News

POLIO OUTBREAKS 2023

Authored by Staff

Last reviewed March 12, 2023

Fact checked by Robert Carlson, MD

Fact checked by Holly Lutmer PharmD

CONTENT OVERVIEW

Poliovirus detection in Montreal, New York, London, Israel in wastewater continue in 2023. Polio outbreak information is fact-checked by medical professionals.

Polio Outbreaks March 2023

Poliovirus (Poliomyelitis) has been recently confirmed in wastewater and ground samples in non-endemic countries in Africa, the Americas, Asia, Canada, Europe, India, Israel, the United Kingdom, and New York (NY).

To notify the international community, the U.S. Centers for Disease Control and Prevention (CDC) issued an updated Global Polio Alert – Level 2, Practice Enhanced Precautions notice on March 7, 2023, regarding polio outbreaks and poliovirus detections in various countries. As of March 10, 2023, the New York Department of Health informed New Yorkers planning to visit Israel in 2023 and other countries with circulating poliovirus to confirm their polio immunization status prior to traveling abroad.

On September 13, 2022, the U.S. was added to a list of about thirty countries where circulating vaccine-derived poliovirus (cVDPV) was recently identified. On September 1, 2022, the CDC’s Clinician Outreach and Communication Activity Call presented: How to Recognize and Report Polio and Reinforce Routine Childhood Polio Vaccination.

As of March 2, 2023, there has been 1 confirmed polio (acute flaccid paralysis) case and 7 reports of patients under investigation in the U.S. (Washington) during 2023. There have been 723 confirmed polio cases in the U.S. since August 2014. An interactive timeline traces polio outbreaks from 1580 B.C. to 2022.

WHO Polio Public Health Emergency of International Concern 2023

On February 2, 2023, the World Health Organization (WHO) confirmed the spread of poliovirus remained a Public Health Emergency of International Concern (PHEIC) concerning Wild poliovirus type 1 (WPV1) and Circulating vaccine-derived poliovirus and recommended the extension of Temporary Recommendations for three months. This WHO issued a report (EB152/19, Dec. 2022) on implementing the Strategic Action Plan on Polio Vaccine Transition (2018–2023). In addition, the polio-endemic countries of Afghanistan and Pakistan have been associated with recent polio outbreaks in other countries, according to the Global Polio Eradication Initiative (GPEI).

Poliovirus Wastewater Detections 2023

Related poliovirus type 2 (PV2) isolates were identified in sewage samples collected in Canada, London, Israel, and New York in 2022. As a result, the U.S. CDC announced on November 30, 2022, that it would expand wastewater testing in the U.S. Dr. José R. Romero, Director of CDC’s National Center for Immunization and Respiratory Diseases, indicated that poliovirus testing would continue into early 2023.

Poliovirus Detroit, Michigan

The U.S. CDC announced plans to collect wastewater samples in communities near Detroit, Michigan. Preliminary testing will last at least four months. Oakland County, Michigan’s population is about 1.2 million. On August 23, 2022, Michigan reported 31% of young children were overdue for routine vaccinations, including polio.

Poliovirus Philadelphia, Pennsylvania

The U.S. CDC announced it would begin collecting wastewater samples from Chester County, with a population of about 500,000 near Philadelphia, PA, for analysis at CDC’s polio laboratory.

Poliovirus New York March 2023

As of March 8, 2023, the U.S. Centers for Disease Control and Prevention (CDC) and the State of New York confirmed sequencing analysis confirmed the presence of circulating vaccine-derived poliovirus (cVDPV2) in 100 samples collected genetically linked to a polio patient (Acute flaccid myelitis) identified in July 2022 in Rockland County, NY, signaling its continued circulation and a health risk to residents.

To enhance local detections, the New York State Department of Health announced on January 23, 2023, that it received $21.6 million in funding to expand its wastewater surveillance and infectious disease monitoring capabilities. NY’s wastewater network reaches all 62 New York counties and, during 2023, will increase the number of participating sewer sheds from 125 to over 215, reaching 16 million New Yorkers, about 81% of the population served by public sewer systems.

Beginning in April 2022, genetically related poliovirus has been detected in wastewater samples collected in Rockland County, Orange County, Sullivan County, Nassau County, Brooklyn (Kings County), and Queens County. On September 28, 2022, a ‘Declaration of an Imminent Threat to Public Health for poliovirus’ was issued by Mary T. Bassett, M.D., M.P.H. Commissioner of Health, NY.

In response to these poliovirus wastewater findings, the Governor of NY, Kathy Hochul, announced on October 9, 2022, she extended Executive Order 21.1, expanding the vaccination authorities for certain NY health providers. And New York State issued HEALTH ADVISORY Update #3 Regarding Poliovirus, which says unvaccinated New Yorkers or those not up to date with immunizations who live, work, go to school in or visit Rockland County, Orange County, New York City, Sullivan County, and Nassau County are at risk of contracting the paralytic disease and should speak with their healthcare provider regarding polio vaccination options.

