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3b.5 I've heard that it is possible to contract polio from handling the diapers of recently immunized infants. How long after receiving the vaccine does the child's excrement continue to contain the virus?




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This article is from the Childhood Vaccinations FAQ, by Lynn Gazis-Sax lynng@alsirat.com with numerous contributions by others.

3b.5 I've heard that it is possible to contract polio from handling the diapers of recently immunized infants. How long after receiving the vaccine does the child's excrement continue to contain the virus?

*************************************************************************
From Caren Feldman:

> Speaking of this, I know there has been mention in the past of
> contracting polio from handling diapers of recently immunized
> infants. Does anyone know how long after receiving the vaccine the
> child's excrement continues to contain the virus? The reason I ask
> is because sean got his polio booster and Rachel has only received
> the first vaccine in the series. The doctor's office said she wain
> no danger of contracting poliofrom him since they don't come in
> contact with each other *that* closely. However, I have to be extra
> careful after helping Sean clean up (he needs help sometimes) or
> handling his underwear to make sure I wash my hands thoroughly. So,
> how long until I can stop being paranoid about remembering to wash
> my hands after handling the laundry? (I forgot to ask)


The short answer is 6 weeks. But since you brought up the
subject...here's what I fond out about polio immunizations:

When I had read one poster's response that the live polio virus from
feces was actually weakened virus that would in fact help immunize
unimmunized kids they'd come in contact with it, naturally I didn't
believe it. Well, not at first. But I had enough doubts of my
disbelief to start asking around, and came up with some (at least to
me) little known facts about polio and polio immunizations. I am
presenting it to misc.kids for everyone's edification.

Indeed, live virus from a recently immunized child's feces is weakened
virus that health officials actually hope unimmunized kids come in
contact with to provide them with individual immunity and the general
population with "herd" immunity.

Now here's the tricky part. One of the attenuated strains used to make
the vaccine has a very low but existing back mutation rate, back to
the "wild type", i.e. back to "regular" polio. If the weakened virus
the child has been given mutates back to wild-type polio, any adult
with no immunity to it (or an immunized adult for whom the
immunization series did not "take") is potentially at risk for full
blown polio. Of course, people with weak immune systems may be at risk
even from weakened virus. Steroid use may also cause the immune system
to weaken (besides the usual anti-rejection drugs, HIV, leukemia) and
thus increase susceptibility for contracting the virus.

Polio in young children manifests itself as a mild gastrointestinal
ailment. Polio in older children and adults starts as a mild
gastroenteritis but with complications that may lead to
paralysis. Before the advent of improved public sanitation, most young
children were exposed to and probably contracted the polio virus, so
by adulthood, chances were everyone had immunity to it. It was only
when public sanitation improved to where exposure to the virus was
delayed until later childhood that polio epidemics became
prevelant. Polio outbreaks in the US were less frequent among poor
children than among more affluent families.

The CDC estimates the chances of getting polio from a first
immunization (I presume this means gastroenteritis symptoms in babies,
not paralytic polio) is one in half million. The chances of getting
polio from subsequent immunizations is 1 in 12 million. I assume the
chances of secondarily contracting polio from feces are even rarer.

These rare cases probably account for the supermarket tabloid (not to
mention "60 Minutes") stories of adults catching polio from recently
immunized kids who'd been given oral vaccine. For those in the US, you
will be glad to hear that a federal compensation program exists,
called the National Vaccine Injury Compensation Program, to help those
stricken with paralytic polio as a result of coming into contact with
a recipient of the oral polio vaccine.


Thanks go to two posters on sci.med for answering my questions
regarding this subject.
*************************************************************************

The 1993 Physician's Desk Reference confirms Caren Feldman's account,
with two small modifications. First, it gives the time when the virus
is shed as 6-8 weeks, rather than six. Second, the CDC estimates which
she gives are the estimates for cases of paralysis in *both* vaccine
recipients and contacts of vaccine recipients combined, not for
recipients alone.

 

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