'Silent' spread of polio in New York prompts CDC to consider additional vaccinations for some people

Case of polio detected in the US 0:57

(CNN) --

A case of polio detected in New York last month is "just the tip of the iceberg" and an indication that "there must be several hundred cases circulating in the community," a senior official told CNN Wednesday. from the US Centers for Disease Control and Prevention (CDC).

The polio case was found in Rockland County, which has a staggeringly low polio vaccination rate.

Dr. José Romero, director of the CDC's National Center for Immunization and Respiratory Diseases, noted that most people with polio have no symptoms, so they can unknowingly spread the virus.

"There are a number of individuals in the community who have been infected with poliovirus. They are spreading the virus," he said.

"Contagion is always a possibility because the spread is going to be silent."

• New York detects the first case of polio in the US in almost a decade.

  What is polio?

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  Is there a cure?

A team of CDC disease detectives traveled last week from the agency's headquarters in Atlanta to Rockland County, and they are "pretty nervous" that polio "could get out of control very quickly and we could have a crisis in our hands," said a community health leader who met with the team.

"They're... what's the opposite of cautiously optimistic?" said another community leader, an expert in vaccine education, who also met with the CDC team in Rockland County.

Both leaders requested anonymity because they are not authorized to speak publicly.

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Polio can cause incurable paralysis and death, but most people in the US are protected, thanks to vaccination.

Others, however, may be vulnerable to the virus for various reasons.

Unvaccinated or undervaccinated people are vulnerable, and polio vaccination rates in Rockland County and neighboring Orange County, just north of New York City, are around 60%, compared to 93% across the country.

Immunocompromised people may be vulnerable even if fully vaccinated.

Romero said the CDC is considering a variety of options to protect people from polio, including offering local children an extra dose of the vaccine, as U.K. health officials are now doing in London, or recommending extra dose to certain groups of adults.

"We are looking at all aspects of how to address this issue. At this point, we don't have a definitive answer," he said.

A "silent killer"

What is polio and how to prevent it?

1:44

The Rockland County polio case is the first identified in the United States in nearly a decade.

The virus has also been detected in sewage from Rockland County and neighboring Orange County.

The positive samples were genetically linked to the individual case, but no other cases have been reported in the United States.

About three out of four people infected with polio have no symptoms but are still capable of transmitting the virus to others, according to the CDC.

Among the rest, most have symptoms such as sore throats or headaches that can be overlooked or confused with other illnesses.

Only a relatively small number, about 1 in 200 infected people, is left paralyzed.

Some of those who become paralyzed die because they can't breathe.

By the late 1940s, polio outbreaks were disabling an average of more than 35,000 people a year in the United States.

In 1955 a vaccination campaign was started, and cases quickly plummeted.

Today, a full round of childhood polio vaccines — four doses between ages 2 months and 6 years — are at least 99% effective, according to the CDC.

But in recent decades, some small groups have not vaccinated their children against the virus.

One of them is that of the ultra-Orthodox Jewish community in New York, including that of Rockland County.

Much of the rest of Rockland County's religious Jewish community has joined efforts to educate "outliers" who refuse to get vaccinated, the community health leader said.

"This is a silent killer, like carbon monoxide, and we don't know when it's going to hit us," he said.

"A press release is not enough"

The vaccine educator said the CDC team has worked hard to learn the best ways to communicate with members of this community, who tend not to use the internet and instead get much of their information from the platform. messaging WhatsApp, as well as the community newspapers.

This week, Rockland County and local health care providers distributed an infographic in English and Yiddish announcing, "Polio is spreading in Rockland County."

• Polio: Signs, Symptoms and the Dangers of an Ancient Virus

The Rockland County vaccine educator said that in meetings with the CDC team, "we talk about needing a message that resonates, and a press release is not going to cut it."

Dr. Mary Leahy, CEO of Rockland County's largest health care provider, Bon Secours Charity Health System, a member of WMCHealth, has attended meetings with the CDC and said that to get people who don't vaccinate to your polio kids understand the seriousness of the disease, "I turn to the grandparents and great-grandparents who actually lived through the days of polio in the '40s and '50s."

That makes sense to Romero.

"I grew up in Mexico. I saw this disease, the complications," he said.

"I went to school with kids who had braces."

He said many Americans don't recognize the "devastating" effects of polio's "lifelong paralysis."

"I think most of the American public has never seen a case of polio. People have lost that fear, if you will, of the disease."

CNN's Danielle Herman and John Bonifield contributed to this article.

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