Good job everyone, Polio is back!

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pmv

Lifer
May 30, 2008
11,636
6,494
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Making a resurgence? CDC is showing steady decline to historic lows:
Basically a nothing-burger in the US compared to COVID.
Now you mention it, there seems to be a lot of contradictory claims about that (TB). I've heard repeatedly that it's seeing a "resurgence" globally. But also that it's particularly bad here in the UK (and most of all in London). Variously seen it blamed on increasingly poor/crowded living conditions, antibiotic resistance, HIV and migration from countries where it's more prevalent.
 

interchange

Diamond Member
Oct 10, 1999
7,921
2,727
136
By what metric was this change "too long?" I think there's multiple issues that played into the timing of the decision for conversion of OPV to IPV that makes it a bit more complex than a simple refusal to switch from one vaccine version to another.

1) The Cutter Incident with IPV. If you haven't heard about it, Paul Offit has a really good book on it. Yes, IPV is still very much inactivated the same way now as it was in the 1950's, which I've always thought to be remarkable (in both good and bad ways). All it takes is a systematic failure of QC and a similar incident is theoretically possible (but I hope the secondary safety nets in place would prevent it from ever happening again).
2) Because of the success of OPV, only one manufacturer produced the original IPV formulation in the US into the 1980's.
3) Of the vaccine associated paralysis when published in 1994, ~15% did not result in significant or severe residual paralysis. On the other hand, not to ignore, 5 cases between 1980 and 1991 resulted in death.
4) There were serious concerns about the immunogenicity and production of the IPV even after the Cutter incident. It wasn't until the 1970's and 1980's that the modern version of IPV was formulated, and it wasn't approved by the US FDA until 1987.
5) Nonetheless, it took further time to understand whether the modern IPV formulation would have sufficient long-lasting immunity. Until that was known, it was unclear if additional booster doses would be needed, whereas OPV was known to offer nearly life-long immunity.
6) Even into the 1990's, it was recognized that the newer IPV vaccine induced a weaker mucosal immune response compared to OPV. This was a concern that could not be discarded given the potential for importation of the virus.
7) The last outbreak of paralytic polio occurred in 1979 in the US, but that doesn't rule out the potential for viral circulation in certain populations beyond that date (and just didn't cause paralytic polio).
8) In fact, as late as 1993, polio was known to circulate in certain unvaccinated populations in Canada, but didn't cause poliomyelitis.
9) The last known case of non-OPV associated poliomyelitis to occur in the Western Hemisphere was 1991 in Peru and Colombia. It wasn't until 2002 that Europe was deemed polio-free.
10) The ACIP and CDC decided to switch from OPV to a mixed series of IPV + OPV in 1997, and the full conversion to IPV occurred in 2000

One last fact I've always found incredible. One mutation is the difference between the attenuated polio strain in OPV versus a neuroinvasive strain. This is why OPV caused paralytic polio in rare cases (1 case per 2.4 million doses), all was needed was a single mutation.
Thanks for all this history. I'll update my post even I get a chance later. I don't know if a retrospective look could conclude the switch should have been sooner. That wouldn't be fair criticism to anyone evaluating it at the time.
 

abj13

Golden Member
Jan 27, 2005
1,032
803
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Now you mention it, there seems to be a lot of contradictory claims about that (TB). I've heard repeatedly that it's seeing a "resurgence" globally. But also that it's particularly bad here in the UK (and most of all in London). Variously seen it blamed on increasingly poor/crowded living conditions, antibiotic resistance, HIV and migration from countries where it's more prevalent.
Rightfully or wrongfully, London has been called the TB capital of Western Europe for nearly the past decade.
 

pmv

Lifer
May 30, 2008
11,636
6,494
136
Rightfully or wrongfully, London has been called the TB capital of Western Europe for nearly the past decade.

Yeah, seems it's most common in South Asian communities. Seems this study looked into why that might be, and its conclusion, as far as I can make out, seems to be "dunno - can someone else please take a look at it?"


Edit - Hmmm....lots of articles from five or more years ago warning that TB was rising alarmingly in London. I wonder if the anti-COVID measures of the last couple of years might have reduced the rates of TB as well? Another reason to carry on wearing a mask.
 
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Captante

Lifer
Oct 20, 2003
28,225
9,030
136
Urging Immunization, State Department of Health Updates New Yorkers On Polio Detected In New York State (NYS Health Dept)


Why Polio, Once Nearly Eradicated, Is Rebounding (Bloomberg)


Polio found in N.Y.’s Rockland County wastewater following first confirmed U.S. case in almost a decade (Daily News)


Wow.... Want to really understand why Polio is rebounding? :oops:


Just read this freaking thread especially the "sage" comments from some so-called "medical professionals" ... AND THEN GET VAXXED!


