Antimicrobial Stewardship

Ebola

HCV / Hepatitis

Blood-Borne Diseases

Climate Change

Coronavirus

Covid Vaccine Race

E. Coli

Food Safety

Listeria

Salmonella

Food Borne Infection / Food Safety

C. Difficile

H. Pylori

Norovirus

Gastrointestinal Infections

Healthcare Associated Infections (HAI)

Antibiotics

Immunizations

Vaccines

Prevention

Community-Acquired Pneumonia 

HAP / VAP

Influenza

Respiratory Infections

HIV / AIDS

PrEP

Sexually Transmitted Diseases

MRSA

Skin & Soft Tissue Diseases

Lyme Disease

ZIKA

Zoonotic & Vector-Borne Diseases

News

Media

Medical World News

Podcasts

Videos

Insights

Peer Exchange

News Network

Roundtables

Conference

Conference Coverage

Conference Listing

Publication

CME/CE

Partners

Resources

Interactive Tools

Special Projects

Contribute

Case Studies

Writers and Mentors

Subscribe

Contagion® is a fully integrated news resource for practitioners and specialists to assist with the identification, diagnosis, treatment, and prevention of infectious diseases.

About Us

Advertise

Editorial

Contact Us

Do Not Sell My Information

Privacy

Terms & Conditions

Contagion Live | Infectious Disease News & Expert Insights

Facebook

LinkedIn

Spotlight

Bench to Bedside With SIDP

C. difficile 

Clinical Corner

Gastrointestinal infections

Hepatitis

RSV: A New Era in Prevention

Clinical

COVID-19

Food-Borne Infections

Healthcare-Associated Infections

Respiratory Diseases

Respiratory Syncytial Virus (RSV)

Video Series

Peers and Perspectives

1rem

Authors

Making Lemonade Out of Lemons: The Effect of Mandatory Infectious Diseases Consultation on Carbapenem Use after Drug Shortages

Along with a 1 reported case in Massachusetts, the

New Hampshire Department of Health and Human Services (DHHS) has confirmed a person infected with eastern equine encephalitis (EEE) has died. The public health agency said the person was hospitalized due to severe central nervous system disease. The last reported human EEEV infection in New Hampshire was in 2014, when DHHS identified 3 human infections, including 2 fatalities. In the same statement, DHHS mentions there has been 1 confirmed case in Vermont this summer.

On August 16, the Massachusetts Department of Public Health (MDPH) released a statement discussing the confirmation of the first human case of EEE in the state this year. The confirmed case was discovered in an 80 year old man who was exposed to the vector borne disease in Worcester County. As a result, the risk level in the local communities of Douglas, Oxford, Sutton, and Webster has been raised to critical, and in Dudley, Northbridge, and Uxbridge the risk is increased to high.

Additionally, the neighboring communities of Auburn, Charlton, Grafton, Leicester, Mendon, Millbury, Millville, Southbridge, and Upton are now considered at moderate risk according to MDPH.

“This is the first time we have seen a person infected with EEE in Massachusetts since 2020,” Public Health Commissioner Robbie Goldstein, MD, PhD, said in a statement. “EEE is a rare but serious disease and a public health concern. We want to remind residents of the need to protect themselves from mosquito bites, especially in areas of the state where we are seeing EEE activity.

Though very rare, EEE is serious and a potentially fatal disease that can affect people of all ages. EEE is generally spread to humans through the bite of an infected mosquito. There were 12 human cases of EEE in Massachusetts in 2019 with 6 deaths, and 5 human cases with 1 death in 2020. There were no human cases of EEE in Massachusetts in 2021, 2022, or 2023.

EEE has a fatality rate of 33% to 70%, with most deaths occurring 2–10 days after the onset of symptoms.

In addition to a high mortality rate, long-term physical and mental complications, including permanent neurological deficits have been identified in many people who survive EEE.

Plymouth is approximately 40 miles south of Boston along the coast, and Worcester County is in the middle of the state, so the 2 areas are not in close proximity, but due to the elevated risk locally, the town of Plymouth decided to take action in response to outdoor parks. As of last Friday, all town public parks and fields are close daily from dusk until dawn.

