Polio confusion as parents CAN’T tell if their children have been vaccinated

Parents are struggling to find out whether their child’s polio vaccinations are up to date, it has emerged after health officials issued a national alert following a suspected outbreak of the once-eradicated disease.

A call went out to British parents on Wednesday to check their polio jabs were up to date after the virus was detected in sewage samples and it emerged as few as a third of teens are vaccinated in some parts of England.

But some parents said they tried up to 30 times to get through to their GP receptionist and access their child’s medical records and were told to call back the next day or get in touch with schools instead.

There was further confusion as it emerged parents have to get permission from a GP to allow them to access their family medical records on the NHS app, meaning the only way for some people to find out their family’s vaccination status was to call their local doctor’s surgery directly.

Deborah Siddoway, who feared her 16-year-old son had missed his teenage booster polio shot because of the first Covid lockdown, revealed her GP had ‘absolutely no idea’ if he was jabbed and told her to phone his school, who initially didn’t know either. The mother, from Hexham, Northumberland, said she was left on hold 45 minutes to ‘various NHS people’.

Polio vaccine coverage in England has been dwindling for years but dropped further during the pandemic, linked to a lull in appointments, school closures and a rise in vaccine hesitancy. 

With just a third of teens vaccinated against the disease in some parts of London — where the virus has been detected — there are fears it could spread for the first time in more than four decades. 

The extent of the current outbreak is not yet known but health experts are concerned doctors no longer recognise the symptoms of polio because it has been eradicated in Britain since 2003.

While the virus can lead to permanent paralysis in rare cases, it typically causes flu-like symptoms that could easily be misdiagnosed as other more common infections, like Covid.

The polio vaccine is given at age eight, 12 and 16 weeks as part of the six-in-one vaccine and then again at three years as part of a pre-school booster. The final course is given at age 14. The World Health Organization has set the threshold of a successful school jabs programme at 95 per cent uptake, which England is failing to hit by all accounts

The virus was detected at the Beckton sewage treatment works, which covers a population of four million in north and east London

The NHS currently offers the polio jab as part of a child’s routine vaccination schedule. The polio vaccine is included in the six-in-one vaccination, which is given to children when they are eight, 12 and 16 weeks old.

Protection against polio is further boosted through top-up jabs given youngers before youngsters go to school, as part of the four-in-one booster, and when they are 14, as part of the three-in-one teenage booster. All of the jabs are needed to be fully vaccinated against polio.

The NHS points patients to their red book to find out if their child has been vaccinated against polio. The book, also known as a personal child health record, is given to parents around the time their child is born and logs their vaccination status and other health information.

Ms Siddoway, was concerned that her son may have missed his booster at 14 because of the first Covid lockdown in spring 2020.

When she contacted her GP to check his records on Thursday they had ‘absolutely no idea’ and told her to contact his school instead – where youngsters are often given the jab. 

And the local School Age Immunisation Service (SAIS), which dishes out jabs at schools, struggled to find her child’s record.

Ms Siddoway told the Telegraph: ‘I’ve spent about 45 minutes on hold to various different NHS people to try and find out if my son is vaccinated, and if not, can we please have an appointment to get him vaccinated, and I am no further forward.’

She was eventually told by SAIS that a catch-up clinic was taking place the following week where her son could get jabbed. But because he finishes school after his final exam this week, it is unclear whether he and other final year students can attend. 

Getting answers and the number of people she had to go through was ‘crazy’, Ms Siddoway said.

Other Britons have taken to Twitter to hit out at their struggles accessing their records on the NHS app, as some surgeries require patients to fill in a form before linking their data with the app.

Some parents said they had tried ‘thirty’ times to get through to their GP receptionist and were told to call back the next day. 

One mother, from Cheshire, took to Twitter to complain that her children are behind on their vaccinations but her local GP does not offer the jabs. The surgery pointed her to a child immunisation centre in a neighbouring country where her children attend school.

But when she tried to book her youngsters in for immunisation, they told her to contact her doctor.

Official figures show that eight local authorities in England — mostly in London — had 50 per cent or lower uptake among Year 9s last year.

Just 35 per cent of 13 and 14-year-olds had received their final booster in Hillingdon, West London, which has the worst coverage in the country,  followed by Brent, where a third were fully vaccinated.

