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A microscopic view of poliovirus

There is a view of a vaccine.

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The UK Health Security Agency is urging people who aren't up to date with their vaccine to get it.

The Beckton sewage treatment works have only detected wastewater so far, with no reports of humans.

The potential for the virus to spread and cause severe disease, particularly among the unvaccinated, is expected to have taken place.

What is polio and how does it spread?

Children under the age of five are most affected by the disease. It spreads when people don't wash their hands after using the toilet and then pass it on to someone else. It can be spread by coughing and sneezing

What are the symptoms?

Most people don't have any symptoms, but some develop flu-like symptoms, such as a high temperature and vomiting, after a few weeks of being exposed to the disease.

The virus can cause paralysis in 1 in 100 to 1000 instances. If the nerves that control our breathing muscles are affected by the disease, it can be fatal.

When was the UK’s last polio outbreak?

There have been no cases of the disease in the UK in the last 25 years. The UK was declared free of the disease in 2003 by the WHO.

Is it unusual to detect polio in wastewater?

In the UK sewage samples are tested for diseases such as hepatis A and E.

Each year, there are at least one to three vaccine-likeviruses detected. After a person received a live oral polio vaccine, there were some findings that happened. The UK doesn't administer these vaccines.

Several closely relatedviruses have been identified in Beckton.

According to the UKHSA, there is a chance that some people in north and east London have been exposed to a strain of the disease.

People who have received the vaccine could be at risk for this strain. This is used in the UK.

How can people shed poliovirus in their faeces?

In parts of the world that are actively fighting the disease, such as Afghanistan and Pakistan, live oral vaccine are given. Oral vaccines are relatively inexpensive and easy to administer.

In poorly-immunised populations, the oral vaccine can lead to vaccine-derived polioviruses. The vaccine works with a weakened version of the liveviruses. This modifies so as not to cause severe disease in rare cases. The virus can cause it to be removed from the body.

Someone who recently received a live oral vaccine may have introduced the Beckton sewage sample strain.

What makes this different to previous polio detections in sewage?

There have been previous detections of the disease in sewage.

The Beckton samples contained a number of viruses. They are related to each other and have different types of genes.

According to David Salisbury at the World Health Organization's Global Commission for Certification of Polio Eradication, it's possible that people who've been vaccineed may have been affected by the changes.

Read more: Will the planet ever be free from the scourge of polio?

The person may have received the live oral vaccine in the UK but did not experience symptoms.

Kathleen O'Reilly at the London School of Hygiene & Tropical Medicine thinks that some local transmission has taken place in the UK.

She says that the genetic analysis shows multiple chains of transmission from one person to another. People who have never been vaccinations have a higher chance of acquiring the disease.

Are only unvaccinated people at risk?

According to the UKHSA, the risk of serious disease is low. The majority of the UK population will be protected from vaccine-related diseases in childhood, but some people may remain at risk.

Babies in the UK are given a vaccine three times before they are 1 years old. They are given two more jabs before turning 15.

In the UK, more than 92 percent of the population have received at least three vaccine doses, but take-up is lower in London.

According to a statement to the Science Media Centre, Paul Hunter at the University of East Anglia, UK, said that it was possible that the live vaccine could spread from one person to another.

Overall, how concerned should we be?

There have not been any paralytic cases so far.

This could pose a serious risk to people who haven't been vaccinations. The vaccine-derived transmission events are described and most end without causing harm, but that depends on the coverage of the vaccine.

The disease threat in the country is low due to our relatively widespread use of the injected vaccine, but we might see some continued spread of the vaccine strain as killed vaccine doesn't always protect from infections.

He told the Science Media Centre that the high levels of vaccine here should eradicate the virus.

The parents of children under 5 years old who are not up to date with their vaccine will be contacted by the National Health Service.

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