Positive samples of the polio virus found in wastewater in the United Kingdom and the United States have raised fears of a resurgence of this deadly disease. A leading expert is calling for widespread testing of polio antibodies in affected areas, to assess the risk to individuals and communities.
Concerns continue to grow that polio could re-emerge in the UK. After positive poliovirus samples were detected in London wastewater, the Joint Committee on Vaccination and Immunization (JCVI) advised polio booster doses directed at all children aged 1 to 9 in all London boroughs. She says this step will ensure a high level of protection against the virus and limit its spread. Some polio samples found in the UK have been genetically linked to a case reported in July 2022 in New York, where a state of emergency was declared.
Leading testing expert, Dr. Quinton Fevelman, Ph.D., and Chief Scientific Officer London Medical LaboratoryHe says: ‘The last case of polio in the UK was in 1984 and is clearly related to this type 2 (PV2) polio samples were detected in UK wastewater. Now the virus has been confirmed in London’s sewer system, and testing is being rapidly expanded to other areas. Additional wastewater treatment sites for sampling are located in parts of Birmingham, Blackburn, Bradford, Brighton and Hove, the city of Bristol, Bury, Castle Point, Glasgow, Leeds, Leicester, Liverpool, Luton, Manchester, North Tyneside, Newcastle upon Tyne, Gateshead, Nottingham, Preston, Salford, Sheffield and Watford.
Before the introduction of the polio vaccine in the 1960s and 1970s, polio infections were fairly common. In the 1950s, around 8,000 people each year were paralyzed from the disease in the UK alone.
While no confirmed cases of the virus, which can cause paralysis and death, have been detected in the UK so far, it seems prudent for the UK government to consider introducing polio antibody testing. This will reassure people that their polio vaccines are still effective and give us a broader idea of how well societies are protected. This move will enhance the current rollout of inactivated polio vaccine (IPV) boosters for children in London.
The areas selected for further wastewater testing were determined by factors such as demographics. For example, a potential cause for concern could be populations with links to countries abroad where wild poliovirus still exists or where live oral polio vaccine is still used. Other considerations include whether the community has low polio immunization coverage or is adjacent to sites in London where the polio virus has already been detected. These areas should also be considered for large-scale polio antibody testing, to get another idea of the potential caseload.
Some groups may be particularly at risk. The polio vaccination rate in London is around 86.6% overall, and 71.4% in booster preschools, according to the UK Health Security Agency (UKHSA). Less than half of 13-14-year-olds received a teenage polio booster in some parts of England in 2021, with only 35% of 13-14-year-olds receiving a polio booster in Hillingdon, West London, which had the worst coverage in the state.
Of the cases of poliovirus found to date, only a few have sufficient mutations to be classified as vaccine-derived poliovirus type 2 (VDPV2). VDPV2 is of greater concern because it behaves like “wild” polio that occurs naturally and can lead to paralysis in unvaccinated people.
Meanwhile, in the United States, health officials say wastewater samples in New York City and four neighboring counties have tested positive for the polio virus. Although only one case has been confirmed so far, it was the first in the country in nearly a decade. Britain’s UKHSA is working closely with health agencies in New York and Israel, along with the World Health Organization (WHO), to investigate links between the virus discovered in London and recent cases in these other two countries. Genetic testing showed that samples found in London were linked to the case of a man who had contracted polio in New York and to samples found in Israel.
Individuals are usually tested for the virus using stool samples. However, only a simple blood test is needed to determine whether a person has successfully developed antibodies after vaccination or is still retaining antibodies from childhood vaccination. It is true that these tests are currently very expensive and specialized, but this is because they were rarely required until now. The government should consider a more widespread antibody testing program similar to its response to Covid-19.
In the absence of readily obtainable polio antibody tests, public health testing may be a useful measure for anyone involved, to ensure that they are generally healthy to help combat symptoms of new viruses. The London Medical Laboratory Health Profile Test provides people with a comprehensive examination of their general health, including vitamin D levels, diabetes (HbA1c), liver and kidney function, complete blood count, bone health, iron levels and a complete cholesterol profile.