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For Future Viral Threats, Health Officials Look to Sewage
When the virologist Kirsten St. George learned last summer that a paralyzed patient in New York’s Rockland County had tested positive for polio, she turned her attention to the state’s sewers.
Polio is particularly stealthy because most infected people never develop symptoms but can still spread the virus. A wastewater-surveillance network established during the Covid-19 pandemic helped officials at the New York State Department of Health’s Wadsworth Center track polio’s spread in several counties.
New York is now expanding wastewater monitoring and starting to look for flu, RSV, hepatitis A, norovirus and antibiotic-resistant genes in parts of the state, as health officials across the U.S. consider wastewater as a more permanent public-health tool for watching a variety of threats.
“Are we on the brink of another outbreak, if it’s rising? Is it just sort of holding steady?” asked Dr. St. George, Wadsworth’s director of virology. “These are all important public health questions.”
Dr. Kirsten St. George of the Wadsworth Center, which is starting to track the spread of pathogens including the hepatitis A virus.
For decades, researchers around the world used wastewater primarily to track poliovirus, which spreads through contact with an infected person’s feces. At the onset of the pandemic, scientists found that the Covid-19 virus’s genetic material could be detected in sewage. That meant sewage might help track other respiratory viruses, too.
Researchers built surveillance networks around the country to track Covid-19 and monitor for variants.
Now they are starting to leverage that system to search for other pathogens they had wanted to track through the sewers for years including norovirus and antibiotic-resistant microbes, said Amy Kirby, program lead of wastewater surveillance at the Centers for Disease Control and Prevention.
“Once you have this system, it’s much easier to activate it for a new pathogen,” Dr. Kirby said.
Sewage samples from treatment plants are sent to labs, where genetic material that can come from hundreds of thousands of people is isolated. Researchers usually test samples for pathogens with the PCR technology used in a Covid-19 lab test administered at the doctor’s office.
Health officials use the data to track changing concentrations of a virus, which can help them monitor the spread of pathogens including flu and RSV for which many people might not be tested. The technique has yielded early evidence of Covid-19 outbreaks and helped officials tailor public messaging and decide where to open testing sites.
Biobot Analytics Inc., which works with the CDC to monitor Covid-19 and the renamed mpox, started tracking opioids in wastewater before the pandemic. It has collected data on substances including fentanyl in more than 100 counties across 47 states. Officials in Cary, N.C., used that data to encourage people to dispose of drugs properly and to distribute more overdose-reversal drugs, Biobot said.
Not everything can be tracked through sewage, and there isn’t a standard national system for collecting data and comparing readings from site to site. Privacy can be a concern in smaller communities or when tracking illicit substances, researchers said, though wastewater data is processed as an anonymous group sample. And some communities that collect wastewater data aren’t using it to guide public-health policy, researchers said.
The wastewater treatment plant in Schenectady, N.Y., where workers collect samples and ship them for analysis at the Wadsworth Center in Albany, N.Y.
The National Academies of Sciences, Engineering, and Medicine said in a report Thursday that the U.S. should invest more in the CDC’s wastewater-surveillance network and expand its reach. The report recommended that the CDC should have an open process for picking which pathogens to track and establish an ethics committee, among other steps.
“We’re at a critical juncture where it has gone from being a grass-roots effort to a more nationally recognized tool,” said Megan Diamond, head of the Rockefeller Foundation’s wastewater-surveillance program, who wasn’t involved with the report.
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After a polio case was confirmed in New York in July, health officials reviewed stored wastewater samples and found poliovirus in wastewater from several counties, including as far back as spring. Health officials urged people who weren’t vaccinated against polio to get the shots and alerted doctors.
The CDC extended poliovirus wastewater testing to a handful of counties with low vaccination rates or potential connections to New York’s polio case.
“What you might expect a virus to do when it starts circulating is exactly what we saw in the wastewater,” said Dan Lang, deputy director of New York’s Center for Environmental Health and head of the state’s wastewater-monitoring program.
No samples tested positive for poliovirus by the end of November, but it was detected again in Orange County last month. Health officials are planning to analyze past samples from additional counties for traces of the virus before deciding whether to widen poliovirus wastewater monitoring when the weather warms and the virus can spread more readily.
“We’re worried about a big sort of roaring back,” said Dr. Eli Rosenberg, a lead epidemiologist who coordinates New York’s polio response. “We’re using this time now to prepare.”
