5 Cases of Polio in Amish Group Raise New Fears

[Guest guest]

Hi Sheri,

It is disgusting that the OPV is still being used and is actual very

ironic that it is causing polio here in the US, but until that

practice is stopped worldwide to at least the IPV, our children in our

country ARE still at risk for possible exposure even if they never

travel. If there was no OPV usage, I would feel completely safe in

not vaxing for Polio because the wild outbreaks are basically

nonexistant here and where I travel - however, the stupid continued

use of the OPV due soley to financial reasons makes the threat

increased to my children and makes me waffle on my decision. Who

knows - Perhaps the use of OPV is actually a security to the vax

makers for this reason?

Sheri wrote:

Quote: The virus that all four children are carrying is derived from

the oral polio vaccine. so what do you make of that? They don't even

have wild polio. WHAT THEY ARE CARRYING is FROM THE VACCINE - did yo

miss that part?

[Guest guest]

What I'm hearing in my discussions with people who are pro-vax is that the

vaccine (especially for polio since the vaccine has caused its own strain) is

kind of like guns or nuclear weapons. (And this is no commentary on my

gun-control stance!)

It's a shame that they're out there, but they're there and nothing is going to

change it. So one should be " armed " in order to protect against the bad guys

(in this case being the strains that have developed through vax).

What to say against that kind of reasoning?

Sheri B.

Sheri Nakken <vaccineinfo@...> wrote:

And the hype continues.........

" Genetic testing showed that the virus was almost identical to that of the

oral polio vaccine given in much of the rest of the world but not in the

United States. The slight changes to the virus from that of the vaccine

suggested that it had been circulating for at least two years. The girl has

never traveled abroad. "

And this one....

" " It's a model of what might happen if we stop vaccinating too soon, " he

said. " - its the vaccine strain not the wild................................

I'll put a reminder of my comments at the end

http://www.nytimes.com/2005/11/08/national/08polio.html

November 8, 2005

5 Cases of Polio in Amish Group Raise New Fears

By GARDINER HARRIS

LONG PRAIRIE, Minn. - Polio was pronounced dead in the Western Hemisphere

years ago, after one of the most successful public health campaigns in

history. But now it is stealing through a tiny Amish community here in

central Minnesota, spreading from an 8-month-old girl to four children on

two neighboring farms.

So far, no one has been crippled by the disease; only 1 in 200 cases of

polio results in paralysis. But worried public health officials say it may

be only a matter of time.

The story of how polio came to this dairy farming community of 24 families,

with 19th-century ways that include a deep-rooted suspicion of vaccination,

is both a medical whodunit and a cautionary tale, suggesting that

eradicating polio may prove far harder than anyone thought, even in the

developed world.

No one expects that the United States will be visited by the kind of

outbreaks that recently flared up in Africa and Asia, frustrating the

longstanding goal of eliminating polio for good by the end of this year.

But the Long Prairie cases highlight a weakness in the worldwide campaign.

The 8-month-old Amish girl, whose name has been withheld by health

officials, has an immune deficiency that makes her unable to rid her body

of the virus.

How she contracted the virus remains a mystery. She may have been infected

in a hospital by another immune-deficient patient who nursed it for years.

A doctor or nurse may have served as a go-between. Or there may have been a

chain of carriers in the Amish community. The virus is spread from stool to

mouth, a surprisingly efficient form of transmission.

Regardless, the girl is now a wellspring for polio, a modern-day Typhoid

who can pass it along to others. Anyone who has not been vaccinated is

vulnerable. And though vaccination rates in the United States are at

historic highs, an increasing number of parents are resisting inoculations

for their children, fearing that they may cause disorders like autism, a

connection scientists have almost universally discounted.

So health authorities are keeping a watchful eye on the girl and her

neighbors.