Nottingham (50.4 per cent) and Middlesbrough (45.6 per cent) now also have some of the poorest rates, meanwhile coverage is below 60 per cent in Torbay, Leicester, Sandwell, Plymouth, Luton and Devon.

Rates are higher among younger children, with more than nine in 10 five-year-olds jabbed nationally.

Data from the World Health Organization shows 114 of 160 nations have not hit its threshold of 95 per cent coverage in one-year-olds. UK health chiefs yesterday revealed that the country could be seeing a resurgence of the disease for the first time in decades after strains were detected in sewage

Figures from Our World in Data show that 95 per cent of one-year-olds in Britain are vaccinated against polio, dropping to 90 per cent in South-East Asia, 87 per cent in the US and 74 per cent in Africa. The world average is 86 per cent

Steve Russell, NHS England’s national director for vaccinations, said: ‘While almost 95 per cent of children under the age of five are vaccinated against polio and the risk is low, it can cause lifelong problems.

‘So the NHS is doing everything it can to ensure everyone eligible takes up their offer – from local NHS teams contacting those who are eligible for vaccination in affected areas to jab clinics in schools.

‘The NHS is asking families to check that all their children’s vaccines are up to date through their Redbook and to speak to their local health teams or GP if they have questions about getting them protected or booking an appointment.’

Local NHS teams are expected to start contacting parents of eligible under-fives who are unvaccinated to encourage them to come forward. The health service said the polio vaccine is dished out at GP surgeries and in schools.

Doctors have been tasked with ensuring migrants and refugees arriving in the UK are fully-jabbed against the virus, with health chiefs concerned they could be unprotected. 

Professor David Heymann, an infectious disease expert at the London School of Hygiene and Tropical Medicine, said vaccination rates were high but ‘not high enough’.

He told the BBC Today programme: ‘They must be high enough to stop transmission of this virus and that’s only if parents are concerned about their children and take them for vaccination.’

He added: ‘There is a suggestion of that because it’s been picked up in the sewage for the last two or three months. 

‘So what that means is it likely is circulating throughout a population in the UK or in the London area and that’s why mothers should get their children vaccinated.’ 

Health chiefs have yet to detect a case of polio in the population. But they have found ‘several closely-related’ polio viruses in sewage samples taken between February and May.

UK Health Security Agency (UKHSA) bosses think a traveller, possibly from Pakistan, Afghanistan or Nigeria, shed the virus in their faeces after getting a live oral vaccine, which is used in some countries with current outbreaks as it has a rapid effect. 

The oral vaccine, given via droplets to the mouth, has not been used in the UK since 2004. Britain uses an inactivated polio vaccine, which is given as part of a combined jab to babies, toddlers and teenagers as part of the NHS routine childhood vaccination schedule.

Sewage samples show that the weakened version of the virus in the vaccine has mutated to the point that it is acting like the wild-type of the virus – called vaccine-derived poliovirus type 2 (VDPV2).

There were nearly 1,000 cases of VDPV2 globally in 2020. 

The virus has been spotted multiple times over the last three months, which suggests the virus has spread between closely linked people – such as a family or extended family – who are shedding the virus in their faces.

But despite clear signs of transmission, no human cases have yet been identified and officials say the risk to the public remains ‘extremely low’ because of high vaccination rates. 

UKHSA teams are working to find out if there has been any community transmission. 

Lord Kamall, Minister for Life Sciences, told the House of Lords yesterday that the source could be traced back to a single house or street. 

He said ‘world-beating’ tactics learned during the Covid pandemic were being deployed to track down ‘patient zero’. He revealed the investigation will see officials ‘go along the pipes’ to locate where the virus came from.

‘In theory it might be possible to find individual households and streets but it is too early,’ Lord Kamall said. 

It comes as World Health Organization (WHO) data shows that more than 114 of 160 countries have failed to meet its key polio vaccination uptake target of 95 per cent and are vulnerable to the virus. 

Experts deem having more than nine in 10 people in every community vaccinated crucial to prevent the highly contagious virus from spreading.

Being vaccinated is even more important for children than adults because they are more likely to catch and therefore fall ill with the disease.

While the majority will experience mild or no symptoms at all, for as many as one in 100, it can cause permanent paralysis or death. 

