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Poliomyelitis

(Polio)

Definition

Poliomyelitis (polio) is viral infection. It is now extremely rare in the Western world due to very effective vaccination programs.
Polio is still a significant problem in parts of Africa and Asia. The infection can lead to paralysis.

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 and travels to the intestines. There the virus grows and spreads quickly. The virus can also travels through the blood and lymph fluid. It can then attack and destroys areas of the nervous system which leads to a loss of control of muscles and paralysis.
Interaction of Lymph, Blood Vessels, and Intestines
Lymph and vessels in Abdomine
Copyright © Nucleus Medical Media, Inc.

Risk Factors

You have an increased chance of developing polio if you:
  • Never received a polio vaccination or did not complete the vaccinations
  • Travel to countries where polio is still common (areas of Africa, Middle East and Asia)

Symptoms

Symptoms can vary. Some may have the virus but never develop symptoms. Others may simply develop flu-like symptoms that last about a week or so. These symptoms may include:
  • Headache
  • Fever
  • Sore throat
  • Illness lasts about a week
  • Back or neck pain and stiffness
  • Muscle tenderness
If the nervous system is affected, symptoms may include:
  • Muscle weakness
  • Paralysis—usually affects each side to varying amounts or only affects a single side
  • Muscles become flaccid (loose, floppy)
  • Muscles required for breathing may become paralyzed
  • Urinary problems
  • Decades later, previously stable muscle weakness may worsen due to postpolio syndrome
Some people with a polio infection can experience symptoms years after the initial attack. This can include muscle weakness, fatigue, breathing and swallowing problems.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done.
To look for the virus you doctor may order:
  • Body fluid samples such as throat swabs, rectal swabs, or stool samples
  • Spinal tap to check fluid around the spine and brain
Your doctor may also do blood tests to look for antibodies. Antibodies are signs that you body is aware of and fighting the virus.

Treatment

Talk with your doctor about the best plan for you. There are no treatments available to get rid of the virus. Treatment will provide support while your body heals. It will also help you avoid complications.

Bedrest

The doctor may recommend bedrest during the initial phase of the illness.

Fever Control

Medication may be given to lower fever and decrease muscle pain. These may include acetaminophen or nonsteroidal anti-inflammatory medication.

Assisted Ventilation

If the muscles you use to breathe become too weak or paralyzed, you may a ventilator. This machine will take over the work of breathing for you.

Rehabilitation

The virus can cause a tightening of tissue around a joint. A splint will help relax the joint and keep your joints from becoming too stiff. You may also receive physical therapy to keep your limbs moving and decrease muscle loss.
After your fever passes, exercises and therapy will help you regain mobility. They will also help to improve your muscle strength.

Prevention

The best way to prevent polio is by completing the vaccine which is started during childhood years.
Most adults have already received this vaccine when they were children. But, if you are at high risk for getting this infection, you may need a booster vaccine. High risk includes:
  • Traveling to areas where polio is present
  • Caring for people with polio
  • Working in labs where poliovirus is handled
The number of doses that you need depends on how many you have had in the past. Talk to your doctor if you are at high risk.

RESOURCES

American Academy of Pediatrics http://www.aap.org/

Centers for Disease Control and Prevention http://www.cdc.gov/

World Health Organization http://www.who.int/en/

CANADIAN RESOURCES

BC Health Guide, British Columbia Ministry of Health http://www.bchealthguide.org/

Ontario March of Dimes http://www.dimes.on.ca/

References

Poliomyelitis. World Health Organization (WHO) website. Available at: http://www.who.int/topics/poliomyelitis/en/. Accessed May 20, 2013.

Polio. Centers for Disease Control and Prevention (CDC) website. Available at: http://www.cdc.gov/polio/about/. Updated January 6, 2012. Accessed May 20, 2013.

Poliomyelitis. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated May 3, 2013. Accessed May 20, 2013.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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