Polio

An Overview

Polio is a contagious viral illness that in its most severe form causes nerve injury leading to paralysis, difficulty breathing and sometimes death. In the U.S., the last case of naturally occurring polio was in 1979. Today, despite a worldwide effort to wipe out polio, poliovirus continues to affect children and adults in parts of Asia and Africa.
The Centers for Disease Control and Prevention (CDC) advises taking precautions to protect yourself from polio if you’re traveling anywhere there’s a risk of polio. Adults who have been vaccinated who plan to travel to an area where polio is occurring should receive a booster dose of inactivated poliovirus vaccine (IPV). Immunity after a booster lasts a lifetime.

Symptoms for Polio

Although polio can cause paralysis and death, the majority of people who are infected with the virus don’t get sick and aren’t aware they’ve been infected. A smaller proportion of people (much less than one out of 100, or 1-5 out of 1000) with poliovirus infection will develop other, more serious symptoms that affect the brain and spinal cord:
• Headache with vomiting
• Stiffness and back pain, neck pain
• Tenderness or weakness in muscles
• Pain and stiffness in the arms and legs
• Sore throat
• Fatigue
• Meningitis

Paresthesia (feeling of pins and needles in the legs)
• Meningitis (infection of the covering of the spinal cord and/or brain) occurs in about 1 out of 25 people with poliovirus infection
• Paralysis (can’t move parts of the body) or weakness in the arms, legs, or both, occurs in about 1 out of 200 people with poliovirus infection
Paralysis is the most severe symptom associated with polio, because it can lead to permanent disability and death. Between 2 and 10 out of 100 people who have paralysis from poliovirus infection die, because the virus affects the muscles that help them breathe.

Nonparalytic polio
Some people who develop symptoms from the poliovirus contract a type of polio that doesn’t lead to paralysis (abortive polio). This usually causes the same mild, flu-like signs and symptoms typical of other viral illnesses.
Signs and symptoms, which can last up to 10 days, include:
• Fever
• Sore throat
• Headache
• Vomiting
• Fatigue
• Back pain or stiffness
• Neck pain or stiffness
• Pain or stiffness in the arms or legs
• Muscle weakness or tenderness
Paralytic syndrome
This most serious form of the disease is rare. Initial signs and symptoms of paralytic polio, such as fever and headache, often mimic those of nonparalytic polio. Within a week, however, other signs and symptoms appear, including:
• Loss of reflexes
• Severe muscle aches or weakness
• Loose and floppy limbs (flaccid paralysis)

Post-polio syndrome

Post-polio syndrome is a cluster of disabling signs and symptoms that affect some people years after having polio. Common signs and symptoms include:
• Progressive muscle or joint weakness and pain
• Fatigue
• Muscle wasting (atrophy)
• Breathing or swallowing problems
• Sleep-related breathing disorders, such as sleep apnea
• Decreased tolerance of cold temperatures

Causes of Polio

Poliovirus can be transmitted through direct contact with someone infected with the virus or, less commonly, through contaminated food and water. People carrying the poliovirus can spread the virus for weeks in their feces. People who have the virus but don’t have symptoms can pass the virus to others.
Once the poliovirus entered into an individual, it starts infecting the cells of the intestine and throat. The virus remains in the intestines, before spreading to the other body parts. Finally, the virus moves into the bloodstream from where the entire body gets affected.

Polio is caused by an infection with a virus. After the infection, Poliovirus reaches the CNS, and when it occurs spinal cord motor cells suffer inflammation and are destroyed. As a result, impulses fail to be sent to the muscles, followed by the paralysis of muscles, especially legs. Due to this, the legs muscles fail to undergo contraction leading to a condition known as flaccid paralysis which is the characteristic feature of Polio.

Diagnosis

For diagnosis of poliovirus doctors generally perform a physical examination of the patient and try to find out if the patient is facing difficulty in lifting the head while lying flat, or is having any impaired reflex and stiffness in the neck and back.
The doctor can also advice a lab test of the patient’s cerebrospinal fluid, stool and sputum from the patient’s throat for determining the presence of poliovirus.

Side effects of polio vaccine

If you had a severe allergic reaction after the first shot, it is not advised to receive a booster. The common side effects of polio vaccine are:
• Drowsiness
• Vomiting
• Pain
• redness and swelling in the injected site
• Body aches
• joint pain along with low fever
Serious side effects or it may be pointed as allergic reactions are:
• Itching, wheezing
• Paleness, hives

Treatment

Because no cure for polio exists, the focus is on increasing comfort, speeding recovery and preventing complications. Supportive treatments include:
• Pain relievers
• Portable ventilators to assist breathing
• Moderate exercise (physical therapy) to prevent deformity and loss of muscle function

Drugs cannot destroy the poliovirus hence a complete cure is not feasible once infection has set in. Hence, the goal of the treatment is aimed at controlling the symptoms. Supportive care for polio is provided based on the symptoms. The treatment for patients with minor poliomyelitis generally focuses on increasing their comfort through bed rest and medications like acetaminophen or ibuprofen to control fever and muscle aches.

Physiotherapy is carried out to regain mobility for muscles in case of paralysis.If the patient encounters breathing difficulty, mechanical breathing through tracheostomy tubes or artificial ventilator facilitates breathing.
Physiotherapy is carried out to regain mobility for muscles in case of paralysis.If the patient encounters breathing difficulty, mechanical breathing through tracheostomy tubes or artificial ventilator facilitates breathing.

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