As of March 2023, the New York Health Department states that under specific situations, a one-lifetime booster dose of IPV should be offered to adults who have previously completed their polio vaccination series and are at the highest risk of infection. Areas considered to have community transmission of poliovirus include those where poliovirus has been repeatedly detected in wastewater. As of January 27, 2023, polio booster doses are not recommended for individuals traveling to the New York City metropolitan area, including Rockland, Orange, or Sullivan Counties, merely because of their travel status.

Local polio vaccination resources: Nassau County, NY, webpage, New York City locations; Orange County, NY, webpage, Rockland County, NY, areas, Sullivan County, NY, Public Health at 845-513-2249, and Cattaraugus County, (NY) Public Health.

Polio in the Americas

As of March 2023, the Pan American Health Organization (PAHO) published AFP Surveillance Data segmented by Country for 2022.

Poliovirus Montreal Canada

On December 23, 2022, the Canada IHR National Focal Point reported detecting a vaccine-derived poliovirus type 2 (VDPV2) in various wastewater samples collected in August 2022 from a wastewater treatment plant and a target site in the city of Montreal, Quebec. Genetic sequencing confirmed it was linked to the cVDPV2 recently detected in New York. Additionally, in January 2023, two cVDPV2-positive environmental samples were collected in Canada. As of January 30, 2023, there have been no confirmed or suspected cases of acute flaccid paralysis (AFP) being investigated in the affected Canadian jurisdiction in 2022 – 2023.

Polio Israel 2023

As of March 10, 2023, Israel has been confirmed with both cVDPV2 and cVDPV3, and there is evidence of the continued existence of poliovirus in the wastewater sewage of many localities. In early March 2023, JPost reported the Health Ministry announced that an unvaccinated child from the Safed region in Galilee arrived at Ziv Medical Center and was found positive for (cVDPV2) acute flaccid paralysis (AFP). On March 2, 2023, the Times of Israel reported the Health Ministry confirmed three other children tested positive for poliovirus.

Poliovirus London

The UK Health Security Agency (UKHSA) declared a “national incident” in June 2022 after poliovirus detection in sewage in London, England. Detection of 118 genetically linked poliovirus isolates related to the serotype 2 Sabin vaccine strain collected in 2022, reported The BMJ and The Lancet. In addition, vaccine-derived poliovirus type 2 isolates environmental samples were found in several north and east London boroughs that were genetically linked to a polio case reported in New York and Israel.

Acute Flaccid Myelitis Polio-Like Virus

The U.S. CDC reported on March 2, 2023, there has been one confirmed AFM case in 2023 out of 7 reports of patients under investigation. AFM is an uncommon but serious neurologic condition caused by viruses, including enteroviruses (EV-D68). It affects the nervous system, specifically the area of the spinal cord called gray matter, which causes the muscles and reflexes in the body to become weak.

During 2022, the CDC reported 43 confirmed AFM cases in 24 states, indicating about a 35% increase from 2021. There have been 723 confirmed cases (children) since the CDC began tracking AFM in August 2014.

Acute Flaccid Paralysis

Acute Flaccid Paralysis (AFP) surveillance is the standard for detecting cases of poliomyelitis in anyone under 15 years of age. For AFP surveillance standards, please visit the WHO-recommended surveillance standard of poliomyelitis. Date of last update: 10/09/2022.

Post-Polio Syndrome

As polio survivors progress through life, a significant proportion develops neurological symptoms known as Post-Polio Syndrome (PPS), says the U.S. NIH. Characterized by new, gradual, and progressive muscle weakness and wasting, difficulty swallowing, joint or muscle pain, and general fatigue after being stable for many years, the non-contagious PPS typically develops 15 to 40 years after people have recovered from polio.

The first medical reports of PPS appeared in France in 1875. Further research published in the 1950s identified significant damage to nerve cells within the spinal cord. However, as the UK-based Polio Survivors Network concludes, PPS has no set pattern of nerve damage. The U.S. CDC posts additional clinical and diagnostic information about poliovirus infection as of August 10, 2022.

Poliovirus Shedding

The WHO, the UK Health Services Agency, the European CDC, and the U.S. National Institutes of Health (NIH) say three types of vaccines can prevent polio but they may indirectly enable virus shedding. However, research demonstrates that poliovirus transmission predominantly follows the oral-fecal route. In addition, concerns remain about the potential for persistent transmission of OPV viruses, as these viruses are known to revert toward wild-type neurovirulence.

Polio Vaccines Approved

Polio is a vaccine-preventable disease, says the U.S. CDC. For the latest polio vaccine information, visit this PrecisionVaccinations webpage.

Polio Outbreak News 2023

March 10, 2023 – New York issued a travel advisory for anyone visiting Israel.

February 23, 2023 – Wastewater sequencing analysis by the CDC confirmed the presence of poliovirus in a total of 100 positive samples of concern in New York.

December 23, 2022 – Canada reported detections of VDPV2 in wastewater samples.

December 19, 2022 – The WHO announced polio had become a high-risk disease in Indonesia.

December 7, 2022 – The WHO reported 2.61 million under-five children were immunized with the trivalent oral polio vaccine in Somalia.

November 30, 2022 – “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.

