Posted by Dennis Dinsmore
Rotary leaders frequently say in their speeches that "Polio is only a plane ride away". We recently got proof that this omen could become a reality when in July, 2022 the US Center For Disease Control announced the confirmation of a polio case in the United States.
An unvaccinated young adult in Rockland County, New York was verified with having polio, probably contracted from a family member or friend visiting from another country who may have had no symptoms and was totally unaware of possible infection.
See latest update at the end of this story
To understand this event, we must first understand some basics about polio vaccination. There are two ways to immunize a person against polio, the Salk vaccine and the Sabin vaccine. The Salk vaccine is injected and contains killed polio virus. It is by far the most prevalent method of immunizing children across the industrialized world. The Sabin vaccine is administered orally with drops and contains a live virus. While the Sabin drops are far more easy to administer and thus became the worldwide standard for our immunization efforts, they also can trigger an unfortunate outcome.
When the Sabin drops are administered they go into the gut of the patient and begin to trigger an immunity process which lasts two to four weeks. In the meantime the patient becomes, in effect, a polio factory who's bodily eliminations contain live polio virus which can get into the environment, including into municipal sanitary systems.  Unvaccinated people coming in casual contact can then be exposed to infection, often without even knowing it.
These polio cases are referred to in the reports as cVDPV, "contracted Virus-Derived Polio Virus". By far, the most susceptible areas of the world where these secondary infections can occur are places where immunizations are spotty.  See Rotary's Status Report and the Worldwide cDVPV Report numbers on the right.
Details of this case are still unfolding but one thing is absolutely clear, this outcome could have been completely avoided had both the patient victim and the carrier been vaccinated.
Update 9/16/22
A victim of polio first appears on the radar when he/she shows symptoms of paralysis and, in general, an average of only 1 in 500 people infected with polio will advance to that level of the disease. In this case, the victim was a 20 year old male who went to an Emergency Room in Rockland County, New York in mid July with paralytic symptoms.  Since it is known that paralysis sets in after exposure from to about 1 to 2 weeks after exposure gave researchers got a clear window as to when transmission occurred. Further, the patient was not immunized against polio.
During that exposure window, the patient had not left the country and his only public contact was with a "large group of people at a local event". Clearly he was exposed through either the local sanitary environment or through an individual who carried the virus without knowing it.
It is known that the average polio vaccination rate in this area is about 60%, far below the national average. The Type II polio virus was also detected in the area's waste water which indicates that the virus is well established in the region and that many more people may have contracted polio asymptomatically and were capable of spreading it. The CDC has taken steps to track the virus and to identify other potential victims and the Governor of New York has declared the area to be a State Disaster Emergency which will help fund and coordinate the response. 
In point of fact there is only one response which will stop this potential outbreak, vaccination. As long as ignorance, economic, religious and political barriers exist to vaccination, polio will exist as will other preventable but incurable diseasess. It is up to us as Rotarians to change perspectives of those who resist vaccination with kindness and understanding. Our triumph over polio depends on it.