What is Polio?
Polio, or poliomyelitis, is a potentially debilitating and sometimes fatal illness. The illness is caused by the poliovirus, which in most common cases, is spread through contact with contaminated feces.
Children under the age of five are at a highest risk of contracting polio. (1)
Back in 1988 a polio eradication initiative was launched in order to stop the virus, thankfully today most of the world is polio free.
However, if just one country failed to completely erase the virus, it could spread and cause 200.000 new cases a year. This means potentially within ten years, it could spread to the rest of the world. (2)
Symptoms
Polio is very contagious, it will linger in the throat or intestines of the infected. However, it’s typically transmitted by coming into contact with feces.
This can happen simply by a lack of sanitation, for example: not washing your hands after a bathroom break or by putting an object in the mouth that has been in contact with infected feces.
In rare cases, it can transmit via coughing and sneezing, or by swallowing contaminated water or food.
The virus brings about flu like symptoms, although around three quarters of people do not display any symptoms at all. (3)
In severe cases, poliovirus can infect the brain or spinal cord, which can lead to paralysis.
In these scenarios, the virus has spread from the intestines to the nervous system. Medical treatment should be sought immediately as it could paralyze the respiratory organs and lead to death.
Symptoms depends on what type of poliovirus has been contracted: non-paralytic, paralytic or post-paralytic.
In the case of non-paralytic polio, the virus does not affect the nervous system. Symptoms usually go away within 2 to 5 days and within a week the person has recovered. (4)
Common polio symptoms include:
Sore Throat
As the infection sits in the throat, it can cause irritation and inflammation. It typically happens during the early stages of the virus and can last from 24 hours to 48 hours. (5)
Fever
A typical fever can be described as when the body temperature is above 37 degrees celsius. In children a fever is above 37.5 degrees C.
When the infection takes hold, the body tries to fight it off by increasing core temperature. It’s a normal reaction from the body and is easily treated either by home remedies or medication. (6)
Tiredness
Tiredness is a common sign during polio infection. This is down to the body working harder to fight off the virus. (7)
It’s recommended for those who have contracted polio to remain in bed and undertake complete rest. This is because fatigue and exertion can in some cases, lead to paralytic polio. (8)
Nausea, Vomiting and Stomach Pain
Following infection, an urge to vomit or stomach pains are a typical symptom during the first stages of polio. (9)
The body is trying to fend off the virus, therefore by trying to drive out the infection it can cause stomach pain and vomiting.
Headache
During the earlier stages of polio it is not unusual to develop a headache and/or pain in the neck or jaw. This happens when the infection settles in the throat and can last up to 48 hours.
Paresthesia
This symptom is a feeling best described as pins and needles in different parts of the body. (10)
However, in the case of polio, this will be felt for most parts in the legs. This kind of symptom is classed as serious because it’s an early indicator the virus is spreading to the nervous system.
Meningitis
Meningitis is a serious condition which affects the brain or spinal cord. In severe cases of polio, the infection spreads to these vital parts of the body which triggers development of this symptom.
This happens to around one in every twenty five people infected with polio. (11)
Paralysis
This happens during the last stages of the polio. But it only occurs in 1 out of 200 infected people. (12)
When the virus takes hold, the person will feel weakness in different parts of the body, such as arms or legs. Later on, the person will be unable to move.
If not treated properly, it can lead to permanent disability and even death. This is because the symptom paralyzes the lungs and the person is unable to breathe. (13)
Stages
There are five stages of paralytic poliomyelitis. Starting from the invasion to a chronic stage.
Stage #1
This is the first stage of polio and is when the infection takes place.
As the person comes in contact with a contaminated object and catches the virus, the infection travels to the back of the throat where it takes hold.
In some cases, this stage causes minor symptoms such as sore throat, headaches and fever, to name but a few.
However, in other cases the infection continues to the nervous system where it can trigger clinical polio. Thus taking us to the next stage. (14)
Stage #2
This is the pre-paralytic stage. At this point the infection has reached the nervous system and is multiplying.
During this stage, meningitis will develop and the person will experience more severe headaches, fevers and nausea.
At the end of this stage the body will become weaker due to the infection.
Stage #3
This is the paralytic stage. Soon after meningitis has developed the infected will start to notice weakness, tenderness and sometimes muscle spasms.
It can also progress rather quickly into paralysis, where the person will experience loss of feeling in the body. Some may even need help to breathe.
Stage #4
At this point the virus is no longer active, but it has caused noticeable damage to important nerve cells.
