On 22 June 2022, the UKHSA announced it had launched investigations after discovering vaccine derived polio virus in sewage samples. The report suggests that there has likely been community spread between closely linked individuals in North-East London. They say it is likely that this has happened because someone who has been vaccinated overseas with the live oral polio vaccine (OPV) returned or travelled to the UK and briefly ‘shed’ traces of the vaccine-like poliovirus in their faeces.
On 14 November 2022, the UKHSA updated its urgent public health message for the NHS on the detection of vaccine derived polio virus in sewage samples:
Regulation 2(1)(b) of the Health Protection (Notification) Regulations 2010 places a duty on registered medical practitioners (RMPs) to report any suspected infections that present or could present significant harm to human health. This covers reporting of acute flaccid paralysis and acute flaccid myelitis (AFP/AFM) not explained by a non-infectious cause.
Full information can be found on the UKHSA webpage or in the PDF below.
The last case of wild polio contracted in the UK was confirmed in 1984, and the UK was declared polio-free in 2003. The live oral polio vaccine is no longer used in the UK and instead an inactivated vaccine is used which is not shed in this way.
Polio vaccines are administered to children when they are 8, 12 and 16 weeks old, with booster vaccines which contain polio before starting school at 3 years 4 months and at 14 years. As uptake of the vaccines is suboptimal, some children and young people will not be protected against polio and so it is very important that they are vaccinated. Vaccination is proven to be a highly effective intervention to prevent diseases such as polio which can cause paralysis in people who are not fully vaccinated. If one or more vaccines have been missed the GP can help to arrange an appointment as there is no upper age limit for polio vaccination.
Professor Helen Bedford, Immunisation Lead for the Royal College of Paediatrics and Child Health (RCPCH), said:
The news that polio virus has been found in London is concerning. In the UK this disease was consigned to history nearly two decades ago. It is reassuring that the UKHSA is investigating the situation. In the meantime, parents are urged to ensure that children who may have missed their polio vaccination for whatever reason are vaccinated now.
This is a stark reminder of the importance of routine childhood immunisations and ensuring continued high uptake. The diseases that these vital vaccines prevent have not disappeared, and lower vaccine uptake allows them to re-emerge. Parents can check their child’s Red Book to see if they have been vaccinated or if unsure by speaking to their GP, health visitor or practice nurse.
To paediatricians, we would highlight that you should take every opportunity to enquire with patients, parents and carers about their vaccination history, and to help them understand the importance of vaccination.