“As Mass DPH has now elevated Plymouth’s EEE risk status to high, it is important to take extra precautions when outdoors and follow state and local health guidelines to avoid unnecessary risk to exposure to EEE. The health and safety of our community, residents, and visitors remain our priority,” Plymouth’s Commissioner of Health and Human Services, Michelle Bratti, said in a statement.

According to the Centers for Disease Control and Prevention (CDC) most people who are infected with the virus do not develop symptoms; however, for those that do, the date from the bite to the onset of the illness is 4 to 10 days. EEE can also result in fever or neurologic disease. The type of illness will depend on the age of the person and other factors. Those who are infected can develop meningitis.

There are no FDA-approved treatments for EEE and for patients who develop severe cases, they can be hospitalized to receive supportive treatment.

Over the weekend, MDPH detailed plans of spraying for mosquitos including aerially in areas of Plymouth County, and truck-mounted spraying in parts of Worcester County. As of Saturday, 10 communities in Massachusetts were raised to high or critical risk for EEE virus.

“The risk from EEE is high in parts of Plymouth County and critical in parts of Worcester County,” State Epidemiologist Catherine M. Brown, DVM, said in a statement. “In addition to recommending that people use mosquito repellent with an EPA-registered active ingredient and clothing to reduce exposed skin, we also recommend that evening outdoor events be rescheduled to avoid the hours between dusk and dawn. The mosquitoes most likely to spread EEE are most active during the dusk to dawn hours.”

There are preventative strategies to avoid EEE, and the MDPH has listed such measures 

For those who live in Massachusetts and want more information on EEE, it can be found 

 or by calling the DPH Division of Epidemiology at 617-983-6800.

1.NH DHHS Identifies Person Infected with Eastern Equine Encephalitis Virus in New Hampshire.The New Hampshire Department of Health and Human Services. August 27, 2024. Accessed August 28, 2024.
https://www.dhhs.nh.gov/news-and-media/nh-dhhs-identifies-person-infected-eastern-equine-encephalitis-virus-new-hampshire
2. State health officials announce season’s first human case of Eastern Equine Encephalitis in Massachusetts. MDPH. August 16, 2024. Accessed August 27, 2024.
https://www.mass.gov/news/state-health-officials-announce-seasons-first-human-case-of-eastern-equine-encephalitis-in-massachusetts
3.Plymouth to Close all Public Parks and Fields from Dusk to Dawn. Town of Plymouth. August 23, 2024. Accessed August 27, 2024. PDF.
4. Eastern Equine Encephalitis: Symptoms, Diagnosis, and Treatment. CDC. May 15, 2024. Accessed August 27, 2024.
https://www.cdc.gov/eastern-equine-encephalitis/symptoms-diagnosis-treatment/index.html
5. State officials announce plans to spray for mosquitoes in sections of Worcester and Plymouth counties due to EEE. MDPH. August 24, 2024. Accessed August 27, 2024. 
https://www.mass.gov/news/state-officials-announce-plans-to-spray-for-mosquitoes-in-sections-of-worcester-and-plymouth-counties-due-to-eee



The town of Plymouth decided to prohibit people from using the parks from dusk to dawn due to concerns over eastern equine encephalitis after a man contracted the rare disease in the state.

Concerns Over Mosquito-Borne Illness Causes Massachusetts Town to Create Curfew for Parks, Spraying in Counties

David Richards emphasized the therapy’s potential to enhance antibiotic effectiveness by targeting bacterial biofilms, a significant challenge in treatment.

Clarametyx Biosciences Initiates Phase 2a Trial for CMTX-101 in Cystic Fibrosis Patients

Clarametyx Biosciences, Inc has announced the initiation of the Phase 2a trial for its antibody therapy, CMTX-101, following the successful completion of Phase 1b. This new stage will further evaluate CMTX-101 as an adjunct treatment for chronic pulmonary infections in patients with cystic fibrosis (CF).

