Polio, also known as poliomyelitis, is a highly contagious and dangerous disease. Although its incidence has decreased by 99% worldwide with vaccination campaigns since 1957, it is still observed in some countries in Africa and Asia. In this article, we have compiled the most frequently asked questions about polio.
What is Polio ?
Polio (poliomyelitis) is a disease caused by a virus called poliovirus attacking the nervous system. The age group most at risk of contracting polio is children younger than 5 years old.
According to World Health Organization (WHO) data, 1 out of every 200 polio infections causes permanent paralysis. However, thanks to the global polio eradication initiative in 1988, regions such as the Americas, Europe, the Western Pacific, and Southeast Asia have eradicated the disease.
However, polio is still observed in some countries such as Afghanistan, Pakistan and Nigeria. The eradication of polio will benefit the whole world globally in terms of health and economy.
What are the symptoms of polio ?
It is estimated that 95 to 99% of people infected with poliovirus have no symptoms (asymptomatic). This condition is called subclinical polio. Even without showing symptoms, people infected with poliovirus can still spread the virus and pass it on to others without realizing it. Polio can have non-paralytic (non-paralytic) symptoms, as well as paralyzing (paralytic) symptoms when it reaches the nervous system.
Symptoms of non-paralytic polio:
Signs and symptoms of this type of polio can last from 1 to 10 days. The following symptoms are observed with flu-like symptoms.
Paralytic polio symptoms:
About 1% of polio cases can develop as paralytic polio. Paralytic polio causes paralysis of the spinal cord (spinal polio), the brain stem (bulbar polio), or both (bulbospinal polio).
Initial symptoms are similar to non-paralytic polio. But after a week, more serious symptoms will appear. These symptoms can be listed as follows.
-Severe spasms and muscle pain
-Loose and drooping limbs (occasionally observed on only one side of the body)
-Sudden paralysis (which can be temporary or permanent)
-Deformed limbs (especially hips, ankles, and feet)
Complete paralysis is rare. Less than 1% of all polio cases cause permanent paralysis. In 5 to 10% of polio cases, the virus can cause death.
Post Polio Syndrome (PPS)
A person who has had polio can still have a disease called post polio syndrome (PPS) even after completely clearing the infection. In general, post-polio syndrome is observed in 80% of people with polio infection. It occurs 15 to 40 years after the acute infection period. Common symptoms of polio syndrome (PPS) include:
-Progressive muscle and joint weakness: It can be observed unilaterally or partially.
-Muscle pains that get worse gradually: It is observed that the pain increases as the amount of use of the muscles increases.
-Fatigue: It is a common symptom. It can be observed as general fatigue or muscle fatigue.
-Muscle wasting (muscle atrophy)
-Difficulty breathing and swallowing
-Sleep apnea or other sleep-related problems
-Low tolerance to cold temperatures
-Concentration and memory problem
It is impossible for individuals who have not had polio before to catch PPS. If you've had polio before and you're starting to see these symptoms, you should contact a healthcare provider.
How is polio transmitted ?
The polio virus, a highly contagious virus, is transmitted through contact with (infected) feces that harbor the disease. Toys that come into contact with or approach virus-containing feces also pose a risk to children. Although very rarely, the virus can sometimes be transmitted through sneaking or coughing. This is because the virus can survive in the throat as well as the intestines.
People living in areas with limited access to running water or flush toilets are at higher risk of being contagious. The reason for this is that the feces of contaminated (infected, diseased) people can mix with drinking water in such regions.
Individuals with a more sensitive immune system, such as pregnant women, people with HIV infection, or young children, are most susceptible to the polio virus.
How is polio diagnosed ?
Polio disease can generally be diagnosed by looking at the symptoms. During the physical examination, your doctor will examine the reflexes and pay attention to the presence of back and neck stiffness. Lab tests may be ordered to confirm the diagnosis. The presence of polio virus can be confirmed by taking a swab from the throat, a stool test, or taking a small sample of the cerebrospinal fluid that surrounds the spinal cord and brain and sending it to the laboratory.
How is polio treated ?
There is no drug that can stop the polio virus or have a direct effect on the virus. Therefore, treatment focuses on improving the quality of life, coping with pain, and trying to prevent complications that may occur. For this reason, it is extremely important to be vaccinated before they get sick and to ensure that children are vaccinated.
Listed below are the most common supportive treatments that can be done while having polio:
-Antispasmodic drugs to relax muscles
-Antibiotics for urinary tract infections
-Portable breathing devices (ventilators) that assist with breathing
-Physical therapy or splints to aid walking
-Hot water bags or hot towels to relieve muscle aches and spasms
-Physical therapy for pain control in affected muscles
-Physical therapy for respiratory and pulmonary problems
-Pulmonary rehabilitation to increase lung endurance
-In cases of advanced leg weakness, a wheelchair or other mobility device may be needed.
How is polio prevented ?
The best way to prevent polio is to get vaccinated. There are two different vaccines for polio. The first of these is Oral Polio Vaccine (OPA = Live Vaccine) administered in the form of two oral drops, and the other is Inactive Polio Vaccine (IPA = Dead Vaccine) administered intramuscularly from the arm. The vaccination schedules of polio vaccines, which are also effectively applied in our country, can be summarized as follows.
OPA: It is administered by giving two drops orally to babies who have completed their 6th and 18th months.
IPA: It is administered in the 5-combined vaccine at the 2nd, 4th, 6th and 18th months. It is a vaccine that is injected into the muscle. Children who are in the 1st grade of primary education are also given intramuscularly in the arm once again in the 4-combined vaccine. This is done 5 times in total.
Healthy adults are not at high risk of contracting the polio virus. The greatest risk comes when traveling to an area where polio is still prevalent. Those who will travel to this type of area should be vaccinated.
The importance of vaccination emerges when we look at the number of cases observed over the years in the United States of America, which has implemented the vaccination policy actively and rapidly. Polio cases in the United States, which peaked at 57,623 cases in 1952, have continued to decline since the Polio Vaccination Assistance Act, and the disease was eradicated in 1979. In other words, there has been no case of polio in the United States since 1979.