Polio - Causes, Symptoms & Treatment

The disease, also known as infantile paralysis, was once a major global health concern, owing to its widespread outbreaks and severe impact in several cases. However, thanks to significant vaccination efforts, polio has been largely controlled and eradicated in many parts of the world.

In this comprehensive article, we will delve into the causes, symptoms, prevention, and ongoing efforts to eliminate polio.

Disclaimer: The information presented in this article is for informational purposes only. It is not meant to be a substitute for professional medical advice.

Understanding Poliovirus

Polio is caused by the poliovirus, a highly contagious virus that primarily spreads through faecal-oral transmission and respiratory droplets. The virus, as mentioned earlier, targets the nerve cells in the spinal cord and brainstem, leading to inflammation and potential paralysis.

The severity of the disease varies, with some individuals remaining asymptomatic while others experience a range of symptoms.

Symptoms of Polio

The symptoms of polio can vary widely based on the severity of the infection -

• Abortive Polio: This mild form of the disease affects around 5% of those infected. Symptoms resemble a flu-like illness and include fever, sore throat, muscle aches, nausea, stomachache, headache, loss of appetite, and vomiting. These symptoms typically last for about 2 to 3 days.
• Nonparalytic Polio: This refers to a more severe manifestation, affecting roughly 1% of the infected individuals. Individuals with nonparalytic polio experience more intense flu-like symptoms along with neck pain or stiffness, severe headaches, and stiffness in legs and arms. A secondary phase of symptoms might follow, including spinal stiffness, decreased reflexes, and muscle weakness.
• Paralytic Polio: The most severe and rarest form of the disease, paralytic polio starts similarly to nonparalytic polio but can quickly progress to the severe stage. It includes symptoms like intense pain, tingling sensations, muscle spasms, heightened sensitivity to touch, and eventual muscle weakness that can lead to paralysis. This paralysis can affect any combination of limbs, although one-leg paralysis is the most common.

When to Seek Medical Attention?

Recognising the signs and symptoms of polio is crucial, as they can resemble those of other viral diseases affecting the nervous system. Timely diagnosis is essential in such cases.

If you have a history of polio and are experiencing new or worsening symptoms, it's recommended to consult a healthcare provider.

Causes of Polio

Polio is attributed to the poliovirus, which primarily targets nerve cells controlling muscle movement in the spinal cord and brainstem. It's worth noting that nerve cells associated with sensation usually remain unaffected.

While the naturally occurring wild-type poliovirus has been eradicated in most countries (leading to a reduction in polio cases), a different strain known as the vaccine-derived poliovirus (VDPV) has gained prominence and is responsible for most infections worldwide.

This variation of the virus is more prevalent in regions where an oral vaccine containing a weakened form of the poliovirus is administered.

Interestingly, the presence of the weakened virus in the oral vaccine does not cause polio itself. Instead, VDPV arises as a new version of the virus within communities or regions with inadequate vaccination coverage.

While the weakened virus in the oral vaccine doesn't induce illness, it can certainly spread. When a community achieves high vaccination rates, the transmission of the weakened virus is controlled. However, in areas with low vaccination rates, the weakened virus can circulate over a prolonged period, affording it the opportunity to mutate and act like the more virulent virus that triggers the illness.

With respect to the US, only a few Instances of VDPV infections have been reported, mainly where the involved individuals were either unvaccinated or possessed compromised immune systems. Since the year 2000, polio vaccination in the United States has transitioned to using an injected vaccine containing an inactivated poliovirus, which eliminates the risk associated with VDPV.

Transmission of Polio

Individuals who carry the poliovirus, even if they remain asymptomatic, can transmit the virus through faeces (stool) or via respiratory droplets resulting from sneezing or coughing.

The virus enters the body of another individual through the mouth. For instance, transmission can occur if individuals fail to wash their hands after using the restroom, prior to eating, or post coughing.

Furthermore, the virus can also spread through water that has been contaminated by poliovirus carrying faeces.

Who are the People at Risk?

While polio predominantly affects children, individuals of all ages who lack proper vaccination are susceptible to contracting the disease.

Complications Related to Polio

Severe cases of polio that impact the ability to breathe can lead to fatalities. Moreover, even among those who recover, long-term complications might arise such as -

• Chronic pain
• Shortening of muscles, leading to deformities in bones or joints
• Post-polio syndrome
• Permanent paralysis

Prevention through Vaccination

Vaccination is the cornerstone of effective polio prevention. Let’s talk about the recommended polio vaccination schedule both for children and adults.

Polio Vaccine Schedule

• Children: The CDC of the US recommends four doses of inactivated poliovirus vaccine (IPV) at specific ages: 2 months, 4 months, between 6 and 18 months, and between ages 4 and 6 years.
• Adults: Even if an adult possesses immunity due to childhood vaccination, they should receive booster shots if they are travelling to regions with high poliovirus transmission rates. If you have completed your initial vaccination, a single IPV booster is recommended. For those with incomplete vaccination histories, three IPV doses are advised.

The Eradication Effort

Global efforts to eradicate polio have made significant progress over the years. Mass vaccination campaigns have brought the world closer to eliminating the disease entirely. Since 1988, the Global Polio Eradication Initiative (GPEI), a partnership between various organisations, governments, and donors, has been working tirelessly to end polio. As a result of these efforts, wild poliovirus is now endemic in only a few countries.

To Conclude

Polio, once a dreaded disease causing widespread fear and health-related complications, is now on the brink of eradication due to concerted global vaccination efforts. Through a combination of vaccination campaigns, public health initiatives, and international collaboration, the world has made remarkable progress in reducing the prevalence of polio.

With that said, challenges remain in ensuring that every child receives the necessary doses of vaccine and that surveillance systems remain vigilant to catch any potential outbreaks.

References

• Global Polio Eradication Initiative - Wikipedia
• Polio - Symptoms and causes - Mayo Clinic

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