A medical degree gets your foot in the door with me, but having one hanging on your wall in NO WAY promises competency, intelligence or ESPECIALLY common-sense.
 
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Meghan54

Lifer
Oct 18, 2009
11,007
4,344
136
Urging Immunization, State Department of Health Updates New Yorkers On Polio Detected In New York State (NYS Health Dept)


Why Polio, Once Nearly Eradicated, Is Rebounding (Bloomberg)


Polio found in N.Y.’s Rockland County wastewater following first confirmed U.S. case in almost a decade (Daily News)


Wow.... Want to really understand why Polio is rebounding? :oops:


Just read this freaking thread especially the "sage" comments from some so-called "medical professionals" ... AND THEN GET VAXXED!


A medical degree gets your foot in the door with me, but having one hanging on your wall in NO WAY promises competency, intelligence or ESPECIALLY common-sense.
That particular county in NY has had a history of outbreaks of infectious diseases typically controllable via vaccination.
 

Zorba

Lifer
Oct 22, 1999
12,767
7,920
136
Urging Immunization, State Department of Health Updates New Yorkers On Polio Detected In New York State (NYS Health Dept)


Why Polio, Once Nearly Eradicated, Is Rebounding (Bloomberg)


Polio found in N.Y.’s Rockland County wastewater following first confirmed U.S. case in almost a decade (Daily News)


Wow.... Want to really understand why Polio is rebounding? :oops:


Just read this freaking thread especially the "sage" comments from some so-called "medical professionals" ... AND THEN GET VAXXED!


A medical degree gets your foot in the door with me, but having one hanging on your wall in NO WAY promises competency, intelligence or ESPECIALLY common-sense.
"But why should we vacinate for diseases no one ever gets? When was the last time you knew someone who got Measles? Checkmate Libtard."
 
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pcgeek11

Lifer
Jun 12, 2005
20,099
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"But why should we vacinate for diseases no one ever gets? When was the last time you knew someone who got Measles? Checkmate Libtard."

My wife who doesn't develope immunity has had the measles 4 times and twice since we have been married. Married for 40 years.
 
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hal2kilo

Lifer
Feb 24, 2009
21,181
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I'd be interested if you could point me to an epidemiologic study about polio and what level of vaccine immunity is required to have herd immunity for polio. Certainly our level of immunization and public health system are sufficient to protect us against having endemic polio be a problem in the US in the future. But that is not a sufficient goal in itself. As I said, a single case in the US would be reason enough for vaccination.

Am I trolling? Well, I was intentionally provocative so you might say so. However my intent was actually to generate a discussion about vaccines that doesn't automatically divulge into partisan name-calling. It hasn't worked.
Heard immunity? Seriously?
 
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Zorba

Lifer
Oct 22, 1999
12,767
7,920
136
My wife who doesn't develope immunity has ad the measles 4 times and twice since we have been married. Married for 40 years.
The vaccine or the disease?

Either way, that's why we need to maintain herd immunity.
 

DAPUNISHER

Super Moderator and Elite Member
Moderator
Aug 22, 2001
25,410
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pmv

Lifer
May 30, 2008
11,636
6,494
136
Is this story related?


Not at all sure I entirely understand the story. Seems to be saying Polio is in the sewage system, becuase some people somewhere in the city have been given the older form of the vaccine (presumably overseas?), where the virus wasn't fully dead - thus creating the very risk the vaccine is supposed to avert?

All children aged between one and nine in London are to be offered a polio booster vaccine in the next four weeks, health officials have said.

Parents have been told to wait until they are approached by the NHS before taking their children to get a jab. GP surgeries will give out the majority of doses.

The UK Health Security Agency (UKHSA) has now seen the polio virus 116 times in 19 sewage samples across London between February and July, and is increasing detection efforts.

Most are harmless forms of the virus from people who have recently had a polio vaccination, but some have been identified as “vaccine derived poliovirus (VDPV2)”.
 

abj13

Golden Member
Jan 27, 2005
1,032
803
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Is this story related?


Not at all sure I entirely understand the story. Seems to be saying Polio is in the sewage system, becuase some people somewhere in the city have been given the older form of the vaccine (presumably overseas?), where the virus wasn't fully dead - thus creating the very risk the vaccine is supposed to avert?
Countries like the US and UK use only the injection form of the polio vaccine. The oral vaccine is actually a more effective vaccine as it has a live, but attenuated version of the polio virus, so it can infect and reproduce when you drink the vaccine. Not only can it infect the person who receives the vaccine, it can be spread to others (fecal-oral transmission), effectively vaccinating others around the initial person who received it. This is a major reason why the world was so close to eradicating polio.