Poliovirus was found in Orange County, N.Y., last month.
Write to Brianna Abbott at brianna.abbott@wsj.com
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Poliovirus found in Brooklyn and Queens sewage, New York health officials say
Polio virus particle, computer illustration.
Kateryna Kon | Science Photo Library | Getty Images
New York Gov. Kathy Hochul has extended the state of emergency declared in response to the spread of poliovirus after sewage tested positive in Brooklyn and Queens.
Hochul said the state disaster emergency will remain in place at least through Nov. 8 to support statewide efforts to boost the vaccination rate against polio.
The New York State Department of Health, in a statement Tuesday, said the sewage sample that tested positive in Brooklyn and Queens is genetically linked to the virus that paralyzed an unvaccinated adult in Rockland County over the summer.
The unvaccinated adult from Rockland County is the only known case of paralysis in the U.S. so far, but state health officials have said there are likely hundreds of people spreading the virus without symptoms.
“These findings put an alarming exclamation point on what we have already observed: unvaccinated people are at a real and unnecessary risk,” New York State Health Commissioner Dr. Mary Bassett and New York City Health Commissioner Dr. Ashwin Vasan said in a joint statement.
A total of 70 sewage samples have tested positive for poliovirus in the New York City metropolitan area so far, according to New York state health officials. The virus has been detected in sewage from Kings, Nassau, Orange, Queens, Rockland, and Sullivan counties.
More than 28,000 doses of polio vaccine have been administered since July in Rockland, Orange, Sullivan and Nassau countries, according to state health officials.
Most people are vaccinated against polio as children and are not at risk, but New York has been struggling with low immunization rates in some communities for years.
In Rockland County, the vaccination rate for children under age two dropped from 67% in 2020 to 60% in 2022, according to the Centers for Disease Control and Prevention. In some areas of Rockland, only 37% of kids in this age group are up to date on their vaccine.
State, national, and global health authorities believe the poliovirus found in New York originated from a country that still uses the oral polio vaccine. The oral vaccine uses a live virus that in rare circumstances can mutate and cause disease.
The U.S. stopped using the oral vaccine more than 20 years ago. It now administers an inactivated vaccine that contains killed virus that cannot mutate. The inactivated vaccine is highly effective at preventing disease but does not stop transmission of the virus.
These scientists traced a new coronavirus lineage to one office — through sewage
Virologist Dave O’Connor admits that he was getting desperate when he started asking dog owners for poo samples.
For much of 2022, O’Connor, at the University of Wisconsin–Madison, and his colleagues have been tracking a heavily mutated variant of SARS-CoV-2, the virus that causes COVID-19. Early this year, they discovered the variant in Wisconsin waste water drawn from more than 100,000 people.
Following the sewer system to ever-smaller watersheds, they narrowed the variant’s source to one particular area. O’Connor and his team thought that the variant might be circulating in dogs, in part because they found canine genetic material in the same wastewater samples. So they headed to the local dog park. “It was the strangest request you’re ever going to hear: ‘Hey, we’re scientists. Can we just have that bag of dog poop that you’re throwing away?’”
The dogs turned out to be another red herring in the team’s months-long quest to trace the variant’s origin.
Similar-looking variants have turned up in people with compromised immune systems — and, increasingly, researchers think that variants from chronic infections in these people might give rise to pandemic-altering lineages, such as Omicron.
O’Connor and his team think that they’re searching for a person carrying the variant — there’s no evidence that the lineage has spread to anyone else. The researchers are working with public-health officials, who hope that by identifying the person — who has been infected for at least eight months — they can treat the infection and reduce the chances of it ever spreading.
No individual case stands much chance of brewing the next super-variant (likely to be dubbed Pi under the WHO’s variant-naming system). But tracing the source of one potential variant — among the thousands probably circulating globally — might help researchers to understand the biological factors that caused variants such as Omicron to emerge. Such infections could also act as a crystal ball into the virus’s future.
“This is where Pi is going to come from. I don’t think people realize how much it’s already here. A lot of the lineages we are finding make Omicron look pedestrian,” says Marc Johnson, a virologist at the University of Missouri in Columbia who, with O’Connor, is co-leading efforts to trace wastewater lineages in Wisconsin, and spearheading searches for similar variants in two dozen other places.
“It’s such smart detective work. It’s phenomenal,” adds Bill Hanage, an epidemiologist at Harvard T.H. Chan School of Public Health in Boston, Massachusetts. “We still don’t really know where variants come from.”
