Polio (Poliomyelitis) - Symptoms, Diagnosis, Prevention and Manage

What Is Poliomyelitis?

Poliomyelitis is a disabling and deadly infectious disease caused by the poliovirus. It can spread from one person to another and invade the brain and spinal cord, leading to paralysis (the inability to move body parts). After acquiring it from the infected person, the person serves as a reservoir for the poliovirus.

Transmission can be mainly through the fecal-oral route or, less frequently, by contaminated water or food. The virus multiplies in the intestine. Children below the age of five are more prone to contracting the virus than any other age group. This virus primarily grows and multiplies in the intestine to attack the nervous system, causing polio and paralysis on an advanced level.

What Are the Symptoms of Poliomyelitis?

A highly infectious disease caused by poliovirus is called poliomyelitis. It usually invades the nervous system and can cause total paralysis in a person affected by poliovirus in a few hours. Initial symptoms may involve fever, headache, fatigue, vomiting, stiffness of the neck, and pain in the limbs. About 1 in 200 infections leads to irreversible paralysis (usually in the legs). Those who are paralyzed will die when their breathing muscles become immobilized. Usually, people infected with poliovirus (72 out of 100) will not have visible symptoms.

What Are the Types of Polio?

1. Abortive Poliomyelitis:

This condition causes flu-like and intestinal issues. It lasts only for a few days and is not a long-lasting condition.

2. Non-Paralytic Polio:

Few people with poliovirus infection will have flu-like symptoms. This type of poliomyelitis is called non-paralytic polio. The symptoms involve

• Sore throat.

• Fever.

• Tiredness.

• Nausea.

• Headache.

• Stomach pain.

• Pain in the limbs.

• Meningitis.

• Abnormal reflexes.

• Back pain.

• Stiffness of the neck.

• Stiffness and tenderness in the arm and leg.

• The trouble with swallowing and breathing.

These symptoms will last two to five days, and then subside independently.

3. Paralytic Polio:

A smaller proportion of people (1 out of 100 or 5 out of 1000) with poliovirus infection will develop more severe symptoms affecting the brain and spinal cord. This type of poliomyelitis is called paralytic poliomyelitis.

The symptoms of paralytic polio may include:

• Paresthesia or abnormal sensation (feeling of pins and needles in the legs).

• Meningitis (infection of the spinal cord or brain).

• Paralysis or weakness in the arms, legs, or both.

• Sudden paralysis (temporary or permanent).

• Loss of reflexes.

• Severe spasms.

• Muscle tenderness.

• Respiratory illness.

• Gastroenteritis.

• Loose and floppy limbs (one-sided).

• Deformed limbs, usually in the hips, ankles, and feet.

4. Polioencephalitis:

It is a very rare type which usually affects the infants. This condition can result in brain swelling.

5. Post-polio Syndrome:

This is a condition where the person experiences symptoms of polio years after the polio infection.

What Are the Causes of Polio?

Polio is usually caused by a virus called poliovirus. This affects the intestine and throat, causing flu symptoms. This can spread to the brain and spine, resulting in paralysis.

What Are the Post-polio Symptoms?

Some children who seem to recover fully from the polio infection can develop weakness, new muscle pain, or paralysis as adults later in their lives. This is called post-polio syndrome. The symptoms may include:

• Continuing muscle and joint weakness.

• Muscle pain that gets worse.

• Easily exhausted or fatigued.

• Depression.

• Muscle wasting.

• Difficulty breathing and swallowing.

• Sleep-related breathing problems.

• Intolerance to cold temperatures.

• Problem with concentration and memory.

How Can Paralysis Affect People With Polio?

Paralysis is the most severe symptom of poliomyelitis infection because it can lead to permanent disability and death. Around 2 to 10 out of 100 people who have paralysis from poliovirus infection may die because the virus will cause paralysis of the muscles that help in breathing.

How Is Poliomyelitis Transmitted?

Poliomyelitis is transmitted through the fecal-oral route when a person contacts the infected feces. Objects like toys that have come into contact with the infected feces can also transmit the virus. Children below the age of five are more prone to contracting the disease. It can also be transmitted through a sneeze or a cough, as the virus lives in the throat and intestines; however, this is less common.

The spreading of the virus in the feces is the reason for it being a highly contagious disease. Maximum excretion of the virus is seen within two to three days before or one week after the appearance of symptoms. Pregnant women, people with poor immune systems, such as those with HIV (human immunodeficiency virus), and young children below five years are the most prone to the poliovirus.

The spread is more common in areas with poor sanitation, especially among people with poor immunity. People living in these areas can contract polio from drinking water contaminated by infected human waste. The virus is so contagious that anyone living with people who have it can contract it, too. The spread of the virus is mainly seen in the summer in warm regions.

If not vaccinated, the chances of contracting polio increase for people who:

• Travel to an area with a recent polio outbreak.

• Live with someone infected with polio.

• Removed their tonsils.

• Handle a laboratory specimen of the virus.

• Have extreme stress after exposure to the virus.

How to Diagnose Poliomyelitis?

Polio can be diagnosed by looking at the symptoms.

The doctor will perform a physical examination to look for:

• Impaired reflexes.

• Back and neck stiffness.

• Difficulty lifting your head while lying flat.

• Testing the sample from the throat, stool, or cerebrospinal fluid for the poliovirus.

How to Prevent and Manage Poliomyelitis?

The two types of vaccine that are available to prevent polio are:

• Inactivated poliovirus vaccine (IPV) is given as an injection in the leg or arm.

• The oral poliovirus vaccine (OPV) is still used throughout the world.

The polio vaccine will protect children by preparing their bodies to fight against the poliovirus. Almost all children who get all the recommended doses of the inactivated polio vaccine will be protected from polio.

What Is Vaccine-derived Polio?

This is a condition that is generally part of the oral poliovirus vaccine. Over time, the virus can mutate (change) from its weak version and spread to people who are not vaccinated. Even though this is caused by a changed, weakened version of polio, it acts like a naturally occurring polio.

What Is the Complication of Polio?

Some common complications include

• Permanent analysis.

• Post-polio syndrome.

• Chronic pain.

• Muscle shortening.

Conclusion:

Since improper sanitation and lack of personal hygiene were the most important contributing factors, it can infect infants at an age beyond the protection of maternal antibodies. Polio is usually caused by poliovirus. It does not show any symptoms, but some people can become paralyzed. There is no permanent cure for polio.