NEW YORK (AP) — New York Governor Kathy Hochul said Friday the state was stepping up its polio-fighting efforts as the virus that causes the life-threatening disease was detected in the wastewater of yet another county in the New York City area.

Health officials began checking for signs of the virus in sewage water after the first case of polio in the United States in nearly a decade was identified in July in Rockland County, which is north of the city. The latest detection involved a wastewater sample collected last month in Nassau County on Long Island, directly east of the city.

The sample is genetically linked to the polio case from Rockland and provides further evidence of expanding community spread, state health officials said. The poliovirus had previously been detected in wastewater in New York City and three counties to its north: Rockland, Orange and Sullivan.

Hochul declared a state disaster emergency that allows EMS workers, midwives and pharmacists to administer polio vaccines and allows doctors to issue standing orders for the vaccine. Data on immunizations will be used to focus vaccination efforts where they’re needed the most.

“On polio, we simply cannot roll the dice,” state Health Commissioner Dr. Mary T. Bassett said in a prepared statement. “If you or your child are unvaccinated or not up to date with vaccinations, the risk of paralytic disease is real. I urge New Yorkers to not accept any risk at all.”

Health officials said all unvaccinated New York residents — including children by 2 months of age, pregnant people and those who haven’t completed their vaccine series — should get immunized immediately. They also urged boosters for certain people, such as healthcare workers in affected areas who treat patients who might have polio.

The statewide polio vaccination rate is 79 per cent, but the counties of Rockland, Orange and Sullivan had lower rates.

Officials have said that it is possible that hundreds of people in the state have gotten polio and don’t know it. Most people infected with polio have no symptoms but can still give the virus to others for days or weeks.

The lone confirmed case in New York involved an unidentified young adult who was unvaccinated.