Wastewater Testing and Detection of Poliovirus Type 2 Genetically Linked to Virus Isolated from a Paralytic Polio Case - New York, March 9-October 11, 2022

Abstract

In July 2022, a case of paralytic poliomyelitis resulting from infection with vaccine-derived poliovirus (VDPV) type 2 (VDPV2)^§ was confirmed in an unvaccinated adult resident of Rockland County, New York (1). As of August 10, 2022, poliovirus type 2 (PV2)^¶ genetically linked to this VDPV2 had been detected in wastewater** in Rockland County and neighboring Orange County (1). This report describes the results of additional poliovirus testing of wastewater samples collected during March 9-October 11, 2022, and tested as of October 20, 2022, from 48 sewersheds (the community area served by a wastewater collection system) serving parts of Rockland County and 12 surrounding counties. Among 1,076 wastewater samples collected, 89 (8.3%) from 10 sewersheds tested positive for PV2. As part of a broad epidemiologic investigation, wastewater testing can provide information about where poliovirus might be circulating in a community in which a paralytic case has been identified; however, the most important public health actions for preventing paralytic poliomyelitis in the United States remain ongoing case detection through national acute flaccid myelitis (AFM) surveillance^†† and improving vaccination coverage in undervaccinated communities. Although most persons in the United States are sufficiently immunized, unvaccinated or undervaccinated persons living or working in Kings, Orange, Queens, Rockland, or Sullivan counties, New York should complete the polio vaccination series as soon as possible.

FIGURE 1

Wastewater polio test results, by jurisdiction (N = 1,053) — 13 counties in New York and New York City, March 9–October 11, 2022 Abbreviation: PV2 = poliovirus type 2. * Sampling sites are sewersheds defined as the community area served by a wastewater collection system. ^† Testing was conducted to determine if a sample was negative or positive for PV2, and if positive for PV2, whether the PV2 was genetically linked to an unvaccinated paralytic poliomyelitis patient from Rockland County, New York identified in July 2022. Some samples had sequencing insufficient to determine relation to the Rockland County patient (i.e., linkage to patient unknown). Indeterminate results are excluded from this figure. Indeterminate results include those from samples that tested positive using real-time reverse transcription polymerase chain reaction, but not enough viral material was available to complete sequencing. Specimens pending sequencing results are also excluded. ^§ Number of samples in each jurisdiction include New York City (408) and the following New York counties: Rockland (124), Putnam (20), Orange (280), Nassau (85), Sullivan (21), Westchester (83), Suffolk (14), and Ulster (18).

FIGURE 2

Sewersheds with detections of poliovirus type 2 genetically linked to the virus isolated from a paralytic polio patient — Sullivan (A), Orange (B), Rockland (C), Kings and Queens (D), and Nassau (E) counties, New York, March 9–October 11, 2022 Abbreviation: PV2 = poliovirus type 2. * Sampling sites are sewersheds defined as the community area served by a wastewater collection system. Sub-sewersheds are upstream sampling locations within a larger sewershed. ^† In July 2022, paralytic poliomyelitis resulting from infection with vaccine-derived PV2 was confirmed in an unvaccinated adult resident of Rockland County, New York. ^§ A single large-volume sample from a sub-sewershed serving parts of Kings and Queens counties tested positive for the PV2 genetically linked to the virus isolated from the patient.