UK public health officials explain national incident over polio virus | Polio

Public health officials have declared a national incident after routine monitoring of wastewater in the north and east London first found evidence of community transmission of poliovirus.

The UK Health Security Agency (UKHSA) said waste from the Beckton water treatment plant in Newham tested positive for vaccine-derived poliovirus in February and further positive samples have since been detected.

No cases of the disease or related paralysis have been reported and the risk to the general public is considered low, but public health officials urged people to ensure they and their families were aware of polio vaccinations to reduce the risk of harm. to decrease .

“Vaccine-derived poliovirus has the potential to spread, especially in communities where vaccination coverage is lower,” said Dr Vanessa Saliba, epidemiologist at the UKHSA. “In rare cases, it can cause paralysis in people who have not been fully vaccinated, so if you or your child are not up to date on your polio vaccinations, it is important that you contact your GP to catch up or if you are unsure consult your red book.”

“Most of the UK population will be protected from childhood vaccination, but in some communities with low vaccination coverage, individuals may remain at risk,” she added.

Tests on UK wastewater pick up a handful of unrelated polioviruses every year. These come from people who received the oral polio vaccine in another country and then travel to the UK. People who receive the oral vaccine may pass the attenuated live virus used in the vaccine in their stool for several weeks.

The London samples detected since February raised the alarm because they were related and contained mutations that indicated the virus developed as it spread from person to person.

The outbreak is believed to have been caused by a person returning to the UK after receiving the oral polio vaccine and spreading it locally. It’s unclear how much the virus has spread, but it could be confined to a single household or extended family.

Poliovirus can spread through poor hand hygiene and contaminated food and water, or less commonly through coughing and sneezing. A common transmission route is for people to get infected hands after using the toilet and then pass the virus on by touching food consumed by others.

While the UK generally makes good use of the polio vaccine, with 95% of five-year-olds having the shot, coverage lags behind in London, with only 91.2% of children vaccinated in that age bracket. Following the detection of the virus, the NHS will contact parents of children who are not aware of their polio vaccination.

Most people who become infected with polio have no symptoms, but some develop a flu-like illness for up to three weeks later. In between one in 100 and one in 1,000 infections, the virus attacks nerves in the spine and base of the brain, which can lead to paralysis, usually in the legs. In rare cases, the virus attacks the muscles used for breathing, which can be fatal.

The UK switched in 2004 from using the oral polio vaccine (OPV) to an inactivated polio vaccine (IPV), given by injection. The injections are given in routine NHS pediatric vaccinations at eight, twelve and sixteen weeks as part of the 6-in-1 vaccine. Boosters are offered at ages three and 14.

The UKHSA is now analyzing samples of wastewater from local areas going to the Beckton plant to determine where the virus is spreading. If those tests pinpoint the center of the outbreak, public health teams could offer polio vaccination to those at risk.

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Professor Nicholas Grassly, the head of the vaccine epidemiology research group at Imperial College London, said: “Polio is a disease that persists in some of the poorest parts of the world and the UK is quite often detecting the entry of the virus during routine sewage testing. . †

“In this case, there are concerns that the virus is circulating locally in London and could spread more widely. Fortunately, so far no one has developed symptoms of the disease, which affects only about 1 in 200 of those infected, but it is important that children are fully informed about their polio vaccines. Until polio is eradicated worldwide, we will continue to address this infectious disease threat.”

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