At IDWeek, David Richards, CEO of Clarametyx Biosciences, highlighted the company’s commitment to tackling bacterial biofilms, which significantly contribute to antibiotic resistance. “Our technology platform is all about bacterial biofilms, which are a key component of bacterial defense that drive recalcitrance and resistance to antibiotic action. Our lead effort is CMTX-101, which is a therapeutic monoclonal antibody. This antibody targets the DNA b2 binding protein, which is a bacterial-only protein that has a critical intracellular function. But for our purposes, it binds an extracellular DNA lattice that stabilizes this bacterial biofilm, and the only thing our drug does is bind that protein, resulting in rapid collapse of the biofilm. This is important because it enables innate immune effectors and antibiotics to do their job better.”

: The trial is structured as a double-blind, randomized, placebo-controlled study assessing the safety, tolerability, pharmacokinetics, and immunogenicity of CMTX-101 when used alongside standard antibiotic therapies. The study aims to enroll up to 41 adults diagnosed with CF, with results expected in 2025. Preliminary data from earlier phases indicated no safety concerns associated with the use of CMTX-101.

Richards further detailed the clinical progress, saying, “We've been steadily making progress in the clinic to prove out this novel technology and mechanism. With respect to CMTX-101, we first completed a Phase 1a in 20 healthy volunteers in 2023. Recently, in Q1 2024, we began a Phase 1b trial focused specifically on individuals with cystic fibrosis who are chronically infected with Pseudomonas aeruginosa. This study involved 41 subjects, and we just completed the Phase 1b portion, having dosed our first patient in the 2a trial just yesterday. This study is not only looking at safety but also early signals of efficacy regarding bacterial load and sputum. Additionally, we have recently completed our Phase 1b study in bacterial pneumonia, which combined safety assessments with our Phase 1a findings. The topline results showed not only safety but also encouraging trends in key inflammatory biomarkers, including IL-6, PCT, and CRP. While this was a small study, we are encouraged by the results.”

Looking forward, Richards elaborated on the broader implications of their therapeutic approach: “The beauty of this approach, to reiterate, is that it targets a highly conserved protein across bacterial species. With a single therapeutic like CMTX-101 or a vaccine with CMTX-301, we have the potential to cover a wide range of pathogens. Initially, with CMTX-101, we’re focusing on the chronic respiratory space. We believe we can intervene in bronchiectasis, which is common in cystic fibrosis and non-CF bronchiectasis, as well as in anti-M lung disease. By addressing chronic bronchial infections—an integral part of the vicious cycle that leads to lung function decline and increased mortality—we aim to improve outcomes and reduce therapy regimens in these patients. We see potential for this approach to extend to other bacterial infections, including prosthetic joint infections and skin diseases.”

In conclusion, Richards emphasized the transformative potential of their research, stating, “We think we have a truly novel category of therapy and vaccine that, if our preclinical data translates, could really change treatment paradigms in the clinic.” Clarametyx's dedication to combating bacterial biofilms aligns with its strategic mission to address chronic infections. The company has also recently completed a study of CMTX-101 for community-acquired bacterial pneumonia, which yielded promising safety and efficacy data.

Clarametyx Biosciences Announces Progress on Study of Antibody Therapy CMTX-101 for Infections Associated With Cystic Fibrosis. 

October 17, 2024. Accessed October 24, 2024. 

https://www.biospace.com/news/clarametyx-biosciences-announces-progress-on-study-of-antibody-therapy-cmtx-101-for-infections-associated-with-cystic-fibrosis

Conferences

The STOP-CDI intervention presented by Matthew J Ziegler, MD MSCE revealed using prophylactic enteral vancomycin, significantly reduced hospital-onset C difficile infections  among immunocompromised patients.

Targeted Prophylaxis Reduces Hospital-Onset C. difficile Infections in High-Risk Patients

Patients undergoing immunosuppression for cancer treatment and transplantation are at the highest risk for developing hospital-onset 

 infections (HO-CDI). STOP-CDI investigated a prophylactic enteral vancomycin intervention aimed at reducing HO-CDI rates in high-risk hospitalized patients. The STOP-CDI intervention was found to effectively reduce HO-CDI rates, length of stay, and associated symptoms within this vulnerable population.

