‘Four-alarm blaze’: New York’s public health crises converge

hit two

But amid the struggle to respond to monkeypox, a new threat emerged.

On July 18, Bryon Backenson, director of the department’s Office of Communicable Diseases, received a call from Kirsten St. George, director of virology and chief of the viral disease lab at the state’s public health lab, Wadsworth Center. Days earlier, the health department had reminded health care providers to watch out for signs and symptoms of acute flaccid myelitis, a polio-like illness.

“It just so happened that that advice came out… pretty much the day before the person who turned out to be our polio case was presented in the hospital,” Backenson said in August. “This particular piece of advice that we put out… really put them at the forefront of their minds to be wary.”

St. George was one of the first to discover the positive case in a person living in Rockland County.

“The lab molecular supervisor showed up at the doorway of my office and simply said, ‘Kirsten, that paralysis case in town…we’ve got the result: It’s probably type 2 polio,'” St. George recalled. “I just looked at him and said, ‘You’re kidding.'”

She asked to run the series again.

“As soon as he told me the result, my mind, your mind, I think, for everyone in that situation, starts running in quite a few different directions at once,” St. George said. “The importance of the finding, the public health implications, the many people who need to be notified… the implications. But also a single thought: where on earth does it come from?”

Scientists at the center had no immediate answer.

Overwhelmed with thoughts of the worst-case scenario, St. George and her team at the Wadsworth Center contacted the CDC. The CDC, members of the Wadsworth Center and health department officials met by phone to develop a plan to determine how the person contracted the virus and the exact extent to which it spread. It’s not entirely clear yet, officials said.

The CDC is testing New York’s wastewater to get an idea of ​​where the virus may be circulating. Samples have tested positive in several counties, including New York City, Sullivan, Rockland and Orange.

Epidemiologists have determined that the Rockland case… genetically linked on a sample from wastewater in Israel and the UK – but that doesn’t mean the person there has contracted the virus. This means that the mutations in the wastewater samples are comparable.

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“We don’t really know where the transmission took place,” Emily Lutterloh, director of the health department’s epidemiology division, said in an August interview.

And that’s part of what’s causing unrest in the department. Polio can spread undetected — and at least one of the counties where wastewater samples have tested positive has a lower rate of polio vaccination than many other areas in the state.

“I’m concerned about people who don’t take polio seriously,” Backenson said. “Because it spreads somewhat invisibly… [and] the vast majority of people have no signs and symptoms, we can quickly increase the amount of polio circulating in a particular area, only increasing the risk. And it brings us to the point where we’re going to see even more cases of paralytic polio.”

As officials worked quickly to respond to a possible spread of polio, cases of monkey pox continued to rise. In August, New York City reported nearly 2,700 cases.

On Aug. 9, the White House announced that the Food and Drug Administration was proposing an alternative method of administering the monkeypox vaccine to help increase the number of doses available. The shots, the FDA said, must be administered intradermally, or between the layers of skin. The new method, officials said, would increase vaccine supply fivefold.

Since then, New York’s monkey pox cases have leveled off, providing the health department with much-needed help.

But concerns about polio only seem to be growing.

In recent weeks, health department officials and top officials from Biden and the White House have debated ways to ramp up vaccinations in communities that traditionally resist gunshots. On Sept. 9, Governor Kathy Hochul announced a public health emergency for polio, hoping it will convince more people in the state to get vaccinated. And last week, Bassett declared polio virus an immediate threat to public health, freeing up additional state resources for local health departments to increase vaccinations.

“Human resources are at the heart of public health infrastructure,” Santilli said. “Really able to support [staff] …will be really critical to ensuring that infrastructure can continue to support public health responses and day-to-day operations.”


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