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Polio found in some U.S. and U.K. wastewater, but should Ontario residents be worried

With the discovery of poliovirus in wastewater samples collected in New York State and London, England, it raises questions about polio preparedness in Ontario.
polio story
Iron lungs kept thousands of polio-stricken children alive. File photo.

With the discovery of poliovirus in wastewater samples collected in New York State and London, England, it raises questions about polio preparedness in Ontario.

“There’s no question that polio, measles, these infections are just a plane ride away, especially for our city,” Dr. Vinita Dubey, an associate medical officer of health with Toronto Public Health (TPH), told CityNews in a recent interview when asked about the potential for the virus to be detected locally.

In the mid-1900s, polio became a household name and worry. The highly infectious virus goes after the central nervous system and it’s usually contracted orally after hands or other items are contaminated with fecal matter.

Dr. Santiago Perez Patrigeon, an infectious diseases physician with Kingston Health Sciences Centre and an assistant professor at Queen’s University, said a large majority of people infected with the virus don’t show any signs.

They said of the smaller percentage who are symptomatic, many will have flu-like symptoms while roughly one in 200 will develop incurable paralysis. A fraction of those people will die from respiratory failure.

“It mainly affects children and that’s the catastrophe because there’s no treatment and if you have this paralysis syndrome, then you get paralyzed for life,” Patrigeon said.

Meningitis, encephalitis and altered feelings — particularly in limbs — can also be symptoms of polio.

Although vaccinations in Canada led to a sharp drop in cases in the 1950s and 1960s, the country wasn’t declared polio-free until 1994. However, wild polio is still present in many countries across the world. Pakistan and Afghanistan see higher numbers of cases, prompting vaccination drives.

Patrigeon said Canada utilizes intramuscular injections with inactive virus. In other countries with a higher presence of polio, an oral version using a weakened live (attenuated) virus is used with Patrigeon noting it’s highly protective and quicker acting. But it can be shed from the body.

When it comes to Ontario’s vaccine uptake, Patrigeon said the province does “very well.”

“I don’t think that there’s reason to be scared even if the wild virus comes, the population should be protected,” they said.

“It’s not exactly a resurgence of polio yet. We have not had cases yet. We are detecting a signal.”

New York State health authorities confirmed on Friday that the virus was found in recent wastewater samples collected in New York City.

The development came after the virus was found in wastewater samples in Orange and Rockland counties, just north of New York City near the New Jersey border. The positive samples have been detected since May. Both areas have polio vaccination rates well below the national average in the United States.

On July 21, officials said an unvaccinated individual in Rockland county developed the rare side effect of paralysis.

In north and east London, England, samples were detected there too. The British government recently announced it was rolling out polio booster doses to children between one and nine years old.

There hasn’t been a definitive conclusion on what is causing the recent uptick in poliovirus found in wastewater.

In a statement to CityNews, a spokesperson for Health Canada and the Public Health Agency of Canada said staff are actively monitoring polio data across the world. They encouraged people travelling to certain countries with active polio cases to get a booster vaccine dose at least six weeks before leaving.

“While the general risk to the Canadian public from polio remains low, these international cases are a good reminder to stay up to date with vaccinations, even for rare vaccine-preventable diseases,” the statement said, adding an up-to-date list of travel health notices is kept.

Federal health officials said it’s recommended children receive four doses (at two, four, six and 18 months) along with a booster between the ages of four and six. Dubey also said teens between 14 and 16 can receive a booster too.

An Ontario Ministry of Health spokesperson said in a statement that polio is required to be reported and tracked by local public health units. Tests are often ordered when someone has unexplained paralysis.

“Ontario’s publicly funded immunization program offers 20 vaccines that protect against 17 diseases, not including COVID-19 vaccines. This includes polio vaccine,” the statement said.

“Immunization protects Ontarians from serious diseases that can be spread. It also protects those who cannot protect themselves, especially young children and those who cannot be vaccinated because of medical reasons.

“In the case of an identified outbreak of vaccine-preventable disease in Ontario, the local public health unit will respond with (the) provision of vaccines to at-risk populations.”

Should there be a positive test in Toronto, Dubey said TPH staff will conduct contact tracing and ensure people are offered a vaccine booster dose in an effort to avoid an outbreak.

Meanwhile, Dubey said with COVID-19 delaying in-person medical appointments over the past two years, there’s a particular message for parents.

“Now is a really good time to look at a child’s record, to go see your doctor, to make sure children have received all of their vaccines,” she said.

Patrigeon reminded people to follow the fundamentals of protecting themselves.

“Wash their hands. It works for COVID, it works for polio … It’s a simple measure and people forget,” they said.


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