Polio in NYC - why it would be so dangerous if found in tap water

NYC news on tap water contamination with the Polio virus might be misleading as the virus seems to be only in the wastewater. 


Polio a paralysis that can end fatally


Polio (poliomyelitis) is a serious and potentially fatal disease caused by an enterovirus called the poliovirus. The virus attacks the nervous system, causing paralysis (the inability to move), and in consequence, can lead to severe deformation. Polio is most commonly seen in children under the age of five.


The virus enters the body through the mouth (e.g. by drinking contaminated water) and multiplies in the intestine where it causes a mild gastrointestinal illness. It then enters the bloodstream, travels to the spinal cord, and multiplies in the nerves that control muscles. Only about 5% suffer from fever, sore throat or headache after infection, whereby the infection is usually misunderstood as a flu infection. The time between infection and illness is about 3 to 35 days. 95 out of 100 infected do not even notice that they have become infected but will have to live with the consequences of the disease for a lifetime. Thus, even decades later, muscle loss and paralysis can still appear (Post-polio syndrome).


There are several different strains of the virus. Most people are infected with the polio virus and have no symptoms. Some infected people have mild symptoms. About 1% of the cases result in irreversible paralysis. We usually think of paralysis affecting the limbs (spinal polio), but Polio can also paralyze the muscles used for breathing and swallowing (bulbar polio). Over 99% of these paralyzed patients are adults, over half of whom die when their breathing muscles become immobilized.


Once infected, there is no cure for polio, but the disease can be prevented through vaccination.


Polio vaccination by midwives


The polio vaccine is given as part of routine childhood immunizations. Thus it is vital that infants are vaccinated to protect them from this devastating disease. The average recommendation of health organizations is a basic vaccination against polio for all infants and young children with a 6-fold vaccine, in which vaccination against diphtheria, tetanus, pertussis (whooping cough), Hib (Haemophilus influenzae type b), and hepatitis B are also vaccinated. Polio vaccination has become a part of routine childhood immunizations. Depending on the country the number of doses ranges from 3 to 4 vaccinations, however, the general recommendation is for children at ages 2 months, 4 months, 6-18 months, and between ages 4-6 years.


There are two main types of polio vaccine:

Inactivated poliovirus vaccine (IPV) and oral polio vaccine (OPV).

Both are safe.

IPV is made from a dead virus that cannot cause infection.

OPV is made from a live, weakened virus. OPV is used in developing countries because it is cheaper and easier to administer than IPV.

OPV can cause polio in rare cases; hence - if available - IPV is the preferred vaccine.

Studies show that especially in developing countries, midwives form the major category of frontline workers. They provide both preventive and curative services such as vaccination. If the amount midwives and nurses further keep diminishing, then there are chances that infectious diseases like Polio will start spreading again. However, the opposite is most likely also true. If the number of midwives or their efficiency increases then their provisioned vaccination service can lead to a significant decrease of such diseases.


Title image by Nidia H De Jesus, 2007


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