Poliomyelitis
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What is polio (poliomyelitis)?
Polio (poliomyelitis) is a highly infectious disease caused by the poliovirus. The virus invades the nervous system and causes paralysis.
What are the symptoms of this disease?
The disease manifestation can range from inapparent infection to severe paralysis. About 90 to 95% of all polio patients do not show symptoms. Another 4-8% experience symptoms such as fever, headache, sore throat and loss of appetite. Paralysis occurs in less than 1% of infections.
Three forms of paralytic polio may be seen:
| a) Spinal paralytic polioPatients would first experience “minor” illness with symptoms such as fever, muscle pain, nausea, vomiting and stiff neck/back. This lasts for 1-3 days and is followed by a symptom-free period of 1-5 days before onset of paralysis. Paralysis varies from single muscle involvement to affliction of all 4 limbs. Despite the paralysis, there is no accompanying sensory loss. |
b) Bulbar paralytic polio (5 - 35% of paralytic cases of polio)
This causes paralysis of the soft palate, pharynx and larynx resulting in difficulty in swallowing and breathing.
c) Polioencephalitis (uncommon, occurs mainly in infants)
This manifests as confusion, sensory changes and seizures.
How long is the incubation period and how is it transmitted?
The incubation period lasts between 7 to 14 days and the patient is infectious a few days before and after the onset of the disease. The disease is spread mainly via the faeco-oral route (Faeco-oral route means that the organisms are transmitted via faeces of one host to the mouth of another) or less commonly through respiratory droplet transmission.
What is the treatment for polio?
There is no specific therapy for polio. Management is supportive and symptomatic.
What are the laboratory tests for polio?
Polioviruses can usually be isolated from the throat swab in the first week of illness. Stool cultures for the virus may remain positive for several weeks. The diagnosis may also be confirmed by detecting a four fold increase in the level of antibodies to polio.
Is there a vaccine available? Who should be vaccinated?
Two types of vaccine are available, an injectable inactivated polio vaccine (IPV) and an oral live, attenuated vaccine (OPV).
The primary course is given at 3, 4 and 5 months while boosters are given at 18 months, 6+ years and 11+ years.
Adults should be sure that they have received at least three doses of polio vaccine in the past. If this is not the case, “catch-up” immunization should be arranged with your doctor.
Booster dose of the polio vaccine is recommended for adults who have had at least 3 doses of the polio vaccine only if they are at risk of poliomyelitis.
These include:
- Travelers to areas where polio is present
- Healthcare workers in possible contact with persons with poliomyelitis
- Laboratory workers who may handle the polio virus
What precautions should I take if I am going to an area where polio is present?
You should ensure that you have been immunized against polio prior to your travel. In addition, you should continue to observe good personal and food hygiene practices.
I have just returned from an area where polio is present. How can I tell if I may have contracted the disease?
If you develop symptoms of fever, muscle pain, nausea, vomiting and stiff neck/back within 2 weeks of your return, please see your doctor immediately and inform him or her of your travel history.
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