Polio

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at February 4, 2016
StartDiseasesPolio

Polio, also known as poliomyelitis, is a viral disease that attacks the nervous system of its host and causes paralysis. Today polio is extremely rare due to the efficacy of the vaccine that was introduced during the 1950s, and the United States has not had a reported case of polio since 1979.

Contents

Definition & Facts

There are three different kinds of polio: non-paralytic, paralytic, and sub-clinical. While paralytic is the only kind of polio that results in paralysis, there are three subdivisions of the paralytic type of polio. These include spinal-polio, bulbar polio, and bulbospinal. Where spinal-polio affects the spine, bulbar polio affects the brain stem, and bulbospinal affects both the brain stem and the spine.

1 in 200 individuals who contract polio will experience permanent paralysis and about 5-10% of those experiencing paralysis will ultimately die of the disease. As of 2010, the World Heath Organization reported that there were only about 1,352 cases of polio in the entire world.

Symptoms & Complaints

Up to 95% of those who contract polio will show no symptoms at all. Most of these cases are recognized as the sub-clinical kind of polio and it does not affect the central nervous system. Those that do show symptoms of the sub-clinical polio virus will usually have a headache, sore threat, a fever, and may be vomiting or just feeling general discomfort within 72 hours of contracting the virus.

Those with non-paralytic polio show similar symptoms but may also experience abnormal reflexes, difficulty swallowing or difficulty breathing, joint pain or joint stiffness, or muscle spasms. These symptoms may last up to two weeks. Finally, the symptoms associated with paralytic polio are the most severe. These symptoms begin similarly to those associated with non-paralytic paralysis then develop to include a complete loss of reflexes, severe muscle spasms or muscle pain, and deformed limbs.

Causes

Polio is a highly contagious virus but those must susceptible to contracting polio are individuals with weakened immune systems, HIV+ individuals, pregnant women, or children who have not been vaccinated. Polio can be transferred through food, water, direct contact, or fecal matter. Children under the age of 5 years old are the most likely to contract the disease. Because of how contagious the polio virus is, it can be expected that any individual who lives with the virus will also develop polio.

Thanks to advancements in vaccinations, contracting polio is much more difficult today than it was before 1955 and is typically only found in areas like Nigeria, Afghanistan, and Pakistan. Individuals who have recently traveled to an area with a polio outbreak or have personally cared for an individual with polio are the most at risk for contracting the virus.

Diagnosis & Tests

To begin diagnosing a patient with polio, the health care professional must establish that the individual was exposed to the polio virus. The doctor will also need to check if the individual has had a polio vaccine. Some of the main factors a doctor looks for when diagnosing a patient with polio includes stiffness in the back or neck, difficulty lifting his or her head, and impaired reflexes.

While these are all signs that the individual has contracted polio, a more conclusive test will need to be done. In most cases, these more conclusive tests come in the form of blood tests, a stool sample, and a sample from the fluid around the spinal cord and brain, known as the cerebrospinal fluid. In whatever test the doctor chooses to administer, the sample taken from the patient will be tested for the presence of the polio virus.

Treatment & Therapy

Unfortunately, polio has no cure and the virus can only be treated to make the individual more comfortable until the infection is done spreading. Treatment options include rest and painkillers to relieve and reduce headaches or muscle aches, physical therapy on the limbs where the infection has already caused paralysis or to treat muscle pain. Muscle pain can also be treated with warm towels or heating pads.

In more severe cases, an individual who has contracted polio might need the assistance of a ventilator for breathing or a wheelchair if the paralysis has already spread to his or her legs. Light exercise and a healthy diet can also prevent the virus from causing deformities or prevent the individual from losing the function of his or her muscles.

Prevention & Prophylaxis

Polio can be prevented through getting the polio vaccine. The success rate of the polio vaccine is about 90% and children as young as 2 months can get their first dose. Another dose is given to a child at 4 months, again at 6 to 18 months, and finally a booster shot of the polio vaccine is given at 4 to 6 years old.

Side effects of the polio vaccination include breathing problems, a fever, or swelling of the throat, so it is important to pay attention for allergic reactions when vaccinating a child with the polio vaccine.

Adults have a smaller chance of contracting the virus and have usually already developed an immunity to polio. Because of this, adult vaccinations are not typically done, but should be carried out for individuals who may come in contact with the virus. For adults, the typical vaccine schedule is shorter than the vaccine schedule for a child, with only one initial vaccination and then one booster shot of the vaccine to protect for a lifetime.

Those traveling to an area where polio is still common should see about getting recommended shots before leaving the country. Other adults who should consider getting a polio vaccine if they were not given one as a child are doctors, nurses, or other care givers who may come into contact with an individual who has contracted the polio virus.

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