Is the oral polio vaccine causing an unexpected problem in the UK?

[pinball1970]

TL;DR Summary

UKHSA have detected the virus in sewage between February and May 2022. They said it was “likely” there has been spread of a vaccine-derived poliovirus type 2 (VDPV2) between closely linked people in northeast London, with infected individuals believed to be shedding the virus in their faeces. So far, no suspected cases have been reported or confirmed

The press release here

https://www.gov.uk/government/news/poliovirus-detected-in-sewage-from-north-and-east-london

Independent article here

https://www.independent.co.uk/news/health/polio-outbreak-uk-london-sewage-vaccine-b2107415.html

I was not aware the PHA (which became the UKHSA) took sewage samples for analysis till COVID. I thought data would have been from GPs/Hospitals.

"The UK is considered by the World Health Organization to be polio-free, with low-risk for polio transmission due to the high level of vaccine coverage across the population. However, vaccine coverage for childhood vaccines has decreased nationally and especially in parts of London over the past few years, so UKHSA is urging people to check they are up to date with their vaccines."

Wastewater surveillance is being expanded to assess the extent of transmission and identify local areas for targeted action. Healthcare professionals have been alerted to these findings so they can promptly investigate and report anyone presenting with symptoms that could be polio, such as paralysis.

 

[jedishrfu]

This is disturbing news as it indicates folks aren't getting vaccinated against it meaning there will be a flare up and people needlessly suffer the consequences of this most horrible of diseases.

NOVA did a show on these scourges and how people forget how bad they were and decide against getting shots for their kids.

https://www.pbs.org/video/nova-vaccinescalling-shots/

 

[pinball1970]

This is disturbing news as it indicates folks aren't getting vaccinated against it meaning there will be a flare up and people needlessly suffer the consequences of this most horrible of diseases.

NOVA did a show on these scourges and how people forget how bad they were and decide against getting shots for their kids.

https://www.pbs.org/video/nova-vaccinescalling-shots/

100,000 5 year olds not vaccinated apparently.

Independent and the Daily mail. I will get the link to the publication

EDIT :this https://www.independent.co.uk/news/health/polio-vaccine-outbreak-uk-sewage-latest-b2107796.html

I looked up the details of the modern UK vaccine program for kids

https://www.babycentre.co.uk/a1011669/vaccination-schedule-for-babies-and-toddlers

So of those 100,000 5 year olds, there will be gaps probably more than in one area. Missed one or more than one follow up/booster.

A very high % of those in London

 

[256bits]

This is disturbing news as it indicates folks aren't getting vaccinated against it meaning there will be a flare up and people needlessly suffer the consequences of this most horrible of diseases.

Perhaps it is just the shedding from a group of people who received the type 2 vaccine from abroad.
Any travelers in the north of London.

The first link even stated
As part of routine surveillance, it is normal for 1 to 3 ‘vaccine-like’ polioviruses to be detected each year in UK sewage samples but these have always been one-off findings that were not detected again. These previous detections occurred when an individual vaccinated overseas with the live oral polio vaccine (OPV) returned or traveled to the UK and briefly ‘shed’ traces of the vaccine-like poliovirus in their faeces.

 

[pinball1970]

Perhaps it is just the shedding from a group of people who received the type 2 vaccine from abroad.
Any travelers in the north of London.

The first link even stated
As part of routine surveillance, it is normal for 1 to 3 ‘vaccine-like’ polioviruses to be detected each year in UK sewage samples but these have always been one-off findings that were not detected again. These previous detections occurred when an individual vaccinated overseas with the live oral polio vaccine (OPV) returned or traveled to the UK and briefly ‘shed’ traces of the vaccine-like poliovirus in their faeces.

Yes and it goes on to say, "the detection of a VDPV2 suggests it is likely there has been some spread between closely-linked individuals in North and East London and that they are now shedding the type 2 poliovirus strain in their faeces."

There could be some politics here. What is the last thing the Government wants to tell the people? Sorry guys there could be an issue here.
What is worst than that? Not saying saying anything.

Perhaps we are more sensitised now and the press will report a finding now that they would not have three years ago?

It was reported, like Monkey pox it will hopefully be one of those infectious diseases that has minimal significance but in the current climate is best mentioned.

100,000 five year olds not fully vaccinated is a stat though. Something that needs addressing.

 

[Astronuc]

and now in a New York City suburb

WASHINGTON, Aug 1 (Reuters) - The polio virus was present in wastewater in a New York City suburb a month before health officials there announced a confirmed case of the disease last month, state health officials said on Monday, urging residents to be sure they have been vaccinated.

https://www.reuters.com/world/us/po...water-state-assesses-virus-spread-2022-08-01/

 

[DaveE]

This short podcast is by far the best coverage of this issue, from someone that knows what they're talking about. The present day IPV vs. OPV story is much more interesting than you'll get in MSM.

