Polio returns to the USA: An epidemiological alert

Area of Science:

• Virology
• Epidemiology
• Public Health

Background:

• Poliomyelitis, a severe paralytic illness caused by poliovirus types 1, 2, and 3, has been largely eradicated globally.
• A resurgence of paralytic poliomyelitis occurred in the USA in July 2022, marking the first case in three decades.
• The identified poliovirus strain was a vaccine-derived poliovirus type 2 (VDPV2), indicating a link to the oral polio vaccine (OPV).

Purpose of the Study:

• To analyze the implications of the VDPV2 detection in the USA.
• To review current vaccination strategies and public health recommendations for poliomyelitis.
• To propose future strategies for polio prevention and outbreak response.

Main Methods:

• Review of epidemiological data and viral sequencing from the reported poliomyelitis case.
• Analysis of Centers for Disease Control and Prevention (CDC) recommendations for polio vaccination.
• Literature review on polio eradication strategies and vaccine-derived poliovirus.

Main Results:

• Confirmation of a paralytic poliomyelitis case in Rockland County, New York, in a traveler.
• Identification of the causative agent as vaccine-derived poliovirus type 2 (VDPV2).
• The case highlights the risk associated with live attenuated oral polio vaccine (OPV) in endemic or susceptible populations.

Conclusions:

• Immunization is critical for preventing poliomyelitis.
• Recommendations include considering Inactivated Polio Vaccine (IPV) for high-risk individuals and potentially phasing out OPV.
• Enhanced epidemiological surveillance, healthcare provider training, and robust outbreak response plans are essential for future preparedness.