Among the vulnerable countries are the UK and US, where overall uptake nationally is as low as 93 per cent. But in parts of Africa, as few as four in 10 are immunised.

And 35 nations, including France, Germany and Portugal, have not shared their polio uptake data — meaning even lower numbers could be protected in some places. 

How long does the polio vaccine last? What are the virus’ symptoms? How many people are infected in the UK? EVERYTHING you need to know amid fears paralysis-causing virus is spreading

Parents are being urged to ensure their children’s polio vaccinations are up to date, particularly after the pandemic when school immunisation schemes were disrupted and uptake fell. Pictured, a girl gets her four-in-one pre-school jab offered by the NHS

Wasn’t polio eradicated?

There are three versions of wild polio – type one, two and three.

Type two was eradicated in 1999 and no cases of type three have been detected since November 2012, when it was spotted in Nigeria. 

Both of these strains have been certified as globally eradicated.

But type one still circulates in two countries – Pakistan and Afghanistan.

These versions of polio have been almost driven to extinction because of vaccines. 

But the global rollout has spawned new types of strains known as vaccine-derived polioviruses.

These are strains that were initially used in live vaccines but spilled out into the community and evolved to behave more like the wild version.

How many people are infected?

Health chiefs haven’t yet detected an actual case. 

Instead, they have only spotted the virus in sewage samples.

But they said several closely-related polio viruses were found in sewage samples taken in North and East London between February and May.

This suggests there has ‘likely’ been spread between linked individuals who are now shedding the strain in their faeces.

The UK Health Security Agency is investigating if any community transmission is occurring.

It is hoped that the cases will be confined to a single household, or extended family. 

How does it spread?

It is spreads between people through contact with food, water, or objects that have been contaminated with the faeces of someone infected.

Places with a high population, poor sanitation and high rates of diarrhoea-type illnesses are particularly at risk of seeing polio spread.

Unvaccinated people are at a high risk of catching the infection.

There is some concern that the virus appears to be spreading in London, which has poorer polio vaccine uptake than the rest of the country.

How is polio diagnosed?

Doctors can spot polio based on their symptoms. 

If a person is in the first week of an illness, a throat swabs is taken, or a faeces or blood sample can be taken up to four weeks after symptoms began.

The sample is then sent to a laboratory, with tests then confirming whether the virus is present.

What does a national incident mean?

UKHSA guidelines set out that when a vaccine-derived polio virus is spotted in Britain.

This instructs health chiefs to set up a national response to manage and coordinate how it responds.

It includes joining up local public health teams. 

While the polio samples have only been spotted in London, health chiefs say it is vital to ensure other parts of the country are aware and taking necessary action to protect people in their area. 

How is polio treated?

There is no cure for polio, although vaccines can prevent it.

Treatment can only alleviate its symptoms and lower the risk of long-term problem.  

Mild cases – which are the majority – often pass with painkillers and rest.

But more serious cases may require a hospital stay to be hooked up to machines to help their breathing and be helped with regular stretches and exercises to prevent long-term problems with muscles and joints.

In the 1920s, the iron lung – a respirator that resembled a ‘coffin on legs’ – was used to treat polio. 

It was first used that decade to save a child infected with the virus who needed help breathing.

Paul Alexander, 76, from Texas, is still in the machine today, 70 years later, after contracting polio at the age of six in 1952.

I missed out on a vaccine as a child, can I still get it?

Health chiefs have encouraged everyone who is unvaccinated against polio to contact their GP to catch up. 

However, they warned vaccination efforts in London will focus initially on reaching out to parents of under-fives that have not had or missed their jabs, amid fears it is spreading in the capital.

The NHS currently offers the polio jab as part of a child’s routine vaccination schedule. The polio vaccine is included in the six-in-one vaccination, which is given to children when they are eight, 12 and 16 weeks old.

When polio weakened muscles used in breathing, patients used to be treated using an ‘iron lung’. Pictured: A female patient in her iron lung at Fanzakerley hospital in Liverpool, now called Aintree University Hospital

British children getting their oral vaccine for polio in 1965 — which used a live version of the virus — 12 years after the first vaccine was invented 

Protection against polio is boosted in top-up jabs when youngers are three-years-and-four-months old and when they are 14.

