Poliovirus Being Detected in Wastewater in Germany, Spain, Poland, Finland and England

Medical News: The Re-Emergence of Poliovirus
In 1988, the World Health Organization (WHO) launched an ambitious initiative to eradicate polio globally. The results were remarkable: cases of poliovirus decreased by over 99%, and Europe was declared polio-free in 2002. Yet, in recent months, poliovirus has been detected in wastewater across several European countries, including Germany, Spain, and Poland. These findings, while not indicative of widespread infections, have raised alarms among public health officials.


Poliovirus Being Detected in Wastewater in Germany, Spain, Poland, Finland and England

Poliovirus, a highly contagious virus that targets the nervous system, can lead to paralysis and even death. While the vast majority of infections are asymptomatic, about one in every 200 cases results in irreversible paralysis. Among those paralyzed, 5-10% die due to immobilized respiratory muscles. The virus spreads primarily through the fecal-oral route, entering the body via contaminated food or water and multiplying in the intestine.
 
This Medical News report highlights the significance of these findings and the urgent need for vigilance in ensuring robust vaccination coverage. The detection of poliovirus in wastewater serves as an early warning system, signaling the potential for resurgence, especially in areas with under-immunized populations.
 
Wastewater Surveillance: A Critical Tool
The resurgence of poliovirus detection has been primarily identified through wastewater surveillance; an approach reinvigorated during the COVID-19 pandemic. Wastewater contains a mix of human excrement, pathogens, and chemical traces, offering a treasure trove of data for public health officials.
 
Routine testing in Spain, Germany, and Poland revealed the presence of a vaccine-derived strain of poliovirus.
https://polioeradication.org/about-polio/polio-this-week/
 
https://www.euronews.com/health/2024/12/04/poliovirus-has-been-detected-in-sewage-in-3-european-countries-what-happens-now
 
Poliovirus was also detected in wastewater in Finland about two days ago.
https://www.helsinkitimes.fi/finland/finland-news/domestic/25852-poliovirus-detected-in-tampere-wastewater-but-no-cases-reported.html
 
Poliovirus was also detected in parts of the United Kingdom according to a report by the UKHSA yesterday.

https://www.gov.uk/government/publications/health-protection-report-volume-18-2024/hpr-volume-18-issue-11-news-10-december< br />  
Vaccine-derived poliovirus emerges from the weakened virus used in oral polio vaccines (OPV). While OPVs have been instrumental in reducing polio cases worldwide, the weakened virus can occasionally revert to a more virulent form capable of causing disease, especially in under-immunized communities. In these recent detections, it is suspected that the virus was shed by an asymptomatic individual or someone recently vaccinated with OPV. The genetic mutations that enable the virus to regain virulence underscore the importance of maintaining high vaccination coverage.
 
The Challenge of Vaccine-Derived Poliovirus
Europe predominantly uses the inactivated polio vaccine (IPV), which cannot mutate into a virulent form. However, IPV does not stop the virus from replicating in the gut and being shed into the environment. This limitation highlights the challenges posed by vaccine-derived poliovirus, particularly in regions with gaps in immunization coverage.
 
The countries where the virus was detected have relatively high vaccination rates, with coverage among one-year-olds hovering around 95%. This level is well above the 80% threshold required for herd immunity. However, pockets of under-immunized populations remain, leaving certain groups vulnerable. Additionally, individuals with weakened immune systems, such as transplant recipients or chemotherapy patients, face increased risks.
 
The Genetic Mystery
Researchers from the WHO, European Centre for Disease Prevention and Control (ECDC), and the Global Polio Eradication Initiative (GPEI) have been analyzing the genetic sequences of the detected virus. The findings are perplexing. The strains identified in Europe are vaccine-derived poliovirus type 2, descended from the Zamfara strain that circulated in Nigeria. This strain has spread across Africa, with recent cases in Algeria, Guinea, and Mali.
 
Genetic analysis suggests that the virus has been circulating undetected for approximately a year. While Africa is the likely origin, researchers cannot rule out the possibility of local transmission in Europe. In Spain, for instance, the virus was first detected in Barcelona in September 2023 during routine wastewater testing. Subsequent detections in Warsaw, Poland, and multiple cities in Germany, including Munich, Cologne, and Hamburg, have raised concerns about the virus's rapid spread.
 
Public Health Response
The detections have prompted swift action. Authorities in Spain, Poland, and Germany have intensified wastewater surveillance and reviewed vaccination records to identify immunity gaps. In Catalonia, public health officials reported no further detections since September, suggesting containment efforts may be effective. Meanwhile, other European countries have been urged by the ECDC to enhance their surveillance systems. Currently, only 26 of the 53 countries in the WHO European region routinely sample wastewater, leaving potential blind spots.
 
Broader Implications
The detection of poliovirus in Europe underscores the interconnectedness of global public health. Poliovirus knows no borders, and the recent findings highlight vulnerabilities even in regions with high vaccination coverage. Humanitarian crises, such as armed conflicts and natural disasters, have disrupted vaccination programs in many parts of the world, leading to declining immunization rates. In some countries, coverage has dropped below 80%, with rates as low as 36% in certain areas.
 
Key Findings
The European waste water and genomic surveillance revealed several critical insights:
 
-Origins and Spread: The virus likely originated in Africa but has since spread widely. The genetic diversity of the strains detected in Europe suggests multiple introductions rather than a single source.
 
-Detection Timeline: Routine surveillance first identified the virus in Spain in September 2023, followed by detections in Poland and Germany in October. Subsequent findings in other European countries, including Finland and the UK, indicate the virus's rapid dissemination.
 
-Transmission Dynamics: While IPV protects against paralysis, vaccinated individuals can still shed the virus, facilitating its spread. The isolates detected in different cities within Germany were genetically closer to strains from Spain and Poland than to each other, complicating efforts to trace the transmission route.
 
Conclusions
The recent detections of poliovirus in wastewater across Europe serve as a stark reminder of the need for vigilance in public health. While vaccination rates in the affected countries remain high, gaps in coverage and the presence of under-immunized groups create vulnerabilities. The findings highlight the critical role of wastewater surveillance in early outbreak detection and prevention.
 
Addressing this challenge requires a multi-faceted approach. Governments must intensify vaccination campaigns, particularly targeting underserved populations. Enhanced surveillance systems are essential to monitor and respond to potential outbreaks. Additionally, the global community must prioritize the eradication of poliovirus in endemic regions to prevent its re-emergence elsewhere.
 
The detections in Spain, Poland, and Germany also underscore the importance of global collaboration. Public health efforts must transcend borders, recognizing that the health of one region affects the well-being of all. As the COVID-19 pandemic demonstrated, no country is immune to the consequences of infectious disease outbreaks.
 
For the latest on Polio, keep on logging to Thailand Medical News.
 
Read Also:
https://www.thailandmedical.news/news/polio-continues-to-cripple-children-in-pakistan-as-48-wild-poliovirus-type-1-cases-reported-in-2024
 
https://www.thailandmedical.news/news/australian-infectious-diseases-specialist-warns-that-hundreds-could-be-infected-with-polio-in-indonesia-and-that-the-situation-is-worrisome