" If that child is a message in a bottle, " said Bruce Aylward, coordinator

of the global polio eradication initiative at the World Health

Organization, " it has just washed up on shore. "

The 24 families moved to this windswept stretch of prairie from Wisconsin

about three years ago. An Amish community generally includes only as many

families as can fit into one house for church services, and each community

must come to a consensus on what to accept from modernity.

This one allows windshields for its horse buggies, kitchen cupboards that

are attached to walls and some upholstered furniture - all somewhat unusual

for the Amish, said Dr. Rutten, a physician from nearby Sauk Centre

who makes house calls in four Amish communities. Men can wear dark green

shirts, not just navy blue and black.

The farms could have come straight out of children's books. There are ducks

and chickens, cattle and hogs. Fence posts are columns of stones enclosed

by wire mesh. Lacking electricity, the farms are remarkably quiet. At one,

the children rarely yelled or even spoke in the presence of a stranger. The

air smelled of turned earth, manure and wood smoke.

The threat of polio seemed remote here - until this summer. That was when

the baby was hospitalized with an immune-system disorder.

As her care became increasingly complex, she was shuttled through four

hospitals. At the third, she developed diarrhea. On Aug. 27, doctors sent a

stool sample to the hospital's laboratory, which determined that the girl

had an intestinal virus. In many states, nothing more would have been done.

But in Minnesota, hospitals send such samples to a sophisticated state

laboratory. On Sept. 29, the tests matured. A laboratory supervisor called

Dr. Harry Hull, the state epidemiologist, to say they had isolated a polio

virus.

Dr. Hull was stunned. " I said, 'You have made a mistake,' " he recalled.

Tall and thin, with glasses and bushy eyebrows, Dr. Hull is one of the

world's foremost polio experts. Before coming to Minnesota, he worked for

10 years in the World Health Organization's global polio eradication

effort. In an interview, he scrawled circles and arrows on a sheet of paper

as he described the search for the virus.

The state laboratory redid the tests. The results were identical. Then it

sequenced the virus's genomic code. A supervisor plugged the code into a

national genomic database, comparing it with the genes of a polio virus.

" Bingo, " said Dr. Norman Crouch, the laboratory's director. " It was a 98

percent match. We knew we had nailed it. "

The Minnesota laboratory sent the sample to the Centers for Disease Control

and Prevention in Atlanta, which confirmed the results. Officials were

immediately concerned about where the virus originated and where it might

have spread.

Confirming the presence of polio in a city with even one infected person is

not impossible, said Dr. Mark D. Sobsey, a professor of environmental

microbiology at the University of North Carolina. The stool of an infected

person contains so many viral particles that tests at a sewage treatment

plant can reveal it. Such tests helped track outbreaks in the Gaza Strip

and Haiti in recent years.

Since many Amish use outhouses, however, state officials geared up to go

door to door. They unearthed a public health form explaining how to collect

stool samples. The form had pictures of a flush toilet and a garbage can

with a plastic liner - things foreign to many Amish communities. Officials

changed the form.

Wax, an epidemiologist for the Minnesota Department of Health,

contacted the leader of the Amish community where the child lives and asked

for his permission to seek stool samples from those in his community. The

leader gave his blessing, Mr. Wax said.

" We really tried to do it in a respectful way rather than just barge right

in there, " Mr. Wax said.

Since the Amish have no phones, he could not call for appointments. He and

his colleagues knocked on doors. They had been warned against speaking

directly to Amish women without their husbands present, Mr. Wax said, and

the men were " running all over the place, helping each other with

harvesting and construction. " So if the man was not at home, they left.

" We came back many times to some places, " Mr. Wax said. After weeks of

effort, just 5 of 24 families in the community agreed to cooperate. Three

of the five, including the family of the 8-month-old, proved to have

infected children.

" I would be surprised if we don't get a paralytic case someplace, " Dr. Hull

said.

In a neighboring community, a 38-year-old farmer who is also a sawyer

agreed to speak with a reporter only if his name would not be used, saying

Amish people avoided calling attention to themselves.

