Experts in London are working to address the discovery of poliovirus in the city's sewage and caution those without immunizations to seek treatment in order to prevent contracting the disease.
United Kingdom health officials have declared a national incident following the discovery of poliovirus in a London sewage treatment facility. Authorities say that while it is "normal for one to three vaccine-like polioviruses" to be found in sewage samples each year, these incidences are usually not consistently detected and are the product of an individual who has been vaccinated with the oral polio vaccine overseas and traveled to the United Kingdom where elements of the virus shed and entered sewage via their feces.
However, these samples, which were found in sewage collected from the London Beckton Sewage Treatment Works, maintained a persistent presence from February through May and are likely the product of what is known as “vaccine-derived” poliovirus type 2 (VDPV2).
While there have not been any polio cases reported, experts who investigated the presence of VDPV2 cautioned that there have likely been cases of transmission between individuals living in North and East London and that these people are now shedding the virus as well.
As of yet, no one has come forward to report associated cases of paralysis, and investigations are focused on identifying areas where community transmission could be occurring.
Dr. Vanessa Saliba, a consultant epidemiologist at the United Kingdom's Health Security Agency, said that the overall risk to the general public is extremely low, but warned VDPV2 does have the ability to spread in communities who have not been vaccinated.
In 1988, the World Health Assembly pledged to eradicate poliovirus worldwide. The Global Polio Eradication Initiative, the product of that 1988 summit, has almost achieved that goal — the transmission of polio has decreased by more than 99% and number of countries regularly reporting outbreaks decreased from 125 to just 3.
The United Kingdom suspects that a traveler from one of those three countries — Afghanistan, Pakistan, or Nigeria — received an oral polio vaccine abroad and began shedding the virus when they traveled to London.
With the discovery that OPV contributed to the outbreak of vaccine-derived polio, western countries like the U.K. ceased using OPV, opting instead for the safer inactivated poliovirus vaccine (IPV). Supply constraints have left countries in the Middle East and Africa with little choice but to continue administering the less reliable vaccine.
The public health alert comes while the U.K. continues to struggle to identify the cause of a sudden onset hepatitis outbreak in young children. As of June 21, 258 cases have been reported — mostly in children under five-year-old. Public health officials do not believe that there is any link to the coronavirus vaccine, noting that the majority of cases occurred in children who were too young to have received it.
Instead, experts believe that the adenovirus, one of the viruses responsible for the common cold in children, might be the common denominator. Children who are suffering from the disease first report symptoms of diarrhea and nausea before developing the typical symptoms of jaundice such as the yellowing of the skin and eyes. While there have not been any fatalities associated with the hepatitis outbreaks, 12 children have undergone liver transplants since January 21.