The problem with the oral vaccine is that the virus only needs to mutate once to cause polio. The risk is actually small (one in 2.4 milllion), so one is more likely to be hit by lightning in the US than get polio from the polio vaccine.

What that story is getting at is that there was probably some children in the UK who recently got the oral vaccine (administered in another country). They detected the vaccine strain in the waste water, which isn't that big of a deal, you would expect that with foreign children who come to the UK who were recently vaccinated. What was concerning is that they detected the mutated form of the vaccine that can cause polio. This can only occur if the vaccine strain was brought in AND it has been circulating to others for a long enough period of time. This would suggest there are people in the UK who aren't vaccinated or had a poor response to the vaccine, enabling the strain to circulate long enough to gain the mutation necessary to cause polio.

So there would be the theoretical risk that a case of paralytic polio could occur in the UK in the coming months (caused by the mutated vaccine strain). Hence the response by the NHS to get children boosted. This is what happened in New York. A person got paralytic polio from the mutated strain derived from the vaccine. So the UK and US situations are pretty much the same.
 
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uclaLabrat

Diamond Member
Aug 2, 2007
5,369
2,477
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Urging Immunization, State Department of Health Updates New Yorkers On Polio Detected In New York State (NYS Health Dept)


Why Polio, Once Nearly Eradicated, Is Rebounding (Bloomberg)


Polio found in N.Y.’s Rockland County wastewater following first confirmed U.S. case in almost a decade (Daily News)


Wow.... Want to really understand why Polio is rebounding? :oops:


Just read this freaking thread especially the "sage" comments from some so-called "medical professionals" ... AND THEN GET VAXXED!


A medical degree gets your foot in the door with me, but having one hanging on your wall in NO WAY promises competency, intelligence or ESPECIALLY common-sense.
Youre way overreacting to this. All hes saying is the cost/benefit analysis of polio previously was more of a coin flip, given:
Attenuated or inactivated vaccines are some of the riskiest as far as vaccines go. While the safety is still excellent, QC issues as stated above, or, depending on the nature of the vaccine, recombination of DNA can lead to wild-type virus.

In cases where risk of infection is so astronomically low that the risk of vaccination is roughly of equal magnitude, the analytical conclusion is roughly a coin flip and either choice (vaccinate or dont) become equally reasonable. Then it comes down to personal philosophy.

All this piling on is a bit extreme. That said, the risk of cross-infection from reservoirs is known and seems to be rising, so i think that calculus has changed.
 

Amused

Elite Member
Apr 14, 2001
55,284
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Youre way overreacting to this. All hes saying is the cost/benefit analysis of polio previously was more of a coin flip, given:
Attenuated or inactivated vaccines are some of the riskiest as far as vaccines go. While the safety is still excellent, QC issues as stated above, or, depending on the nature of the vaccine, recombination of DNA can lead to wild-type virus.

In cases where risk of infection is so astronomically low that the risk of vaccination is roughly of equal magnitude, the analytical conclusion is roughly a coin flip and either choice (vaccinate or dont) become equally reasonable. Then it comes down to personal philosophy.

All this piling on is a bit extreme. That said, the risk of cross-infection from reservoirs is known and seems to be rising, so i think that calculus has changed.
I think you may be severely underreacting to the current anti-vax movement that just went on a full steroidal power ranger rage with the COVID vaccines and has grown to damn near 20% (or more) of the country now.
What many who do not follow the issue do not understand, is the current COVID refusal rate will be nearly the refusal rate of all vaccines going forward. We're going to have an entire generation severely under vaccinated and a resurgence of virtually all vaccine preventable diseases.

Unfortunately, society forgot what vaccine preventable epidemics look like and need to learn all over again the hard way.

Those COVID deniers now have unvaxxed kids who are infant-4 years old. Presenting an unprecedented percentage of unvaccinated children.

And I am betting as soon as Monkey Pox makes it's way into daycares and kindergartens we'll have a version of small pox all over again. Kids don't have gay sex but they are unabashedly (nonsexually) physically intimate with each other and spread every kind of parasite and disease


Paywall buster:

 
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Captante

Lifer
Oct 20, 2003
28,225
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I think you may be severely underreacting to the current anti-vax movement that just went on a full steroidal power ranger rage with the COVID vaccines and has grown to damn near 20% (or more) of the country now.
What many who do not follow the issue do not understand, is the current COVID refusal rate will be nearly the refusal rate of all vaccines going forward. We're going to have an entire generation severely under vaccinated and a resurgence of virtually all vaccine preventable diseases.

Unfortunately, society forgot what vaccine preventable epidemics look like and need to learn all over again the hard way.

Those COVID deniers now have unvaxxed kids who are infant-4 years old. Presenting an unprecedented percentage of unvaccinated children.

