Tuesday 16 August 2022

LETTER: Brent councillors & officers should have training on disease danger from raw human sewage

 Dear Editor,

Reading all the latest from Neil Nerva and UKHSA (see Notes below) plus other local commentary you can imagine that I am just appalled at the previous lack of action given that indications are that the polio virus is spreading and mutating. Why Brent Council has not declared a ‘Major Incident’ is totally and utterly beyond my comprehension. 


Once again, Brent Council is trying to shut the gate after the horses have bolted. The total combined lack of understanding and action is just appalling.


Perhaps some in-service training for Councillors and Council Officers on the connection between the presence of untreated raw human sewage in waterways and the spread of diseases might be in order?


John Poole




Cllr Neil Nerva (Cabinet Member for Public Health and Adult Social Care) wrote to all Brent councillors on August 10th attaching the UK Health Security Agency on the health dangers after detection of the pokio virus in waste water in the borough. He stated:

Councillors have a key role to promote vaccination for children aged one to nine.

 UK Health Security Agency Press Release

  • JCVI has advised all children aged one to nine in London are offered a polio booster vaccine, prioritising the areas where the virus is present.
  • The NHS in London will contact parents when it's their child’s turn to come forward for a booster or catch-up polio dose.
  • Vaccine-derived poliovirus has been detected in sewage in Barnet, Brent, Camden, Enfield, Hackney, Haringey, Islington and Waltham Forest.
  • There have been no confirmed cases of polio and the risk to the wider population is low.
  • Across London, childhood vaccination uptake is lower than the rest of the country.

Following the discovery of type 2 vaccine-derived poliovirus in sewage in north and east London, the Joint Committee on Vaccination and Immunisation (JCVI) has advised that a targeted inactivated polio vaccine (IPV) booster dose should be offered to all children between the ages of one and nine in all London boroughs.

This will ensure a high level of protection from paralysis and help reduce further spread of the virus. Nationally the overall risk of paralytic polio is considered low because most people are protected from this by vaccination.

Many countries globally, including the USA and EU countries like Belgium, provide an additional dose of polio-containing vaccine as part of their childhood vaccination schedule. The NHS in London will contact parents when it's their child’s turn to come forward for a booster or catch-up polio dose - parents should take up the offer as soon as possible.

The programme will start with the areas affected, where the poliovirus has been detected and vaccination rates are low. This will be followed by rapid rollout across all boroughs. This booster dose will be in addition to the NHS childhood vaccination catch up campaign across London. It’s important all children aged 1-9, even if up-to-date with their vaccinations, accept this vaccine when offered to further strengthen their protection against the poliovirus.

Following the findings earlier this year of type 2 poliovirus (PV2) collected from the Beckton sewage treatment works, further upstream sampling undertaken by the UK Health Security Agency (UKHSA) and the Medicines and Healthcare products Regulatory Agency (MHRA) has now identified at least one positive sample of the poliovirus currently present in parts of several boroughs: Barnet, Brent, Camden, Enfield, Hackney, Haringey, Islington and Waltham Forest.

The sampling has also detected the virus in lower concentrations and frequency in areas adjacent to the Beckton catchment area to the South (immediately below the Thames) and to the east of Beckton. However, it is not clear whether the virus has established itself in these areas or if the detections are due to people from the affected area visiting these neighbouring areas.

The level of poliovirus found and the high genetic diversity among the PV2 isolates suggests that there is some level of virus transmission in these boroughs which may extend to the adjacent areas. This suggests that transmission has gone beyond a close network of a few individuals.

A total of 116 PV2 isolates have been identified in 19 sewage samples collected in London between 8 February and 5 July this year, but most are vaccine-like virus and only a few have sufficient mutations to be classified as vaccine derived poliovirus (VDPV2). VDPV2 is of greater concern as it behaves more like naturally occurring ‘wild’ polio and may, on rare occasions, lead to cases of paralysis in unvaccinated individuals.

UKHSA is working closely with health agencies in New York and Israel alongside the World Health Organisation (WHO) to investigate the links between the poliovirus detected in London and recent polio incidents in these two other countries.

Dr Vanessa Saliba, Consultant Epidemiologist at UKHSA said:

No cases of polio have been reported and for the majority of the population, who are fully vaccinated, the risk is low. But we know the areas in London where the poliovirus is being transmitted have some of the lowest vaccination rates. This is why the virus is spreading in these communities and puts those residents not fully vaccinated at greater risk.

Polio is a serious infection that can cause paralysis but nationally the overall risk is considered low because most people are protected by vaccination. The last case of polio in the UK was in 1984, but decades ago before we introduced the polio vaccination programme around 8000 people would develop paralysis every year.

It is vital parents ensure their children are fully vaccinated for their age. Following JCVI advice all children aged one to nine years in London need to have a dose of polio vaccine now – whether it’s an extra booster dose or just to catch up with their routine vaccinations. It will ensure a high level of protection from paralysis. This may also help stop the virus spreading further.

Jane Clegg, Chief Nurse for the NHS in London said:

While the majority of Londoners are protected from polio, the NHS will shortly be contacting parents of eligible children aged one to nine years old to offer them a top-up dose to ensure they have maximum protection from the virus.

We are already reaching out to parents and carers of children who aren’t up to date with their routine vaccinations, who can book a catch-up appointment with their GP surgery now and for anyone not sure of their child’s vaccination status, they can check their Red Book.

The UKHSA, working with the MHRA, has already increased sewage surveillance to assess the extent of spread of the virus and are currently sampling eight further sites across London. A further 15 sites in London will start sewage sampling in mid-August, and 10 -15 sites will be stood up nationally to determine if poliovirus is spreading outside of London.

Editor's Note:  With primary schools closed for the summer holiday the usual method of communication  with parents of young children is unavailable. Brent Council should be seeking imaginative ways of communicating the urgent information about the need for parents  to take advantage of the vaccination offerfor their children (aged 1-9. Councillors could be doing that for their wards via social media, Facebook sites and Next Door as well as personal contact.

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