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.
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
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
- Strenuous exercise
- Recent tonsillectomy]]> or dental procedure
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.
- Sore throat
- Illness lasts about a week
- Nausea and vomiting
- Stiff neck
- Neck pain
- Severe muscle pain
- Muscle spasms
- Muscle weakness
- 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
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
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.
You’ll rest in bed while have a fever. This is in the initial phase of illness.
Medications can be given to lower fever and decrease muscle pain. This may include:
- Nonsteroidal anti-inflammatory agents
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.
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.
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
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
American Academy of Pediatrics
Centers for Disease Control and Prevention
World Health Organization
BC Health Guide, British Columbia Ministry of Health
Ontario March of Dimes
Ferri FJ, ed. Ferri's Clinical Advisor: Instant Diagnosis and Treatment . St. Louis: Mosby Inc; 2005.
Goldman L et al, eds. Cecil Textbook of Medicine . 22nd ed. St. Louis: WB Saunders Company; 2004.
Mandell GL et al, eds. Principles and Practice of Infectious Diseases . 5th ed. London: Churchill Livingstone Inc; 2000.
Mandel GL et al, eds. Principles and Practice of Infectious Diseases. 6th ed. Churchill Livingstone Inc; 2005.
Last reviewed January 2009 by ]]>David L. Horn, MD, FACP]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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