November 17, 2022 – The latest Annenberg Science Knowledge national panel survey finds that a sizable portion of the U.S. public is unfamiliar with the risks of polio. Only a third of U.S. adults know there is no cure for polio, and over 22% of adults do not know whether they’ve been vaccinated against polio.

October 27, 2022 – New York State Health Department issued a Polio Letter to Providers & Polio Publication Request Form – Notification ID: 109528 – This is an urgent plea: as the most trusted source of medical guidance for your patients and their families, we need your help to make sure that any child who is not vaccinated or up to date with polio immunizations gets all the recommended doses immediately. This is particularly urgent for providers and patients in Rockland, Orange, and Sullivan Counties, where poliovirus has been detected in wastewater repeatedly.

October 19, 2022 – The UK Health Security Agency is investigating the extent of poliovirus transmission across north-east and north-central London. Based on recent sampling, poliovirus is considered present in sub-areas of the Beckton plant covering all or parts of the following London boroughs: Barnet, Brent, Camden, Enfield, Hackney, Haringey, Islington, and Waltham Forest. The sampling has also detected the virus in lower concentrations and frequency in areas adjacent to the Beckton catchment area to the South (immediately below the Thames) and the East.

October 12, 2022 – The Lancet published: Sustained detection of type 2 poliovirus in London sewage between February and July 2022. Interpretation: Environmental surveillance allowed early detection of poliovirus importation and circulation in London, including whole-genome sequences generated through nanopore sequencing, established linkage of isolates and confirmed transmission of a unique recombinant poliovirus lineage that has now been detected in Israel and the USA.

October 9, 2022 – New York state extends and expands Executive Order 21.1 – Continuing the Declaration of a Statewide Disaster Emergency Due to the Ongoing Spread of Polio in the State of New York.

September 28, 2022 – New York State Department of Health issued Advisory #3 regarding poliovirus detections. It recommended polio-preventive vaccinations, and the Commission issued a Declaration of an Imminent Threat to Public Health for poliovirus.

September 9, 2022 – NY State Health Department confirmed that of the 50 wastewater samples, 31 poliovirus samples were collected in Rockland County, 13 in Orange County, 6 in Sullivan County, and 1 in Nassau County. In response, NY’s governor declared a State of Disaster Emergency.

September 2, 2022 – The UKHSA reported following advice from the Joint Committee on Vaccination and Immunisation that all children aged 1 to 9 years in London need to have a dose of polio vaccine now – whether it’s an extra booster dose or to catch up.

September 1, 2022 – The U.S. CDC is investigating a case of poliomyelitis, or paralytic polio, in New York state.

August 26, 2022 – The New York State Department of Health confirmed that sequencing analysis performed by CDC has now detected poliovirus in four samples from Sullivan County, two collected in July and two collected in August, which are genetically linked to the case of paralytic polio previously identified in Rockland County. Already, poliovirus had been identified in samples collected in Rockland County, Orange County, and NYC, the types of poliovirus that can cause paralysis in humans.

August 25, 2022 – The JAMA Network published a Perspective: What Physicians Need to Know About the Polio Resurgence in New York State.

August 19, 2022 – New York Department of Health HEALTH ADVISORY: Update #2 Regarding Poliovirus in New York State: All children, adolescents, and adults who are unvaccinated or under-vaccinated should be brought up to date with all routine CDC-recommended IPV doses. This is particularly important and urgent if they live, work, attend school, or have frequent social interactions with Rockland and Orange Counties communities.

August 19, 2022 – The U.S. CDC published: Public Health Response to a Case of Paralytic Poliomyelitis in an Unvaccinated Person and Detection of Poliovirus in Wastewater — New York, June–August 2022. Twenty specimens from wastewater samples collected during May, June, and July were genetically linked to viruses from the patient’s stool samples. This case highlights the risk of paralytic disease among unvaccinated persons.

August 17, 2022 – Long-Term Immunogenicity of Inactivated and Oral Polio Vaccines: An Italian Retrospective Cohort Study. Protective antibodies against all three polioviruses persisted for at least 18 years after administration of the last vaccine dose.

August 16, 2022 – The U.S. CDC issued an MMWR – Public Health Response to a Case of Paralytic Poliomyelitis in an Unvaccinated Person and Detection of Poliovirus in Wastewater — New York, June–August 2022.

August 12, 2022 – Poliovirus Confirmed in NYC’s wastewater by the New York State Department of Health. and NYC Health issued: 2022 Health Alert #20: Update on Poliovirus in New York City.

August 4, 2022 – “Based on earlier polio outbreaks, New Yorkers should know that for every one case of paralytic polio observed, there may be hundreds of other people infected,” State Health Commissioner Dr. Mary T. Bassett said. HEALTH ADVISORY #1: Update Regarding Poliomyelitis in Rockland County, New York State.

July 13, 2022 – Israel’s Ministry of Health published updated polio vaccination guidelines #6.

July 3, 2022 – Israel’s Operation Two Drops 2022 polio vaccine program reached over two million children.

April 2, 2022 – Israel reported potentially eight polio cases in 2022.