Cryptic lineages
Public-health investigators have been plumbing water for more than a century: in 1854, British epidemiologist John Snow traced a London cholera outbreak to a contaminated water pump. The global push to eradicate poliovirus, which is shed in faeces, relies on detecting viruses in waste water, because paralysis cases are so rare.
During the pandemic, researchers found that sewer-sampling can offer warning of COVID-19 surges. Most of these efforts focused on common SARS-CoV-2 variants circulating in the community that were picked up in routine testing. But in March last year, Johnson and his colleagues started noticing viral lineages in waste water that didn’t match anything in global databases containing millions of sequences.
These ‘cryptic lineages’ were laden with changes to the spike protein that SARS-CoV-2 uses to enter cells — and which the immune system targets. These changes would later turn up in immune-evading variants such as Omicron.
Wastewater sequencing for SARS-CoV-2 can be exquisitely sensitive. But when Omicron cases flooded the watersheds that Johnson was studying in late 2021, they drowned out the cryptic lineages that his team was hunting. To overcome this, Johnson developed a sequencing approach to identify rare, non-Omicron lineages that might have been infecting just a single person. “You’re really looking for a needle in the haystack,” he says.
With this method in place, Johnson put a call out for waste water, ultimately collecting samples from more than 600 areas served by wastewater collection systems, in 39 US states. “I wrote to everyone I knew. I posted it on Twitter: ‘I’m just like, send me your shit.’”
Martin Shafer, an environmental biogeochemist at Wisconsin State Laboratory of Hygiene in Madison, provided samples from the state. O’Connor, whose lab was part of a Wisconsin-wide effort to track SARS-CoV-2 through wastewater and air sampling, mobilized a team to investigate the cryptic lineage that the researchers are now tracking. The variant, which first appeared in sewage collected in January 2022, shared numerous mutations with Omicron, but came from an entirely different part of the SARS-CoV-2 family tree.
“We didn’t stumble across this. I was hunting,” Johnson says. “I wanted to know what the source was.”
Sewer sleuths
To narrow down the variant’s origin, the researchers followed samples that had been collected from smaller and smaller watersheds in the sewer network (see ‘Hunting a cryptic lineage’). This required municipal workers to place dozens of specialized sampling devices beneath manhole covers during the depths of the Wisconsin winter. “People were doing work well outside their job descriptions,” says O’Connor.
Such help can’t be taken for granted, says Rose Kantor, a microbiologist at the University of California, Berkeley, who is working with Johnson to trace cryptic lineages in California waste water. Their investigations hit a dead end when they couldn’t convince officials to collect additional samples.
As the search for the Wisconsin variant narrowed, Johnson was perpetually worried that the variant would disappear. “This wasn’t the first time we tried to track a lineage, but often they fizzle out,” he says. “I was constantly flipping out.”
But at each fork in the sewer system, the lineage was found along only one path. After ruling out dogs, rats and deer — which can all carry SARS-CoV-2 — the researchers suspected that they were looking for a person with a chronic infection. In June, they traced the lineage to waste water from a single business with fewer than 30 employees (the researchers wish to keep the name and location of the business confidential to protect the community’s privacy). The researchers are preparing a preprint describing the investigation.
Evasion skills
While public-health officials involved in the investigation weighed their next moves, O’Connor and Johnson’s team continued tracking the variant and studying its properties.
Since its discovery, the lineage had gained extra mutations and its genetic diversity had grown — hallmarks of a virus evolving in a single person’s body without spreading. Experiments showed that the variant was even better than the Omicron lineage BA.1 at thwarting antibodies triggered by vaccination and previous infection.
But it wasn’t clear what risk the variant posed to anyone other than the person carrying it. “The vast majority of these lineages are not transmitting to the best of our knowledge,” says O’Connor.
Ryan Westergaard, the state epidemiologist for communicable diseases at the Wisconsin Department for Health and Safety in Madison, says that his team thought long and hard before asking the company and its employees whether they would be tested for SARS-CoV-2. “We didn’t want to cause panic and say there’s a dangerous new variant lurking in our community,” he says. But he wanted to help the person carrying the infection to get treatment — and reduce any risk of spread.
