In 1988, polio still ravaged about 350,000 people each year, causing damage that will last for the rest of their lives. The World Health Organization, UNICEF, the CDC, and Rotary International saw that polio could be entirely eradicated from the world. By the turn of the millennium, they had been 99 percent successful (only 2881 new cases in 2000).
But enormous challenges remained in bringing immunizations to 16 million children in war-torn Central and Western Africa. Using bicycles, boats, and canoes (and an amazing variety of methods to keep the vaccine cold and fresh), courageous vaccinators began visiting children in the Democratic Republic of the Congo, Congo-Brazzaville, Gabon, and in Angola – one of the most war-torn and landmine-infested areas in the world. And each child had to be visited 3 times! Volunteers have been arrested and killed trying to protect children from this disease.
What is it?
Polio is a disease once widely feared for its ability to strike healthy children without warning, causing paralysis or death. Wild polio was eliminated in the United States in 1979, but as long as it is in the world it is only a few plane flights away. If it weren’t for the polio vaccine, the poliovirus might be used as an agent of bio-terror.
The word poliomyelitis comes from the Greek words “polio,” meaning gray, and “myelon,” meaning spinal cord.
There are 3 strains of the poliovirus. Polioviruses are part of the enterovirus family.
Who gets it?
Polio was once found around the globe. It has now been eliminated from most countries of the world. Today most cases of polio are found in either of two large areas, one in south Asia and the other in sub-Saharan Africa. Involved countries include Afghanistan, Angola Bangladesh, Democratic Republic of the Congo, Ethiopia, India, Liberia, Nepal, Nigeria, Pakistan, Sierra Leone, Somalia, Sudan, and Tajikistan.
In the Western Hemisphere, there were outbreaks of polio in the Dominican Republic and in Haiti in 2000, even though it had been hoped that the last outbreak had happened long before.
As recently as 2005, a small outbreak of polio occurred in the United States. At that time, four unimmunized children in Minnesota were infected with polio.
What are the symptoms?
Children with polio may develop a fever along with one or more of a variety of symptoms including headache, neck and back pain, sore throat, abdominal pain, constipation, appetite loss, nausea, vomiting, and fatigue.
There may be muscle weakness, progressing to muscle paralysis. Bladder paralysis can also occur. There is no loss of sensation.
Is it contagious?
Yes. Like other enteroviruses, polioviruses are spread both from stool to mouth and via the respiratory route.
How long does it last?
The initial illness lasts only days, but the paralysis can last a lifetime. Also, people who have had polio can develop postpolio syndrome 30 or 40 years later, with muscle pain and weakness.
How is it diagnosed?
Polio should be suspected based on the symptoms – especially with the combination of fever, headache, neck and back pain, and paralysis without loss of sensation. The diagnosis can be performed by blood or spinal fluid tests.
How is it treated?
Treatment efforts are focused on managing the complications of this illness. Specialty care is important. Antibiotics are not useful in treating polio.
How can it be prevented?
The polio vaccine is the cornerstone of polio prevention. Good hygiene can reduce the spread of illness, especially hand washing after toileting and diapering, and before eating.