Professor Monica Trujillo holds up wastewater samples at a lab at Queens College on August 25, 2022, in New York City. - Since the first polio case was identified in July in New York's Rockland County, the disease has been detected in New York City sewage, suggesting the virus is spreading. The developments are leading experts to fear that polio, once one of the most feared diseases in America but now endemic to just a couple of developing countries, may wreak devastation stateside again. Professor Monica Trujillo holds up wastewater samples at a lab at Queens College on August 25, 2022, in New York City. Since the first polio case was identified in July in New York’s Rockland County, the disease has been detected in New York City sewage, suggesting the virus is spreading.

The Centers for Disease Control and Prevention is considering using the oral vaccine for the first time in more than two decades to stop an outbreak in the greater New York City metropolitan area.

The CDC is talking to their New York State and New York City colleagues about the use of the vaccine.

It will take time. Routh told CNBC on Friday that it wasn't something we could pull thetrigger on and have it show up overnight. She said that there would be a lot of thought and discussion about the reintroduced vaccine.

The New York State Department of Health is working with the CDC on future options to respond to the outbreak.

The oral vaccine was pulled off the shelves in the U.S. in 2000 because it contained a live but weakened strain of the virus that could cause serious illness and even death if it were to spread.

Sewage samples in New York are linked to earlier samples in London and Jerusalem, according to scientists. It's not clear where the transmission started.

While the oral vaccine doesn't usually cause people to be paralyzed from the waist down, this one did because it was able to spread among people who weren't vaccine-vaccinated.

The U.S. uses a vaccine that can't cause disease because it contains a dead virus. New York state health officials have launched an immunization drive, but it hasn't stopped the outbreak.

The CDC has set up a work group within its committee of independent vaccine advisers to develop criteria for when the novel oral vaccine might need to be used to stop the current outbreak in the New York City area. Experts from New York are in the work group.

Since the outbreak in New York, it was decided that we need to revisit the disease. The chairperson and chief medical officer at Watts healthcare said it was simple.

Although the vaccine is effective at preventing paralysis, it doesn't stop the spread of the virus. The oral vaccine is usually used to stop the spread of the disease.

The strain circulating in the New York City metro area is related to an older version of the oral vaccine and has a different genetic make up.

If needed, the U.S. would use the novel oral vaccine which is a safer and newer version that is more stable and less likely to cause disease in people who are unvaccinated.

According to the Global Polio Eradication Initiative, the new oral vaccine was developed to stop the spread of the disease. In 21 countries, more than 450 million doses have been given.

Emergency use authorization from the FDA is required for any decision to use the novel oral vaccine. The FDA was contacted by CNBC for comment.

The goal of the public health response is to prevent further cases of paralysis, but also to eliminate the circulation of the virus in wastewater.

There is ongoing transmission in the community even without paralysis if we have wastewater detections of this circulating virus linked back to the case patient's virus.

If the inactivated vaccine doesn't stop the outbreak, the U.S. should use the novel oral vaccine.

Routh said that if the virus breaks out of its current geography and population then we need to start thinking about other methods.

In Rockland County, New York, an unvaccinated adult was paralyzed after contracting the disease. It was the first case in the US in nearly a decade and the first in New York in twenty years. New York state health officials have warned that unvaccinated people are at serious risk and should get up to date on their vaccinations immediately.

A single case of paralytic polio is considered a public health emergency by theCDC. When a person is paralyzed from the waist down, it is an indication that the virus has spread widely and silently.

The New York State Department of Health has found the disease in sewage in several counties in the New York City area. There are 70 sewage samples from Rockland, Sullivan, Orange, Nassau, Kings and Queens counties that have tested positive for the virus.

The US was free of the disease in 1979.

The governor of New York declared a state of emergency in September.