After polio cases were found abroad, Australian health officials are on high alert.
Health officials have started testing sewage around the nation for the polio virus, and experts have advised the people to think about being vaccinated to protect themselves from the disease.
For the first time since the 1980s, polio was proven to be spreading across London in August.
The virus is also spreading in New York, where the governor last month proclaimed a state of emergency.
Although there have been no indications of polio reaching Australian soil, health officials have continued to be on high alert in case the virus does.
This Monday, NSW Health made the announcement that it will join other Australian governments in testing sewage for polio.
In order to explore the benefits and limitations of wastewater monitoring to help identify other infectious illnesses, including polio, NSW Health organized an expert group last week that included specialists from Victoria, according to a spokesman for Daily Mail Australia.
Even though there are presently no signs of polio infection in NSW, NSW Health is creating a wastewater monitoring program for the poliovirus based on the success of the SARS CoV-2 wastewater surveillance program as a precaution.
Sydney Water and NSW Health are collaborating to finalize the procedures and launch monitoring as soon as practicable.
In the 1930s and 1950s, Australia saw two polio outbreaks that killed over 1000 individuals.
American virologist Johas Salk created a vaccination in the US in 1952. Four years later, it was brought to Australia, where it essentially put an end to the pandemic.
Patients are most contagious seven to ten days before and after the development of symptoms of polio, a dangerous viral illness that may linger in the throat and intestines for up to six weeks.
The CDC estimates that only around one in every 1,900 polio infections in unvaccinated individuals will result in paralysis. There is no booster dose for the polio vaccine, and infant inoculation offers lifetime immunity.
The virus may spread by contact with an infected person’s feces or droplets released into the air when someone coughs or sneezes. It is more prevalent in newborns and young children.
The majority of polio patients exhibit no symptoms at all, but around one in 20 will have mild side effects including fever, muscular weakness, headache, nausea, and vomiting.
One in fifty individuals has neck and back stiffness and significant muscular pain.
Less than 1% of those with polio get paralysis, and one in ten of those instances end in death.
Before being almost completely eradicated by a vaccine that employed a weakened strain of the virus, polio dates back to 1500 BC and incapacitated kings in Ancient Egypt and paralyzed thousands of children for decades: Exposing the disease’s history
You may have assumed that polio was a disease consigned to the past.
The last domestic epidemic of the illness that causes paralysis occurred in the 1980s, and it was declared formally eliminated in the UK in 2003. But polio seems to have returned decades later owing to declining vaccination rates, which may have been a result of complacency.
The first accounts of the archaic illness date back to ancient Egypt, and it has existed for as long as human civilization itself.
But epidemics didn’t really start to pick up until the 1800s.
The damage that polio wreaked in the early 1950s and the reasons it was one of the most dreaded diseases in the world will be remembered by millions of Britons. In the middle of the 20th century, polio outbreaks shook the UK and rendered thousands of people annually paralyzed.
The former Great British Bake Off judge Mary Berry was hospitalized after developing polio at the age of 13 and suffering a twisted spine and crippled left hand.
Despite being eliminated in the majority of the globe, the virus still circulates in Afghanistan and Pakistan, and vaccine-derived strains of the virus sometimes flare up in certain regions of Africa.
Here, MailOnline examines the background of the virus:
Polio epidemics, in which the virus spreads rapidly among a population, did not appear until the late 1800s.
But according to sources, it first appears in ancient Egypt around 1570 BC.
This is based on a depiction of a priest with a withered leg who is using a cane to assist him walk that was found on a stone slab known as a stele.
In addition, Siptah, an Egyptian pharaoh who perished in 1188 BC, is believed to have had polio based on the deformities in his left leg and foot that scientists discovered when they discovered his tomb in 1905.
But other from these two instances, polio was almost completely forgotten about until it was first noted in 1789 by London-based Dr. Michael Underwood.
In a medical textbook, he provided the first precise definition of polio in newborns, who are especially susceptible to the illness, referring to it as “debility of the lower extremities.”
A few polio cases were sometimes recorded in medical publications in the early 1800s.
However, experts think that humans were often exposed to the virus, particularly when they were young, in the normal filthy conditions of the period.
At the end of the 1800s, polioviruses began to cause issues in Europe and North America. Strangely, the improvement in sanitization was attributed for this.
Polio is transferred by eating an infected person’s feces, which may happen if you don’t practice good hand hygiene.
Typhoid and cholera epidemics increased as sewage and water systems improved, while polio occurrences decreased.