One of my favorite bits (paraphrased 2nd hand) from a CDC guy: 'We don't test for polio in sewage in the US because we know we'll find it and we don't know what to tell the public when we do.'

 

[Astronuc]

Now for the rest of the story - from July 21, 2022

A person from Rockland County, New York, has been diagnosed with polio, the first case identified in the United States in nearly a decade.

The unvaccinated young adult began experiencing weakness and paralysis about a month ago, county Health Commissioner Dr. Patricia Schnabel Ruppert said Thursday.

https://www.cnn.com/2022/07/21/health/new-york-polio/index.html

 

[Astronuc]

Polio fears rise in New York amid possible community spread​

https://apnews.com/article/covid-sc...ew-york-city-70185547b47eece66cc8e3347ecc1e44

ALBANY, N.Y. (AP) — New York state health officials issued a more urgent call Thursday for unvaccinated children and adults to get inoculated against polio, citing new evidence of possible “community spread” of the dangerous virus.

The polio virus has now been found in seven different wastewater samples in two adjacent counties north of New York City, health officials said.

So far, only one person has tested positive for polio — an unvaccinated adult in Rockland County who suffered paralysis.

I'm guessing that 'elevated' levels of polio in waste water would indicate that more than one person has been infected. If the levels are increasing, then perhaps that would indicate a 'community spread' of the virus.

 

[pinball1970]

An update from yesterday

https://www.gov.uk/government/news/...-london-to-be-offered-a-dose-of-polio-vaccine

 

[pinball1970]

Polio fears rise in New York amid possible community spread​

https://apnews.com/article/covid-sc...ew-york-city-70185547b47eece66cc8e3347ecc1e44
I'm guessing that 'elevated' levels of polio in waste water would indicate that more than one person has been infected. If the levels are increasing, then perhaps that would indicate a 'community spread' of the virus.

Yes so they may take a lead from what is going on in London. UKHSA offering vaccines to 1-9 year olds.

 

[Astronuc]

Yes so they may take a lead from what is going on in London. UKHSA offering vaccines to 1-9 year olds.

I believe that the health department has been monitoring this for some time, probably before the London reported it. It relates to some communities who do not believe in vaccinations, so it is a politically sensitive matter.

It became more obvious when an "unvaccinated young adult began experiencing weakness and paralysis about a month ago."

I believe the same population had a measles outbreak during the recent past.

 

[Laroxe]

I believe that the health department has been monitoring this for some time, probably before the London reported it. It relates to some communities who do not believe in vaccinations, so it is a politically sensitive matter.

It became more obvious when an "unvaccinated young adult began experiencing weakness and paralysis about a month ago."

I believe the same population had a measles outbreak during the recent past.

The UK is one of the few countries to routinely monitor the sewerage in this sort of way, and I understand that some other countries have started checking and sure enough have found the virus.

It does appear to be a vaccine derived virus, and its suggested there is evidence that it is spreading in the population. Really, this is all a bit meaningless, it's always been known that the virus used in the vaccine using the attenuated live virus could spread, this originally was considered a real advantage. A child could be vaccinated and because of this transmission the whole family were effectively vaccinated or received a booster dose. It took some time to recognise that in some circumstances the virus could in fact regain its ability to cause disease, but this is still relatively uncommon and in some countries the advantages continue to outweigh the risks. Prior vaccination prevents this type of infection and outbreaks are managed by increased vaccination coverage

So far, there have been no confirmed symptomatic cases, so really this action by the UK government seems simply to be an opportunity to promote vaccine uptake. The vaccine is and has been available to all children of this age, so essentially this means no change. To be honest, in the current climate, I'm not sure that using this finding in this way is a good idea, it will inevitably be exploited by the people who want to see more deaths from vaccine preventable diseases.

 

[Astronuc]

Interesting discussion on polio in two counties of NY State.

Officials respond after polio samples were found in wastewater in 2 New York counties​

Polio cannot be cured. And once it's paralytic polio, you're paralyzed, plain and simple.

It appears that some individual brought polio back from a trip abroad, and it has been circulating for sometime in a population that does not get vaccinated.

DANIEL: Meaning there are more cases, potentially way more cases of polio in these communities than just a single paralytic patient. Then when the county started testing the wastewater for polio, there it was again. Samples taken from both counties going back to May were positive for polio. Then, sequencing the virus's genetic material surfaced something else that was unsettling.

GELMAN: There are multiple strains. So they are different, meaning we do know that it's more than one individual.

DANIEL: That is more than one individual shedding polio virus. In other words, the outbreak isn't contained.

 

[ProfuselyQuarky]

Reminds me of that that risk of polio coming back from melting permafrost in relatively rural Siberia due to climate change and the inadequate burial of past dead bodies that have died from the virus..