About 60% of the company’s employees have come forwards for nasal swab testing but none seems to carry the cryptic lineage. Westergaard’s team is now looking out for the variant in community SARS-CoV-2 testing, and in waste water from other Wisconsin sewers. The researchers are also going back to previously collected clinical specimens to see whether the variant has turned up already. “We’re remaining vigilant,” says Westergaard.
Gut instinct
Johnson, O’Connor and their team haven’t given up their search. They continue to detect the variant, and at quantities that Johnson has never seen before in waste water. At those levels — and combined with the employees’ negative nasal swabs — Johnson wonders whether the infected person is harbouring the virus mainly in their gut, rather than their airways. The team hopes to analyse stool samples from willing employees and is seeking ethical approval for such a study.
Smruthi Karthikeyan, a computational biologist at the University of California, San Diego, noticed something similar while conducting wastewater sequencing at university buildings. Some people shed large quantities of SARS-CoV-2 genetic material for weeks after their airway infections and symptoms disappeared.
Chronic gut infections are a strong candidate for the source of SARS-CoV-2 variants of concern such as Omicron, says Kristian Andersen, an evolutionary biologist at Scripps Research in La Jolla, California. Immune cells in the gut are more tolerant of microorganisms than are those elsewhere in the body, potentially allowing the virus to evolve in the presence of some — but not too much — immune pressure. In most cases, such gut infections will never transmit to others, Andersen says — unless something in the body changes and the virus moves back to the airways. “Then that gives the risk of an emergence event like Omicron,” he hypothesizes.
Identifying the person in Wisconsin might therefore help researchers to understand how variants such as Omicron emerge, Andersen adds. “What this shows you is the engine of variants,” he says. “The detective work they’ve done is unbelievable.”
Even if the researchers cannot identify a person carrying the Wisconsin lineage, studying cryptic lineages like it might help to predict SARS-CoV-2’s future, says O’Connor. Most of its standout mutations are in the spike protein, but his team has identified changes to key regions of another viral molecule, called membrane protein ectodomain, that might also be important to immunity (see ‘Cryptic comparison’).
Cryptic lineages might not turn out to be the “oracle of the toilet bowl”, says O’Connor, but if they can help to forecast broad trends in SARS-CoV-2 evolution, this could help researchers to test vaccines and treatments against potential future variants — which might already be bobbing around a sewer somewhere in the world. “If we see this in Wisconsin by shining a bright light on it,” says O’Connor, “you have to know that it’s happening everywhere.”
Polio detected in NYC’s sewage, suggesting virus circulating
NEW YORK (AP) — The virus that causes polio has been found in New York City’s wastewater in another sign that the disease, which hadn’t been seen in the U.S. in a decade, is quietly spreading among unvaccinated people, health officials said Friday.
The presence of the poliovirus in the city’s wastewater suggests likely local circulation of the virus, health authorities from the city, New York state and the federal government said.
The authorities urged parents to get their children vaccinated against the potentially deadly disease.
“The risk to New Yorkers is real but the defense is so simple — get vaccinated against polio,” New York City Health Commissioner Dr. Ashwin Vasan said. “With polio circulating in our communities there is simply nothing more essential than vaccinating our children to protect them from this virus, and if you’re an unvaccinated or incompletely vaccinated adult, please choose now to get the vaccine. Polio is entirely preventable and its reappearance should be a call to action for all of us.”
Dr. José R. Romero, director of the Centers for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases, said, “This is sobering; we know polio spreads silently, and it’s likely that there are many people infected with polio and shedding the virus in these communities. This is also an urgent and living reminder of the importance of vaccination.”
New York City is being forced to confront polio as city health officials are struggling to vaccinate vulnerable populations against monkeypox and adjusting to changing COVID-19 guidelines.
“We are dealing with a trifecta,” Mayor Eric Adams said Friday on CNN. “COVID is still very much here. Polio, we have identified polio in our sewage, and we’re still dealing with the monkeypox crisis. But the team is there. And we’re coordinating and we’re addressing the threats as they come before us, and we’re prepared to deal with them with the assistance of Washington, D.C.”
The announcement about the discovery of the polio virus in New York City comes shortly after British health authorities reported finding evidence the virus has spread in London but found no cases in people. Children ages 1-9 in London were made eligible for booster doses of a polio vaccine Wednesday.
In New York, one person suffered paralysis weeks ago because of a polio infection in Rockland County, north of the city. Wastewater samples collected in June in both Rockland and adjacent Orange County were found to contain the virus.