March 15, 2022 – The Israeli Ministry of Health, under guidance from the Consultant Committee on Poliovirus, launched a nationwide vaccine operation, ‘Two-Drops 2022,’ for additional vaccination against polio for children.

1997 – Duration of Poliovirus Excretion and Its Implications for Acute Flaccid Paralysis Surveillance: A Review of the Literature.

 

 

 

https://www.precisionvaccinations.com/polio-outbreaks-2023

Polio victims face increasing problems

 

THOUSANDS of polio victims around the world who survived post-war epidemics of the crippling illness are battling a cruel second phase of the disease most thought they had beaten.

Post-polio syndrome, identified polio have nerve cells that were 9 only in the past few years, over-functioning for many years has produced a growing number — they have been trying to of support groups for victims as compensate for lost cells. But well as specialists clinics.

after a number of years, these Experts studying the cells cannot maintain all of the syndrome agree it is not a recurence functions of the muscle they used of the polio virus, but an to.” onset of fatigue, pain and muscle That was a speculative theory weakness caused by failing nerve in 1982 when doctors first began cells which have been working paying attention to the problem, overtime for 30 years or more to he said, but now we have the compensate for the damage done evidence to prove it. It is a by the original infection.

process that continues for many

years. The whole system is Wiped out

trying to remodel itself, but it Polio has been all but wiped

cannot do any more remodell out in industrialised nations since the advent of vaccines in 1955. Less than a dozen cases occur in

Syndrome the United States each year.

He said the syndrome was not But it remains a killer and a life-threatening but could incapacitate çrippler in less developed areas. It’s effects were worst with at least 300.000 cases of among people who had the dis paralytic polio around the globe ease most severely first time each year. around. In the United States, as many He said there was no overall as a third of the 300.000 polio therapy for the syndrome, victims who survived epidemics after World War Two are although doctors had experi believed to be at risk from post experimented with certain drugs. They had also encouraged patients to polio syndrome. use walking sticks or braces and Neurologist Dr Varinos had instructed them how to Dalakas said: “Patients with old compensate for the problems.

Fighting for people affected

by polio’s second blow

The polio epidemics of the 1940s and 1950s

EING in an iron lung is The pol

about three days a week, at Cherry like lying in a coffin with

Orchard in an iron lung, which I your head sticking out. affected an estimated 9,000 people in the State, have had specially adapted so I Contytwo years ago, when most of them children. Many recovered to live

can use the telephone, the TV, the I was first placed in the iron lung,

lights and the radio — all through I was so terrified one of the nurses normal lives, but sadly, in their 40s and 50s, controls at my feet, one of which would open the lung, the pains.

operates a telephone headset, and aches were secondary. Pain is

about half of polio survivors are developing which comes down on an electric secondary to your need to take post-polio syndrome, a debilitating neurological

arm when I need to use it. The your next breath.

entire staff has been most helpful When the iron lung was opened,

), chairman of the to me over many, many years, get you.could not breathe. A team of

ting me through a number of criti nurses would come to change your

Post-Polio Support Group, is trying to help cal illnesses. sheets or pyjamas so that it would

The rest of the week I live in my be done very efficiently and fast.

mews in Ballsbridge, which I share They would open the iron lung international between Ireland and Dublin. You recover to a certain with my partner of 15 years, and you would be lying there go- Scotland. The doctors reckoned I point, and then stop.

Delia. At home, I use a Nippy por ing blue, fully conscious, but got the polio from a carrier in the Polio is very indiscriminate in table-respirator for 12-14 hours a struggling to breathe. The nurses crowd in the main terrace at the way that it attacks. Some day. would be watching your colour so Lansdowne Road. No one else at people are affected in one part of

people are affected in one part of My personal assistant, Trish, is they would know when you Clongowes was affected. My two the body, then fully recover. like a pair of arms for me. She needed to get back inside the iron great interests are rugby and rac- Others are affected in the whole of dresses me, feeds me and does all lung, fast.

ing and I still go to Lansdowne their body, then only partially the normal things for me that one I was diagnosed with polio in Road with my lifelong school recover in the upper half, leaving would normally do with one’s Joan Bradley, secretary of the Post in that it causes a second disabil 1958 at the age of 15, which is friend Phil Mooney, who has them in a wheelchair which is the arms — dressing, feeding, scratch- Polio Support Group, have been ity through one or all of the unusual because 90 per cent of po- spent his life in youth rugby classic image of polio. I’m one of ing my nose and even going to the organising next weekend’s confer- following symptoms: extreme fa lios were affected as younger training.

the small percentage of “upside toilet. She carries my briefcase ence, Polio in the 21st Century. tigue; pain in muscles and joints; children.