The farmer, who has seven children, explained that nothing in Amish law

forbade vaccinations, but that many Amish believed that vaccines weakened

the immune system. He added that as a result of the infections, he planned

to have his children vaccinated against polio, measles, mumps and rubella,

and that most of the families in his community were doing the same. " We'll

get vaccinated if we feel it's necessary, " he said. " But our definition of

necessary may be very different from yours. "

A further challenge for public health officials is that their surveillance

efforts cannot be confined to a few remote farming communities.

" My mental image of the Amish was that they don't travel at all because

they don't drive cars, " Dr. Hull said. " That's not true. "

The Amish commonly take buses and trains, and occasionally even planes.

Families from the baby girl's community recently attended a wedding in

Ontario, Canada, that health officials said drew more than 1,000 guests.

Some have visited Wisconsin in recent weeks.

Polio experts have long feared that an immune-deficient person could cause

an outbreak of paralytic polio. That is a particular hazard in poorer

countries.

In much of the developing world, children are given an oral vaccine made of

a live, nonparalytic polio virus. Two drops confer partial immunity, making

mass vaccination campaigns achievable in poor countries. To become fully

immunized, a child must be vaccinated several times. The vaccine causes an

infection that usually lasts a few weeks. The infection can spread to

others and immunize them, too.

But if the virus spreads too far among previously unvaccinated people, its

genes will change and the virus will regain its ability to cripple and

kill. Such a virus caused an outbreak of paralytic polio in Haiti and the

Dominican Republic in 2000 and 2001, crippling 21. (The outbreaks in Africa

and Asia began after many Nigerians refused vaccinations in 2003,

suspecting they were a Western plot to sterilize Muslim girls.)

The United States and much of the developed world used live-virus

vaccinations for decades, but switched in recent years to a dead virus that

is injected. The dead virus does not cause an infection or paralysis.

In people with poor immune systems like the 8-month-old Amish child, the

live polio vaccine can change to a paralytic form without being passed to

anyone else, since such people can nurse a mutating virus for years.

In most of the world, such patients die quickly because of poor medical

care. In the West, they can live for years, with a few of them shedding

polio viruses all the while. Among experts, these patients are called

" chronic excreters. " That such a polio wellspring would be born among a

largely unvaccinated population like the Amish, Dr. Hull said, was a

" random unlucky event. "

" It's a model of what might happen if we stop vaccinating too soon, " he said.

The Amish girl remains hospitalized in strict isolation. Health officials

will not say where. And they are still trying to figure out where she

contracted the virus.

Genetic testing showed that the virus was almost identical to that of the

oral polio vaccine given in much of the rest of the world but not in the

United States. The slight changes to the virus from that of the vaccine

suggested that it had been circulating for at least two years. The girl has

never traveled abroad.

A fear is that such a person could unwittingly incubate a polio infection

for a decade or more and then accidentally reintroduce it - years after

experts have declared it eliminated from the world and vaccinations have

stopped.

That prospect has long seemed remote, because such children are so rare,

Dr. Aylward of the World Health Organization said. But an outbreak of

paralytic disease in Minnesota would prove that it was more likely than

many had believed, and it would demonstrate that work now under way to

better understand the risks posed by chronic excreters would have to be

intensified.

" Or we may need to revisit the strategy and time frame for stopping the use

of the oral polio vaccine, " Dr. Aylward said. " It's a tiny chance, but it's

something we need to keep an eye on. "

********

My comments on original Washington Post article

Quote: The Amish typically decline to vaccinate their children.

This is NOT necessarily true - many Amish vaccinate.

Quote:The outbreak was discovered by chance on Sept. 29 after the first

child -- a 7-month-old infant with a severe immune deficiency disease --

was tested for another problem in August

Just happened to find it - the infant does NOT HAVE polio. Just happened to

find it. How many of us would they find it in? It was normal to have polio

in your gut prior to sanitation improvements. We probably all had polio -

polio is just very mild like a cold or the flu in most people.

