Rare case of polio sparks alarm and urgent investigation in New York

The scene in Rockland County on Friday morning could well have come straight from a time capsule: residents roll up their sleeves and get vaccinated against polio, the highly contagious and sometimes deadly disease that has unexpectedly emerged in the suburbs of New York City.

The sudden interest in such vaccinations came a day after county officials announced that a local adult, unvaccinated, had tested positive for the disease. The case sparked alarm from local officials and residents, some of whom could not remember whether or not they had received the vaccine, which had been widely available since the 1950s.

Among them was Todd Messler, 64. He was one of 18 people who received shots at a pop-up clinic set up by the county health department in Pomona, NY, about 35 miles north of midtown Manhattan.

“It hurt like hell, but I’m feeling better,” he said. “That’s definitely the way to go.”

On Friday, state and county health officials were investigating the case, interviewing immediate family members of the patient and urging immunizations for anyone in the public who hadn’t received one.

Bryon Backenson, the director of the Office of Communicable Disease Control at the state Department of Health, said there was still no evidence of additional cases, although he noted the state was trying to collect as many samples as possible for testing and the sewage check for signs of the virus.

Officials also tried to get the word out about the severity of the infection because “people aren’t familiar with polio,” Mr Backenson said, noting that he wasn’t exactly familiar with it himself.

“The last real case of polio I saw in a person was probably pictures of FDR,” he said, referring to Depression-era President Franklin D. Roosevelt. “I think a lot of people don’t necessarily understand the seriousness of what polio actually is.”

It was still not clear when or where the patient contracted the disease, although health officials believe the person was infected by someone who had received the oral polio vaccine, which contains a live, weakened virus.

Such vaccines have not been administered in the United States since 2000, suggesting that the virus “could have originated from a location outside the United States where OPV is administered,” according to county officials. The oral vaccine is safe, but people who are unvaccinated can become infected if a vaccine-derived virus circulates in a community.

County officials said the strain in question could be spread by people “who come into contact with the stool or respiratory secretions of an infected person, such as by sneezing.”

The person started showing symptoms about a month ago, according to the Rockland County Health Commissioner, who said Thursday the patient suffered from “weakness and paralysis.”

Mr Backenson noted that only a tiny percentage of cases would progress to severe paralysis, but that many of those infected with the poliovirus would remain asymptomatic, which could make it difficult to determine the extent to which the disease is progressing has spread.

“That’s probably the biggest concern: You might have a lot of people out there who might never have severe paralytic polio but could potentially transmit it to others,” he said. “That is the reason for the urgency.”

On Friday, Rockland County officials said that “the person did not travel outside the country during the transmission window,” adding that “up to 95 percent of those infected have no symptoms, making the transmission difficult to trace.”

Mr Backenson said the Rockland case was discovered after state officials sounded the alarm about another neurological condition – acute flaccid myelitis – which can cause polio-like symptoms and lead to paralysis in children. In June, the department distributed a notice to clinicians about the disease, asking them to keep an eye out for cases. The patient’s doctor then sent a sample to state authorities, who — instead of finding AFM — detected polio.

County officials were alerted Monday night to the positive identification of polio by state officials and the Centers for Disease Control and Prevention. The county is releasing little personal information about the patient, although several local officials said, on condition of anonymity for privacy reasons, that he was a man in his 20s and a member of the county’s large Orthodox Jewish community.

This community was also a hub of a measles outbreak in 2018 and 2019, with hundreds of cases in the county and in Brooklyn, where many Orthodox residents also live. The rate of polio immunization for young children in Rockland County is significantly lower than rates in other counties outside of New York City, according to state data. (Misinformation about vaccines abounds in the Orthodox community, although most Orthodox rabbis encourage vaccination among their parishioners.)

The measles outbreak led to new legislation, passed in June 2019, ending religious exemptions for vaccinations amid a heated debate in Albany, a dispute that heralded even broader battles over Covid vaccinations across the country after the pandemic began in 2020.

In Monsey, Yechiel Teichman, 27, an Orthodox father of two young daughters, said he was alarmed by the news of a resurgence in polio, even though he and his daughters have been vaccinated.

“It reminded me of older family members who are still suffering from the polio they had as kids,” Mr. Teichman said as he walked his girls, ages 2 and 4, home from a pizza. “I advise everyone to get vaccinated.”

Like other residents, Mr. Teichman also confessed to feeling exhausted and lacking patience when speaking about illnesses, including the coronavirus and recent cases of monkeypox. Still, he said: “I’m a lot more worried about polio than I am about Covid – polio could do a lot more damage.”

Layla Deutsch, 21, said that although she grew up ultra-Orthodox, her parents were scared enough of polio to get her vaccinated. However, many of her friends were unvaccinated, which made her worried and anxious.

“It’s a little crazy,” she said. “Anything can come. We don’t know what’s coming next.”

Likewise, elected local officials said the community and government response to polio should be as aggressive as possible.

“This can’t wait,” said Rep. Kenneth Zebrowski, a Rockland Democrat, who said he was shocked to learn of the polio case. “They need to attack this on whiteboards in a war room.”

Mr Zebrowski, who has three children, appeared frustrated that his district had once again struggled with a disease like measles, which modern medicine seemed to have defeated, only to flare up again in an unvaccinated person.

“Are you in danger if you take your kids to the mall?” he said. “To be honest, we haven’t had to worry about that for decades.”

Aron B. Wieder, a member of the Rockland County Legislature and a Hasidic Jew, said he was encouraged by the response from residents in his community and he encourages unvaccinated people to get vaccinated as soon as possible. “It can save lives,” he said.

Once one of the world’s most feared diseases, polio was largely tamed with the help of vaccines developed in the 1950s. The last known case of polio in the United States was in 2013, believed to have been imported from abroad. The last case to originate in the United States was in 1979, according to the CDC

For Mr Messler, Friday morning’s vaccination helped settle his spirit, although he said the ongoing threat of various diseases had made him a little tired.

“It’s a burden, isn’t it?” he said. “Personally, I’m not worried at all. But those things will always come back and come back and come back.”

Hurubie Meko contributed to the coverage.