Polio (Polio)

Polio

Polio has been around since ancient times. Between 1840 and the 1950s, polio was a worldwide scourge that only ended when immunization became widespread in the second half of the 20th century.

Today, polio has been wiped out in most countries, only reappearing when someone travels to an area where polio is common. Only a few countries in Asia, Africa and India still suffer from widespread polio.

What is polio?

Polio, or poliomyelitis, is a very contagious viral infection that attacks the nervous system and can cause total paralysis in a matter of hours. Death can follow in five to ten percent of cases when the paralysis moves to the breathing muscles. The very young, pregnant women, and those with compromised immune systems are most at risk.

How does it spread?

The polio virus enters the body through the mouth. Poor hand washing and contaminated water are the main sources of infection.

Signs and Symptoms

There are three basic types of polio.

A. Subclinical infections

90% of polio infections are subclinical, which means that 95% of people infected with subclinical polio may not have symptoms. If there are symptoms, they are generalized:

  • headache
  • slight fever
  • sore, red throat
  • vomiting

If the symptoms are present, they may last 72 hours or less.

B. Clinical infection

This infection may develop from the subclinical infection. It affects the nervous system—the brain and spinal cord—and breaks down into different forms:

1. Nonparalytic polio:

This means that the infection is not likely to result in paralysis. Some of the symptoms include:

  • back pain or backache
  • diarrhea
  • excessive tiredness, fatigue
  • headache
  • irritability
  • leg pain (calf muscles)
  • moderate fever
  • muscle stiffness
  • muscle tenderness and spasm in any area of the body
  • neck pain and stiffness
  • pain in front part of neck
  • pain or stiffness of the back, arms, legs, abdomen
  • skin rash or lesion with pain
  • vomiting

The symptoms last up to two weeks.

2. Paralytic polio:

  • fever, five to seven days before the appearance of other symptoms
  • abnormal sensations (but not loss of sensation) in an area
  • bloated feeling in abdomen
  • difficulty breathing
  • constipation
  • difficulty beginning to urinate
  • drooling
  • headache
  • irritability or poor temper control
  • muscle contractions or muscle spasms in the calf, neck, or back
  • muscle pain
  • sensitivity to touch—mild touch may be painful
  • stiff neck and back
  • difficulty swallowing
  • muscle weakness that is only on one side or worse on one side
  • comes on quickly
  • location depends on where the spinal cord is affected
  • worsens into paralysis

 

How can I protect myself and people around me?

There is no cure for polio. The best prevention is immunization.

While most people in the western world are routinely immunized against polio, there are still outbreaks from time to time among groups of people who have not been immunized. Polio is still active in India, Africa and South Asia, and travel to those regions can be risky if you haven’t been fully immunized against polio.

In Yukon, polio is a part of the combination immunization DTaP-HB-IPV-Hib, which protects infants and children from: diphtheria, tetanus, pertussis, Hepatitis B, polio and Haemophilus influenzae type B, all in one shot.

The Yukon immunization schedule calls for:

  • DTaP-HB-IPV-Hib  immunization at 2, 4 and 6 months of age
  • A dose (DTaP-IPV-Hib) at 18 months
    • After the dose at 18 months, children are protected against polio. After this, they need a one booster dose when they start school for lifelong polio protection.
  • Booster dose (DTaP-IPV) at 4 to 6 years old
  • Adults travelling to countries where polio is endemic should receive a booster dose of IPV. It is available at cost.

Polio immunization can also be give on its own to children and adults who were not immunized as infants.

For children, the primary series and booster doses need to be given for them to be protected. If you missed your booster dose, your body cannot protect itself from polio. Contact your local health centre for drop-in and appointment times to be immunized.

Most children and adults have no reactions to immunization. Some people have minor reactions to immunization. These reactions do not interfere with day-to-day activities and go away on their own in two to three days. The most common reaction is swelling and redness with or without tenderness around the injection site. A few people develop fever (one to 18 in 100 children immunized), headaches or muscle pain. If this is the case with you or your child, you many choose to give/take a fever medication such as acetaminophen if the fever is 38.5°C or higher.

Any fever medication, such as acetaminophen, before the immunization is not recommended.