Quote: The virus that all four children are carrying is derived from

the oral polio vaccine.

so what do you make of that? They don't even have wild polio. WHAT THEY ARE

CARRYING is FROM THE VACCINE - did yo miss that part?

--------------------------------------------------------

Sheri Nakken, R.N., MA, Classical Homeopath

Vaccination Information & Choice Network, Nevada City CA & Wales UK

$$ Donations to help in the work - accepted by Paypal account

vaccineinfo@... voicemail US 530-740-0561

(go to http://www.paypal.com) or by mail

Vaccines - http://www.nccn.net/~wwithin/vaccine.htm

Vaccine Dangers On-Line course - http://www.nccn.net/~wwithin/vaccineclass.htm

Homeopathy On-Line course - http://www.nccn.net/~wwithin/homeo.htm

ANY INFO OBTAINED HERE NOT TO BE CONSTRUED AS MEDICAL

OR LEGAL ADVICE. THE DECISION TO VACCINATE IS YOURS AND YOURS ALONE.

******

" Just look at us. Everything is backwards; everything is upside down.

Doctors destroy health, lawyers destroy justice, universities destroy

knowledge, governments destroy freedom, the major media destroy information

and religions destroy spirituality " .... Ellner

[Guest guest]

" ...an increasing number of parents are resisting inoculations

for their children, fearing that they may cause disorders like autism,

a connection scientists have almost universally discounted "

Here it is again, just some parents and their foolish fears. No

respected researchers or real doctors. And it's much more than autism.

If anyone lives near any Amish folks then let them know there's a ton

of information they need to know about.

Dan

[Guest guest]

At 07:07 PM 11/8/2005 -0000, you wrote:

>Hi Sheri,

>

>It is disgusting that the OPV is still being used and is actual very

>ironic that it is causing polio here in the US, but until that

>practice is stopped worldwide to at least the IPV, our children in our

>country ARE still at risk for possible exposure even if they never

>travel. If there was no OPV usage, I would feel completely safe in

>not vaxing for Polio because the wild outbreaks are basically

>nonexistant here and where I travel - however, the stupid continued

>use of the OPV due soley to financial reasons makes the threat

>increased to my children and makes me waffle on my decision. Who

>knows - Perhaps the use of OPV is actually a security to the vax

>makers for this reason?

>

>

I would suggest to you that the vaccine does NOTHING to prevent polio

So many lies about polio.

I'm teaching about that right now in one of my classes and I'll share some

of it on the lists.

These children in MN are NOT even sick.

I bet many of us have this in us?

It isn't about OPV really.

I'll share the info

Sheri

--------------------------------------------------------

Sheri Nakken, R.N., MA, Classical Homeopath

Vaccination Information & Choice Network, Nevada City CA & Wales UK

$$ Donations to help in the work - accepted by Paypal account

vaccineinfo@... voicemail US 530-740-0561

(go to http://www.paypal.com) or by mail

Vaccines - http://www.nccn.net/~wwithin/vaccine.htm

Vaccine Dangers On-Line course - http://www.nccn.net/~wwithin/vaccineclass.htm

Homeopathy On-Line course - http://www.nccn.net/~wwithin/homeo.htm

ANY INFO OBTAINED HERE NOT TO BE CONSTRUED AS MEDICAL

OR LEGAL ADVICE. THE DECISION TO VACCINATE IS YOURS AND YOURS ALONE.

******

" Just look at us. Everything is backwards; everything is upside down.

Doctors destroy health, lawyers destroy justice, universities destroy

knowledge, governments destroy freedom, the major media destroy information

and religions destroy spirituality " .... Ellner

[Guest guest]

and again this doesn't matter as these children are NOT ill. And polio

probably not caused by any virus.

