Public Health Response to a Case of Paralytic Poliomyelitis in an Unvaccinated Person and Detection of Poliovirus in Wastewater — New York, June–August 2022
Ruth Link-Gelles, Emily Lutterloh, Patricia Schnabel Ruppert, P. Bryon Backenson, Kirsten St. George, Eli S. Rosenberg, Bridget J. Anderson, Meghan Fuschino, Michael Popowich, Chitra Punjabi, Maria Júlia Silveira Souto, Kevin McKay, Samuel Rulli, Tabassum Z. Insaf, Dustin Hill, Jessica Kumar, Irina Gelman, Jaume Jorba, Terry Fei Fan Ng, Nancy Gerloff, Nina B. Masters, Adriana Lopez, Kathleen Dooling, Shannon Stokley, Sarah Kidd, M. Steven Oberste, Janell Routh, 2022 U.S. Poliovirus Response Team, 2022 U.S. Poliovirus Response Team, Hanen Belgasmi, Barrett Brister, James E. Bullows, Cara C. Burns, Christina J. Castro, Janine Cory, Naomi Dybdahl-Sissoko, Brian Emery, Randall English, Ann D. Frolov, Halle Getachew, Elizabeth Henderson, Alexandra Hess, Karen Mason, Jeffrey W. Mercante, Stacey Jeffries Miles, Hongmei Liu, Rachel L. Marine, Nehalraza Momin, Hong Pang, Daniel B. Perry, Shannon Rogers, Brandon Short, Hong Sun, Farrell Tobolowsky, Eileen Yee, Scott Hughes, Enoma Omoregie, Jennifer B. Rosen, Jane R. Zucker, Mohammed Alazawi, Ursula Bauer, Alex Godinez, Brianna Hanson, Eugene Heslin, James McDonald, Neida K. Mita-Mendoza, Megan Meldrum, Dana Neigel, Robin Suitor, David A. Larsen, Christina Egan, Nicola Faraci, G. Stephanie Feumba, Todd Gray, Daryl Lamson, Jennifer Laplante, Kathleen McDonough, Natalie Migliore, Amruta Moghe, Simon Ogbamikael, Jonathan Plitnick, Rama Ramani, Lindsey Rickerman, Erik Rist, Lynsey Schoultz, Matthew Shudt, Julie Krauchuk, Eric Medina, Jacqueline Lawler, Heather Boss, Emanuele Barca, Danish Ghazali, Tarini Goyal, Sean J.P. Marinelli, Jackson A. Roberts, Grace B. Russo, Kiran T. Thakur, Vivian Yang
Abstract
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.