The polio paralysed me from down polios” because I was para- around and helps me with my Since 1994 I have worked on a decline in ability to carry out cus As a child I was a ruffian. My the waist up, attacking my lungs lysed in the upper body. I can paperwork.

voluntary basis as chairman of the tomary daily activities such as mother used to say if you were and making it impossible to walk normally, but I must wear a When I’m lying in the iron lung Post Polio Support Group. Since I walking; swallowing and respira looking for me, you’d find me at breathe. I spent nearly nine brace to support my back and my

cannot use my hands, I use a tory difficulties, which may pres the top of the nearest high tree. months in an iron lung without arms are paralysed.

times my thoughts are racing and voice-activated laptop computer ent as problems relating to sleep. When I got polio, it caused quite a , getting out of it in Cherry Orchard I have a very slight amount of I cannot sleep. I have a device to write, correspond through Diagnosis in people who be scare because I was one of 360- hospital. The process of recovery movement in my left hand. You which enables me to use the tele- email and surf the Internet.

lieved they had recovered may be odd boys in Clongowes school in was very gradual. I had three years have to do the most you can with phone so I can stay in touch with According to international difficult, because many polio sur Co Kildare, and the diagnosis of treatment in hospital — first at what you have.

the outside world. I cannot write research, some 40-60 per cent of vivors were encouraged to forget raised the possibility there was a Cherry Orchard, then at the In my 20s I worked in the fam- so when I have an idea in the polio survivors develop post-polio they ever had the disease. Polio is carrier in the school and others world-renowned Nuffield Ortho- ily business, a clothing shop, middle of the night at Cherry Or- syndrome 20-40 years after_sur- not on their current medical might have been infected. In those paedic Centre in Oxford, England. O’Reilly’s, in Earl Street. When chard, I leave it on the answering viving the initial epidemic. They records so when they go to their days students very seldom got out I spent most of those three hospi- that was sold I was in the restau- machine in the office of the post- have led useful, independent lives, GPS complaining of symptoms,

once or twice a term if you tal years in a wheelchair and grad. rant trade for a while, then dab- polio support group in Carmichael often with very little contact with neither they nor their doctors were lucky.

ually learned to walk during bled in a small way in the property House.

the medical profession. Develop- relate the symptoms to the polio, About two or three weeks before several years as an outpatient at business.

For the past year, with the helping the syndrome is a hard blow to they had as children. I got polio, I had been at a rugby the Central Remedial Clinic in I still spend 12-14 hours a day, of a dedicated committee, I and someone who is already disabled We commissioned a profes

‘They would open the iron lung and you would be lying there going blue, fully conscious, but struggling to breathe

 

at Cherry lung, which I adapted so I, the TV, the all through one of which one headset, on an electric to use it. The n most helpful years, get umber of

I live in my , which I share of 15 years, Nippy 12-14 hours a

Jim Costello: “I know lots of lads I was in school with who never had polio and they’re dead now and I’m not.’ Photograph: Pat Langan

;

, Trish, is s for me. She le and does all or me that one o with one’s Joan Bradley, secretary of the Post in that it causes a second., scratch-. Polio Support Group, have been ity through one or all of the en going to the organising next weekend’s confer- following symptoms: extreme fa my briefcase, Polio in the 21st Century. fatigue; pain in muscles and joints; me with my Since 1994 I have worked on a decline in ability to carry out cus

voluntary basis as chairman of the customary daily activities such as the iron lung Post Polio Support Group. Since I walking; swallowing and respira at night, some- cannot use my hands, I use a tory difficulties, which may pres- are racing and voice-activated laptop computer ent as problems relating to sleep. have a device to write, correspond through Diagnosis in people who be o use the  email and surf the Internet.

they had recovered may be in touch with According to international difficult, because many polio sur I cannot write research, some 40-60 per cent of were encouraged to forget n idea in the polio survivors develop post-polio they ever had the disease. Polio is at Cherry Or- syndrome 20-40 years after not on their current medical the answering the initial epidemic. They records so when they go to their of the post- have led useful, independent lives, GPs complaining of symptoms, in Carmichaeloften with very little contact with neither they nor their doctors

the medical profession. Develop- relate the symptoms to the polio with the helping the syndrome is a hard blow to they had as children. committee, I and someone who is already disabled We commissioned a professional survey which found many may have to wait a year or post-polio people were in urgent two just to be assessed for things need of things such as bathroom such as bathroom adaptations. adaptations, electric wheelchairs I’m lucky that I am not affected and many other aids and appliances by post-polio syndrome at the mo. We have many polio survivors, and that I have the in who have worked all their dependent financial means to lives but who have earned relatively low incomes have a part-time carer and the  but just aids and appliances I depend on. I above the limit for a medical card. never worry about my condition. I This gives them very little hope know lots of lads I was in school because they cannot afford to pay with who never had polio and for the appliances, aids and physiotherapy they need they’re dead now and I’m not. . We’ve been fighting for medical cards for • The medical conference, Polio polio survivors for many years in the 21st Century: The Late Ef without much success.

of Polio and Post-Polio Another problem is that within drome, will be held on Friday and the community-care system there Saturday at the Green Isle Hotel, is a lack of occupational therapists Dublin. Further information: tel and physiotherapists, so polio sur- (01) 873-0338

1952 newspaper clipping reporting on polio cases

The Sunday Tasmanian 8 August 2010

ScienceDaily

Survivors Of Childhood Polio Do Well Decades Later As They Age

Date: August 27, 2006

Source: Mayo Clinic

Summary:

Mayo Clinic researchers have found that years after experiencing childhood polio, most survivors do not experience declines greater than expected in their elderly

counterparts, but rather experience only modest increased weakness which may be commensurate with normal aging.