Most Londoners are fully jabbed against polio. But uptake is not 100 per cent.

How long does protection from the polio vaccine last?

Scientists do not know how long people who received the inactivated polio vaccine, the one used in the UK, lasts for.

But they expect it provide immunity for years after getting jabbed.

Two doses are 90 per cent effective, while three doses are 100 per cent effective. 

Can it kill?

Polio can kill in rare cases. But it is more famous for causing paralysis, which can lead to permanent disability and death.

Up to a tenth of people who are paralysed by the virus die, as the virus affects the muscles that help them breathe.

What are polio’s symptoms?

Three-quarters of people infected with polio do not have any visible symptoms.

Around one-quarter will have flu-like symptoms, such as a sore throat, fever, tiredness, nausea, a headache and stomach pain. These symptoms usually last up to 10 days then go away on their own.

But up to one in 200 will develop more serious symptoms that can affect the brain and spinal cord. This includes paraesthesia – pins and needles in the leg – and paralysis, which is when a person can’t move parts of the body.

This is not usually permanent and movement will slowly come back over the next few weeks or months.

However, even youngsters who appear to fully recover from polio can develop muscle pain, weakness or paralysis as an adult – 15 to 40 years after they were infected.

Do vaccines cause polio?

Although extremely rare, cases of vaccine-derived polio have been reported.

They do not make the vaccinated person ill but rather cause them to shed tiny pieces of the virus, which can then infect other, unvaccinated people.

This is only the case with the oral polio vaccine, which uses a live and weakened version of the virus to stimulate an immune response.

But, over time, the strain can mutate to behave more like wild versions of polio. 

How did polio end up in the UK?

The polio spotted in Britain was detected in sewage, which is monitored by health chiefs, rather than in a person.

This suggests the virus has been imported from a country where the live polio vaccine is still being used.

Professor Paul Hunter, an infectious disease expert at the University of East Anglia, said: ‘Such vaccine derived transmission events are well described and most ultimately fizzle out without causing any harm but that depends on vaccination coverage being improved.’

Polio used to paralyse millions of children around the world every year in the 1940s and 1950s but has been eliminated in virtually every country thanks to vaccines

The remaining, type 1, wild polio remains endemic in only two countries, Afghanistan and Pakistan but parts of Africa still suffer flare-ups

Could this trigger an outbreak?

Uptake of the polio vaccine is around 90 per cent across the UK so it is unlikely to cause a massive outbreak.

But it has dipped further over the last year due to the knock-on effects of the pandemic.

There are concerns vaccine hesitancy has risen during the Covid crisis due to misinformation spread about jabs for that virus and school closures.

Experts say the best way to prevent the virus from spreading is for Britons to ensure their vaccinations are up to date, especially for children.

Dr Kathleen O’Reilly, an associate professor in statistics for infectious disease and expert in polio eradication, said that all countries are at risk of an outbreak until all polio cases are stopped globally. 

This ‘highlights the need for polio eradication, and continued global support for such an endeavour’, she added.

When was last time Britain saw a case of polio?

The last time someone caught polio within the UK was in 1984 and Britain was declared polio-free in 2003.

But there have been dozens of imported cases since then, which are often detected in sewage surveillance.

However, these have always been one-off findings that were not detected again and occurred when a person vaccinated overseas with the live oral polio vaccine travelled to the UK and ‘shed’ traces of the virus in their faeces.

Now, UK health officials have detected several closely-related viruses in sewage samples taken between February and May. This finding suggests there has been spread between close contacts in North and East London, where the samples were collected.

Where did polio originate?

Polio epidemics, when the virus is constantly spreading within a community, did not start happening until the late 1800s.

But scientists say that it is an ancient disease that first struck people in Egypt as early as 1570 BC. This is based on depictions of paralysis and weak limbs from that time.

A doctor in London was the first to publish a clear description of polio in infants in a medical textbook in 1789.

Polio dates back to 1500 BC, crippled rulers in Ancient Egypt and paralysed thousands of children for decades before being almost entirely wiped out by a vaccine that used a weakened version of virus: The disease’s history laid bare

You could be forgiven for thinking polio was a disease resigned to history.

The paralysis-causing disease was officially eradicated in the UK in 2003 and the last domestic outbreak was in the 1980s. But dwindling vaccination rates, in part due to complacency, appear to have allowed polio to creep back in decades later.

