As polio threatens a return, UK expert calls for extensive antibody testing to protect vulnerable communities

Positive poliovirus samples found in sewage in the UK and US have prompted fears of the return of this potentially fatal disease. A leading expert is calling for widespread polio antibody testing in affected areas, to assess the threat to individuals and communities.

Concerns continue to grow that polio could make a reappearance in the UK. Following the detection of positive poliovirus samples in London sewage, the Joint Committee on Vaccination and Immunisation (JCVI) has advised targeted polio booster doses for all children aged between 1 and 9 in all London boroughs. It says this move will ensure a high level of protection against the virus and limit further spread. Some of the polio samples found in the UK have been genetically linked to a case reported in July 2022 in New York, where a State of Emergency was declared.

The leading testing expert, Dr Quinton Fivelman PhD, Chief Scientific Officer at London Medical Laboratory, says: ‘The last case of polio in the UK was in 1984 and it’s obviously concerning that type 2 (PV2) polio samples have been detected in the UK’s waste water. Now the virus’ presence has been established in London’s sewage network, testing is being quickly expanded to other areas. The additional sewage treatment sites where the sampling is being rolled out are in parts of Birmingham, Blackburn, Bradford, Brighton and Hove, City of Bristol, Bury, Castle Point, Glasgow, Leeds, Leicester, Liverpool, Luton, Manchester, North Tyneside, Newcastle upon Tyne, Gateshead, Nottingham, Preston, Salford, Sheffield and Watford.

‘Before the polio vaccine was introduced in the ’60s and ’70s, polio infection was fairly common. As recently as the 1950s, around 8,000 people every year developed paralysis from the disease in the UK alone.

‘While no confirmed cases of the virus, which can cause paralysis and death, have been detected in the UK yet, it would seem prudent for the UK Government to consider the introduction of polio antibody testing. This will reassure individuals that their polio vaccinations are still effective and give us a wider idea of how protected communities are. This move would strengthen the current rollout of boosters of the inactivated polio vaccine (IPV) to children within London.

‘The areas chosen for further sewage testing have been determined by factors such as demographics. For example, one potential cause for concern could be population groups with links to countries overseas where wild poliovirus is still found or where the live oral polio vaccine is still used. Other considerations include whether a community has low polio vaccination coverage or is adjacent to locations in London where poliovirus has already been detected. These areas should also be considered for widespread polio antibody testing, to gain a further idea of the scale of potential cases.

‘Some groups may be particularly at risk. Vaccination for poliovirus in London is about 86.6% overall, and 71.4% for the preschool booster, according to the UK Health Security Agency (UKHSA).  Fewer than half of 13 to 14-year-olds received their teenage booster against polio in some parts of England in 2021, with just 35% of 13 and 14-year-olds receiving polio boosters in Hillingdon, west London, which had the worst coverage in the country.

‘Of the instances of poliovirus found so far, only a few have sufficient mutations to be classified as type 2 vaccine-derived poliovirus (VDPV2). VDPV2 is of greater concern as it behaves more like naturally occurring “wild” polio and could lead to cases of paralysis in unvaccinated people.

‘Meanwhile, in the US, health officials say wastewater samples in New York City and four adjacent counties have tested positive for poliovirus. Although only one case has so far been confirmed, it was the first in the country in nearly a decade. Britain’s UKHSA is working closely with health agencies in New York and Israel, alongside the World Health Organisation (WHO), to investigate the links between the virus detected in London and recent cases in these two other countries. Genetic tests have shown the samples found in London were related to the case of a man who developed polio infection in New York and in samples found in Israel.

‘Testing for the presence of the virus in individuals is usually done using stool samples. However, only a simple blood test is needed to establish if a person has successfully developed antibodies after being vaccinated or still retains their antibodies from their childhood vaccination. It’s true that these tests are currently expensive and specialist but that’s because, until now, they have rarely been required. The Government must consider a more widespread programme of antibody testing similar to its Covid-19 response.

‘In the absence of easily obtainable polio antibody tests, a general health test might be a useful course of action for anyone concerned, to ensure they are in overall good health to help fight the symptoms of new viruses. London Medical Laboratory’s Health Profile Test provides people with a comprehensive check-up of their general health, including vitamin D levels, diabetes (HbA1c), liver & kidney function, full blood count, bone health, iron levels and a full cholesterol profile.

‘It can be taken at home through the post, or at one of the many drop-in clinics, selected pharmacies and health stores that offer this test across London and UK-wide. For full details, see: https://www.londonmedicallaboratory.com/product/general-health