CDC officials said the virus identified in wastewater samples collected in New York City did not contain enough genetic material to determine if they were linked to the Rockland County patient.
Most people infected with polio have no symptoms but can still give the virus to others for days or weeks. Vaccination offers strong protection, and authorities urged people who haven’t gotten the shots to seek one immediately.
Based on past outbreaks, it is possible that hundreds of people in the state have gotten polio and don’t know it, officials said.
Polio was once one of the nation’s most feared diseases, with annual outbreaks causing thousands of cases of paralysis. The disease mostly affects children.
Vaccines became available starting in 1955, and a national vaccination campaign cut the annual number of U.S. cases to less than 100 in the 1960s and fewer than 10 in the 1970s, according to the Centers for Disease Control and Prevention.
A small percentage of people who contract polio suffer paralysis. The disease is fatal for 5-10% of those paralyzed.
All schoolchildren in New York are required to have a polio vaccine, but Rockland and Orange counties are both known as centers of vaccine resistance.
According to the CDC’s most recent childhood vaccination data, about 93% of 2-year-olds had received at least three doses of polio vaccine. But the rate is only 80% in New York state, and is far lower in the area around where the polio case was reported — just 60% in Rockland County and 59% in Orange County, according to state data.
Nearly 1 million children in London offered polio boosters after virus is detected in sewage
The UK Joint Committee on Vaccination and Immunisation said a targeted inactivated polio vaccine booster dose should be offered to all children between the ages of 1 and 9 in all London boroughs.
“This will ensure a high level of protection from paralysis and help reduce further spread of the virus,” the UK Health Security Agency (UKHSA) said in a statement announcing the move.
Around 1 million children of that age live in the London region, according to the most recent data from the UK Office for National Statistics.
The UKHSA said a total of 116 virus isolates were identified in 19 sewage samples collected in London between February and July.
While most of the samples contained vaccine-like virus, some showed “sufficient mutations to be classified as vaccine derived poliovirus.” The UKHSA said this was more concerning as such virus behaves more similarly to “wild polio and may, on rare occasions, lead to cases of paralysis in unvaccinated individuals.”
The authorities stressed the vaccination drive is a precautionary measure.
“No cases of polio have been reported and for the majority of the population, who are fully vaccinated, the risk is low. But we know the areas in London where the poliovirus is being transmitted have some of the lowest vaccination rates,” Dr. Vanessa Saliba, a consultant epidemiologist at UKHSA said.
Vaccines are key as there’s no cure for polio
Polio is caused by an enterovirus called the poliovirus. It was one of the world’s most feared diseases until Dr. Jonas Salk invented the polio vaccine and tested its safety in 1954.
By 1988, reported cases of polio worldwide reached a peak of 350,000, according to the World Health Organization.
About 1 in 4 infected people have flu-like symptoms including sore throat, fever, tiredness, nausea, headache and stomach pain. As many as 1 in 200 will develop more serious symptoms that include tingling and numbness in the legs, an infection of the brain or spinal cord and paralysis, according to the US Centers for the Disease Control and Prevention.
There is no cure for polio. Treatment to address symptoms may include medication to relax muscles and heat and physical therapy to stimulate muscles. However, any paralysis caused by polio is permanent.
The last case of polio in the UK was in 1984, according to the UKHSA statement.
“Decades ago before we introduced the polio vaccination programme around 8,000 people would develop paralysis every year,” Saliba added.
There are three strains of the virus, two of which have been eliminated in the world, according to the Global Polio Eradication Initiative, a WHO program. One type of wild polio virus still circulates in Pakistan and Afghanistan. Transmission can also occur when not enough children are vaccinated in an area.
Last month, a person from Rockland County, New York, was been diagnosed with polio, the first case identified in the United States in nearly a decade. The unvaccinated young adult began experiencing weakness and paralysis, county Health Commissioner Dr. Patricia Schnabel Ruppert said at the time.
This story has been updated with additional information.
CNN’s Benjamin Brown, Molly Stazicker, Zahid Mahmood and Brenda Goodman contributed reporting.
Polio virus detected in London sewage; no cases reported
However, its health security agency and medical regulator said in a statement Wednesday that authorities had found traces of poliovirus in sewage samples collected from the London Beckton Sewage Treatment Works, as part of “routine surveillance.” The sewage treatment plant covers a population close to 4 million in the north and east of the capital.
“Investigations are underway after several closely-related viruses were found in sewage samples taken between February and May,” the statement said.