The archaic disease has existed as long as human civilisation itself, with the earliest records dating back to ancient Egypt.

But it was until the 1800s that outbreaks began to really take off.

Millions of Brits will remember the devastation polio caused in the early 1950s and why it was one of the most feared infections in the world. The UK was rocked by a series of polio epidemics in the mid-20th century that saw thousands crippled by the virus each year.

Mary Berry, the ex-Great British Bake Off judge, was hospitalised after contracting polio aged 13, leaving her with a twisted spine and damaged left hand.

Despite being eradicated in most of the world, it still spreads in two countries — Afghanistan and Pakistan — while parts of Africa suffer flare-ups of vaccine-derived versions of the virus.

Here, MailOnline takes a look at the history of the virus: 

1500 BC

Polio epidemics, when the virus is constantly spreading within a community, did not start happening until the late 1800s.

But records suggest it dates back to as early as 1570 BC in ancient Egypt.

This is based on a drawing on a stele — a stone slab — which shows a priest with a withered leg and using a cane to help him walk.

And an Egyptian ruler called Siptah, who died in 1188 BC, is thought to have had polio based on his deformed left leg and foot, spotted by archaeologists who found his mummy in 1905. 

1700s 

But apart from these two incidents, polio largely vanished from the record books until it was logged in in 1789 by London-based Dr Michael Underwood. 

He published the first clear description of polio in infants, who are particularly vulnerable to the disease, in a medical textbook, calling it ‘debility of the lower extremities’.

Records show polio dates back to as early as 1570 BC in ancient Egypt. This is based on a drawing on a stele – a stone slab (pictured) – which shows a priest with a withered leg and using a cane to help him walk

1800s 

In the early 1800s, a handful of polio cases were sporadically reported in medical journals. 

But scientists believe people were commonly exposed to the virus in the typical unhygienic environments of the time, especially when they were young.

However, polioviruses started causing problems in Europe and North America at the end of the 1800s. This was, bizarrely, blamed on sanitation improving. 

Polio spreads through consuming an infected person’s faecal matter — which can happen as a result of poor hand hygiene. 

While better water and sewage systems saw the demise of typhoid and cholera, outbreaks of polio became more common.

Three-quarter of those who become infected don’t have symptoms. But around a quarter suffer a flu-like illness, including a sore throat, fever and tiredness. 

Up to one in 200 will develop more serious symptoms that affect their brain and spinal cord, including paralysis. 

Professor Ian Jones, a virologist at Reading University, explained the virus ‘wasn’t a problem until hygiene improved’. 

Previously, low levels of infection would have given immunity to people but the unforeseen circumstance of better living conditions was that this declined and polio ‘took off’, he said. 

Professor Paul Hunter, an infectious disease expert at the University of East Anglia, told MailOnline that although polio has been around for centuries or millennia, it was only during the early part of the 20th century that big epidemics of paralytic polio took off. 

He explained: ‘When every child got infected with poliovirus in the first couple of years of life you still saw some paralysis but it was only when infections were delayed until older age that such paralysis became more common. 

‘Young children who contract poliovirus infection generally suffer only mild symptoms, but delay those infections to teens and adulthood and paralysis becomes more common.’

The first epidemic struck more than a dozen people in Norway in 1868, while the second, which occurred 13 years later, caused a similar number of confirmed cases in Sweden. An outbreak in the US in 1894 saw 132 people infected. 

Early 1900s

It was in 1916 that the first large-scale epidemic took hold in Brooklyn, New York, with more than 9,000 cases and 2,000 deaths. 

The outbreak spread to the rest of the US and led to more than 27,000 cases and 6,000 polio deaths that year.

Newspapers published the names and addresses of infected people, ‘keep out’ notices were nailed to their doors and their families were quarantined. 

Parents were urged to keep their children away from public spaces, such as swimming pools, parks and beaches, over virus fears.

The outbreak triggered concern across the world and sped up research into the illness.

Scientists had already made some progress in understanding and treating the virus.

In 1840, German orthopaedic Dr Jacob von Heine had become the first to produce a robust study on polio. He suggested that the disease may be contagious. 

By 1908, Austrian physicians Karl Landsteiner and Erwin Popper said that polio may be caused by a virus. 

