Vaccine-derived poliovirus type 2 was detected in the wastewater samples in Gaza.

With the way polio operates, you can get a lot of cryptic transmission as most infections don't cause paralysis.

Polio vaccination rates have declined in the strip since the war. They were at 99% in 2022. Now they are reported to have fallen to 86%. So it may be only a matter of time before we get a case.

The last reported poliomyelitis case in Gaza was in 1988. They've had consistently high vaccination rates for decades up till now.

Normally in this instance you'd do an emergency catch-up vaccination program with a combination of oral polio vaccine and inactivated polio vaccine to interrupt transmission and boost population coverage. But it will be hard to do that without a ceasefire and cooperation of the Israelis.

The region has been declared polio free for decades now. It would be terrible to see it become endemic again. Global polio eradication has faced a number of setbacks recently between the pandemic and global conflict.