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Definition

Poliomyelitis (polio) is viral infection. It is very contagious. The infection can lead to paralysis.

Polio is now extremely rare in the Western world. This is due to very effective vaccination programs. Polio is still a significant problem in parts of Africa and Asia.

Causes

Polio is caused by the poliovirus. You can get the virus from contact with:

  • An infected person
  • Infected saliva or feces
  • Contaminated water or sewage

The virus enters the body through the mouth. It travels to the intestines. There it reproduces quickly. The virus then travels through the blood and lymph fluid. It attacks and destroys areas of the nervous system.

Interaction of Lymph, Blood Vessels, and Intestines

Lymph and vessels in Abdomine
© 2009 Nucleus Medical Art, Inc.

Risk Factors

The following factors increase your chance of developing polio:

  • Lack of vaccination or incomplete vaccination
  • Travel to countries where polio is still common (areas of Africa and Asia)
  • Preschool child with immune disorder, exposed to live polio virus through vaccination
  • Young adult exposed to poliovirus through contact with someone recently vaccinated
  • Elderly adult
  • Pregnancy
  • Strenuous exercise
  • Recent tonsillectomy]]> or dental procedure
  • Immunodeficiency

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Symptoms

If you experience any of these do not assume it is due to polio. These symptoms may be caused by other, less serious health conditions. Contact your physician if you experience these symptoms.

  • Minor illness
    • Headache
    • Fever
    • Sore throat
    • Illness lasts about a week
  • Major illness
    • Fever
    • Headache
    • Nausea and vomiting
    • Diarrhea
    • Stiff neck
    • Neck pain
    • Severe muscle pain
    • Muscle spasms
    • Muscle weakness
    • Paralysis
    • Usually asymmetric (affecting each side to varying amounts, or only affecting a single side)
    • Muscles become flaccid (loose, floppy)
    • Legs more commonly affected than arms
    • Muscles required for breathing may become paralyzed
    • Urinary retention
    • Decades later, previously stable muscle weakness may worsen due to postpolio syndrome

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done.

Tests may include the following:

  • Throat swabs, rectal swabs, stool samples, or cerebrospinal fluid to look for the virus
  • Spinal tap]]> —removal of a small amount of cerebrospinal fluid to check for the virus
  • Immunological tests—prove that the body has responded to the presence of poliovirus by producing antibodies designed to fight the virus

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Treatment

Talk with your doctor about the best plan for you. There are no treatments available to get rid of the virus. Treatment is designed to be supportive. It will treat your symptoms. It will also help you avoid complications.

Bedrest

You’ll rest in bed while have a fever. This is in the initial phase of illness.

Fever Control

Medications can be given to lower fever and decrease muscle pain. This may include:

Assisted Ventilation

If the muscles you need to breathe become too weak or paralyzed, you may require a period of time on a mechanical ventilator. This machine will take over the work of breathing for you.

Rehabilitation

The virus can cause contractures. This is a tightening of tissue around a joint. You may be fitted with splints. They will keep your joints from becoming too stiff. You may also receive physical therapy. In therapy your limbs will be moved for you. These are called passive exercises.

After your fever passes, exercises and therapy will help you regain mobility. They will also help to improve your muscle strength.

Prevention

Two types of vaccines are available to prevent polio:

  • Oral polio vaccine is given by mouth and uses weakened live viruses
  • Injected vaccine is in shot form and uses killed viruses
There is a tiny chance of actually acquiring polio due to exposure to the live viruses in the oral polio vaccine. Therefore, the Centers for Disease Control and Prevention now recommend that only injected vaccine be used.

Current immunization recommendations from the Centers for Disease Control and Prevention include:

  • Children should receive a series of four immunization injections, at
    • Two months
    • Four months
    • 6 to 18 months
    • 4 to 6 years
  • Adults who have never been immunized should receive a series if they are at high risk of contracting polio. Risk is increased in adults who:
    • Travel to areas where poliovirus is still common
    • Care for individuals with polio
    • Work in labs where poliovirus is handled