And I am betting as soon as Monkey Pox makes it's way into daycares and kindergartens we'll have a version of small pox all over again. Kids don't have gay sex but they are unabashedly (nonsexually) physically intimate with each other and spread every kind of parasite and disease


Paywall buster:


Yep... that all sounds about right with the exception of the leap on Monkey-pox and daycare centers. (it's plausible but very unlikely IMO)

Either way though I GOT the smallpox vaccine. ;)

Thing that bothers me the most on this topic are the apparent anti-vax "apologists" who play this stuff down all the time.

When one of these formerly eliminated/controlled disease's DOES cause a major outbreak (and it's only a matter of time) they'll be partially responsible.
 

HomerJS

Lifer
Feb 6, 2002
32,066
21,143
136
Is it time we give insurance companies the option when people refuse vaccinations and catch a given disease the option not to cover.

This way people will make smarter decisions or pay for treatment themselves.
 

Amused

Elite Member
Apr 14, 2001
55,284
12,032
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Yep... that all sounds about right with the exception of the leap on Monkey-pox and daycare centers. (it's plausible but very unlikely IMO)

Either way though I GOT the smallpox vaccine. ;)

Thing that bothers me the most on this topic are the apparent anti-vax "apologists" who play this stuff down all the time.

When one of these formerly eliminated/controlled disease's DOES cause a major outbreak (and it's only a matter of time) they'll be partially responsible.
It is spread through close contact skin to skin contact, contact with fabric that has touched sores, and respiratory secretions.

This is just WAITING for a daycare. I don't see how it couldn't be spread there.



  • Monkeypox can spread to anyone through close, personal, often skin-to-skin contact, including:
    • Direct contact with monkeypox rash, scabs, or body fluids from a person with monkeypox.
    • Touching objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with monkeypox.
    • Contact with respiratory secretions.
  • This direct contact can happen during intimate contact, including:
    • Oral, anal, and vaginal sex or touching the genitals (penis, testicles, labia, and vagina) or anus (butthole) of a person with monkeypox.
    • Hugging, massage, and kissing.
    • Prolonged face-to-face contact.
    • Touching fabrics and objects during sex that were used by a person with monkeypox and that have not been disinfected, such as bedding, towels, fetish gear, and sex toys.
  • A pregnant person can spread the virus to their fetus through the placenta.
It’s also possible for people to get monkeypox from infected animals, either by being scratched or bitten by the animal or by preparing or eating meat or using products from an infected animal.

A person with monkeypox can spread it to others from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. The illness typically lasts 2-4 weeks.
 
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Captante

Lifer
Oct 20, 2003
28,225
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It is spread through close contact skin to skin contact, contact with fabric that has touches sores, and respiratory secretions.

This is just WAITING for a daycare. I don't see how it couldn't be spread there.



  • Monkeypox can spread to anyone through close, personal, often skin-to-skin contact, including:
    • Direct contact with monkeypox rash, scabs, or body fluids from a person with monkeypox.
    • Touching objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with monkeypox.
    • Contact with respiratory secretions.
  • This direct contact can happen during intimate contact, including:
    • Oral, anal, and vaginal sex or touching the genitals (penis, testicles, labia, and vagina) or anus (butthole) of a person with monkeypox.
    • Hugging, massage, and kissing.
    • Prolonged face-to-face contact.
    • Touching fabrics and objects during sex that were used by a person with monkeypox and that have not been disinfected, such as bedding, towels, fetish gear, and sex toys.
  • A pregnant person can spread the virus to their fetus through the placenta.
It’s also possible for people to get monkeypox from infected animals, either by being scratched or bitten by the animal or by preparing or eating meat or using products from an infected animal.

A person with monkeypox can spread it to others from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. The illness typically lasts 2-4 weeks.
Like I said... it's a plausible theory.

If you want to see some REAL problems how about if it evolves to spread via droplets like the aforementioned Smallpox? (assuming its not already)

Even worse from what I've read normal medical-grade protective gear is sometimes ineffective against Monkey-Pox with cases have been spread to care-givers apparently through gloves/N-95 masks and clothing.
 
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Amused

Elite Member
Apr 14, 2001
55,284
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Like I said... it's a plausible theory.

If you want to see some REAL problems how about if it evolves to spread via droplets like the aforementioned Smallpox? (assuming its not already)
Scary, but unlikely... that never happened to smallpox in all the millennia it infected people. It was always close contact.

"Smallpox spreads from contact with infected persons. Generally, direct and fairly prolonged face-to-face contact is required to spread smallpox from one person to another. Smallpox also can be spread through direct contact with infected bodily fluids or contaminated objects such as bedding or clothing."

In fact, the spread of smallpox is virtually identical to monkeypox.

Which is why I think it's somewhat probable it will spread like wildfire as soon as it reaches schools and daycares.
 
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