See what I have sent

Sheri

At 11:19 AM 11/8/2005 -0800, you wrote:

>What I'm hearing in my discussions with people who are pro-vax is that the

vaccine (especially for polio since the vaccine has caused its own strain)

is kind of like guns or nuclear weapons. (And this is no commentary on my

gun-control stance!)

>It's a shame that they're out there, but they're there and nothing is

going to change it. So one should be " armed " in order to protect against

the bad guys (in this case being the strains that have developed through vax).

>

>What to say against that kind of reasoning?

>Sheri B.

>

>Sheri Nakken <vaccineinfo@...> wrote:

>And the hype continues.........

>

> " Genetic testing showed that the virus was almost identical to that of the

>oral polio vaccine given in much of the rest of the world but not in the

>United States. The slight changes to the virus from that of the vaccine

>suggested that it had been circulating for at least two years. The girl has

>never traveled abroad. "

>

>And this one....

> " " It's a model of what might happen if we stop vaccinating too soon, " he

>said. " - its the vaccine strain not the wild................................

>

>I'll put a reminder of my comments at the end

>

>

>http://www.nytimes.com/2005/11/08/national/08polio.html

--------------------------------------------------------

Sheri Nakken, R.N., MA, Classical Homeopath

Vaccination Information & Choice Network, Nevada City CA & Wales UK

$$ Donations to help in the work - accepted by Paypal account

vaccineinfo@... voicemail US 530-740-0561

(go to http://www.paypal.com) or by mail

Vaccines - http://www.nccn.net/~wwithin/vaccine.htm

Vaccine Dangers On-Line course - http://www.nccn.net/~wwithin/vaccineclass.htm

Homeopathy On-Line course - http://www.nccn.net/~wwithin/homeo.htm

ANY INFO OBTAINED HERE NOT TO BE CONSTRUED AS MEDICAL

OR LEGAL ADVICE. THE DECISION TO VACCINATE IS YOURS AND YOURS ALONE.

******

" Just look at us. Everything is backwards; everything is upside down.

Doctors destroy health, lawyers destroy justice, universities destroy

knowledge, governments destroy freedom, the major media destroy information

and religions destroy spirituality " .... Ellner

[Guest guest]

5 Cases of Polio in Amish Group Raise New Fears

By GARDINER HARRIS

Published: November 8, 2005

LONG PRAIRIE, Minn. - Polio was pronounced dead in the Western Hemisphere

years ago, after one of the most successful public health campaigns in history.

But now it is stealing through a tiny Amish community here in central Minnesota

, spreading from an 8-month-old girl to four children on two neighboring

farms.

So far, no one has been crippled by the disease; only 1 in 200 cases of polio

results in paralysis. But worried public health officials say it may be only

a matter of time.

Dr. Rutten, a physician, makes house calls in four Amish communities in

Central Minnesota.

The story of how polio came to this dairy farming community of 24 families,

with 19th-century ways that include a deep-rooted suspicion of vaccination, is

both a medical whodunit and a cautionary tale, suggesting that eradicating

polio may prove far harder than anyone thought, even in the developed world.

No one expects that the United States will be visited by the kind of

outbreaks that recently flared up in Africa and Asia, frustrating the

longstanding

goal of eliminating polio for good by the end of this year. But the Long Prairie

cases highlight a weakness in the worldwide campaign.

The 8-month-old Amish girl, whose name has been withheld by health officials,

has an immune deficiency that makes her unable to rid her body of the virus.

How she contracted the virus remains a mystery. She may have been infected in

a hospital by another immune-deficient patient who nursed it for years. A

doctor or nurse may have served as a go-between. Or there may have been a chain

of carriers in the Amish community. The virus is spread from stool to mouth, a

surprisingly efficient form of transmission.