Matthew J Ziegler, MD MSCE, assistant professor of medicine at UPenn, presented the STOP-CDI trial results at IDWeek and discussed key findings on screening and targeted prophylaxis for CDI, and whether they challenge and/or support current clinical practices. “The key finding of our research was that among the patients who were screened, there was a very low rate of HO-CDI, less than 1%, compared to our control group, which had roughly 5.6% after waiting for the same diseases. We found that this STOP intervention was very successful at reducing HO-CDI, which contrasts with common clinical and infection control practices.”

From November 2021 to December 2023, 692 patients were screened for 

, with 11% colonized. The intervention group had lower odds of HO-CDI compared to matched controls, with a number needed to screen 31. Notable reductions in 90-day HO-CDI rates, stool output, and length of stay were observed, while no differences in vancomycin-resistant Enterococcus (VRE) infections or mortality were noted.

Ziegler discussed the implications for specific patient populations at higher risk for CDI, “When we did subgroup analyses of our research and looked at the relative benefit in solid organ transplant versus oncology patients, we saw a pretty stark difference. Our oncology patients historically had roughly a 7.5% rate of HO-CDI, and that went down to 1% in our intervention, showing a large difference and significant benefit from the intervention.”

Patients undergoing solid organ transplants, autologous stem cell transplants, CAR-T therapy, or leukemia treatment were screened for 

 colonization. Those who tested positive received oral vancomycin prophylaxis for 10 days or until discharge. Outcomes were compared to concurrent and historical controls, with the primary outcome being HO-CDI and secondary outcomes including 90-day CDI rates, stool output, length of stay, VRE infections, and mortality.

“On the other hand, our solid organ transplant patients were enrolled during their index admission for organ transplantation, and our historical rate of HO-CDI in that group is only 1%. While that dropped from 1% to zero, that’s a much smaller absolute difference. We thought that would be a group likely to benefit, but it turns out that this group seems to be at lower risk of transitioning from colonization to an infection state during that specific time period,” Ziegler said.

Ziegler discussed the integration of screening and prophylactic measures for CDI evolving in clinical settings, considering emerging guidelines and antibiotic stewardship initiatives: “I think the uptake of this practice, clinically or more broadly, requires some additional research to identify other patient populations that are at high risk. It’s possible that there are other patient populations where this intervention may also be useful, but it’s also possible that this research intervention, or the STOP intervention, may not be beneficial for all hospitalized patients.”

Ziegler concludes, “Many antibiotic stewardship interventions focus on giving antibiotics to patients who will benefit and trying to avoid them in patients who won’t. I think this targeted prophylaxis approach really falls in line with some of these tenets of antibiotic stewardship.” Future research will explore how targeted screening and prophylaxis can reduce 

 transmission in various units and its effectiveness in other patient populations.

Ziegler M, et. al. Screening and Targeted Prophylaxis for 

Infection: STOP-CDI. Presentation #203 presented at IDWeek 2024. October 16-19, 2024. Los Angeles, CA.

The STOP-CDI intervention presented by Matthew J.Ziegler, MD MSCE revealed using prophylactic enteral vancomycin, significantly reduced hospital-onset C difficile infections  among immunocompromised patients.

Targeted Prophylaxis Reduces Hospital-Onset C difficile Infections in High-Risk Patients

John McLaughlin, PhD, examines high-risk individuals with prior SARS-CoV-2 immunity and presents that Paxlovid reduces the risk of hospitalization, death, and severe symptoms, highlighting its ongoing value for high-risk patients in a post-peak pandemic landscape.

 Evaluating the Efficacy of Paxlovid in High-Risk Patients with Pre-Existing Immunity

The EPIC-HR trial, conducted early in the COVID-19 pandemic, demonstrated that oral nirmatrelvir-ritonavir (NMV/r) is over 85% effective in preventing hospitalization and death among unvaccinated high-risk patients, raising questions about its relevance in today's context of high population-level immunity. Although, the relevance of these findings in the context of current high population-level immunity remains unclear. To address this, investigators evaluated the efficacy of NMV/r (Paxlovid) in a subset of high-risk trial participants with pre-existing SARS-CoV-2 immunity from prior infection or vaccination. This analysis focused on the outcomes associated with Paxlovid in high-risk EPIC-HR and EPIC-SR modified intention-to-treat patients with a history of SARS-CoV-2 infection or vaccination.

