“Flame at 4 alarms”: New York’s public health crises converge

strike two

But amid the rush to respond to monkeypox, a new threat has 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 head of the viral diseases lab at the Wadsworth Center, the state’s public health lab. . The health department had days earlier reminded health care providers to watch out for the signs and symptoms of acute flaccid myelitis, a polio-like illness.

“This notice just happened to appear … about the day before the individual who turned out to be our polio case presented to the hospital,” Backenson said in August. “That particular advisory that we put out…really brought their minds to the fore.”

St. George was one of the first to find out about the positive case of someone living in Rockland County.

“The lab’s molecular supervisor appeared on my office doorstep and simply said, ‘Kirsten, that paralysis case in town…we’ve got the result: it’s probably type 2 polio’. remembers St. George. “I just looked at him and said, ‘You’re kidding. “”

She asked for the sequence to be replayed.

“As soon as he told me the outcome, my mind, your mind, I think, for anyone in that situation, starts racing in a lot of different directions at once,” St. George said. “The significance of the discovery, the implications for public health, the many people who need to be informed… the consequences. But also just one thought: where the hell did it come from?

Scientists at the center had no immediate answer.

Flooded 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 individual contracted the virus and the exact degree to which it was spreading. It’s still not entirely clear, officials said.

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

Epidemiologists have determined that Rockland’s case is genetically linked to a sample taken from sewage in Israel and the UK – but that does not mean the individual contracted the virus there. This means that the mutations in the wastewater samples are similar.

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

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

“I’m afraid people don’t take polio seriously,” Backenson said. “Because it spreads somewhat invisibly… [and] the vast majority of people have no signs or symptoms, we can rapidly increase the amount of polio that can circulate in a particular area, which only increases the risk. And that brings us to the point where we’re going to see additional cases of paralytic polio.

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

On August 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 injections, according to the FDA, must be administered intradermally or between the layers of the skin. The new method, officials said, would increase vaccine supplies fivefold.

Since then, monkeypox cases in New York have stabilized, bringing much-needed relief to the health department.

But concerns about polio are only growing.

Over the past few weeks, health department officials and senior Biden and White House health officials have debated ways to scale up vaccinations in communities that have traditionally been resistant to injections. On September 9, Governor Kathy Hochul announced a public health emergency for polio, hoping this will convince more people in the state to get vaccinated. And last week, Bassett declared poliovirus an imminent threat to public health, opening up additional public resources to local health departments to increase vaccinations.

“Human resources are at the heart of the public health infrastructure,” Santilli said. “To be able to really support [staff] … is really going to be essential to ensure that the infrastructure can continue to support public health responses and day-to-day operations.


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