Thankfully, many people who develop paralytic polio, have a good chance of recovery at this stage. (15)
However, if weakness and loss of feeling is still present after 12 months, it’s an indicator of permanent paralysis.
Stage #5
This is the last stage where paralytic polio is divided into three types: spinal polio, bulbar polio and bulbospinal polio.
The most common is spinal polio. Spinal polio will cause the infected to lose feelings in the lower body, mostly in the legs.
In cases of bulbar polio, the muscles and the different nerves bringing information to the brain will be affected. Bulbospinal polio is a combination of the two other types. (16)
Children with paralytic polio have a two to five percent chance of death, whereas adults, have a 15 to 30 percent chance. In cases of bulbar involvement, the chances increase greatly with 25 to 75 percent. (17)
Treatment
Polio is a highly contagious disease, which cannot be cured. However, there are vaccines which can immunize the body. These are typically offered to newborns up to the age of five. However, if you are travelling to an infected country it’s advisable to check whether you need a booster vaccination to ensure you are protected.
Treatment depends on what type of polio you have. Some require little to no treatment, while others need physical therapy. In severe cases, breathing devices are needed.
Polio treatment is for most parts, a supportive treatment, to help ease pain or fever, and sometimes deformities. (18)
The treatments include the following:
Complete Rest
Rest is very important, especially in the early stages. Too much movement or over exertion, could lead to further complications.
Physical Therapy
During the recovery stage, physical therapy is important to reduce the chances of being paralysed. (19)
There are different therapies to help the recovery as well as ease the muscle pains.
Medication
This can include painkillers or different antispasmodic medicines to help relax the muscles. Some may need antibiotic treatment or other medication to help ease a fever or another infection.
Respiratory Assistance
In severe cases of polio, if the lungs become paralysed the infected person will inevitably have trouble breathing. If this occurs portable ventilation devices can be used. However, in emergency situations intubation or mechanical ventilation will be needed.
Orthotic Devices
Severe polio can cause deformities, especially in the legs.
This will be treated with orthotic devices such as a knee-ankle-foot brace which will support the lower leg, and keep it straight. Other devices are available for the spine or upper leg.
Surgery
Corrective surgery is also another treatment.
However, as the person could have difficulties recovering from surgery or experience neurovascular complications, it’s only performed where absolutely necessary. (20)
FAQ
What is polio? Polio is a highly infectious illness which can be debilitating and sometimes fatal. Children under five are at most risk of this condition.
What are the sign of polio? A telltale sign of polio is a sore throat. It is one of the first symptoms developed because the infection resides in the throat. Although some people may not show any symptoms at all, others will show signs of paralysis. Therefore, it does depend on the severity of the infection.
How do you develop polio? The poliovirus thrives in the throat and intestines and the infection can spread by contact with feces or sometimes by coughing or sneezing. In rare cases, polio vaccine can trigger paralytic poliomyelitis. (21)
How are you diagnosed for polio? Doctors can diagnose polio by examining specimens from the throat or stool. Other alternatives include: a cerebrospinal fluid test (CSF), or through a polymerase chain reaction (PCR). (22)
What is the best treatment for polio? The best treatment for polio depends on what type of polio you have. Some types require physical therapy or other rehabilitating treatments. Others might need assistance with breathing.
What are the long term complications of polio? Post-polio syndrome (PPS) is a long term complication of polio which affects the recovered person maybe many years later. It’s not fatal, but the person will start to show muscle weakness in areas that were previous infected. People most at risk for PPS are those who had a harder recovery from the first infection. (23)
Is polio considered a disability? Polio is a crippling illness, which can lead to paralysis. In those cases it is considered a disability.
Is there any cure for polio? No, polio can’t be cured. However, there is a vaccine available for children from two months old up to five years of age.
Is polio life threatening? Yes it can be. The poliovirus can in some cases paralyse the respiratory organs where the person will be unable to breathe. This is the number one cause of death in polio. (24)
Summary
Polio or poliomyelitis, is a highly infectious illness, which can paralyse the infected and even cause death.
It is spread through contact with feces or by coughing and sneezing. In rare cases it can be transmitted through contaminated water or food.
A telltale symptom is a sore throat, fever or headaches. In severe cases symptoms are meningitis and paresthesia.
The virus is present in the intestines and throat, but in some cases it can travel to the nervous system where it can cause paralysis. Thankfully, in most cases it can be treated with physical therapy and make a full recovery.
It’s a condition which can affect anyone of any age, although children under five years of age are most susceptible.
There is no cure, but it can be prevented through vaccination and following basic hygiene and sanitation practices, like washing your hands and cleaning toys regularly.