FULL STORY

Mayo Clinic researchers have found that years after experiencing childhood polio, most survivors do not experience declines greater than expected in their elderly counterparts, but rather experience only modest increased weakness which may be commensurate with normal aging.

“Other researchers have suggested that polio is a more aggressive condition later in life, but we’ve actually found it to be relatively benign,” says Eric Sorenson, M.D., Mayo Clinic neurologist and lead study researcher. “Our results suggest that polio survivors may not age any differently than those in the normal population – they’re not doing too badly compared to their peers. This tells us that the cause for the decline in muscle strength in polio survivors may be ageing alone.”

Polio is a contagious, viral illness that peaked in the United States in 1952, when 3,000 people died of the disease. Mass immunizations in the mid-1950s began to slow the spread of the disease, and the last case of polio not caused by a vaccine occurred in the United States in 1979. The three major types of polio include spinal polio, a paralytic polio that attacks nerve cells in the spinal cord; bulbar polio, in which the virus attacks motor neurons in the brainstem, and bulbospinal polio, a combination of spinal and bulbar polios. The effects of polio run the gamut from a complete return to normal function to paralysis of limbs to acute death. Following the illness, most patients are worried about their long-term prognoses, according to Dr. Sorenson,

To conduct this study, the researchers randomly selected a group of 50 polio survivors from the general population of Olmsted County, home of Mayo Clinic, and followed them for 15 years. The average age of participants at the study’s start was 53, and the patients were an average of 40 years past their childhood experience with polio. The researchers measured strength and loss of neurons at the beginning of this period, and then again five and 15 years later with

electrophysiological testing, strength testing and timed tests of performing basic functions. They found modest declines. Each patient also completed questionnaires about symptoms of progressive weakness at the beginning and end of the study period. Though the majority complained of progressive weakness during the time they were studied, these symptoms did not correspond with

their actual magnitudes of decline over time. Rather, the researchers found patients’ symptoms experienced were associated with the degree of residual weakness immediately following their polio infections.

“Overall, we found that strength changed very little in these polio survivors as they grew older, and we discovered the neurons dropped off at a rate comparable to other non-polio survivors as they aged,” says Dr. Sorenson. “We concluded this was normal aging on top of their old deficits. Very few had to change their homes or add adaptive equipment. Those who had weakness problems during our study had a larger deficit at the end of their childhood disease, making them more likely to develop symptoms. So, as deficits at the end of the disease increase, the probability of experiencing post-polio symptoms increases.”

The discrepancy between what some of the patients experienced with growing weakness and their actual measurements of strength and neuronal loss likely is due to increased sensitivity due to their disease experiences, according to Dr. Sorenson.

“Patients feel their weakness progressing, but when you measure it, it’s very modest,” he says. “Likely, they lost so much strength at the time of their illness that any change is very noticeable to them. Though the likelihood is high that patients who have had childhood polio will complain of weakness later in life, they can expect years of stability without the need for major lifestyle modifications.”

Other Mayo Clinic researchers involved in this study include Anthony Windebank, M.D., and Jasper Daube, M.D.

Story Source:

Materials provided by Mayo Clinic. Note: Content may be edited for style and length.

Cite This Page:

MLA

APA

Chicago

Mayo Clinic. “Survivors Of Childhood Polio Do Well Decades Later As They Age.” ScienceDaily. ScienceDaily, 27 August 2006. <www.sciencedaily.com/releases/2006/08/060826171832.htm>,

Many polio survivors faring well

Please note: This article was published more than one year ago. The facts and conclusions presented may have since changed and may no longer be accurate. And “More information links may no longer work. Questions about personal health should always be referred to a physician or other health care professional.

By Angela Pirisi HealthDay Reporter

THURSDAY, Aug. 24, 2006 (Health Day News) — In most cases, polio may not have the severe long-term effects on survivors that experts have previously feared, a new study finds.

A team from the Mayo Clinic found that survivors did much better as they aged than had been expected, with most only suffering a modest increase in muscle decline over time. Very few of the study participants had to adapt their homes or move out due to crippling symptoms, the researchers said.

“Our polio studies have demonstrated that these aging survivors of poliomyelitis do slowly weaken over time, however, this change is very modest in the majority,” said study author Dr. Eric ]. Sorenson, a Mayo Clinic neurologist.

His team published its findings in the August issue of the Journal of the Peripheral Nervous System

 

For many childhood polio survivors, their battle with a potentially crippling and fatal virus that ravaged the world over half a century ago is more than a terrible memory

 

Decades later, symptoms can resurface or worsen, usually marked by pain and weakness that affects survivors quality of life. The fear of further physical deterioration and disability often plagues polio survivors, Sorenson added.

But the new study “allows us to be reassuring even to those polio survivors with significant deficits,” Sorenson said. That means a better long-term prognosis, which is the main concern of patients.

