Polio (Poliomyelitis)

What is polio?

Poliomyelitis, commonly called polio, is an infectious disease. It is caused by 3 types of poliovirus. Polio is easily spread from person to person. The poliovirus is a virus that causes paralysis. But, most people who are infected with polio have no symptoms and a few have mild symptoms. Very few people who get polio develop paralysis. Since the polio vaccine was invented in 1955, polio has been nearly stamped out. In the U.S. There have been no known cases of polio since 1979.

Poor and developing countries do not have access to the vaccine. Polio is still a concern in these areas, especially for infants and children.

What is the cause of polio?

Polio is caused by 1 of 3 types of the poliovirus. It usually spreads due to contact with infected feces. This often occurs from poor hand washing. It can also occur from ingestion of contaminated food or water. It can also be spread when an infected person coughs or sneezes infected droplets into the air. Those infected with the virus can excrete the virus in their stool for several weeks. People are most contagious immediately before the onset of symptoms and soon after they appear.

What are the symptoms of polio?

Symptoms of polio vary in their severity. Most affected people have no symptoms at all. This is called an inapparent infection. The other types of polio are abortive, nonparalytic, and paralytic.

The following are the most common symptoms of polios. However, each person may experience symptoms differently.

Abortive polio

Abortive polio is a mild and short course of the disease with one or more of the following symptoms:

  • Fever
  • Decreased appetite
  • Nausea and/or vomiting
  • Sore throat
  • Not feeling well all over (malaise)
  • Constipation
  • Abdominal pain

Nonparalytic polio

The symptoms for nonparalytic polio are similar to abortive polio. The infected person may feel sick for a couple of days then appear to improve before getting sick again with the following symptoms:

  • Pain of the muscles in the neck, trunk, arms, and legs
  • Stiffness in the neck and along the spine

Paralytic polio

The symptoms for paralytic polio are the same as nonparalytic and abortive polio. In addition, the following symptoms may occur:

  • Muscle weakness all over
  • Severe constipation
  • Muscle wasting
  • Weakened breathing
  • Trouble swallowing
  • Muscle paralysis (may be permanent)
  • Drooling

How is polio diagnosed?

Along with a complete physical exam and medical history, the following tests may be done:

  • Cultures of the throat, cerebrospinal fluid, and stool
  • Test for polio antibodies levels
  • Lumbar puncture or spinal tap

How is polio treated?

Specific treatment will be determined by your health care provider based on:

  • Your age, health, and medical history
  • Extent of the disease
  • Your tolerance for specific medications, procedures or therapies
  • Expectations for the course of the disease
  • Your opinion or preference

While there is prevention of the polio, there is no specific treatment for people who become infected. Treatment is focused on symptom relief. Supportive measures include:

  • Pain relievers such as acetaminophen or ibuprofen
  • Healthful diet
  • Minimal activity
  • Hot packs or heating pads for muscle pain

What are the complications of polio?

The most common complication of polio is paralysis. This can lead to problems with breathing, swallowing, and bowel and bladder function.

Post-polio syndrome can occur many years after the initial infection. This syndrome causes muscle weakness and shrinking of the muscles, extreme fatigue, and pain in the muscles and joints.

Can polio be prevented?

Measures to prevent polio include:

  • Good hygiene and hand-washing
  • Immunization

In the U.S., the polio vaccine is recommended to be given at the following ages:

  • 2 months
  • 4 months
  • Between 6 and 18 months
  • Between 4 and 6 years

Vaccines include:

  • IPV. Inactivated polio vaccine is given by a shot (injection). This vaccine is given at all 4 immunization visits. IPV can’t cause polio and is safe to use for people with weak immune systems. Tell your health care provider if you have an allergy to neomycin, streptomycin, or polymyxin B, as you may not be able to receive the IPV.
  • OPV. Oral polio vaccine is given by mouth. In rare cases, OPV has been known to cause vaccine-associated paralytic poliomyelitis. It is now recommends that the OPV not be given routinely and that only IPV be given. OPV should NOT be given to anyone with a weak immune system.

Living with polio

Polio can have various effects on your lifestyle, depending on the severity of your symptoms. Types of treatment and support can include:

  • Assistive devices for movement, such as braces, canes, orthotics, and wheelchairs
  • Breathing help, such as extra oxygen or a ventilator
  • Physical and occupational therapy to assist with movement
  • Nutritional therapy such as special diets or assistance with eating
  • Lifestyle changes to adapt to your symptoms

When should I call my health care provider?

If your symptoms get worse or you have new symptoms, let your health care provider know. Certain signs and symptoms should be reported immediately, such as:

  • Breathing trouble
  • Swallowing trouble
  • Problems with walking or other types of movement
  • Weakness or extreme fatigue

Key points about polio

  • Polio is an infectious disease caused by 3 types of poliovirus. It is easily spread from person to person.
  • Polio can cause paralysis. But, most people who are infected with polio have no symptoms and a few have mild symptoms.
  • Since the introduction of the polio vaccine in 1955, polio in the U.S. has nearly been eliminated.
  • Poor or underdeveloped countries do not have access to the vaccine. Polio is still a concern, especially for infants and children.
  • While there is prevention of the polio, there is no specific treatment for infected people.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.