Early treatments of the disease included tying the paralysed limbs of infected patients to splints, in a bid to stop their muscles from tightening.

But by 1928, an invention called the iron lung was rolled out to revolutionise how the disease was treated. The contraption – a respirator that resembled a ‘coffin on legs’ – was developed for patients whose lungs were so paralysed that they could no longer breathe unaided. Paul Alexander, 76, from Texas, is still in the machine today — 70 years after contracting polio at the age of six in 1952

But by 1928, an invention called the iron lung was rolled out to revolutionise how the disease was treated. 

The contraption – a respirator that resembled a ‘coffin on legs’ – was developed for patients whose lungs were so paralysed that they could no longer breathe unaided. 

It was first used that decade to save an American child infected with the virus who needed help breathing. The majority patients stayed inside the chamber for short spells until their lungs recovered. 

But some struck down by permanent paralysis stayed inside the machines for the rest of their lives. 

Paul Alexander, 76, from Texas, is still in the machine today — 70 years after getting polio at the age of six in 1952.

And by 1930, Elizabeth Kenny, a self-trained nurse from Queensland, Australia, developed a treatment applying hot packs to muscles and exercise to keep stimulating nerve cells and avoid long-term muscle damage. The methods are still used today.

As part of the increased focus on research, Australian virologists Sir Macfarlane Burnet and Dame Jean MacNamara identified for the first time that there were three types of the polio virus in 1931.

The fight against the virus was further boosted when a team of scientists at Harvard Medical School, led by Dr Jonas Salk, in the 1940s used blood samples of infected patients to extract and grow the virus in live cells. 

Late 1900s

By 1955 the team, with the support of funds from the March of Dimes non-profit organisation, developed the first effective vaccine — an injectable inactive (killed) polio vaccine (IPV). 

Nearly 2million children in the US were jabbed as part of the largest medical trials ever seen at the time. 

They proved successful and 450million doses of the jab were dished out across the country. Cases subsequently fell from 18 per 100,000 people to two per 100,000.

The following decade, a team at the University of Cincinnati in Ohio, led by medical researcher Dr Albert Sabin, developed a second vaccine using a live version of the virus that could be given in drops through the mouth.

This vaccine was much more effective and became the most popular throughout the world. 

Politicians in the US didn’t support Dr Sabin’s oral poliovirus vaccine (OPV), so he tested it in the former Soviet Union. 

The USSR rolled out the jab and polio subsequently declined. Drops in cases were also seen in nearby Eastern Europe and Japan. 

The US licensed the jabbed in 1961 and it became the main vaccine used worldwide. 

The fight against polio was further boosted when a team of scientists at Harvard Medical School, led by Dr Jonas Salk, in the 1940s used blood samples of infected patients to extract and grow the virus in live cells. Pictured: Dr Salk at the Municipal Hospital laboratory in April 1955 after announcement of the successful vaccine results

Great Britain was pronounced clear of polio in 2003 with the last case coming in 1984. A young girl is pictured getting her polio jab in May 1956

By 1955 researchers at Harvard Medical School, with the support of funds from the March of Dimes non-profit organisation, developed the first effective vaccine against polio — an injectable inactive (killed) polio vaccine (IPV). Pictured: children getting a lump of sugar while getting a polio vaccine at a mobile unit in Blackburn in Lancashire, England in 1965

Professor Jonathan Ball, a virologist from the University of Nottingham, told MailOnline that polio had a ‘devastating effect’ worldwide and the introduction of the two jabs was ‘immense’. 

Studies throughout the 1970s and 1980s revealed the virus was widespread in many richer nations, which pushed leaders to introduce routine vaccination using the OPV in national immunisations programmes. 

The jabs saw polio vanish in developed countries. In the UK, cases fell from a peak of 8,000 a year to just a few hundred before being eradicated.

In the US, infections dropped from a peak of 58,000 to zero just a few years after the jab was dished out.

Kathleen O’Reilly, an associate professor in statistics for infectious disease and expert in polio eradication, told MailOnline: ‘After the second world war cases of paralytic polio in England and Wales rose considerably, reaching several thousand cases each year. 

‘Vaccines were developed in response to these worrying outbreaks, and were introduced in the late 1950s. 

