Top 5 Takeaways

1. Wastewater Testing Identified PV2 in New York: Wastewater testing in New York detected poliovirus type 2 (PV2), genetically related to the virus from a paralytic polio case in Rockland County, in at least five counties.
2. Evidence of Community Transmission: Continuous detection of PV2 in Orange, Rockland, and Sullivan counties indicates community transmission. A single large-volume sample from Kings and Queens counties also tested positive.
3. Polio Vaccination Imperative: The report emphasizes the importance of completing the polio vaccination series, especially in undervaccinated areas like Kings, Orange, Queens, Rockland, and Sullivan counties.
4. Sampling and Testing Challenges: The reliability of wastewater testing results is influenced by sewershed size and system design, highlighting the need for careful interpretation and standardized testing methods.
5. Public Health Response: Efforts include enhanced case detection, increased vaccination access, and targeted public health communication, particularly in communities with low IPV coverage.

Original Article Author and Citation

Corresponding Author

A. Blythe Ryerson, ztq6@cdc.gov.

Suggested Citation

Ryerson AB, Lang D, Alazawi MA, et al. 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. MMWR Morb Mortal Wkly Rep 2022;71:1418–1424. DOI: http://dx.doi.org/10.15585/mmwr.mm7144e2.

Summary

In July 2022, a case of paralytic poliomyelitis caused by vaccine-derived poliovirus type 2 (VDPV2) was confirmed in an unvaccinated adult in Rockland County, New York. Subsequent wastewater testing in surrounding areas detected PV2 genetically linked to this case. A total of 1,076 samples were collected from 48 sewersheds across 13 counties, with 8.3% testing positive for PV2.

Methods

The study involved wastewater sample collection for poliovirus testing from various sewersheds. Samples were processed using ultracentrifugation or polyethylene glycol precipitation, followed by nucleic acid extraction. Real-time reverse transcription–polymerase chain reaction (RT-PCR) assay was employed for detection, and positive samples were sequenced.

Discussion

The study underscores the complexities in interpreting wastewater testing results due to factors like sewershed size. It also highlights the challenges in differentiating between vaccine-derived and wild-type polioviruses in areas with high oral poliovirus vaccine (OPV) use. The findings emphasize the need for standardized testing and sequencing methods.

Conclusion

The detection of PV2 in wastewater samples in New York points to community transmission of poliovirus. The study highlights the critical role of maintaining robust acute flaccid myelitis (AFM) surveillance and improving polio vaccination coverage, especially in undervaccinated communities.

This summary highlights the importance of public health efforts to prevent the spread of polio through improved vaccination coverage and ongoing surveillance. The use of wastewater testing as a tool in these efforts offers valuable insights but also presents challenges that require careful management and interpretation.

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