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Abortive Poliomyelitis - Causes, Symptoms, Prevention and Treatment

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Abortive poliomyelitis is less severe with flu-like symptoms and accounts for 80 % to 90 % of polio cases. Read this article to know more.

Written byDr. Saima Yunus

Medically reviewed byDr. Shubadeep Debabrata Sinha

Published At October 17, 2022
Reviewed AtJuly 4, 2024

Introduction:

Abortive poliomyelitis is a minor form of poliomyelitis, chiefly affecting young children without involving the central nervous system. Common symptoms include low-grade fever, headache, sore throat, fatigue, and vomiting after exposure to the virus. These symptoms take around five to seven days to subside. There is a complete recovery within seven days without any permanent deformity. The spread of this virus is through the fecal-oral route or aerosol droplets.

What Is Poliomyelitis?

Poliomyelitis is a major form in comparison to abortive poliomyelitis. The symptoms usually occur seven to 14 days after exposure to the virus. It is a highly transmissible disease caused by RNA viruses of the Enterovirus genus (Picornaviridae family). The polio virus disrupts the central nervous system and can cause complete paralysis. Initial symptoms include fever, headache, malaise, and vomiting. It can also cause limb pain and a stiff neck, which may lead to irreversible paralysis of the limbs.

What Are the Different Forms of Polio?

Polio manifests in various forms depending on where the virus attacks and replicates in the body:

  • Abortive Poliomyelitis: Resembles flu-like symptoms with intestinal issues, typically lasting a few days without causing lasting effects.

  • Non-paralytic Poliomyelitis: This can lead to aseptic meningitis, causing more symptoms than abortive polio and often requiring hospitalization.

  • Paralytic Poliomyelitis: This is the most severe form, where the virus attacks the brain and spinal cord, potentially causing paralysis of muscles crucial for breathing, speaking, swallowing, and limb movement. It includes spinal polio affecting limbs and bulbar polio affecting cranial nerves, with a rare combination known as bulbospinal polio.

  • Polioencephalitis: This type predominantly affects infants, involves brain swelling, and is a rare manifestation of polio.

  • Post-polio Syndrome: This type occurs when symptoms of polio reappear many years after an initial polio infection.

What Are the Risk Factors?

Polio primarily impacts children, but individuals who have not been vaccinated are susceptible to contracting the disease.

What Is Abortive Poliomyelitis?

Abortive poliomyelitis is a mild infection that particularly affects children. The symptoms include fever, headache, sore throat, and vomiting, which last for five to seven days. These symptoms usually occur three to five days after exposure and have no neurological involvement. A physical examination also shows no sign of illness except for a raised temperature. The term abortive means not reaching completion or not fully developed. Hence, abortive poliomyelitis is a form of the disease that does not develop in its full form and only shows minor symptoms.

What Are the Symptoms of Abortive Poliomyelitis?

Poliovirus infections can lead to various clinical features, ranging from a mild infection to paralysis and even death. Most poliovirus infections are asymptomatic, with around 70 percent of infected cases showing no symptoms and around 25 percent experiencing mild symptoms.

Paralytic poliomyelitis is seen in less than one percent of infections. Depending on the site of the affected motor cells of the central nervous system, the disease is classified into spinal, bulbar, and bulbospinal types. The symptoms of abortive poliomyelitis are very mild. It does not affect the brain or the spinal cord.

The symptoms are of short duration and may include one or more of the following:

  • Fever.

  • Malaise.

  • Sore throat.

  • Decreased appetite.

  • Abdominal pain.

  • Nausea.

  • Vomiting.

The symptoms of abortive poliomyelitis usually last for about two to five days and then disappear on their own. An extremely small percentage of the population infected with poliovirus may develop severe symptoms that affect the central nervous system, leading to abnormal sensations in the skin (paresthesia), an infection in the meninges of the brain (aseptic meningitis), and the inability to move the limbs (paralysis). Paralysis is the most dangerous form of poliomyelitis, leading to permanent dysfunction of the limbs.

How Is Abortive Poliomyelitis Transmitted?

Poliovirus is highly infectious and can be transmitted from person to person. It thrives in the throat and intestines of the patient. The infected person can transmit it through feces, droplets from coughing or sneezing, or the intake of contaminated food and water. The virus can be alive in the feces of an infected person for many weeks. People without symptoms can also transmit the virus to healthy individuals, which can cause the disease.

What Is the Prevention and Treatment of Abortive Poliomyelitis?

Abortive poliomyelitis and severe forms of poliomyelitis can be prevented by taking the polio vaccine regularly during childhood.

In the United States, the inactivated poliovirus vaccine (IVP) is given to the following age:

  • Two months.

