Poliomyelitis, also known as infantile paralysis or polio, is a highly contagious viral infection. In its most severe form, polio may cause rapid and irreversible paralysis. Until the late 1950s, it was one of the most feared infectious diseasesoften occurring in epidemics. Postpolio syndrome or postpoliomyelitic progressive muscular atrophy may occur 30 years or more after the initial infection, gradually producing additional muscle weakness, atrophy, and pain.
Polio is preventable by immunization and has virtually disappeared in most areasincluding the United States; however, the danger from this disease still exists. The dramatic decline in cases of polio has created a false sense of securityfewer children in the United States have been receiving the vaccine, so the number of people vulnerable to the infection is rising. Polio is still common in much of the world, and there is no cure; therefore, until the poliovirus is destroyed, immunization remains essential for protection.
According to the Centers for Disease Control and Prevention (CDC) in May 2015, poliovirus transmission still occurs in Pakistan, Afghanistan, and Nigeria. In 2014, 359 cases of polio were reported in 9 countries6 of which had been previously polio-free (Somalia, Ethiopia, Equatorial Guinea, Cameroon, Iraq, and Syria). As of May 5, 2015, 22 polio cases were reported in Pakistan and 1 case occurred in Afghanistan. The World Health Organization (WHO) reported in August 2015, that it had been 1 year since the last wild polio case was detected on the entire African continentsignaling important progress toward eradication of the disease.
What Causes Polio?
- Poliomyelitis is caused by a viral infection by one of the three forms of polioviruswild poliovirus (WPV) type 1, WPV type 2 and WPV type 3.
- The poliovirus may be spread through contact with contaminated food and water, or by infected saliva expelled during coughing or sneezing.
Symptoms of Polio
- Headache and sore throat
- Stiff neck and back
- Nausea and vomiting
- Muscle pain, weakness, or spasms
- Difficulty in swallowing
- Constipation and urine retention
- Swollen or bloated abdomen
- Pain in front part of neck
- Excessive tiredness
- Back pain
- Pain in the calf muscles
- Muscle tenderness and spasm in any area of the body
- Muscle stiffness
- Skin rash or lesion, accompanied by pain
- Emergency symptoms of paralytic poliomyelitis: muscle weakness; fever; breathing difficulty; muscle contractions or muscle spasms in the calf, neck, or back; abnormal sensations in an area; sensitivity to touch (even mild touch may be painful); difficulty swallowing and/or urinating; bloating; drooling.
- A series of vaccines is recommended to begin at two months of age, repeated at four and 18 months of age, and followed by a booster shot when the child enters school (between the ages of four and six).
- In adults, immunization against polio is only recommended before traveling to an area where polio is common.
- Patient history and physical examination.
- Blood tests.
- Lumbar puncture (spinal tap).
How to Treat Polio
- Bed rest is advised until severe symptoms subside.
- Pain relievers may be administered to reduce fever, pain, and muscle spasms.
- Your doctor may prescribe bethanechol to treat urinary retention and antibiotics to fight an associated bacterial infection of the urinary tract.
- A urinary catheter, a thin tube attached to a storage bag used to collect urine, may be necessary if bladder control has been lost because of paralysis.
- Artificial respiration may be required if breathing is impaired; in some cases a surgical opening (tracheotomy) in the throat may be necessary.
- Physical therapy is needed in cases of temporary or permanent paralysis. Mechanical aids such as braces, crutches, a wheelchair, and special shoes may aid in mobility.
- A combination of occupational and psychological therapy may help patients adapt to the limitations imposed by the disease.
When to Call a Doctor
- Call a doctor immediately if you or your child develops symptoms of polio, or if you may have been exposed to the virus and have not yet been immunized.
- Make an appointment with your doctor to receive the polio vaccine if you have not been immunized and plan to travel where polio is common.
- EMERGENCY Call an ambulance if someone experiences breathing difficulty or develops paralysis in any of the limbs.
Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference
Simeon Margolis, M.D., Ph.D., Medical Editor
Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50
Updated by Remedy Health Media