John McLaughlin, PhD, epidemiologist, VP, and head of anti-infectives, COVID-19, and flu vaccines at Pfizer provides an overview at last week’s IDWeek this real-world analysis, “One of the questions with Paxlovid in the contemporary era is, how is Paxlovid performing among people who have pre-existing immunity, either from vaccination or prior infection? Because in the original trials, everybody was pretty much unvaccinated, and most people had no evidence of previous infection. The analysis that we did took people from our first study, EPIC-HR, who were baseline seropositive, or people from the EPIC-SR trial who were previously vaccinated, and we still showed that in that population, people with pre-existing immunity, Paxlovid was still providing a benefit against hospitalization and death, severe symptoms, all symptoms. It's still working, even though the height of the pandemic has come down and more people have baseline immunity.”

A total of 1,600 participants were involved in the study. Among them, 969 were high-risk and had SARS-CoV-2 antibodies, while 631 were high-risk and vaccinated. Of these, 807 received Paxlovid, and 793 received a placebo.

Paxlovid lowered the risk of COVID-19 hospitalization and death by 73.7% compared to placebo. It also reduced medical visits for COVID-19 by 65% and severe symptoms by 22% to 46% in the weeks after treatment. Additionally, those who took Paxlovid experienced symptom relief two days sooner than those on placebo.

McLaughlin discussed the new information this analysis provides about Paxlovid in previously infected or vaccinated patients, “I think the biggest thing that it adds is that there's still an incremental benefit in today's world among people with pre-existing immunity to take Paxlovid. If you're a high-risk patient and you're eligible for Paxlovid, it's still providing a benefit against hospitalization and death. We also showed that it reduced severe symptoms and reduced all COVID-19-related medical encounters, so it's still providing a benefit, even though the absolute rates of disease aren't the same as we saw early on in the pandemic.”

The effectiveness of Paxlovid administered within 5 days of the onset of COVID-19 symptoms was evaluated against a placebo over 28 days across various pre-defined outcomes. The analysis combined data from two Phase 2/3 randomized controlled trials with modified intention-to-treat populations: 

1. High-risk EPIC-HR patients who were unvaccinated and seropositive for SARS-CoV-2 at baseline

2. High-risk EPIC-SR patients who had previously received a COVID-19 vaccine.

According to McLaughlin, clinicians should note, “There’s still a benefit of Paxlovid, and even though we're not in the height of the pandemic, it's still providing a benefit for patients. So if you have an eligible patient in front of you who could benefit from Paxlovid and meets the guidelines for Paxlovid, then you should think about offering that drug to them, because it's still going to reduce their risk of severe outcomes that we know are still occurring from COVID-19.”

In a group of trial participants with existing natural or vaccine-derived immunity to SARS-CoV-2, Paxlovid treatment significantly lowered the risk of COVID-19 hospitalization and death, with a number needed to treat of 71. Patients who received the treatment also had fewer medical visits related to COVID-19, a lower chance of experiencing severe symptoms, and a quicker recovery. These findings highlight the effectiveness of Paxlovid in high-risk patients with prior SARS-CoV-2 immunity.

McLaughlin J, et. al. Efficacy of nirmatrelvir-ritonavir in high-risk trial participants with prior SARS-CoV-2 infection or vaccination: a pooled analysis Presentation #88 presented at IDWeek 2024. October 16-19, 2024. Los Angeles, CA.

Nigel McCracken, PhD, presents a diagnostic test to identify early T cell dysfunction in post-acute infection syndromes like Long COVID and ME/CFS, aiming to improve treatment strategies before symptoms escalate.

