Polio (Poliomyelitis)

What is polio?

Poliomyelitis is commonly called polio. It's an infectious disease. It is caused by 1 of 3 types of poliovirus. Polio is easily spread from person to person. The poliovirus is a virus that can cause paralysis. But most people who are infected with polio have no symptoms. And about 1 in 4 people may have flu-like symptoms. Very few people who get polio develop paralysis. Since the polio vaccine was invented in 1955, polio has been nearly stamped out in the U.S.

Poor and developing countries may not have access to the current polio vaccines. Polio is still a concern in these areas, especially for infants and children.

What causes polio?

Polio is caused by 1 of 3 types of the poliovirus. It often spreads due to contact with infected feces. This often happens from poor handwashing. It can also happen from eating or drinking contaminated food or water. It can also be spread when an infected person coughs or sneezes infected droplets into the air. Those with the virus can excrete the virus in their stool for several weeks. People are most contagious right before symptoms start and soon after they appear.

What are the symptoms of polio?

Symptoms of polio vary in their severity. Most affected people have no symptoms at all. This is called an inapparent infection. The other types of polio are abortive, nonparalytic, and paralytic.

The following are the most common symptoms of polio. But each person may have different symptoms.

Abortive polio

Abortive polio is a mild and short course of the disease with 1 or more of these symptoms:

• Fever

• Decreased appetite

• Nausea or vomiting

• Sore throat

• Not feeling well all over (malaise)

• Constipation

• Belly (abdominal) pain

Nonparalytic polio

The symptoms for nonparalytic polio are like abortive polio. The infected person may feel sick for a couple of days. Then they may seem to improve before getting sick again with these symptoms:

• Muscle pain in the neck, trunk, arms, and legs

• Stiffness in the neck and along the spine

Paralytic polio

The symptoms for paralytic polio are like the other 2 types. Plus these symptoms may happen:

• Muscle weakness all over

• Severe constipation

• Muscle wasting

• Weakened breathing

• Trouble swallowing

• Muscle paralysis (may be permanent)

• Drooling

How is polio diagnosed?

Along with a complete physical exam and health history, these tests may be done:

• Cultures of the throat and stool are most commonly used.

• Blood levels or cerebrospinal fluid testing is less commonly used.

How is polio treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

A vaccine can prevent polio, but there is no specific treatment for people who become infected. Treatment is focused on easing symptoms. Supportive measures include:

• Pain relievers, such as acetaminophen or ibuprofen

• Healthful diet

• Minimal activity

• Hot packs or heating pads for muscle pain

• Physical or occupational therapy to help with arm or leg weakness in more severe cases

What are possible complications of polio?

The most severe complication of polio is paralysis. This can lead to problems with breathing, swallowing, and bowel and bladder function.

Postpolio syndrome can happen many years after the initial infection. This syndrome causes:

• Muscle weakness and shrinking of the muscles

• Extreme tiredness (fatigue)

• Pain in the muscles and joints

Can polio be prevented?

Measures to prevent polio include:

• Good hygiene and handwashing

• Vaccines

In the U.S., the polio vaccine is recommended to be given at these ages:

• 2 months

• 4 months

• Between 6 and 18 months

• Between 4 and 6 years

Vaccines are:

• IPV. Inactivated poliovirus vaccine is given by a shot (injection). This vaccine is given at all 4 vaccine visits. IPV can't cause polio. That's because the virus has been killed. It is safe for people with a weak immune system. Tell your healthcare provider if you have an allergy to neomycin, streptomycin, or polymyxin B, as you may not be able to get the IPV.

• OPV. Oral poliovirus vaccine is given by mouth. In very rare cases, OPV has been known to cause vaccine-linked paralytic poliomyelitis. Experts now recommend that the OPV not be given routinely and that only IPV be given. OPV should not be given to people with a weak immune system.

Living with polio

Polio can have various effects on your lifestyle. It depends on the severity of your symptoms. Types of treatment and support can include:

• Assistive devices for movement, such as braces, canes, orthotics, and wheelchairs

• Breathing help, such as extra oxygen or a ventilator

• Physical and occupational therapy to help with movement

• Nutritional therapy, such as special diets or help with eating

• Lifestyle changes to adapt to your symptoms

When should I call my healthcare provider?

If your symptoms get worse or you have new symptoms, let your healthcare provider know. Certain signs and symptoms should be reported right away, such as:

• Breathing trouble

• Swallowing trouble

• Problems with walking or other types of movement

• Weakness or extreme fatigue

Key points about polio

• Polio is an infectious disease caused by any 1 of 3 types of poliovirus. It is easily spread from person to person.

• Polio can cause paralysis. But most people who are infected with polio have no symptoms, and a few have mild symptoms.

• Since the introduction of the polio vaccine in 1955, polio in the U.S. has nearly been eliminated.

• Poor or underdeveloped countries may not have access to the current polio vaccines. Polio is still a concern, especially for infants and children, and for others who are unvaccinated.

• While there is a vaccine to prevent polio, there is no specific treatment for infected people.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new directions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are and when they should be reported.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions, especially after office hours or on the weekends and holidays.