British public health authorities declare national poliovirus incident | Polio

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

The UKHSA said waste from Beckton’s sewage treatment plant in Newham tested positive for vaccine-derived poliovirus in February, and that further positive samples have been discovered since.

No cases of the disease or related paralysis have been reported, and the risk to the general public is considered low, but public health authorities urged people to make sure they and their families were up to date with polio vaccinations to reduce the risk of injury. .

“Vaccine-derived poliovirus has the potential to spread, especially in societies where vaccine uptake is lower,” said Dr Vanessa Saliba, consultant epidemiologist at UKHSA. “In rare cases, it can lead to paralysis in people who are not fully vaccinated, so if you or your child are not up to date with your polio vaccinations, it is important that you contact your GP to take it again or if you are unsure, check your red book. “

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

British sewage tests usually detect a handful of unrelated polioviruses each year. These come from people who have received oral polio vaccine in another country and then travel to the UK. People who receive the oral vaccine can shed the attenuated live virus used in the vaccine in the stool for several weeks.

The London tests, which were discovered since February, sounded the alarm because they were related to each other and contained mutations that indicated that the virus developed as it spread from person to person.

The outbreak is believed to have been triggered by a person who returned to the UK after receiving oral polio vaccine and spreading it locally. It is unclear how much the virus has spread, but it may be limited to a single household or extended family.

Poliovirus can be spread through poor hand hygiene and contaminated food and water, or less frequently through coughing and sneezing. A common route of transmission is that people get contaminated hands after toilet visits and then transmit the virus by touching food that others have eaten.

While the UK generally has a good uptake of the polio vaccine, with 95% of the five-year-olds who have had the shock, the coverage lags behind in London, with only 91.2% of children vaccinated in that age group. In response to the detection of the virus, the NHS will contact parents of children who are not up to date with their polio vaccinations.

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

The UK switched from using oral polio vaccine (OPV) to an inactivated polio vaccine (IPV), given by injection, in 2004. The syringes are given in routine NHS childhood vaccinations at eight, 12 and 16 weeks as part of a 6-in-1 vaccine . Boosters are offered at the ages of three and 14 years.

UKHSA is now analyzing samples of sewage from local areas that flow into the Beckton plant to limit where the virus spreads. If these tests identify the center of the outbreak, public health teams can offer polio vaccination to those at risk.

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Prof Nicholas Grassly, 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 quite often detects the import of the virus during routine sewer testing.

“In this case, there is concern that the virus could circulate locally in London and could spread more widely. Fortunately, so far no one has developed symptoms of the disease, affecting only around 1 in 200 of those infected, but it is important that “Children are fully up to date with their polio vaccines. Until polio is eradicated globally, we will continue to face this contagious disease threat.”