology laboratory workers).

• Individuals with occupational exposure to wastewater can consider a booster.

Polio is a dangerous, debilitating, and life-threatening disease. Spread from person-to-person, poliovirus enters the body through the mouth, usually from hands contaminated with the stool of an infected individual. People can spread the virus even if they do not know they are sick, and asymptomatic spread is a high concern among health officials. According to CDC, 70 percent of people infected with polio experience no symptoms. About 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. 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.

There is no cure for polio, but it is preventable through safe and effective vaccination. 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, Sullivan County has a polio vaccination rate of 62.33 percent, and Nassau County has a polio vaccination rate of 79.15 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, and every adult and child must be up to date with vaccinations to prevent disease at the individual level. 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.

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. Available polio vaccination rates by ZIP code are available here.