Detecting T Cell Dysfunction in Post-Acute Infection Syndromes

At IDWeek, Nigel McCracken, PhD, COO of Virax Biolabs, discussed their work on developing a diagnostic test for early detection of T cell dysfunction in post-acute infection syndromes like Long COVID, chronic fatigue syndrome, and Lyme disease. The test aims to identify T-cell exhaustion by measuring cell surface markers and cytokines released by B and T-cells. Early detection could enable better treatment management, including lifestyle changes and antioxidants, before symptoms become irreversible. The test could also differentiate between symptoms caused by post-acute infections and those requiring specific treatments for conditions like depression and anxiety.

Focusing on the implications of viral infections such as SARS-CoV and RSV, he explained, “We’re speaking to investigators and clinicians around post-acute infection syndromes. We’ve obviously heard about SARS-CoV-2 and RSV. The viral infections themselves actually do cause problems afterwards. And we know, and we’ve heard about Long COVID, we know things about chronic fatigue syndrome, or even post-acute Lyme disease. The symptoms, if you leave them long enough, are all the same.”

McCracken emphasized the importance of developing diagnostics to identify early signs of T-cell dysfunction, which he believes plays a significant role in the symptoms associated with these syndromes. “What we’re trying to do is basically try and develop a diagnostic to identify the early signs of T cell dysfunction, because we believe that the dysfunctional immune system plays quite a big role in a lot of the main symptoms associated with post-acute infection syndromes like Lyme disease as well as Long COVID,” he noted.

He explained the two types of immune responses: innate and adaptive. “There’s an innate immune response, which is a quick response, and then there’s an adaptive response. The adaptive response is more focused, involving B cells that form antibodies and T cells that are cytotoxic, meant to kill the virus and remove it from the body.”

McCracken explained that their test aims to identify T cell dysfunction early, before it becomes irreversible. “We hope to be able to identify that early to allow treatment management. There are no drugs specifically at this moment, but drug companies are working on Long COVID treatments. Meanwhile, we can focus on lifestyle changes or dietary adjustments, such as antioxidants, to reduce chronic inflammation.”

He described the lengthy journey many Long COVID patients experience. “The journey of a Long COVID patient is long. It can be up to 18 months. You’re going to get tested for many things. Most of the diagnosis is self-diagnosed. I think anyone who can understand what’s causing the problem can help address it.”

McCracken noted that chronic inflammation plays a role in the response to viral infections. “You need chronic inflammation to create an environment to get rid of a virus, but you don’t want it to last for a long period. There are things we can do to reduce chronic inflammation, like lifestyle changes and antioxidants.”

Reflecting on the broader implications of these conditions, Nigel expressed hope that the increased awareness surrounding Long COVID could benefit others suffering from chronic conditions. “I think the whole thing around Long COVID has helped patients who have dealt with chronic fatigue syndrome for years. It has brought attention to a general problem around chronic inflammatory conditions. We really need to do something about it, as it is causing a huge healthcare problem and a significant burden on society.”

Watch our latest roundtable series to learn more about Long COVID: 

A Deep Dive: Understanding the Neurological Toll of Long COVID

Nigel McCracken, PhD, presents a diagnostic test to identify early T cell dysfunction in syndromes like Long COVID and ME/CFS, aiming to improve treatment strategies before symptoms escalate.

Carol Pandak, EdD, director of PolioPlus, Rotary International, discusses the significance of this day 

World Polio Day: A Time to Reflect on Accomplishments, Acknowledge There’s Still Work to Do  

According to the World Health Organization, October 24 marks World Polio Day which was designed, “to raise awareness of the importance of polio vaccination to protect every child from this devastating disease, and to celebrate the many parents, professionals and volunteers whose contributions make polio eradication achievable. To ensure a polio-free future for everyone, efforts must continue to maintain high immunization coverage, implement high-quality surveillance to detect any presence of the virus, and prepare to respond in the event of an outbreak.”

“Polio Day gives us the opportunity to recognize the extraordinary progress we have made in eradicating only the second human disease in history, the first, the first disease that was eradicated was smallpox, and polio is onboard to be the only, only, the second human disease to be eradicated,” said Carol Pandak, EdD, director of PolioPlus, Rotary International. “So it's an opportunity to recognize the progress, but also to talk about what challenges remain and why it's important to finish the job.”

