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Wastewater to be tested for polio in some Michigan communities

Michigan is working with federal officials to assess in which under-vaccinated communities to begin testing wastewater for polio.

On Wednesday, Nov. 30, the U.S. Centers for Disease Control and Prevention announced it would expand the polio surveillance being conducted in New York to two additional areas — Michigan and Philadelphia.

Which Michigan counties will undergo surveillance for polio remains to be seen, though the Associated Press identified Oakland County as one such location. State officials said Thursday they’re working with the CDC to identify which communities have the greatest risk for polio transmission based on lower vaccination rates.

Once testing begins, it’s expected to last at least four months. The results will be used to help determine if the program should be continued and/or expanded to other communities.

“Wastewater testing can be an important tool to help us understand if poliovirus may be circulating in communities in certain circumstances,” said Dr. José R. Romero, Director of CDC’s National Center for Immunization and Respiratory Diseases, in a prepared statement.

“Vaccination remains the best way to prevent another case of paralytic polio, and it is critically important that people get vaccinated to protect themselves, their families and their communities against this devastating disease.”

Related: After COVID, wastewater could be used to detect flu and other viruses

Polio is an infectious and potentially life-threatening disease caused by the poliovirus. The virus can infect a person’s spinal cord, causing paralysis and/or meningitis. Even children who appear to recover from polio can develop muscle pain, weakness or paralysis as adults, according to the CDC.

In July, the New York State Department of Health identified a case of paralytic polio in an unvaccinated young adult in Rockland County. The individual experienced severe symptoms including paralysis and was hospitalized.

More than 99% of children who receive the recommended doses of polio vaccine are protected from polio, per the CDC. Good hygiene is also important, as the virus can be spread through an infected person’s saliva, respiratory droplets, and/or feces.

It’s recommended that children get four doses of polio vaccine. The first doses are typically given at 2 months and 4 months, with the third administered between months 6 and 18, and the fourth given between age 4 and 6 years.

Michigan requires children to be vaccinated against 14 communicable diseases including polio. In 2020, about 93% of K-12 students were fully vaccinated against those disease, while about 3.3% had received waivers allowing them to attend school without the required shots.

Of the 14,163 waiver requests in 2020, 65% were for philosophical reasons, 31% were for religious reasons, and about 5% were for medical purposes.

Of Michigan’s 83 counties, 13 had a waiver rate of 5.3% or higher in 2020. The majority were located in northern Michigan, including Benzie, Charlevoix, Emmet, Houghton, Kalkaska, Leelanau, Montmorency, Oscoda, Ogemaw, and Presque Isle. The other three — Lapeer, Livingston and St. Clair counties — are in southeast Michigan.

Below is a map of Michigan’s 2020 kindergarten immunization rates by school district. Hover over, and click on, school districts in your region to see more 2020 data.

Viruses can be passed through human saliva and feces, which end up in the sewer system. Those samples can then be tested for the genomic material in various pathogens.

During the coronavirus pandemic, researchers found wastewater surveillance useful for catching trends in transmission rates before case data was available. The state greatly expanded its surveillance capability from two university labs to now at least 20 labs throughout the state.

In recent months, wastewater surveillance has been used to track other viruses including influenza, norovirus and monkeypox/mpox.

The federal government hasn’t allocated additional dollars for Michigan to fund its wastewater surveillance for polio, but a health department spokesperson said the state submitted a request for authorization to redirect certain funds to support wastewater sampling activities.

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