Regardless, the girl is now a wellspring for polio, a modern-day Typhoid

who can pass it along to others. Anyone who has not been vaccinated is

vulnerable. And though vaccination rates in the United States are at historic

highs,

an increasing number of parents are resisting inoculations for their

children, fearing that they may cause disorders like autism, a connection

scientists

have almost universally discounted.

So health authorities are keeping a watchful eye on the girl and her

neighbors.

" If that child is a message in a bottle, " said Bruce Aylward, coordinator of

the global polio eradication initiative at the World Health Organization, " it

has just washed up on shore. "

The 24 families moved to this windswept stretch of prairie from Wisconsin

about three years ago. An Amish community generally includes only as many

families as can fit into one house for church services, and each community must

come

to a consensus on what to accept from modernity.

This one allows windshields for its horse buggies, kitchen cupboards that are

attached to walls and some upholstered furniture - all somewhat unusual for

the Amish, said Dr. Rutten, a physician from nearby Sauk Centre who makes

house calls in four Amish communities. Men can wear dark green shirts, not

just navy blue and black.

The farms could have come straight out of children's books. There are ducks

and chickens, cattle and hogs. Fence posts are columns of stones enclosed by

wire mesh. Lacking electricity, the farms are remarkably quiet. At one, the

children rarely yelled or even spoke in the presence of a stranger. The air

smelled of turned earth, manure and wood smoke.

The threat of polio seemed remote here - until this summer. That was when the

baby was hospitalized with an immune-system disorder.

As her care became increasingly complex, she was shuttled through four

hospitals. At the third, she developed diarrhea. On Aug. 27, doctors sent a

stool

sample to the hospital's laboratory, which determined that the girl had an

intestinal virus. In many states, nothing more would have been done.

But in Minnesota, hospitals send such samples to a sophisticated state

laboratory. On Sept. 29, the tests matured. A laboratory supervisor called Dr.

Harry

Hull, the state epidemiologist, to say they had isolated a polio virus.

Dr. Hull was stunned. " I said, 'You have made a mistake,' " he recalled.

Tall and thin, with glasses and bushy eyebrows, Dr. Hull is one of the

world's foremost polio experts. Before coming to Minnesota, he worked for 10

years

in the World Health Organization's global polio eradication effort. In an

interview, he scrawled circles and arrows on a sheet of paper as he described

the

search for the virus.

The state laboratory redid the tests. The results were identical. Then it

sequenced the virus's genomic code. A supervisor plugged the code into a

national

genomic database, comparing it with the genes of a polio virus.

" Bingo, " said Dr. Norman Crouch, the laboratory's director. " It was a 98

percent match. We knew we had nailed it. "

The Minnesota laboratory sent the sample to the Centers for Disease Control

and Prevention in Atlanta, which confirmed the results. Officials were

immediately concerned about where the virus originated and where it might have

spread.

Confirming the presence of polio in a city with even one infected person is

not impossible, said Dr. Mark D. Sobsey, a professor of environmental

microbiology at the University of North Carolina. The stool of an infected

person

contains so many viral particles that tests at a sewage treatment plant can

reveal

it. Such tests helped track outbreaks in the Gaza Strip and Haiti in recent

years.

Since many Amish use outhouses, however, state officials geared up to go door

to door. They unearthed a public health form explaining how to collect stool

samples. The form had pictures of a flush toilet and a garbage can with a

plastic liner - things foreign to many Amish communities. Officials changed the

form.

Wax, an epidemiologist for the Minnesota Department of Health, contacted

the leader of the Amish community where the child lives and asked for his

permission to seek stool samples from those in his community. The leader gave

his

blessing, Mr. Wax said.

" We really tried to do it in a respectful way rather than just barge right in

there, " Mr. Wax said.

Since the Amish have no phones, he could not call for appointments. He and

his colleagues knocked on doors. They had been warned against speaking directly

to Amish women without their husbands present, Mr. Wax said, and the men were

" running all over the place, helping each other with harvesting and

construction. " So if the man was not at home, they left.

