Poliovirus Detected in European Wastewater in Late 2024, Underscoring Importance of Vaccination

The detections occurred in Barcelona (Spain) in September, Warsaw, and Rzeszów (Poland) in October and December, and nine German cities, including Munich, Bonn, Cologne, Hamburg, Dresden, Dusseldorf, Mainz, Berlin, and Stuttgart, between late October and mid-December. In Finland, the detection of cVDPV2 was reported in Tampere in November, while the UK reported positive samples from Leeds, London, and Worthing between November and December. Genetic analysis indicates that these virus sequences belong to the NIE-ZAS-1 cVDPV2 group, first identified in Nigeria in 2020 and primarily detected in northern and western Africa. The virus likely circulated undetected for about a year before reaching Europe and appears to have been introduced multiple times from different sources.

The last indigenous case caused by an infection with wild poliovirus in Europe was reported in 1998, and the WHO European Region was declared polio-free in June 2002. Poliovirus is highly infectious and can be transmitted easily and silently across vast geographical areas. Therefore, despite the region being polio-free, the detection of poliovirus in environmental samples highlights the need for increased vigilance. The WHO and UNICEF estimated that polio third dose vaccination coverage in the European region averaged 94 percent in 2023, ranging between 78-99 percent. The ECDC estimated that approximately 600,000 children aged 12-23 months did not receive a complete primary polio vaccination course in 2022 and 2023.

The five countries reporting cVDPV2 detections have maintained high national immunization rates (85-93 percent for three doses of the polio-containing vaccine). However, pockets of under-vaccination in sub-national communities exist in every country. Sub-national coverage of the third dose of polio-containing vaccine in areas that tested positive for cVDPV2 averaged 81.2 percent, ranging from 68-94.6 percent, leaving some populations under-vaccinated and vulnerable to poliovirus infection.

There is no specific treatment or cure for polio, and only immunization can prevent it. When vaccination is unavailable to prevent infection, basic health precautions can reduce the likelihood of exposure, including practicing good hand hygiene and basic food and water precautions. However, polio eradication hinges on maintaining high immunization coverage and addressing barriers to vaccine access.  

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