NPR’s Ali Daniel
Polio is the disease most people thought had left us here in the United States. I was infected with the virus from the hospital and was eventually paralyzed.
The last case of community polio in the United States was in 1979. In the Americas he was declared polio free in 1994. Although this is just his one case of paralysis at this time, local and national public health officials are taking the news very seriously. .
Wastewater testing and genetic sequencing have shown that the virus has been quietly circulating in several New York counties since at least May. “Even his one case of paralytic polio represents a public health emergency in the United States,” the Centers for Disease Control and Prevention declared in a recent report.
Low vaccination coverage in Rockland County means there is a risk of more paralysis cases in the area, the report said. The challenges health officials face in managing the local response in New York may indicate that other parts of the country may soon be headed.
“Rockland County is basically New York City,” says Perry Halkitis, dean of the Rutgers School of Public Health. “New York City is basically New Jersey. Rockland County is basically Connecticut.” Because people travel a lot, diseases like polio can spread quickly, he explains. “Do we probably have dozens, if not hundreds, of undetected cases of polio in our population? Maybe. Are we catching them? Probably not. .”
And health authorities must grapple with this outbreak at a time when the COVID crisis has put public health on alert.
feeling of fear
News of the paralysis cases spread among local authorities before being announced to the public. Mona Montal, chief of staff for the town of Ramapo, Rockland County, remembers it crossing her mind. Of course, she was thinking about the grimness of her struggle with COVID over the past two years. Is it?” she wondered.
NPR’s Ali Daniel
And polio, which can be paralyzing, is a particularly terrifying disease. “There is no cure for polio,” explains Montal. “And when you have paralytic polio, you’re paralyzed. It’s that simple.”
Paralyzed and orthopedic, wheelchair-bound children were haunting images of the outbreaks of the 1940s and ’50s, before vaccines became available nationwide. In fact, Montal was told that his family had died of illness or had become paralyzed.
During COVID, she worked on the county’s COVID vaccine information campaign, working with independent health communicator Shoshana Bernstein of Rockland County. News of paralytic polio brought Bernstein together. “She checks her phone about seven times a night,” she says. “I wake up and I’m like, ‘Oh my God, do you have another case?'”
A small percentage of polio patients become paralyzed. Most people have no symptoms at all. So for public health, the paralytic polio outbreak is just the tip of the iceberg.
“It’s very difficult to predict how many people, but it’s definitely an actively spreading number,” said Irina Gelman, Ph.D., health director for Orange County, next to Rockland. says. “Obviously, the confirmed cases of polio in the United States is big news.”
When Rockland and Orange counties began testing their wastewater for polio, samples dating back to May were positive for polio. Sequencing of the virus’ genetic material later revealed another disturbing fact.
“There are multiple strains, so they’re different,” Gelman said. In other words, the outbreak is not contained.
NPR’s Ali Daniel
Risk of low vaccination coverage
Declining vaccination coverage is a big part of the problem, both in the United States and abroad. During the pandemic, many children missed immunizations and vaccine services were interrupted, notes the CDC in its report on Rockland polio cases. Nationwide, nearly 93% of her infants born between 2017 and her 2018 were vaccinated against polio by the time she was two years old. However, according to the New York State Immunization Information System, the vaccination rate for infants under 24 months of age living in Rockland County was 60.3% as of August 2022. In some communities, coverage was as low as 37.3%.
“Frankly, I am disappointed that we are still here at this point,” Gelman says. “This is a vaccine-preventable disease.
Here’s how officials believe the virus got here.
A person came to New York state with a polio strain associated with samples found in wastewater from Israel and the UK. The person was unaware that he had polio: he had no, mild, or late-onset symptoms. Then, due to low vaccination levels in some communities in New York State, the virus began to spread, eventually causing paralysis in people in Rockland. The virus continued to spread, as some areas had the lowest vaccination coverage.
“It’s a multitude of reasons across a multitude of demographics,” says Bernstein. “There isn’t a single group that hasn’t been vaccinated.” That’s not just true for these communities in and around New York City.
“We have a large population…who are choosing not to vaccinate. [their children]says Halkitis. We know there are huge differences today, from region to region, from borough to borough, from region to region. ”
So far, polio has only been detected in these few locations in New York State, but halkytis is likely to spread to other locations near and far in areas where vaccination is low. I am warning you.
NPR’s Ali Daniel
Addressing vaccine hesitancy
Polio outbreaks elsewhere in the United States could face the same challenges that Rockland and Orange counties have encountered in reaching unvaccinated communities.
Bernstein explains that all the talk of COVID and vaccination left everyone in Rockland County tired and confused. She is part of the large, ultra-Orthodox Jewish population living here, some of whom lead more closed lives, she says.
“Social media and secular media aren’t really brought in,” Bernstein says. “We always say that it’s very easy to instill fear and very difficult to undo it,” says Bernstein. increase.
The county is a mosaic of people with low vaccination rates, including Haitians and members of the Latino community. “Press from the CDC he thinks every release is just a bunch. Nobody reads it,” Bernstein says.
Together, Bernstein and Montal have therefore become a vital conduit between all official public health languages and the hearts and minds of neighboring countries. The duo helped launch a big printed infographic that just went to print, and there are four versions of him in English, Spanish, Haitian Creole, and Yiddish. Montal says it’s carefully worded.
“People have experienced PTSD with the word vaccination,” explains Montal. “So we vaccinate, but we don’t vaccinate. That’s the message.”
The two women work with trusted community leaders such as rabbis and pastors to disseminate information. And they asked the CDC for a letter they could show to these leaders in support of their efforts.
“My dream is that after this, the CDC really has something of a game plan: ‘Okay, we’re going to use Rockland County as a model, and now we’re going to repeat that model across the country. ..'”
The Rockland County Health Department hosts various polio-only immunization clinics once or twice a week in various locations. ‘We have to get vaccinations to people. We can’t expect people to come to us,’ said Montal.
To that end, a total of about 15 people stopped by for several hours last Wednesday afternoon at the Spring Valley polio immunization clinic. Brian Hastings took his two hour drive from Long Island to shoot. Dolores Thaxton, 89, said she had never been vaccinated against polio and decided to roll up her sleeves.
This kind of outreach is a long-term effort that can pay off slowly. Abigail Guerrero, a young mother from Ecuador who speaks little English, came to the clinic wanting something else, but she saw a large infographic in Spanish taped up. Bernstein and Montal helped create it. This symptom was her first encounter with a polio outbreak in her community. After reading it and learning about her illness, she decided to get vaccinated.
Back in Orange County, health director Dr. Irina Gelman says she’s a good sleeper. She gets up at 3:30 every morning. Her sick heartbeat has never stopped since she started her job four years ago.
“We started with a measles outbreak,” she says. “And then we gradually moved to COVID 19. At the same time, we’re dealing with monkeypox. And now we’re dealing with polio. It’s officially eradicated, yes. It’s It raises so many concerns.”