 

In the study, the Mayo group tracked changes in strength and motor function for 50 polio survivors (average age 53) in Olmsted County, Rochester, Minn, for a period of 15 years. The participants were an average of 40 years past their childhood experience with polio when the study began. Participants also answered a related questionnaire.

 

According to the researchers, participants did lose some strength over the 15-year study period, but this decrease was relatively small, Motor neurons — which control motor function — dropped off with advancing age at a rate that was comparable to non-polio survivors. The majority of study participants did complain of progressive weakness over the 15-year study period, however.

Survivors who were most affected by polio earlier in life, or with the greatest residual weakness, were most likely to be aware of their slow deterioration, the researchers said, perhaps because they had learned to expect a decline. However, measurements suggest that these individuals didn’t get worse any faster than others in the study.

 

“This study sheds some objective light on polio, showing that at least some of the deterioration is neurological and that the decline in function is real, not imagined. So, it’s reassuring to polio survivors that their decline has some neurologic basis,” said Dr. Nancy Green, Medical Director at the March of Dimes.

 

Post Polio Syndrome (PPS), which occurs in two-thirds of survivors, is the re-emergence or worsening of residual deficits decades after the childhood infection, Green said. Problems can include worsening weakness and/or pain, as well as problems eating, swallowing, or breathing.

According to another expert, a loss of motor neurons — the nerve cells in the spinal cord that control muscles — occurs in normal aging, as well. But since polio has already depleted

ny of these neurons earlier in life, they have less of a reserve when they start aging

“There’s a threshold of strength required to do anything, like lifting half a gallon of milk. For people without polio, there’s a big reserve of strength, and even if they lose a little, they can compensate, whereas polio survivors have less strength to start, so every bit seems to count for more,” sad Dr. Julie Silver, director of the International Rehabilitation Center for Polio at Spaulding Rehabilitation Hospital, in Framingham, Mass.

Polio survivors are also at a higher risk of other musculoskeletal problems, such as Osteoarthritis and overuse injuries, which are often treatable. The tricky part about labeling al physical problems as PPS is that it may overlook other conditions, Sorenson said. That means survivors may not get the appropriate attention or treatment that they should.

“I think as they age, almost all polio survivors have special needs, but while they may experience increased disability, they do much better with proper intervention and treatment,” said Silver, who is also an assistant professor in the department of physical medicine and rehabilitation at Harvard Medical School. For example, many polio survivors who rely on crutches or a cane can develop carpal tunnel syndrome, which can be surgically cured, she said

There’s more on polio and PPS at the March of Dimes.

SOURCES: Eric ). Sorenson, M.D., section head, neurology, Mayo Clinic, Rochester, Minn; Nancy Green, M.D., medical director, March of Dimes, White Plains, N.Y.; Julie Silver, M.D., director, International Rehabilitation Center for Polio, Spaulding Rehabilitation Hospital, Framingham, Mass., and assistant professor, department of physical medicine and rehabilitation, Harvard Medical School, Boston; August 2006 Journal of the Peripheral Nervous System

Last Updated: Aug 24, 2006

Copyright © 2006 ScoutNews, LLC. All rights reserved.

NEWS Health ‘No polio effects’ in later life

BBC

Many ‘defenceless’ against polio

27 Jul 06 Health UK funding ‘to help polio fight

News Front Page

Page Last Updated: Saturday, 26 August 2006, 23:55 GMT 00:55 UK

‘No polio effects’ in later life

England Northern Ireland Many people who survive Scotland polio in childhood will not suffer further effects later in Business e, say US researchers.

Politics

The Mayo Clinic team looked at Health

50 people who had had the Medical notes disease as children and found

Education most did not suffer any polio

Science & related decline when older. Environment

A vaccine against policores cut the Technology However, critics said the sample Entertainment was small, and possibly not representative, Also in the news

Polio has been wiped out in most places but remains a threat, Video and Audio particularly in India, Pakistan and Nigeria.

Q&A: Polio 31 May 05

Medical notes

RELATED INTERNET LINKS

Journal of the Peripheral Nervous System Post-Polio Health International Global Polio Eradication Initiative The BBC is not responsible for the content of external internet sites

Hospitals ‘eyeing private market’ Stem cell method put to the test Stem cell ‘hope’ for arthritis

News feeds

MOST SHARED

Have Your Say Experts said the Journal of the Peripheral Nervous System

Magazine paper offered reassurance to polio survivors. In Pictures

Polio is a contagious, viral Country Profiles

liness which can attack nerve that the polio survivors who Special Reports

cells in the spinal cord or motor are having the most problems

neurones in the brainstem. In SPORT

some cases, it affects both.

acute polion yelitis WEATHER People who contract the

Joan Headley Post-Polio Health CBBC NEWSROUND disease may not be left with

International ON THIS DAY

any lasting effects – but polio can cause paralysis or even EDITORS’ BLOG death.

DOLU

the

BBC News

It affected thousands of children across the world before widespread vaccination programmes were introduced in the

1950s and 60s.

BBC News BBC News BBC News BBC News BBC News Church ‘colluded’ with sex abuse bishop UK rail ticket machines hit by IT glitch BBC News BBC News

Now, 98% of all cases are found in India, Nigeria and Pakistan.

