German authorities have pinpointed Hamburg as the site where a sewage sample containing the wild strain of the poliovirus was discovered. The Robert Koch Institute (RKI), Germany’s leading public health organization, confirmed the presence of the wild poliovirus in a wastewater test at an undisclosed location in the country. This finding, the first of its kind since routine monitoring began in 2021, is a setback in the global fight against polio, as the last cases of wild polio virus infections in Germany occurred over three decades ago.
Health officials in Hamburg have formed an expert task force on infection control following the discovery and are working closely with RKI to conduct further sampling. Despite the detection, no polio infections have been reported, and the risk remains low due to widespread polio vaccination coverage in Germany.
Polio, short for poliomyelitis, is a contagious disease that primarily affects children under five years old. Although some cases may be asymptomatic, polio can also manifest with symptoms such as fever and vomiting. Approximately one in 200 infections leads to irreversible paralysis, with up to 10% of affected individuals succumbing to the disease. While there is no cure for polio, vaccination has led to a significant decline in global case rates since mass vaccination campaigns began in 1988.
There are two forms of polio: wild polio and vaccine-derived polio. Wild polio, endemic to Afghanistan and Pakistan, causes a limited number of cases annually. The strain detected in German wastewater is linked to the strain circulating in Afghanistan. Vaccine-derived polio, more prevalent but still rare, stems from the use of an oral polio vaccine containing weakened live virus. This form of polio can result in hundreds of cases worldwide each year, particularly in countries like Yemen and Nigeria.
The detection of wild polio in Germany underscores the effectiveness of sewage sampling efforts to monitor poliovirus spread. While no infections have been reported in Germany, high vaccination rates help minimize the risk of an outbreak. The detection of wild polio in Europe is infrequent, with the last instance occurring in 2010. However, it is crucial to remain vigilant, as imported cases of the virus have led to outbreaks in other polio-free regions, such as Malawi and Mozambique in 2022.
Global efforts to eradicate polio face challenges, including budget cuts affecting initiatives like the Global Polio Eradication Initiative (GPEI). Despite progress in combating the disease, sustained funding and commitment are essential to achieving a polio-free world. Beate Kampmann, scientific director at Germany’s Charité hospital, emphasizes the critical role of vaccination in preventing the spread of polio. She highlights the need for continued support for polio eradication efforts and encourages individuals to verify their vaccination status to safeguard against the disease.