The detection 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,” the statement said.
The type 2 vaccine-derived poliovirus — as opposed to the wild or naturally occurring strain — is a weakened form of the live virus used in oral polio vaccines. Many countries, including the U.K. and United States, have moved away from using the oral vaccine as it can spread to unvaccinated people. But it remains common in nations such as Pakistan, Afghanistan and Nigeria.
The vaccine-derived poliovirus detected in the U.K. “on rare occasions can cause serious illness, such as paralysis, in people who are not fully vaccinated,” the British health authorities said.
So far, the poliovirus has only been detected in sewage samples but investigations are underway to establish whether any community transmission is occurring.
Like other nations, Britain is also grappling with the ongoing coronavirus pandemic and monkeypox cases.
The United Kingdom was declared polio-free by the World Health Organization in 2003 and the last case of wild or naturally occurring polio contracted was in 1984, according to the government.
“Vaccine-derived poliovirus is rare and the risk to the public overall is extremely low,” Vanessa Saliba, consultant epidemiologist at UK Health Security Agency, said in a statement.
“We are urgently investigating to better understand the extent of this transmission and the NHS has been asked to swiftly report any suspected cases,” she said, adding that “no cases have been reported or confirmed so far.”
Polio, or poliomyelitis, is a crippling and potentially fatal infectious disease, which invades the nervous system and spreads mainly through contamination of fecal matter.
There is no cure, but vaccinations since the 1960s, mostly in childhood, have been a game changer allowing many countries to eradicate wild polio. The U.K. maintains vaccine coverage of more than 95 percent, the government said, largely through a routine childhood immunization program.
Surveillance, vaccination and investment to #EndPolio 🌍 is critical, as the #UK’s announcement of environmental #polio samples identified in London sewage reminds us. No child has been infected so far. @WHO is supporting 🇬🇧 and partners.https://t.co/97zNVNUiBg
— Tedros Adhanom Ghebreyesus (@DrTedros) June 22, 2022
The U.K. health security agency says it normally detects between one and three “poliovirus isolates per year” in sewage but they are normally one-offs and unrelated to each other. “In this instance, the isolates identified between February and June 2022 are genetically related. This has prompted the need to investigate the extent of transmission,” it added.
The most likely scenario is that a recently vaccinated individual entered the U.K. from a country where an oral polio vaccine was used. The U.K. stopped such oral vaccines in 2004, authorities said.
WHO Director General Tedros Adhanom Ghebreyesus tweeted that “surveillance, vaccination and investment to #EndPolio is critical,” following news of the U.K. announcement.
The Global Polio Eradication Initiative, which works to end all wild and vaccine-related cases of the virus, said although largely eradicated, the disease remains endemic in Afghanistan and Pakistan.
“It is important that all countries, in particular those with a high volume of travel and contact with polio-affected countries and areas, strengthen surveillance in order to rapidly detect any new virus importation and to facilitate a rapid response,” the group said in a statement.
Meanwhile, health officials in London are urging parents to ensure young children are fully vaccinated to prevent any outbreak. The National Health Service will begin reaching out to parents of children aged under 5 in the capital who are not up to date with their vaccinations, the government said.
Poliovirus identified in London sewage, says UK health agency
Investigations are underway after several closely related viruses were found in sewage samples from the Beckton Sewage Treatment Works taken between February and May, said the UK Health Security Agency (UKHSA) in a statement on Wednesday.
“It is normal for 1 to 3 ‘vaccine-like’ polioviruses to be detected each year in UK sewage samples but these have always been one-off findings that were not detected again,” the UKHSA said.
“These previous detections occurred when an individual vaccinated overseas with the live oral polio vaccine returned or travelled to the UK and briefly ‘shed’ traces of the vaccine-like poliovirus in their faeces,” it added.
The recent samples raised alarm as the virus “continued to evolve and is now classified as a ‘vaccine-derived’ poliovirus type 2 (VDPV 2), which on rare occasions can cause serious illness, such as paralysis in people who are not fully vaccinated,” the UKHSA said.
No cases of the virus have been reported and the risk to the public is considered low. But Vanessa Saliba, consultant epidemiologist at the UKHSA, urged the public to check their polio vaccinations are up to date.
“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,” Saliba said in the statement.
“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,” added the statement.
Large global vaccination campaigns have long been underway to eradicate the wild poliovirus. The UKHSA said the last such case of wild polio contracted in the UK was confirmed in 1984, and the UK was declared polio-free in 2003.
