Poliovirus Detected in German Wastewater: RKI Warns of Reintroduction Risks

By SWA

Related Article:  Ärzteblatt.de https://www.aerzteblatt.de/nachrichten/157114/Impfstoffabgeleitete-Polioviren-im-Abwasser-an-weiteren-Standorten-nachgewiesen-Wachsamkeit-geboten

Berlin – Circulating vaccine-derived poliovirus type 2 (cVDPV2) has been detected in wastewater at two new locations in Germany, according to a report by the Robert Koch Institute (RKI) published in the Epidemiological Bulletin (2025; DOI: 10.25646/12988). This discovery follows earlier detections at seven other sites in 2024 (Epidemiological Bulletin 2024; DOI: 10.25646/12938), raising concerns about the potential reintroduction of polioviruses in regions previously declared polio-free.

“The current detection of cVDPV2 in Germany and Europe is a reminder that even regions that are already polio-free are not protected from the reintroduction of polioviruses,” the RKI warns in its latest report.

What is cVDPV2?

cVDPV2 stands for circulating vaccine-derived poliovirus type 2. Unlike the wild poliovirus, which has been largely eradicated in many parts of the world, cVDPV2 arises from the oral polio vaccine (OPV). The OPV contains a weakened (attenuated) form of the virus, which helps build immunity in the vaccinated individual. However, in areas with low immunization coverage, the weakened virus can circulate in the community for extended periods. Over time, it may mutate and revert to a form capable of causing paralysis—this mutated virus is what’s known as cVDPV2.

Why is cVDPV2 a Concern?

Poliovirus has three serotypes: types 1, 2, and 3. While type 2 wild poliovirus was declared eradicated in 2015, the type 2 strain used in vaccines has been the most common source of cVDPV outbreaks. Due to this risk, the type 2 component was removed from OPV in 2016 in a coordinated global effort known as the "OPV switch." Despite these measures, outbreaks of cVDPV2 continue in regions where immunity gaps exist.

The primary risk associated with cVDPV2 is that it can cause acute flaccid paralysis (AFP), just like the wild poliovirus. This condition can lead to irreversible muscle weakness or paralysis, particularly in the lower limbs, and in severe cases, it may affect respiratory muscles, leading to life-threatening complications.

How Does cVDPV2 Affect the Body?

The virus primarily attacks motor neurons in the spinal cord, disrupting signals to muscles and leading to flaccid paralysis. The most commonly affected muscles include:

  • Lower Limbs: Weakness or paralysis in the legs, often asymmetrical.
  • Core and Trunk Muscles: Leading to posture and balance issues.
  • Upper Limbs: Less commonly affected, but may cause weakness in arms and hands.
  • Respiratory Muscles: In severe cases, leading to respiratory failure.
  • Bulbar Muscles: Affecting swallowing and speech if the brainstem is involved.

While sensory functions remain intact, the asymmetrical paralysis can lead to long-term complications such as muscle atrophy and, in some cases, post-polio syndrome years after recovery.

Preventing cVDPV2 Outbreaks

The best defense against cVDPV2 is maintaining high vaccination coverage. The RKI emphasizes that even in polio-free regions like Germany, lapses in immunization can create opportunities for the virus to spread and mutate. To address this, newer vaccines such as the novel OPV2 (nOPV2) have been developed. These vaccines are designed to be more genetically stable, reducing the likelihood of mutation and the emergence of cVDPV2.

What’s Next?

The RKI is actively monitoring the situation and has urged health authorities to reinforce vaccination programs, especially in communities with low immunization rates. The detection of cVDPV2 in German wastewater serves as a critical reminder of the global nature of infectious diseases—even countries with robust healthcare systems are not immune to the threats posed by reintroduced viruses.

As the global fight against polio continues, vigilance, high vaccination coverage, and effective surveillance systems remain key to preventing a resurgence of this debilitating disease.

© 2000-2025 Sieglinde W. Alexander. All writings by Sieglinde W. Alexander have a fife year copy right. Library of Congress Card Number: LCN 00-192742 ISBN: 0-9703195-0-9

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