(CNN) Poliovirus has been detected in wastewater samples in New York City, suggesting likely local circulation of the virus, according to state and local health officials.
"We are dealing with a trifecta. Covid is still very much here. Polio, we have identified polio in our sewage. And we're still dealing with the monkey pox crisis," New York Mayor Eric Adams said Friday on CNN's New Day. "We're addressing the threats as they come before us and we're prepared to deal with them and with the assistance of Washington, DC."
In a statement about the wastewater finding, New York officials underscored the urgency of staying up to date with polio immunizations, particularly for those in the greater New York metro area.
Most people in the US are protected from polio because of vaccination. The primary series of three vaccines provides 99% protection. However, unvaccinated and undervaccinated people are vulnerable.
"For every one case of paralytic polio identified, hundreds more may be undetected," State Health Commissioner Dr. Mary T. Bassett said. "The detection of poliovirus in wastewater samples in New York City is alarming, but not surprising."
The virus most commonly spreads through feces and, in less common circumstances, when a person infected with the poliovirus sneezes or coughs. About 90% of people with polio do not have any visible symptoms, according to the World Health Organization. Some have flu-like symptoms such as sore throat, fever, tiredness and nausea.
About 1 in 25 people will get viral meningitis, an infection of the covering of the spinal cord and/or brain, according to the US Centers for Disease Control and Prevention.
About 1 in 200 people will have paralysis and be unable to move parts of their body or will feel a kind of weakness in their arms, legs or both. Even kids who fully recover from the initial disease can develop muscle pain and weakness years later.
Paralysis can lead to a permanent disability and death, since it can affect the muscles used to breathe.
City Health Commissioner Dr. Ashwin Vasan said that with polio circulating in our communities, "there is simply nothing more essential than vaccinating our children to protect them from this virus, and if you're an unvaccinated or incompletely vaccinated adult, please choose now to get the vaccine."
The wastewater finding comes after the identification of a case of paralytic polio in a Rockland County, New York, resident on July 21 and the detection in wastewater samples in May, June and July from Rockland and Orange counties.
A CDC official told CNN this week that the case in Rockland County was "just the very, very tip of the iceberg" and suggested there "must be several hundred cases in the community circulating."
The agency sent a team of disease detectives to Rockland County last week to investigate the case and assist with vaccination. A community health leader who has met with the team told CNN that the investigators are "quite nervous" that polio "could mushroom out of control very quickly and we could have a crisis on our hands."
Prior to the invention of the vaccine, polio was considered "one of the most feared diseases in the United States," according to the CDC. In the 1940s, it disabled an average of more than 35,000 people a year in the US. Once the polio vaccine became available in 1955, case numbers dropped significantly.
The last case in the US was reported nearly a decade ago.
Officials say routine vaccine coverage has fallen among New York City children since 2019, noting that only 86.2% of NYC children between the ages of 6 months and 5 years old have received three doses of the polio vaccine, meaning nearly 14% are not fully protected.
Some children missed vaccination appointments due to the pandemic. Others live in small groups of the ultraorthadox Jewish community in New York, including in Rockland County, that have made a decision not to vaccinate their children. Others in the religious Jewish community in Rockland have embraced efforts to work with public health officials to educate those who refuse to vaccinate their children.
In some New York City neighborhoods, the vaccination rate is significantly lower than in the rest of the city. In Williamsburg, for instance, only 56.3% of children are vaccinated. In Battery Park City, it's 58%. In Bedford-Stuyvesant/Ocean Hill/Brownsville, it's 58.4%. Nationally, the vaccination rate for children is nearly 93%.
"The risk to New Yorkers is real but the defense is so simple: Get vaccinated against polio," said Vasan, the city health commissioner. "Polio is entirely preventable, and its reappearance should be a call to action for all of us."