POLIO
What is polio?
What are the causes?
What are the symptoms?
How is it diagnosed?
What is the treatment?
FAQ’s
What is polio?
Poliomyelitis or polio, is an infection caused by the poliovirus leading to
nerve damage and muscle paralysis. Transmission of the poliovirus occurs by
contact with infected secretions from the nose and throat (airborne), or
contact by the faeces (faeco-oral). The virus enters mouth and nose, multiplies
in the throat or digestive tract, and spreads through the blood to the rest of
the body.
What are the causes?
Poliovirus may infect a person who is not vaccinated against the disease. There
are 3 types of polioviruses. All three can cause paralysis, but type 1 causes
paralysis most often followed by types 3 and 2. Most epidemics are caused by
type 1. Types 3 and 2 cause cases of paralysis associated with vaccination.
What are the symptoms?
Polio occurs in three forms: abortive, nonparalytic, and paralytic.
Abortive form is the most common and is a brief febrile illness that may
go unnoticed. Symptoms are nonspecific and may include:
In cases of nonparalytic poliomyelitis, the symptoms last one to two
weeks and include:
In about one-third of cases this resolves in a week without developing
paralysis. Approximately two thirds of these children have a short symptom free
interlude between minor and major (CNS) illnesses.
The symptoms in cases of paralytic polio are:
How is it diagnosed?
Several diseases can be associated with muscular weakness. Polio is suspected
in a patient who develops sudden paralysis on one side of the body following a
short febrile illness. Rigidity of the neck and spine are the hallmarks of
nonparalytic form. The virus can be easily cultured from stool, throat
secretions and cerebrospinal fluid (CSF). Blood can be tested for antibodies
against polioviruses. CSF tests help to confirm the diagnosis in cases with
neurological involvement.
What is the treatment?
The aims of management are to allay fear, minimize skeletal deformities,
anticipate and prevent complications and prepare the child and family for a
prolonged treatment of the disability. Abortive and nonparalytic forms are
treated similarly. They usually get better after few days of bed rest. The
treatment generally includes pain relievers to treat the muscle spasm and pain,
antipyretics for fever and sedatives with good diet. Avoid exertion for the
next two weeks. Hot packs (warm water fomentation) for 10-15 minutes every 2-4
hours can relieve muscle stiffness and spasm.
A child with paralytic form of disease during acute stage requires complete bed
rest. Stress on the affected muscles should be avoided. Massage and injections
are contraindicated. Positioning of limbs using sand bags, splints or
footboards helps in relaxation of affected muscles. Passive movements of joints
within the range of pain are allowed. Hospitalisation is necessary for
progressive paralysis, breathing difficulty and worsening sensorium. Once the
virus is no longer active, physical therapy can improve muscle function.
FAQ’s
What is polio?
It is a highly infectious disease caused by one of 3 related polio viruses
(type 1, 2 or 3), which belong to the group of enteroviruses (transient
inhabitants of the intestines).
Who is at risk?
It mainly affects children under five years of age. Globally, there has been a
decrease by 99.8% in polio cases since 1988 (from ~3,50,000 to 500 in 2001).
Can polio be cured?
There is no cure for polio. Giving multiple doses of oral polio vaccine (OPV)
to children is the only way to prevent it.
What constitutes polio-free region?
Three conditions need to be satisfied:
What are “polio endgame” strategies?
These include laboratory containment, certification of polio eradication and
development of post-certification polio immunization policy
Laboratory containment
Before the world can be certified polio-free, all wild polioviruses in
laboratories must be adequately contained. Wild poliovirus materials in
laboratories must be identified and all remaining laboratory stocks are handled
under appropriate biosafety conditions in the post-eradication era.
Global polio-free certification
This requires the maintenance of certification-standard acute flaccid paralysis
surveillance for at least 3 years following the last polio case in any WHO
region, and assurance that wild virus in the IPV manufacturing sites will be
safely managed.
What has been the impact of Global Polio Eradication Initiative?