Vaccine-derived polioviruses, like those recently identified in London, stem from the weakened poliovirus in the live oral polio vaccine used in some parts of the world.
Those viruses can change over time to behave more like the wild virus, and vaccine-derived poliovirus can spread, especially among unvaccinated people.
Symptoms of polio include fever, fatigue, headache, vomiting, stiffness in the neck, pain in the limbs and, in a very small percentage of cases, paralysis, which is often permanent. There is no cure for polio.
Presence of vaccine-derived polio virus detected in sewage Kolkata waters | Kolkata
Health officials detected the presence of vaccine-derived polio virus from sewage waters in Kolkata, prompting authorities to plan large-scale sampling although experts said the discovery does not represent a significant threat.
A vaccine-derived polio virus is a rare variant that mutates from the strain contained in the oral polio vaccine (OPV).
“Sewage monitoring goes on throughout the country. This virus was found in a sample in Kolkata. It has been analysed with the help of World Health Organisation (WHO). Most likely it has come from someone’s gut, who is immune deficient and has since multiplied. It is not a case of human-to-human polio transfer,” NS Nigam, state health secretary told HT.
According to WHO data, India has not reported a VDPV confirmed case since 2016. Globally, 49 confirmed cases of VDPV cases have been recorded since the beginning of this year, according to WHO’s latest epidemiological report on the disease issued on June 7.
The sample detected in sewage was collected earlier this year from Metiabruz area in south-west Kolkata.
Minutes of a meeting at the state health department said that frequent measles outbreaks and the detection of the VDPV type 1 virus from the sewage sample indicate the need for better surveillance.
To ascertain whether the virus is present in any case of clinically diagnosed primary immune deficient (PID) child, stool samples from such children in and around Kolkata may be initiated, an official said.
“We have done an extensive survey in that area. Genome sequencing has also been done by US health agency Centers for Disease Control and Prevention and WHO. It is not a case of human polio transfer. We would step up the pulse polio immunization program in that area. This is a reason for caution but definitely not a worry,” said a senior health department official, asking not to be named.
India reported its last polio case from Howrah district in West Bengal on January 13, 2011. A year later on February 24, 2012 the World Health Organization removed India from the list of ‘endemic countries with active polio virus transmission’.
“It was also decided in the meeting that medical colleges in and around Kolkata would be soon asked to get baseline information about PID (primary immunodeficiency) cases. Letters would be sent to the principals, medical superintendents and vice principals of medical colleges soon in this connection,” said the person quoted above.
Attending doctors will be requested to counsel guardians of these patients to give stool samples to ascertain their virological status.
“The situation is not alarming. This is just a VDPV and we haven’t come across any child who has been infected with polio after 2011. But at the same time, we have to be alert, because if children are left out of the polio immunization program then they might get infected from these VDPV,” said Dr Sabyasachi Roy, paediatrician.
In New York City Sewage, a Mysterious Coronavirus Signal
“To have something in a sewershed that you’re detecting, you need a fair bit of it around,” said Dr. Adam Lauring, a virologist at the University of Michigan, who was not involved in the research.
Dr. Johnson, the Missouri virologist, agrees. He favors the hypothesis that the sequences are coming from animals, perhaps a few specific populations with limited territories. In May and June of 2021, when the number of human Covid-19 cases in the city was low, the mysterious lineages made up a greater proportion of the viral RNA in wastewater, suggesting that they may have come from a nonhuman source.
The researchers initially considered a diverse array of potential hosts, from squirrels to skunks. “This is a very promiscuous virus,” Dr. Johnson said. “It can infect all kinds of species.”
To narrow down the possibilities, they went back to the wastewater, assuming that any animal that was shedding virus might be leaving its own genetic material behind, too.
Although a vast majority of the genetic material in the water came from humans, small amounts of RNA from dogs, cats and rats were also present, the scientists found.
Dr. Johnson has been considering rats, which roam the city by the millions. In his lab, he created pseudoviruses — harmless, nonreplicating viruses — with the same mutations present in the cryptic sequences. The pseudoviruses were able to infect both mouse and rat cells, he found. The original version of the virus does not appear able to infect rodents, although some other variants, like Beta, can.
“So in and of itself, that isn’t huge data, but it is at least consistent with the idea that it’s coming from rodents,” Dr. Johnson said.