Poliomyelitis
Poliovirus causes poliomyelitis, which is a life-threatening disease. Up to 70% of people infected do not have symptoms so it can spread unknown through a community quite rapidly. It is easily prevented by taking very well-known and effective vaccines. Despite this, polio infection is on the rise and can have devastating consequences.
There are two vaccines. One is a live virus that is a liquid and is swallowed. It is still used throughout the world. The other is not live. It is a shot called IPV (Inactivated PolioVirus). It is more than 99% effective and has been the one used in the United States since 2000.
In 1988, the Global Polio Eradication Initiative (GPEI) was developed. It was extremely successful at decreasing cases of polio throughout the world. Cases went from 350,000 in the world in 1988 to 140 reported cases in 2020. These cases were in 2 countries-Pakistan and Afghanistan. These are the only two countries in the world with continued poliovirus spread, but that may be changing. There have been multiple sporadic outbreaks throughout the world since.
Poliovirus secretly runs through communities
As poliovirus is found in feces, checking our wastewater periodically for the virus can let us know if there are people infected that we don’t know about before it becomes a problem. There are communities throughout the world and the United States that do not vaccinate. Some of these are right in the middle of bustling New York, who started testing their wastewater in July of this year only after a case of paralytic polio showed up. When paralytic polio is only a small portion of polio cases, this means there were 100s if not 1000s more cases of polio infection that were not reported. So it wasn’t surprising when New York’s tests of their wastewater came up positive in multiple places. Poliovirus was indeed going through New York, a very busy international hub.
Very few developed countries do routine checking for poliovirus in their wastewater. The United Kingdom does do routine checking, but only in Glasgow and London. They have been finding poliovirus in London’s wastewater since February of this year. There was also a recent case of polio paralysis in Israel.
These countries are all ramping up their efforts at educating and vaccinating the public in hopes of staving off further spread of this devastating disease.
So what are the symptoms of poliovirus?
While most infected persons have no symptoms, 25% will develop these common symptoms:
- Headache
- Fever
- Nausea
- Fatigue/tired
- Sore throat
Meningitis and Poliomyelitis
Sometimes the virus continues to worsen and can infect the brain and spinal cord causing meningitis. This happens in 1-5 out of every 100 people infected with the poliovirus. Another smaller portion of those infected will develop paralysis, which is weakness or loss of function of their arms, legs or both. This is called poliomyelitis and can happen 15-40 years after the initial infection!
What is Post-Polio Syndrome?
Anyone infected with poliovirus that seems to have recovered can have it reactivate later in life as Post-Polio Syndrome. Some of these people may have appeared perfectly healthy and even highly athletic. They develop muscle-wasting where the muscles of often one leg will waste away leaving the patient bed bound or in a wheelchair.
I have seen this disease and it is devastating, especially when there is no reason in our day and age. We have the resources and vaccines to prevent the spread of poliovirus.
How can I get Polio?
Viruses tend to be very contagious and poliovirus is no different. Rates of infection among household contacts of an infected person are 90-100%. People infected with polio can pass it to others whether they show symptoms or not. Remember, 70% of people do not have symptoms.
The virus can live in a person’s gastrointestinal tract (throat to anus) for up to six weeks. We get the virus through our mouths by direct contact. This means if we touch a person or object with infected feces, saliva, or respiratory droplets (such as from a sneeze or cough) and then touch our mouth we can become infected. It is very easy to get a small amount of unseen feces on our hands after wiping. We could even wash our hands and not get it all off.
Poliovirus lives on surfaces you may touch for weeks. It can take anywhere from 4-35 days from exposure to develop the infection. This is called the incubation period. Yes, you read that correctly, while it is most common to develop the infection within the week after exposure, it may be a whole month later.
Poliovirus is only found in humans. Children less than 6 years old are the most susceptible to the virus. If a birth mother was immunized, her infant may have some protection against the virus until it is about 6 months old. So get your babies immunized!
How do I protect myself and my family against poliovirus?
- FOLLOW VACCINE RECOMMENDATIONS!
- Practice good hand hygiene with soap and water.
- Do not use alcohol-based hand sanitizers because they do not kill the polio virus. They will kill the good bacteria on your skin that protect you.
- Wear a mask, gloves and other protective gear when handling any clothing or persons with possible poliovirus infection.
Testing for poliovirus:
There are many ways to test for poliovirus. This includes testing the blood, urine, feces, spinal fluid and respiratory secretions. It is more likely to be found in stool samples, which is why Health Departments test sewage to look for this virus in the community. Remember most people do not have symptoms or have mild, flu-like symptoms which will most likely go undetected as polio.
Your doctor may also order an MRI of your spine and brain.
What is the treatment for Poliovirus?
There is no cure or specific treatment for poliovirus infection. Treatment consists of treating the symptoms such as physical therapy for arm and leg weakness and/or paralysis. Patients are typically admitted to the hospital and treated with supportive care.
If you or anyone you know suspects possible poliovirus contact your local health department immediately. In the United States, you can find this by googling the name of your county with the words “health department”.
Stay safe and follow recommended vaccine guidelines!
State of Polio outbreaks worldwide puts scientists on alert 22 August 2022, News Explainer, Nature, accessed 10 September 2022.
Global Immunization Polio updated 11 August 2022, Centers for Disease and Control, CDC US government website, accessed 10 September 2022.
Disease factsheet about Poliomyelitis, European Centre for Disease Prevention and Control, ECDC Europa Government Website, accessed 10 September 2022.