Scientists fear polio plan will repeat COVID horror show

Polio has emerged in the United States for the first time in a generation. On July 18, the New York State Department of Health told the U.S. Centers for Disease Control and Prevention that it detected the poliovirus, which can cause paralysis or death in a small number of cases, in a young adult in Rockland County outside New York. City.

New York authorities then detected the virus in sewage in Rockland and neighboring Orange County — evidence of transmission in the local community.

The first case prompted British and Israeli authorities to step up surveillance – they also detected polio.

A polio crisis may be brewing. But despite describing polio as “one of America’s most feared diseases,” the CDC has tried to maintain full government control over poliovirus testing. Only the federal government and certain states that already have polio testing have the ability to monitor for the pathogen.

While withholding testing materials and protocols, private labs (such as Massachusetts-based surveillance startup BioBot) need to detect and track the virus, the CDC risks allowing the virus to spread unnoticed in some communities, while also limiting research into potential outbreaks .

“They want to do it themselves,” Vincent Lacanillo, a professor in Columbia’s Department of Microbiology and Immunology, told The Daily Beast. “It’s like they wanted to control COVID testing at the start of the pandemic.”

The problem is, even the CDC admits that its initial response to COVID was terrible. Last week, CDC Director Rochelle Walensky told the agency’s 11,000 employees that the CDC needs to be overhauled from the top down. “Frankly, we’re responsible for some pretty dramatic, pretty public errors in everything from testing to data to communications,” Varensky said.

The CDC may repeat the same mistakes. Amy Kirby, an epidemiologist at Emory University and director of the CDC’s National Wastewater Surveillance System, did not respond to a request for comment.

Poliovirus is spread through direct contact with feces. Before the invention of oral vaccines and mass childhood vaccination campaigns in the early 1950s, polio outbreaks resulted in more than 15,000 cases of paralysis each year in the United States alone.

The vaccine suppressed polio. By the 1970s, the disease had almost disappeared from all but a few of the poorest and most remote countries, such as Afghanistan. When it reappears, it is usually the result of international travel – where local health authorities quickly isolate the infected and prevent further spread.

The CDC has tracked poliovirus in U.S. communities only once between 1979 and 2022. In 2005, the Minnesota Department of Health found polio virus in an unvaccinated baby girl in a largely unvaccinated Amish community. Three other children fell ill before the virus was contained.

[It] Shouldn’t be hard to do.

Today, in the wealthiest countries, including the United States, 90 percent or more of the population is vaccinated against polio. But childhood vaccination rates have been falling as more people develop aversion to vaccines. It’s no coincidence that Rockland County, where the CDC detected the polio virus last month, has lower vaccination rates than the rest of the country: about 60 percent.

In a report released last week, the CDC emphasized: “The occurrence of this case, combined with the detection of poliovirus in wastewater in neighboring Orange County, underscores the need to maintain high vaccination coverage to prevent populations of all ages. The importance of the emergence of paralytic polio.”

As the world grapples not only with the ongoing COVID-19 pandemic, but also with an accelerating outbreak of monkeypox, the public health risk couldn’t be higher. But the potential looming disaster didn’t prompt the CDC to release the DNA primers they needed to detect polio to private labs. “Basically no one can do this except the public [i.e. government] Health lab,” Rob Knight, director of the Genetic Computing Lab at UC San Diego, told The Daily Beast.

Without primers and other materials, private labs—and the researchers associated with those labs—can’t help the government find polio in other communities. Racaniello compared the CDC’s reluctance to expand polio testing to the agency’s similarly tight control of COVID testing in the early months of the novel coronavirus pandemic. “It doesn’t work well,” Lacanello pointed out in a tweet.

Worst-case scenario is polio spreads for weeks without anyone realizing it – just like monkeypox was initially ignored because many doctors mistook it for herpes or some other sexually transmitted transmission disease.

The CDC’s stubbornness seems bureaucratic. From a technical standpoint, detecting poliovirus in sewage is no more difficult than detecting SARS-CoV-2 or any other virus, Knight explained. Take samples from sewage for PCR testing.

But in the U.S., the rules for polio are stricter than those for other diseases. “From a regulatory perspective, you have to consider every sample that could potentially contain polio,” Knight said. He added that polio surveillance was “an established paperwork nightmare”.

There is also the cost factor. Boosting polio testing in private labs can cost millions. Labs may want the government to help pay for it. CDC leaders may have noticed the growing reluctance in Congress to pay for COVID testing and concluded that it would be easier for the CDC to keep polio testing in-house.

But easier doesn’t necessarily mean better, especially when it comes to public health. With some effort and a little money, private labs can beef up government surveillance systems. “[It] It shouldn’t be difficult to do wastewater testing,” James Lawler, an infectious disease specialist at the University of Nebraska Medical Center, told The Daily Beast. “BioBot and others who are doing surveillance have been able to quickly stand up. “

When it comes to infectious diseases, both speed and comprehensive surveillance are important.A little effort from the CDC and some government funding could lead to generational polio outbreaks that have stalled in two small New York counties, or a broader outbreak that could affect the entire U.S.

even the whole world.

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