Of the 3 types of the polio strain, wild poliovirus type 1, wild poliovirus type 2, and wild poliovirus type 3, both type 2 and 3 have been eradicated. Pandak points out only 2 countries (Afghanistan and Pakistan) have never stopped the transmission of the wild polio virus, down from over 100 countries. 

For people afflicted with polio, in the acute stage of the disease, patients can suffer paralysis. And in addition to the initial infection, people can suffer from a condition called Post-Polio Syndrome (PPS) that can affect survivors years later. According to the Centers for Disease Control and Prevention, PPS affects between 25 and 40 out of every 100 polio survivors. And it can begin approximately 15 to 40 years after the initial infection. Individuals can experience muscle weakness, fatigue, and joint pain. 

One of the foremost leaders in the fight against the disease, 

, was responsible for initiating the global fight to end polio. Rotary members have donated $2.8 billion and countless volunteer hours to help immunize 3 billion children and eliminate polio in 122 countries. 

Rotary and its Global Polio Eradication Initiative (GPEI) partners (WHO, CDC, UNICEF, Bill and Melinda Gates Foundation, or Gavi, the Vaccine Alliance) have reduced polio cases by more than 99.9% percent worldwide. The massive polio eradication infrastructure (largest-ever global public health initiative, per WHO) and Rotary’s “PolioPlus” system support broader health systems, inform other infectious disease outbreak strategies, and guard against pandemics.

“There used to be 350,000 cases of polio every year. That's 1000 children a day being affected by polio, paralyzed or even dying. Today, only 2 countries have never stopped the transmission of the wild polio virus. And last year, there were just 12 cases of wild polio,” Pandak said.

Here in the US, with the population vaccinated, the disease has been mostly dormant for years; however, there is the rare case that does happen. Two years ago, there was a single case of circulating vaccine-derived poliovirus (cVDPV). The case of polio was reported to be in an unvaccinated 20 year old man who contracted the virus. The person is said to have suffered paralysis. The case occurred in Rockland County, NY. Circulating vaccine-derived poliovirus occurs when local immunity to poliovirus is low enough to allow prolonged transmission of the original weakened virus in the oral polio vaccine.

As the virus circulates and more genetic changes occur, the virus can regain its ability to infect the central nervous system and cause paralysis. It’s important to note that cVDPVs are not caused by a child receiving the polio vaccine.

The 2022 case was the first in the US since 2013. The last case to originate here was in 1979. Polio can originate from different countries and travelers can bring it back to the US.

Polio in Low and Middle Income Countries (LMIC)

Pandak points out there were just 12 cases of wild polio last year. Despite these promising numbers, the need to continue vaccination remains, and people in LMIC are at the greatest risk.

“You do have cases where there are shortages of vaccines in some of the lower income countries, but one of the goals of the global health community is to reduce that inequity between the high income countries and low income countries, such that every child has access to the vaccines they need to grow up healthy and strong, “ Pandak said.





1.World Polio Day. WHO. Accessed October 24, 2024 

https://www.who.int/europe/campaigns/world-polio-day


2.Poliomyelitis (polio). WHO. Accessed October 24, 2024
https://www.who.int/health-topics/poliomyelitis#tab=tab_1
3.About Polio in the United States. Centers for Disease Control and Prevention. Updated May 9, 2024. Accessed October 24, 2024
https://www.cdc.gov/polio/about/index.html
4.Ending Polio. Rotary International.  Accessed October 24, 2024.
https://www.rotary.org/en/our-causes/ending-polio
5. Parkinson J. CDC: US is Country With Circulating Vaccine-Derived Polio. Contagion. September 13, 2024. Accessed October 24, 2024. https://www.contagionlive.com/view/cdc-us-is-country-with-circulating-vaccine-derived-polio




Carol Pandak, EdD, director of PolioPlus, Rotary International, discusses the significance of this day and efforts that continue around the world to work towards eradication of this disease.

Rachel Britt, PharmD, BCIDP

Articles

Latest Updated Articles