One-third of persons who get the disease don’t exhibit any symptoms. However, around 25% have flu-like symptoms, such as a sore throat, fever, and fatigue.
Up to one in 200 people may have more severe symptoms, such as paralysis that impact their brain and spinal cord.
A virologist at Reading University named Professor Ian Jones said the virus “wasn’t a concern until hygiene improved.”
Prior to improved living circumstances, individuals would have developed immunity to low levels of infection, but this reduced and polio “took off,” according to him.
Although polio has been there for decades or millennia, Professor Paul Hunter, an infectious disease specialist at the University of East Anglia, told MailOnline that significant outbreaks of paralytic polio first began to spread around the early 20th century.
According to him, some paralysis was still present in every kid who had the poliovirus throughout the first few years of life, but this paralysis only started to become more prevalent when infections were postponed until later in life.
Young children who get the poliovirus infection often only have minor symptoms, but if they wait until they are teenagers or adults, paralysis becomes more prevalent.
More over a dozen persons were affected by the first epidemic in Norway in 1868, and a similar number of verified cases were reported in Sweden during the second epidemic, which occurred 13 years later. 132 persons were infected during an epidemic in the US in 1894.
1800s – 1900s
With almost 9,000 cases and 2,000 fatalities, Brooklyn, New York had the first widespread outbreak in 1916.
More than 27,000 cases and 6,000 fatalities from polio were caused by the epidemic that year, which expanded throughout the rest of the US.
Names and addresses of ill persons were publicized in newspapers, “stay out” signs were attached to their doors, and their families were isolated.
Because of virus concerns, parents were advised to keep their kids out of public places like parks, swimming pools, and beaches.
The epidemic increased interest in the sickness and worried people all across the globe.
In their knowledge and treatment of the virus, scientists had already made considerable progress.
Dr. Jacob von Heine, a German orthopaedic surgeon, was the first to conduct a thorough investigation of polio in 1840.
He opined that the illness may be infectious.
By 1908, Austrian doctors Karl Landsteiner and Erwin Popper suggested that a virus may be responsible for polio.
Early therapies for the illness included splinting paralyzed limbs of infected patients and attaching them to them in an effort to prevent their muscles from contracting.
But in 1928, a device known as the “iron lung” was introduced, completely altering how the illness was managed.
For patients whose lungs were so paralyzed that they could no longer breathe on their own, a respirator that resembled a “coffin on legs” was created.
The first time it was used during that decade was to rescue a virus-infected American toddler who required assistance breathing.
The majority of patients spent brief periods inside the chamber as their lungs healed.
However, some people who suffered from lifelong paralysis spent the remainder of their lives within the machines.
Paul Alexander, a 76-year-old Texas resident who had polio at age six in 1952, is still in the machine today.
Elizabeth Kenny, an Australian self-trained nurse from Queensland, created a therapy in 1930 that included putting hot packs to the muscles and engaging in physical activity to maintain nerve cell stimulation and prevent long-term muscle damage. Today, the techniques are still in use.
In 1931, Australian virologists Sir Macfarlane Burnet and Dame Jean MacNamara made the first distinction between the three forms of the polio virus as part of the increasing emphasis on study.
The war against the virus gained more momentum when, in the 1940s, a group of researchers at Harvard Medical School under the direction of Dr. Jonas Salk utilized blood samples from afflicted individuals to extract and culture the virus in living cells.
By 1955, the team had created the first successful vaccination, an injectable inactive (killed) polio vaccine, with the aid of funding from the non-profit March of Dimes (IPV).
As part of the biggest medical study ever conducted at the time, about 2 million youngsters in the US received injections.
They were effective, and 450 million doses of the vaccine were administered nationwide. As a result, the number of cases decreased from 18 per 100,000 persons to 2 per 100,000.
A second vaccine employing a live strain of the virus that could be administered orally as drops was created in the next decade by a team at the University of Cincinnati in Ohio, under the direction of medical researcher Dr. Albert Sabin.
Because it was so much more effective, this vaccine quickly rose to the top of the global vaccination rankings.
Dr. Sabin tested his oral poliovirus vaccine (OPV) in the former Soviet Union because American politicians were against it.
Polio decreased when the USSR administered the vaccine. Drops in instances were also seen in Japan and neighbouring Eastern Europe.
The vaccination was granted US approval in 1961, and it quickly rose to become the most widely used vaccine globally.
