Polio is Coming Back: Should We Be Concerned?

Every time we start to believe that we are returning to “normalcy,” we are presented with another dilemma, recently in the form of a disease. In September, a New York adult was diagnosed with polio—the first U.S. case in nearly a decade. For many, it feels like an old disease has come back to haunt us, and that is rightfully scary. Polio has already left us scarred, and fears of history repeating itself are arising.

Polio is not a new disease—we see historical evidence of it dating as far back as the ancient Egyptians with their depictions of children with canes and withered limbs. The way we know polio today speaks to the epidemics and trauma that occurred from events in the 20th century. The first polio epidemic occurred between 1948 and 1955. Feared by most people, especially those in industrialized nations, polio paralyzed hundreds of thousands of children each year. The worst recorded outbreak of polio in New York was in 1952, which left about 3,000 dead.

But, the scariest part wasn’t the death toll—it was polio’s lasting effect on those who survived. Many survivors faced challenges like deformities and paralysis, and depended on technologies like artificial breathing devices. By the 1960s, polio was prevalent all over the world and was affecting over half a million people every year. With no success trying to finding a cure, scientists knew it was time to look at other options. The rise in deaths and paralyzed patients highlighted the need for a vaccine. Soon enough, scientists created two types of vaccines: Salk’s inactivated polio vaccine (IPV), licensed in 1955, and Albert Savin’s new oral vaccine (OPV) in 1961. The U.S. used the IPV as it was coming out, so when the OPV was issued, there was no transition into using it. In developing countries, like those in the Soviet Union, the ease that came with the administration of OPV made it the ideal candidate for mass vaccination campaigns.

Both vaccines did work. By 2003, we were only concerned with polio in six countries, and by 2006, it dropped to four. The 21st century saw further advances, with cases brought down by more than 99 percent worldwide in less than two decades.

Considering such promising numbers, polio resurfacing in Western countries was unforeseen to scientists. There does seem to be a loose explanation behind this rise. Due to recent pandemics involving diseases like COVID-19, public health officials have placed less emphasis on other diseases like polio in attempts to hone in on the current pandemic. People are shocked about this outbreak—polio “isn’t supposed to spread” in places with good sanitation and public health. But this mentality fails to realize the severity of polio that still exists in so many third-world countries.

Generally, the oral vaccine is safe and effective to administer. The endemic of polio would have been very different without the creation of the OPV. Even though a live version of the virus is used, the weakened virus is ideal to promote immunity, protecting those who receive the vaccine. The problem here is that if vaccination rates are low and the weakened virus keeps spreading, it can mutate into a new strain, which is called vaccine-derived poliovirus. This is what happened, as genetic analysis of New York poliovirus samples showed that it was a mutation of the weakened virus strain that afflicted the patient in New York. The virus was able to slip into the U.S. this year because of low vaccination rates in some communities and continued global travel, which is what happened in the Rockland County case. Because other countries were using the OPV while we were using the IPV, there was a tiny loophole for a slip-up, and that is exactly what happened.

So should we be concerned?

In terms of countries like the United States, it is important to be aware, but there is no need to panic. The most important thing is to make sure you are vaccinated. The patient in NY was unvaccinated, as are many people in that community, and those are the people who are most susceptible. Since polio is only preventable and not treatable, vaccines are of the utmost importance and if you are inoculated, statistics show that you will likely be okay.

But this news is a reality check for many. While we sit in our first-world countries in the comfort of our safety and fancy medications, others around the world don’t have access to the same materials: something government officials are finally starting to realize. Just recently, on October 18, global leaders confirmed U.S. $2.6 billion toward the Global Polio Eradication Initiative’s 2022-2026 Strategy to eradicate polio. Recent cases have highlighted the need for a global initiative. Even if one country has promising numbers, as highlighted by the German Federal Minister for Economic Cooperation and Development, no place is safe until polio has been eradicated everywhere. This is a wake-up call for many leaders, and with new initiatives being set in place, there seems to be hope for a safe and polio-free future.