  • Four months.

  • Between 6 to 18 months.

  • Between four to six years of age.

The inactivated poliovirus vaccine shows side effects like redness and pain at the injection site.

The oral poliovirus vaccine (OVP) is also used in many parts of the world with excellent results.

Sometimes, adults in the United States must also be vaccinated against the virus. Since most of the population is already vaccinated, only those adults who take a booster shot are at great risk of getting the disease if they are traveling to a polio-infected part of the world or if they are in constant contact with polio patients.

No specific treatment is available for poliomyelitis, and the case can be managed symptomatically. The availability of clean water and good hygienic sanitation practices are important for reducing the risk of transmission of poliomyelitis in endemic countries.

Has Polio Been Eliminated?

Wild poliovirus types 2 and 3 have been globally eradicated, meaning there are no longer any naturally occurring cases of these types. Poliovirus type 1 has been eliminated in most countries but has not yet been eradicated worldwide. "Eliminated" indicates that the disease no longer spreads within a specific area, though occasional cases or outbreaks may still occur, typically through international travel. Currently, Pakistan and Afghanistan are the only countries where naturally occurring cases of polio still exist.

What Are the Complications of Polio?

Severe cases that impair breathing can be fatal. For those who recover, long-term complications may include:

  • Post-polio syndrome.

  • Permanent paralysis.

  • Chronic pain.

  • Muscle shortening leads to bone or joint deformities.

Conclusion:

Abortive poliomyelitis is a less severe form of poliomyelitis that targets children with minor symptoms. It does not affect the central nervous system. Usually, the patient complains of low-grade fever, headache, sore throat, fatigue, and vomiting after the virus enters the body.

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Frequently Asked Questions

 
Poliomyelitis occurs in three distinctive immunological poliovirus strains - poliovirus type 1, poliovirus type 2, and poliovirus type 3. The disease caused by all these three strains is symptomatically similar, causing irreversible paralysis or death. However, these strains are genetically and virologically different and need to be individually eradicated.
The stages of poliomyelitis include the acute stage, recovery stage, and residual paralysis stage. 
 
During the acute phase, the patient experiences clinical features like fever, muscular weakness, neck stiffness, autonomic dysfunction, and paraparesis (partial paralysis involving the lower limbs). 
In the recovery stage, the features of the acute stage disappear, and the recovery of paralyzed muscles is initiated. This stage can extend up to two years. 
During the last stage, the patient experiences residual paralysis, poor posture, and muscle power imbalance.
 
The polio virus is transmitted from person to person. The infected person can transmit it through feces, droplets from coughing or sneezing, or intake of contaminated food and water. The virus can thrive in the feces of an infected person for many weeks. People without symptoms can also transmit the virus to healthy individuals, which can cause the disease.
The complications of poliomyelitis infection include paralysis with fatal respiratory and cardiovascular collapse, bulbar involvement (impairment of motor neurons in the corticobulbar region of the brainstem), and post-polio syndrome (PPS). PPS involves progressive muscle weakness in a patient previously affected with poliomyelitis. It has been documented that 30 to 40 % of the 15 to 20 million survivors of poliomyelitis globally develop some form of post-polio syndrome (PPS), causing progressive muscle weakness years after the acute infection. It also causes respiratory distress, myalgias, joint pain, atrophy, dysphagia, and generalized fatigue.
Poliomyelitis is usually managed symptomatically through supportive care, as no antiviral medications have yet been approved for its treatment. Inactivated polio vaccine or live-attenuated oral polio vaccine can be used to establish immunity against the polio virus. An important step in management is the release of joint contractures for which surgical interventions might be required to prevent deformities.
 
The acute stage can be managed by providing general symptomatic relief for fever and irritation, managing respiratory paralysis, and preventing respiratory tract infections. In the last stage, the goal of management is to achieve a decent physical status for the patients by organizing non-fatiguing exercise programs that help to deal with muscle overuse weakness
The common cause of the spread of poliomyelitis is person-to-person contact or fecal-oral transmission. It can also be transmitted spreads through droplets from a sneeze and cough or contact with the feces of an infected person. Individuals without any symptoms can also transmit the virus to healthy individuals and can cause the disease.
 
Poliomyelitis can be prevented primarily through polio vaccines, as there is no cure for the disease yet. The vaccines for poliomyelitis are administered multiple times and provide protection against the disease in children throughout their lifetime. The vaccines are available in two forms - oral polio vaccine and inactivated polio vaccine. Both these vaccines are safe and effective, and both are administered in different combinations around the world based on the local epidemiology and programs implemented.
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Dr. Shubadeep Debabrata Sinha from iCliniq
Dr. Shubadeep Debabrata Sinha

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