Professor Jonathan Ball, a virologist at the University of Nottingham, told MailOnline that the introduction of the two vaccines was “immense” and that polio had a “devastating impact” on the globe.
Studies conducted in the 1970s and 1980s indicated that the virus was common in many wealthier countries, which prompted policymakers to include regular OPV vaccination in national immunization programs.
In affluent nations, polio was eradicated thanks to vaccinations. Before being eliminated, incidences in the UK decreased from a high of 8,000 per year to only a few hundred.
Infections in the US decreased from a high of 58,000 to nil within a few years following the vaccination.
According to Kathleen O’Reilly, an associate professor of infectious disease statistics and an authority on the elimination of polio, incidences of paralytic polio in England and Wales significantly increased after the Second World War, reaching several thousand cases annually.
In response to these alarming epidemics, vaccines were created and became available in the late 1950s.
“Polio cases rapidly decreased, and by the 1970s, there were just a few new cases recorded year. Since 1984, there haven’t been any polio cases in the UK.
However, acceptance was substantially lower in less developed countries where the virus generated fewer epidemics.
To vaccinate all children against polio, the World Health Organization (WHO) began a global immunization rollout in 1974.
The UN health organization established the goal of eliminating the virus worldwide by 2000 in 1988. A worldwide viral monitoring system is established to find the virus two years later.
In 1991, a three-year-old kid named Luis Fermin Tenorio who lived in Junin, northern Peru, was the final example the US recorded.
Three years later, the WHO declared the area to be polio-free. This is the time frame required by the organization before a country can be considered to have eradicated the virus.
The oral polio vaccination was employed in almost every nation’s distribution. However, when infections were under control in the US and the UK, in 2000 and 2004, respectively, both nations discontinued utilizing this vaccine. Other countries did the same.
Although the weakened live virus in the vaccine may very rarely mutate and cause paralysis, it does provide greater levels of protection against infection, making it more successful in containing spread in endemic regions.
It may potentially spread to other people and result in an epidemic of polio from the vaccination.
According to Professor Hunter, the live vaccination is more effective at preventing illness, “but may very infrequently induce paralysis.”
Meanwhile, he said that although the inactivated vaccine “doesn’t induce infection and is still effective at halting paralysis,” it “is not nearly as good at preventing infection.”
The oral vaccination is no longer used by many people.
Europe received the designation as polio-free in 2002. A 33-month-old kid in Turkey was the subject of its last reported instance in 1999.
The final known case of polio occurred in a 15-month-old Cambodian child named Mum Chanty in Phnom Penh, which contributed to the Western Pacific being declared polio-free in 2000. And in 2014, the WHO declared South East Asia virus-free.
Additionally, two wild strains of the virus were successfully wiped from the globe in 2015 and 2019, respectively.
The WHO’s worldwide objective to eradicate the virus by the year 2000, however, has still not been achieved. In Pakistan and Afghanistan, polio is prevalent.
These two countries routinely send travelers abroad who bring the virus with them.
2011 saw the end of China’s polio-free status when the disease arrived from Pakistan. But as the epidemic subsided, it reclaimed it.
The live vaccination has shown to be highly efficient at eradicating the virus, according to Professor Ball.
However, on rare instances it might revert to the wild-type and spread the illness; for this reason, nations that successfully eradicate the virus convert to employing killed vaccination to protect their citizens.
According to Professor Jones, the problem with polio today is its eradication. “Is it preferable to remain where we are or is it worth the expense in terms of money and lives lost to eliminate the last few cases?
“Finally, another conundrum: how long should you continue to vaccinate and with what if it is eradicated?”
Following the discovery of the poliovirus in sewage samples in several areas of London on June 22, 2022, UK health officials said that polio may be spreading in the population for the first time in forty years. It is a strain produced from a vaccination.
But given that authorities have collected several samples from various individuals, each with new mutations, there are indications that it is spreading amongst people.
While most of the world has moved away from live attenuated vaccine, some nations still use it, and there is a risk that you can get secondary infections (typically from a family member), which can very rarely be linked to paralysis in someone who has not received the vaccine. Professor Hunter continued:
The worry is that even a virus generated from a vaccination, if it spreads further, might ultimately regain its full virulence over the course of a year or two, leading to an epidemic of paralytic polio in individuals who have not received the vaccine, which would be disastrous.
Therefore, it is likely that the present state of affairs does not immediately endanger public health, but if transmission continues long enough and the virus regains its virulence, a public health catastrophe may result.