Polio is back in the UK! Virus detected in London sewage samples

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The possible resurgence of a disease that has been extirpated for 38 years in the metropole of the industrialized world is a sign of significantly escalating disease risk as both lack of government effectiveness and increasing enviromental disaster take its toll. While it may or may not amount to anything, that this alarm is happening may be a bad sign of itself…

Iron lungs help polio patients breathe during an outbreak of the disease in the US in the 1950s. Photograph: Science History Images
Iron lungs help polio patients breathe during an outbreak of the disease in the US in the 1950s. Photograph: Science History Images

Here’s the article:

British health officials are urging the public to ensure polio vaccines are up to date after the virus was discovered during routine London sewage testing.

The last case of polio in the United Kingdom was detected in 1984, making the current outbreak the first transmission in more than 40 years.

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The UK Health and Security Agency on Wednesday reported the virus was detected in sewage from North and East London in February and April, suggesting there had been spread between individuals.

So far no cases have been found, the health agency announced in a statement.

The U.K. was declared polio-free in 2003, health officials wrote in the news release.

Officials also said the risk of infection from the disease, which causes paralysis in children in under 1% of cases, was also low because of high vaccination rates.

But the agency is recommending anyone who missed being vaccinated against the virus do so.

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Most of the UK population will be protected from vaccination in childhood, but in some communities with low vaccine coverage, individuals may remain at risk,” UK Health and Security Agency Consultant Epidemiologist Vanessa Saliba said in a statement.

Jane Clegg, chief nurse for the National Health Service in London said most people in the city are fully protected against polio and won’t need to take further action but the National Health Service in the city will begin contacting parents of children under five who are not immunized.

Short for poliomyelitis, polio is a disabling and life-threatening disease spread from person to person mainly through contamination by feces, according to the Centers for Disease Control and Prevention. There is no cure, only a vaccination.

In the early 1950s, the CDC reports, before polio vaccines were available, polio outbreaks caused more than 15,000 cases of paralysis each year.

The United States has been polio-free since 1979, the CDC reports.

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Wild type or vaccine derived

The article doesn’t say if the samples were wild type or vaccine derived. Some countries still use the oral vaccine and that vaccine can cause shedding. This is why most places no longer use it. Anyway, sometimes shedders can infect unvaccinated people with what is called vaccine derived polio, which is usually milder compared to wild polio.

This is being reported as vaccine derived in the official report:

The virus has continued to evolve and is now classified as a ‘vaccine-derived’ poliovirus type 2 (VDPV2), which on rare occasions can cause serious illness, such as paralysis, in people who are not fully vaccinated.

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.

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The virus has only been detected in sewage samples and no associated cases of paralysis have been reported – but investigations will aim to establish if any community transmission is occurring.

Oral vaccines and inactivated vaccines

Briefly, there are two types of polio vaccines: the attenuated oral vaccines and inactivated vaccines.

Many high-income countries that are considered polio-free—including the UK and the US—use the inactivated vaccines, which do not have viruses capable of replicating or spreading. These vaccines are highly effective at preventing paralytic polio, but they do not produce high levels of local immune responses in the gut. So, if a vaccinated person encounters wild poliovirus, the virus may still be able to replicate in their gut and spread. In areas affected by wild polio outbreaks, this means that the virus can continue spreading.

Oral polio vaccines, on the other hand, can not only prevent paralytic polio, they can also produce strong local immune responses in the gut that block the virus from replicating there, thus disrupting its spread. These vaccines can also be more than five times cheaper than the inactivated kind. For all of these reasons, oral polio vaccines are the predominant vaccines used in the long, drawn-out battle to eradicate wild polio. Currently, wild polio is still found in Afghanistan and Pakistan, and Malawi and Mozambique have recently reported single cases.

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But, one of the downsides to oral polio vaccines is that vaccinated people can shed the attenuated vaccine virus in their stool for several weeks after vaccination. If this happens in a community with poor sanitation, hygiene, and low vaccination coverage, the vaccine virus can spread from person to person. Over time, as the vaccine virus spreads to more people, it can pick up mutations that make it more like wild-type polio, allowing it to regain the ability to cause disease and, in rare instances, paralysis in unvaccinated people. At this point, the mutated vaccine virus gets dubbed “vaccine-derived poliovirus” or VDPV.

Recently, VDPV cases have been reported from several African countries and Israel. Nigeria and the Democratic Republic of the Congo (DRC) reported new polio cases this week, both involving circulating vaccine-derived poliovirus type 2 (cVDPV2), according to the latest update from the Global Polio Eradication Initiative (GPEI).

And now in the UK…

Never forget how the CIA used a fake Hepatitis vaccine drive in Pakistan to root out Osama bin Laden’s location. This caused considerable vaccine hesitancy in the region, which fueled a large polio outbreak and proved to be a public health nightmare where anti-vaccination Taliban radicals killed at least 70 polio workers.

Hundreds of people, primarily children, were infected with a debilitating and deadly virus so a bunch of hooting primates could fly around the world and canoe another primate so they could write competing books about what badasses they are.

It’s things like this and the Tuskegee Experiment that I hate… You can’t do stuff like that and then expect people to blindly trust you… [UK, Yahoo]

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