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Health News -- December 12, 2022: In a few counties around the nation, the U.S. Centers for Disease Control
and Prevention (CDC) will selectively increase
wastewater testing for the poliovirus. The Philadelphia Department of Public Health (PDPH) and the Michigan Department of Health and Human Services (MDHHS) are two of the first organizations to investigate ideas for beginning to collect wastewater samples in particular communities for investigation at the CDC's polio laboratory. With a few other state and municipal health departments, preliminary negotiations are currently being held.
The results of the CDC's strategic wastewater testing program will assist authorities in deciding which communities of concern to target with vaccination campaigns. Wastewater testing will take place in a few areas where there is a chance that the polio vaccination rate is low or where there may be ties to at-risk New York towns because of a single paralytic polio case in Rockland County, New York. Testing will continue for at least four months after it has begun. With the help of the CDC, MDHHS and PDPH are able to pinpoint areas where poliovirus vaccination rates are low and where wastewater can be sampled.
“Wastewater testing can be an important tool to help us understand if poliovirus may be circulating in communities in certain circumstances,” said Dr. José R. Romero, Director of CDC’s National Center for Immunization and Respiratory Diseases. “Vaccination remains the best way to prevent another case of paralytic polio, and it is critically important that people get vaccinated to protect themselves, their families and their communities against this devastating disease.”
It's crucial to understand that testing for the poliovirus differs from testing for other infections like COVID-19. Testing for the poliovirus in wastewater is not commonly or routinely advised, and there are stringent safety guidelines for labs. However, judicious wastewater testing in a small number of at-risk communities can help identify the presence of the poliovirus in other regions of the country and can be used to focus vaccination campaigns to quickly increase local polio vaccination coverage if necessary. The CDC will help the chosen jurisdictions test wastewater over the coming months and will support them in reacting to positive wastewater detections and, if asked, in increasing immunization rates.
Poliovirus in sewage or wastewater is a sign that someone in the neighborhood is spreading the disease. Wastewater data can be used to improve other data that are utilized as part of polio prevention efforts, including quick investigation of suspected polio cases. Wastewater data cannot be used to determine or identify who is infected or how many people or households are impacted.
Testing wastewater for poliovirus would not be unexpected given that some forms of the virus can be transmitted in feces without causing symptoms, putting unvaccinated individuals at risk. Not every possible detection, though, will be alarming. Since the vast majority of Americans—more than 92% of them—were immunized as children, there is no risk to the general public in the United States. The entire recommended polio vaccination series is quite successful in avoiding paralytic polio, and practically everyone who has gotten the recommended doses of the vaccine is protected against severe disease. Modern sewage systems, wastewater management, and access to clean water all contribute to the containment of viruses like the poliovirus.
Unvaccinated people are at danger of contracting the poliovirus when it is discovered in areas with poor vaccination rates because it can spread to them. To stop further paralytic polio cases in the United States, vaccine coverage must be increased. Rapid reporting and national case surveillance are also important.
No matter where they reside, children and adults must receive the entire polio vaccine in order to successfully protect them from polio-related sickness and disability.
