A third county in New York with a low vaccination rate has detected poliovirus in its wastewater, suggesting that spread of the dangerous virus is expanding, which continues to pose a significant threat to anyone unvaccinated.

Wastewater sampling in Sullivan County detected poliovirus twice in July and twice in August, the New York State Health Department announced. Genetic sequencing determined that the positive samples are linked to the case of paralytic polio reported from Rockland County in July, which was genetically linked to viruses circulating in London and Israel.

Sullivan Country joins nearby Rockland County, Orange County, and New York City in having poliovirus detected in sewage. At least 13 sewage samples from Rockland and eight from Orange have tested positive since April. The three counties are all in a northwest-pointing line from New York City, along the state’s southern border. Earlier this month, New York City also announced finding poliovirus in wastewater surveillance

All three counties have low vaccination rates against polio, the state’s health department notes. In the US, children are advised to get three doses of inactivated polio vaccine by 24 months, which is 99 percent effective at preventing paralytic disease. Statewide, about 79 percent of New York children have gotten their three polio shots by 24 months. But that vaccination rate is 62 percent in Sullivan County, 59 percent in Orange County, and 60 percent in Rockland County.

Those low county-wide averages suggest pockets of even lower vaccination rates. For instance, health officials at the Centers for Disease Control and Prevention noted in a recent polio report that some zip codes in Rockland County have vaccination rates as low as 37 percent. In such communities, the highly contagious poliovirus can easily spread, increasing the risk of more paralytic polio.

“One New Yorker paralyzed by polio is already too many, and I do not want to see another paralytic case,” State Health Commissioner Dr. Mary Bassett said in a statement. “The polio in New York today is an imminent threat to all adults and children who are unvaccinated or not up to date with their polio immunizations. Every New Yorker, parent, guardian, and pediatrician must do everything possible to ensure they, their children, and their patients are protected against this dangerous, debilitating disease through safe and effective vaccination.”

Local, state, and federal health officials have been making urgent calls for vaccination for weeks now, setting up vaccination clinics. But the rates of people signing up for immunizations are far from what’s needed to reach the state’s goal of “well over 90 percent” vaccinated.

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