Polio in pool water?

[Jaxsmomma]

Dear Dr. Bob,

We just went to a new pediatrician today and she advised giving the polio vaccine to my 18 month old at this visit do to the fact that we bring him to pools to swim.  She said that polio could be passed through the water if someone was 'shedding' after a visit to a country with active polio cases.  I am concerned about this and had never heard of this before.  How likely is this?  I would have thought that all of the chlorine and other chemicals in pools would kill bacteria/viruses?

We did get the vaccine at this visit and the varicella vaccine too but didn't get DTAP at this time.  Until now, we have been following your alternative schedule.  Should I make a special visit back for DTAP or just get it with the flu vaccine in Oct or at the 2 year visit in Nov (when he would have had the polio vaccine that he got today)?

FYI-my son actually had a **likely*** case of whooping cough last summer (about 8 months old) despite being immunized.  I say likely because the culture was negative but he had all of the symptoms.  The health dept and our pediatrician both diagnosed whooping cough and said that the culture wasn't reliable after about 3 weeks-which it was.

Thank you for reading,

Jaxsmomma

[DrBobSears]

Anyone who definately has had whooping cough doesn't need more vaccines for it. You'll have to decide how likely it was that he had it. I wouldn't get it on same day as flu shot though - get it any other time.

As for polio, technically this is possible.  Since 99% of cases of polio only show minor cold or intestinal symptoms or even no symptoms (with no neuro symptoms), it's very possible people could catch it during travel and not know it. BUT in practical terms, this is likely not occuring because if it actually was happening, we'd expect to see at least a case or three of paralytic polio showing up randomly here and there in the U.S.  Since it's not, then it's highly unlikely that the virus is being carried or shed this way. There was a case or three of such happening from a traveler who got an oral polio VACCINE while traveling, and shed the virus to a few others here. 

But I'd say that such occasions are either so rare or don't really happen that it isn't a reason to vaccinate if you were hoping not to. As for chlorine in pool water, I don't know how toxic it is to every virus, so I won't comment.

[YvonneC-M]

Jaxsmomma: Knowing something about the history of polio in the US will give your pediatrician's comments some context. Before the polio vaccine became widely available in the 1950s, polio cases would peak every summer and fall, understandably causing much fear among parents. To reduce the risk of transmission of the polio virus (which enters the body through the mouth), public swimming pools were often closed.