" We came back many times to some places, " Mr. Wax said. After weeks of

effort, just 5 of 24 families in the community agreed to cooperate. Three of the

five, including the family of the 8-month-old, proved to have infected children.

" I would be surprised if we don't get a paralytic case someplace, " Dr. Hull

said.

In a neighboring community, a 38-year-old farmer who is also a sawyer agreed

to speak with a reporter only if his name would not be used, saying Amish

people avoided calling attention to themselves.

The farmer, who has seven children, explained that nothing in Amish law

forbade vaccinations, but that many Amish believed that vaccines weakened the

immune system. He added that as a result of the infections, he planned to have

his

children vaccinated against polio, measles, mumps and rubella, and that most

of the families in his community were doing the same. " We'll get vaccinated if

we feel it's necessary, " he said. " But our definition of necessary may be very

different from yours. "

A further challenge for public health officials is that their surveillance

efforts cannot be confined to a few remote farming communities.

" My mental image of the Amish was that they don't travel at all because they

don't drive cars, " Dr. Hull said. " That's not true. "

The Amish commonly take buses and trains, and occasionally even planes.

Families from the baby girl's community recently attended a wedding in Ontario,

Canada, that health officials said drew more than 1,000 guests. Some have

visited

Wisconsin in recent weeks.

Polio experts have long feared that an immune-deficient person could cause an

outbreak of paralytic polio. That is a particular hazard in poorer countries.

In much of the developing world, children are given an oral vaccine made of a

live, nonparalytic polio virus. Two drops confer partial immunity, making

mass vaccination campaigns achievable in poor countries. To become fully

immunized, a child must be vaccinated several times. The vaccine causes an

infection

that usually lasts a few weeks. The infection can spread to others and immunize

them, too.

But if the virus spreads too far among previously unvaccinated people, its

genes will change and the virus will regain its ability to cripple and kill.

Such a virus caused an outbreak of paralytic polio in Haiti and the Dominican

Republic in 2000 and 2001, crippling 21. (The outbreaks in Africa and Asia began

after many Nigerians refused vaccinations in 2003, suspecting they were a

Western plot to sterilize Muslim girls.)

The United States and much of the developed world used live-virus

vaccinations for decades, but switched in recent years to a dead virus that is

injected.

The dead virus does not cause an infection or paralysis.

In people with poor immune systems like the 8-month-old Amish child, the live

polio vaccine can change to a paralytic form without being passed to anyone

else, since such people can nurse a mutating virus for years.

In most of the world, such patients die quickly because of poor medical care.

In the West, they can live for years, with a few of them shedding polio

viruses all the while. Among experts, these patients are called " chronic

excreters. " That such a polio wellspring would be born among a largely

unvaccinated

population like the Amish, Dr. Hull said, was a " random unlucky event. "

" It's a model of what might happen if we stop vaccinating too soon, " he said.

The Amish girl remains hospitalized in strict isolation. Health officials

will not say where. And they are still trying to figure out where she contracted

the virus.

Genetic testing showed that the virus was almost identical to that of the

oral polio vaccine given in much of the rest of the world but not in the United

States. The slight changes to the virus from that of the vaccine suggested that

it had been circulating for at least two years. The girl has never traveled

abroad.

A fear is that such a person could unwittingly incubate a polio infection for

a decade or more and then accidentally reintroduce it - years after experts

have declared it eliminated from the world and vaccinations have stopped.

That prospect has long seemed remote, because such children are so rare, Dr.

Aylward of the World Health Organization said. But an outbreak of paralytic

disease in Minnesota would prove that it was more likely than many had believed,

and it would demonstrate that work now under way to better understand the

risks posed by chronic excreters would have to be intensified.

" Or we may need to revisit the strategy and time frame for stopping the use

of the oral polio vaccine, " Dr. Aylward said. " It's a tiny chance, but it's

something we need to keep an eye on. "