‘The number of polio cases quickly declined, and since the 1970s only a small number of cases were reported each year. There has not been a single case of polio in the UK since 1984.’

But in poorer nations, where the virus caused fewer outbreaks, uptake was much lower.

The World Health Organization (WHO) launched an worldwide immunisation rollout in 1974, in an attempt to vaccinate all children against polio. 

By 1988, the UN health agency set the target of eradicating the virus globally by 2000. Two years later, a global virus surveillance system is set up to detect the virus. 

The US logged its last case in 1991, in a three-year-old boy called Luis Fermin Tenorio living in Junin, northern Peru. 

The WHO certified the region as polio-free three years later — the duration set by the agency before a nation can be deemed to have eradicated the virus. 

A team at the University of Cincinnati in Ohio, led by medical researcher Dr Albert Sabin, developed a second vaccine using a live version of the virus that could be given in drops through the mouth. This vaccine was much more effective than the inactivated one, and became the most popular throughout the world. Pictured: a health worker giving a oral polio vaccine to a child in Karachi, Pakistan

There was also success in ridding the world of two wild types of the virus, with type two eradicated in 2015 and type three stamped out by 2019. However, the WHO global goal of eradicating the virus by 2000 has still not been met. Polio is endemic in Afghanistan and Pakistan. Pictured: a child in Kabul, Afghanistan being given the oral vaccine in November 2021

2000

Nearly every country in the world used the oral polio vaccine in their rollout. But after infections were brought under control in the US and the UK, both countries stopped using this vaccine — in 2000 and 2004, respectively. Other nations followed suit.

While the oral version provides higher levels of protection against infection — meaning it is more effective at limiting spread in endemic countries — the weakened live virus in the vaccine can mutate on very rare occasions and cause paralysis.

It can also spread to others and cause an outbreak of vaccine-derived polio. 

Professor Hunter explained that the live vaccine does a better job at stopping infection ‘but can very rarely cause paralysis’.

Meanwhile, the inactivated vaccine ‘doesn’t cause infection and is still excellent at stopping paralysis but not quite as good at preventing infection’, he said. 

Only a handful still use the oral vaccine.

In 2002, Europe was certified as polio-free. Its final case was logged in a 33-month-old child in Turkey in 1999.

The Western Pacific was labelled polio-free in 2000, with the last confirmed infection being in a 15-month-old girl called Mum Chanty in Phnom Penh, Cambodia. And the WHO confirmed South East Asia is virus free in 2014. 

There was also success in ridding the world of two wild types of the virus, with type two eradicated in 2015 and type three stamped out by 2019. 

However, the WHO global goal of eradicating the virus by 2000 has still not been met. Polio is endemic in Afghanistan and Pakistan. 

Travellers from these two nations frequently spread the virus to other countries.

2010

China lost its polio-free status in 2011 after the infection spread to the country from Pakistan. However, it regained it after the outbreak fizzled out. 

Professor Ball explained: ‘The live vaccine has proven to be incredibly effective at eliminating the virus. 

‘But on rare occasions it can revert to wild-type and cause the disease; that’s why countries that do get rid of the virus switch to using killed vaccine to keep their populations safe.’

Professor Jones said the dilemma around polio is now around eradication. ‘Is it worth the cost in terms of money and lives lost to eradicate the last few cases or is it better to maintain where we are?

‘Lastly, another dilemma, if it is eradicated how long do you continue to vaccinate and with what?’ 

UK health chiefs revealed polio could be spreading in the community for the first time in four decades after the virus was spotted in sewage samples in parts of London on June 22, 2022. It is a vaccine-derived strain.

But there are signs it is spreading between people as officials have picked up several samples from different people, each with new mutations. 

Professor Hunter added: ‘Whilst most of the world has moved away from live attenuated vaccine some countries still use it and there is a risk that you can get secondary infections (generally a family member) which very rarely can be associated with paralysis in someone who has not been immunised.

‘The concern here is that even a vaccine derived virus if it continues to spread could eventually recover its full virulence over a year or two and then cause an outbreak of paralytic polio in people who have not been vaccinated and that would be a disaster. 

‘So probably the current situation does not pose an immediate threat to public health but if transmission goes on long enough and the virus recovers its virulence it could become a public health disaster.’