Poliomyelitis (Polio)

• Unvaccinated or under-vaccinated individuals;
• Children under five;
• Those in regions with poor sanitation;
• Travelers to polio-endemic areas;
• Immunocompromised individuals;
• Close contacts of infected individuals.

Can Adults Get Polio?

Yes, adults can get polio if they’re not immune to the virus and come into contact with the poliovirus. While polio primarily affects children, adults who aren’t vaccinated or have not previously been exposed to the virus can still contract it.

How Common Is Polio?

Polio has become relatively uncommon in most parts of the world, thanks to extensive vaccination efforts. The Global Polio Eradication Initiative, led by organizations such as the World Health Organization (WHO), UNICEF, Rotary International, and the Centers for Disease Control and Prevention (CDC), has made significant progress in reducing polio cases. According to WHO, since 1988, with polio vaccines, there has been a remarkable 99% reduction in polio cases worldwide. At that time, there were estimated to be over 350,000 cases across 125 endemic countries, and now there are only two countries where polio remains endemic.

What Is the Survival Rate of Polio?

The majority of individuals with non-paralytic polio typically survive the illness. However, among those who develop paralytic polio, 5–10% die when their breathing muscles become immobilized.

What Are the Symptoms of Polio?

The symptoms of polio can vary widely, and not everyone who contracts the virus will experience the same symptoms. There are three main types of polio symptoms:

1. Asymptomatic: Many people infected with the poliovirus do not develop any symptoms and are referred to as asymptomatic carriers. They can still spread the virus to others without realizing it.

2. Non-Paralytic Polio (Abortive Polio): About 1 out of 4 people have mild, flu-like symptoms, which may include:

• Fever;
• Headache;
• Sore throat;
• Fatigue;
• Muscle pain or stiffness;
• Vomiting;
• Meningitis-like symptoms (stiff neck and back) - occur in about 1–5 out of 100 people.

3. Paralytic Polio: This is the most severe form of polio and can lead to muscle weakness or paralysis. These symptoms occur in about 1 out of 200 people to 1 in 2000 people, depending on virus type.

Paralytic polio can be further categorized into different types:

• Spinal Polio: Paralysis primarily affects the limbs, causing muscle weakness or complete paralysis in the arms and legs.
• Bulbar Polio: Paralysis affects the muscles involved in swallowing and speaking and can lead to difficulties in breathing and swallowing.
• Bulbospinal Polio: A combination of limb paralysis and involvement of bulbar muscles.

It's important to note that most polio infections result in asymptomatic or mild symptoms, with only a small percentage of cases progressing to paralytic polio. The severity of symptoms can vary from person to person, and in rare instances, serious symptoms of paralytic polio can be life-threatening.

What Causes Polio?

Polio, short for poliomyelitis, is caused by the poliovirus. The poliovirus is a highly contagious virus that primarily spreads through the fecal-oral route, meaning it’s transmitted when an infected person's feces come into contact with the mouth of an uninfected person.

How Does Polio Spread?

Polio spreads primarily through the fecal-oral route, which means it is transmitted through contact with infected feces and subsequent ingestion of the virus. Here's how polio spreads:

1. Poor Hygiene Practices: Fecal-oral transmission occurs when individuals don’t practice proper handwashing after using the bathroom or coming into contact with feces, such as when changing diapers.
2. Contaminated Water and Food: Ingesting poliovirus-contaminated water or consuming food that has been in contact with contaminated water can lead to infection.
3. Swimming in Contaminated Water: Water can become contaminated if someone with polio or diarrhea swims in it, posing a risk to others who use the same water source.
4. Respiratory Transmission: While less common, poliovirus can be transmitted through respiratory secretions when an infected person coughs or sneezes.
5. Close Contact: Being in close contact with an infected person can also increase the risk of transmission, especially when engaging in activities like sharing utensils or close personal contact.
6. Contaminated Surfaces: Touching surfaces or objects contaminated with the virus can potentially lead to infection if proper hygiene isn’t observed.

Is Polio Contagious?

Yes, polio is very contagious. It’s caused by a highly contagious virus, and it can be transmitted from person to person through various means, including fecal-oral contact and respiratory secretions.

How Is Polio Diagnosed?