Modest declines

People who have had polio worry about long-term effects.

Most popular now, in detail

In this study, researchers randomly selected a group of 50 polio survivors, with an average age of 53, from the area around the Mayo Clinic.

The researchers measured muscle strength, heart rhythm and nerve cell loss in the brain at the start of the study, and then carried out the same tests five and 15 years later.

It was found that people experienced only modest functional declines, in the same way that anyone in their sixties might.

Questionnaires filled in by the patients revealed most complained of progressive weakness during the time they were studied.

However, these symptoms did not correspond with their actual magnitudes of decline over time.

http://news.bbc.co.uk/1/hi/health/4799725 stm

07/08/2017

BBC NEWS 1 Health “No pollo effects’ in later life Instead, it was linked to the degree of residual weakness immediately following their polio infections.

Dr Eric Sorenson, who led the study, said: “Other researchers have suggested that polio is a more aggressive condition later in life, but we’ve actually found it to be relatively benign.

“Our results suggest that polio survivors may not age any differently than those in the normal population – they’re not doing too badly compared to their peers.”

He added that the findings should be comforting to people worried about polio-related decline later in life.

“Though the likelihood is high that patients who have had childhood polio will complain of weakness later in life, they can expect years of stability without the need for major lifestyle modifications.”

Joan Headley, executive director of the US organisation Post Polio Health International, said: “The Mayo study is important because it follows people over many years, while other studies may represent just a snippet in time.

“The research emphasises that the polio survivors who are having the most problems now are those who had the greatest weakness during the acute poliomyelitis.

“That fact can be reassuring to those survivors who have heard a very disturbing message about the ravages of post-polio syndrome for all polio survivors.”

However she said the fact that declines may be small, but could be noticed by individuals was important

“That really is the crux of the matter for the members we serve.

“If you are that polio survivor, the new weakness can have a major impact on your day-to-day activities.”

Critics warned that, as the people in the study were drawn from a small geographical area, it was possible they were infected with a relatively mild strain of the polio virus,

E-mail this to a friend

E

Printable version

FEATURES, VIEWS, ANALYSIS

Ghost town Has China’s housing bubble burst?

The guerilla plant How the world’s oldest clove tree defied an

Walking away Why Royal Ballet principal Serge Polunin quit

Most Popular Now

Traffic to this site is currently 32% below normal

E-mail news

Mobiles

Alerts

News feeds

Interactive TV

Podcasts

http://news.bbc.co.uk thuhealth/4799725.sim

2/3

Doctors hail paralysis breakthrough

SCIENTISTS last night claimed From Sarah Chalmers We believe that if the experiment. It comes at a time when Presi- heal or regrow. Dr Kerr added: ‘We a breakthrough in the treatment of paralysis. works using human cells in mice, dent Bush is trying to decide are being cautiously aggressive. in New York then it has a strong chance of whether or not to allow federal want to advance as fast as success in humans. funding for such research. possible.’ It involves the use of stem cells similar to a disease suffered by Embryonic stem cells are theThe Johns Hopkins project was More than 200 scientists and from human embryos, a practice humans called amyotrophic lateral basic building blocks of body financed by Project ALS, a New doctors attending a genetics meet which has been shrouded in sclerosis, or motor neurone disease. tissue. They can develop into any York-based charity dedicated to ing in Bar Harbor, Maine, were due controversy. The disease claimed the lives of the body’s different components. finding a cure for the condition. to see a dramatic video clip of the In what is believed to be the first of actor David Niven and former Neurologist Douglas Kerr, who Dr Kerr and colleague Professor partially cured mice last night. successful experiment of its kind, England football manager Don led the experiment, said: “The John Gearhart isolated the Supporters of embryonic stem researchers at Johns Hopkins Uni Revie. Professor Stephen Hawking majority of the animals recovered primitive human stem cells from cell research hope this latest devel in Baltimore say they have is a sufferer. some function. five to nine week-old  will help sway President

used the cells to partially cure The mice then had a solution “They are not completely normal foetuses. : Bush… paralysed laboratory mice. . . containing human embryonic stem but they can begin to move their. The foetuses had been selectively Bush is still considering his

The team hope to experiment on ‘cells infused into their spinal fluid. hind limbs under them and some aborted after IVF treatment but is thought to feel uneasy human paralysis sufferers within The cells migrated to the area of – can bear weight.’ . resulted in multiple pregnancies. about the use of human embryos in three years. the damaged spinal cord and . The extraordinary progress of the Professor Gearhart said the such work. The mice were first infected with developed as healthy new nerve mice will challenge critics of stem experiment proved that embryonic On his European tour this week a virus which damaged nerve cells cells. They also released proteins. cell research who have argued that stem cells can be used to treat dis- he met the Pope, who has con in their spines, leaving them – that spurred the regeneration the work has not yielded the break- eases in which nerve cells have stem cell research as. The resulting condition was of normal nerve cells. Scientists throughs promised by scientists. been damaged and do not normally devaluing human life.’

July 26th 2001

Sir Arthur Clarke

Colombo, Sri Lanka