 

[DaveE]

it has been circulating for sometime in a population that does not get vaccinated.

It can also circulate in vaccinated people. The vaccine (like virtually all vaccines) doesn't stop OPV variant infection, it stops the disease of polio. For every case of polio in an unvaccinated population there will be something like 100 asymptomatic infections. Check out the This Week In Virology podcast for more info. Also the video I posted above.

 

[Laroxe]

Reminds me of that that risk of polio coming back from melting permafrost in relatively rural Siberia due to climate change and the inadequate burial of past dead bodies that have died from the virus..

The polio virus is dependent on living human tissue and can only survive outside of this environment for a limited period, (around 2 months) melting permafrost isn't really an issue. What is found in the sewage is viral RNA which isn't really a good indicator of infectivity, the fact it's an enterovirus means that sewage is exactly the place you would expect to find the most significant levels. In countries with an effective sewage system significant spread is unlikely. Remember, we still don't know if this finding represents a significant risk, so far it seems unlikely, it's now been identified in several countries, and we still haven't seen a confirmed symptomatic case of polio in the developed world. These vaccine derived strains do continue to represent a risk but there doesn't seem to be any increase is the low number of cases seen worldwide and these only occur in areas of low vaccine coverage.

* addition; apparently there is now a confirmed case in New York, as, yet I haven't seen if it's a vaccine derived strain or the wild type, the patient was unvaccinated. The state does have a fairly high vaccination rate so I still don't think this represents a huge threat, a booster campaign has started. I think we should avoid getting caught up in any media alarmism, currently everyone is sensitised to the risks of infections.

 

[DaveE]

apparently there is now a confirmed case in New York, as, yet I haven't seen if it's a vaccine derived strain or the wild type

It's an OPV derived strain. There is almost no wild type left in the world.
https://www.nytimes.com/2022/08/16/health/polio-new-york.html

 

[J Boogie]

Sewage is being checked all over. Its being found in California and New York. It is no doubt going to spread across the world.

Vaccine deniers are the new postmodern plague. We must redouble our efforts to inoculate young minds against superstition, religion, and psuedo-science.

 

[pinball1970]

Sewage is being checked all over. Its being found in California and New York. It is no doubt going to spread across the world.

Vaccine deniers are the new postmodern plague. We must redouble our efforts to inoculate young minds against superstition, religion, and psuedo-science.

There is certainly a lot of mis-information out there. I was tempted to start a thread on this but there are always cultural and political overtones so the thread would probably end up in trouble.
I obviously did not agree with people not trusting the Covid vaccines but you can see some justification for apprehension.
It was new, the general public may have thought it was rushed plus lots nonsense regarding the virus, the tests and vaccine. If it is on the net there could be some truth to it right? No smoke without fire?
Zero science training and little education, Joe bloggs would not be sure what to believe, especially when the experts were flanked by politicians every briefing.

Polio though?
We had polio, it was a huge issue, along comes the vaccine polio went away, from the UK at least. Job done, no controversy. Science works, thanks for that.
So we already know it works and we already know Polio is a serious disease for kids.
What on Earth would the argument be this time? to not vaccinate if it is out there?

I may start that thread.

 

[Laroxe]

Oh well, it never rains but it pours.

I did make a number of reassuring comments about the discovery of the poliovirus in sewage, which may have been unwarranted. A few interesting facts have emerged that impact on this whole issue, to summarise;

The oral vaccine contained an attenuated live version of all 3 of the virus strains, it produced high levels of immunity and immunity in the gut tissues, it is an enteric virus. It was known that the live version could potentially be transmitted to close contacts but this wasn't considered a problem.

It was realized that there was a problem in that the attenuated virus, over time and over several episodes of transmission, could regain its ability to cause disease. In fact in the early 2000's symptomatic cases of the vaccine derived virus particularly serotype 2, became a more common cause of symptomatic disease than that caused by the wild type's. This lead to countries with very low levels of disease to adopt a vaccine using inactivated virus, while this was generally less effective and didn't stimulate gut immunity, it did its job. In 2016 the type 2 serotype was also removed from the oral vaccine as the type 2 wild type virus is thought to have been eliminated.

For whatever reason, the CDC has been resisting making the genome of the virus discovered in the sewage and in causing a symptomatic case available. Other countries have been less reticent, we now know that this virus, which has been found in several countries now is a genetically related vaccine derived serotype 2. This does mean that this virus has been widely circulating for around 20 years in the population and that current vaccines have no effect on the shedding of the virus, though the inactivated vaccine still protects against symptomatic disease.

Unfortunately, this may mean that the Global campaign to eradicate polio has since its inception been doomed to failure. The fact that the virus can continue to live and be transmitted in humans, even without causing disease, makes it increasingly likely that this vaccine will need to needed for many years to come.