Polio diagnosis involves a healthcare provider conducting a physical examination, getting body fluid samples, and discussing symptoms. Testing includes:

1. Saliva: Samples from the throat.
2. Stool: Examination of fecal matter.
3. Blood: Blood tests for signs of infection.
4. Cerebrospinal Fluid: Analysis of fluid around the brain and spinal cord.

Since polio symptoms can resemble the flu, additional tests may be performed to rule out more common conditions.

How Is Polio Treated?

Unfortunately, there are no specific medications to treat polio. In cases of paralytic polio, treatment involves:

1. Physical Therapy: Patients with muscle weakness or paralysis receive physical therapy to improve mobility and muscle function.
2. Mechanical Ventilation: If breathing muscles are affected, mechanical ventilation, a machine assisting with breathing, may be needed.

Additionally, symptom management includes:

• Staying hydrated with fluids like water, juice, and broth;
• Using heat packs to alleviate muscle aches;
• Taking pain relievers like ibuprofen;
• Following physical therapy and exercise recommendations from your healthcare provider;
• Getting sufficient rest to aid in recovery.

How Can I Prevent Polio?

The most effective way to prevent polio is through vaccination. Here's how you can prevent polio:

1. Routine Vaccination: Ensure that you and your children receive the recommended polio vaccine. In the United States, the routine vaccination schedule includes a series of doses of the inactivated polio vaccine (IPV) administered to infants and young children:

• 2 months;
• 4 months;
• Between 6 and 18 months;
• Between ages 4 and 6 when children are just entering school.

2. Booster Shots: Depending on your age and vaccination history, you may need booster shots to maintain immunity. Consult with your healthcare provider to determine if you need additional doses.

3. Vaccination for Travel: If you plan to travel to regions where polio is still endemic or where outbreaks have occurred, talk with a healthcare provider. They may recommend a booster dose of the polio vaccine to provide additional protection.

4. Maintain Good Hygiene: Practicing good hygiene, such as regular handwashing with soap and water, can help reduce the risk of infection, as polio can spread through fecal-oral contact.

5. Avoid Close Contact with Infected Individuals: If you’re in an area with a polio outbreak, take precautions to avoid close contact with individuals who may be infected.

What Can I Expect If I Have Polio?

If you have polio, your experience can vary based on the type and severity of the disease. Here's what you can expect:

1. Asymptomatic Infection: Many polio cases are asymptomatic, meaning you may not experience noticeable symptoms. In such cases, the virus may clear from your system without causing any lasting effects.
2. Mild Symptoms (Non-Paralytic Polio): Some individuals with polio have mild symptoms, like fever, headache, and muscle stiffness. These symptoms typically resolve without long-term consequences.
3. Paralytic Polio: In severe cases, the virus can lead to muscle weakness or paralysis. The extent of paralysis varies, and it can affect limbs (spinal polio), muscles used for swallowing and speaking (bulbar polio), or both (bulbospinal polio).
4. Recovery: Recovery depends on the severity of paralysis. Physical therapy plays a significant role in regaining muscle function. Orthotic devices, like braces and splints, can help support weakened muscles and provide stability to affected limbs. They are often used in rehabilitation.
5. Amputation: In cases of severe muscle damage and non-functional limbs, amputation may be considered as a last resort to improve mobility and quality of life. If amputation is necessary, prosthetic limbs can be customized to replace lost function. Prosthetic devices have come a long way in providing individuals with greater mobility and independence.
6. Post-Polio Syndrome (PPS): Individuals who had polio in the past, even if they initially recovered, may develop post-polio syndrome (PPS) later in life. PPS can include muscle weakness, fatigue, and pain in previously affected muscles.

Can Polio Come Back?

Polio itself doesn’t typically come back once a person has fully recovered from the acute infection. Once the poliovirus has been cleared from the body, it doesn’t persist in a latent form that can later reactivate.

However, some individuals who have had polio in the past may experience a condition called "post-polio syndrome" (PPS). PPS isn’t a recurrence of the original polio infection but rather the development of new symptoms or the return of old symptoms many years after the initial recovery. These symptoms can include muscle weakness, fatigue, pain, and other neurological issues.

It's important to differentiate between PPS and a recurrence of the acute polio infection. PPS is a long-term consequence of the initial illness and isn’t caused by the active poliovirus infection.