Grim milestone: U.S. sees first case of polio since 2013

(AP Photo/Sunday Alamba, File)

My first thought was, “I wonder if this person declined vaccination because they’re a New Age left-winger who’s into ‘homeopathic immunization’ or whatever or a post-COVID right-winger who’s decided ivermectin is the cure for everything.”

There’s a third, more tragic possibility, though. Many parents who want their children vaccinated for common diseases ended up having to delay their shots due to COVID lockdowns during the pandemic. That’s shaping up to be a major health crisis abroad, with the number of kids who haven’t received a single dose of basic vaccines ballooning from 13 million in 2019 to 18 million now. Inevitably, there are some in the U.S. who are also behind and at risk of infection from diseases we thought we had conquered.

But based on the thin details we have from today’s reporting, there may be something else altogether that’s to blame for this infection. It appears to be vaccine-derived — and likely to have originated abroad.

The New York State Department of Health (NYSDOH) and the Rockland County Department of Health today alerted the public to a case of polio in a Rockland County resident. State and County health officials are advising medical practitioners and healthcare providers to be vigilant for additional cases.

As the polio vaccine continues to be included on the Centers for Disease Control and Prevention’s (CDC) standard child immunization schedule, those already vaccinated are considered to be at lower risk. Notably, the polio vaccine is part of the required school immunization schedule for all children, and therefore school-age children are vaccinated before they start school…

In this case, sequencing performed by the Wadsworth Center – NYSDOH’s public health laboratory – and confirmed by CDC showed revertant polio Sabin type 2 virus. This is indicative of a transmission chain from an individual who received the oral polio vaccine (OPV), which is no longer authorized or administered in the U.S., where only the inactivated polio vaccine (IPV) has been given since 2000. This suggests that the virus may have originated in a location outside of the U.S. where OPV is administered, since revertant strains cannot emerge from inactivated vaccines.

In poorer countries overseas, doctors prefer to use the version of the polio vaccine that can be administered orally. That makes it easy to deliver, eliminating the need for tens of thousands of syringes and putting reluctant needle-averse children at ease. But the oral version of the vaccine comes with a catch: Unlike the one that’s administered with a needle, it contains a live but weakened version of the virus that can mutate and replicate once it’s inside the patient. Occasionally the patient becomes infectious to others around them, or at least to those who haven’t themselves been vaccinated.

Evidently that’s what happened here. Someone, presumably a child, got the oral vaccine abroad and then traveled to the U.S., where they infected someone in Rockland County. Maybe the infected patient grew up abroad and was never vaccinated for polio; possibly the child is a relative who was overseas recently with family for whatever reason.

The AP reports that the patient is a young adult, was indeed unvaccinated — and has now developed paralysis, which doesn’t happen to everyone infected with polio.

The person developed symptoms a month ago and did not recently travel outside the country, county health officials said…

The person is no longer deemed contagious, but investigators are trying to figure out how the infection occurred and whether other people may have been exposed to the virus…

Rarely, travelers have brought polio infections into the U.S. The last such case was in 2013, when a 7-month-old who had recently moved to the U.S. from India was diagnosed in San Antonio, Texas, according the federal health officials. That child also had the type of polio found in the live form of vaccine used in other countries.

And so the search begins to see if this is the tip of a local iceberg, a la the first cases of monkeypox. Are there any other unexplained cases of paralysis in Rockland County? Maybe not. The key difference between monkeypox and polio is that, although the smallpox vaccine protects recipients from monkeypox infection, that vaccine was discontinued for children once smallpox was eradicated. The polio vaccine is still given to this day. There shouldn’t be any wider risk — unless polio shots given decades ago to senior citizens have lost their efficacy over time.

One last point worth noting. Coincidentally, Rockland County was also the site of a measles outbreak three years ago that infected more than 300 people. It could be that today’s polio patient grew up abroad in a country where kids aren’t routinely immunized against that disease — but don’t bet on it. He may be a native American, a casualty of whatever weird cultural aversion to vaccination is leaving Rockland residents susceptible to outbreaks of viruses that are supposed to have been conquered.

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