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Poliomyelitis (Polio)

Poliomyelitis - also called polio and infantile paralysis - is an acute communicable disease caused by the poliovirus. Most patients present with minor illness (fever, malaise, headache, sore throat, and vomiting), but a few develop aseptic meningitis and paralytic illness.

In the United States, only 5 to 10 cases of the disease are reported annually. These cases are associated with the use of oral poliovirus vaccine, with infants frequently developing signs and symptoms after the first dose of the vaccine. Most of the other cases develop in individuals who haven't received vaccines and are in close contact with infected individuals.


The poliovirus (an enterovirus) is found worldwide and is transmitted from person to person by direct contact with infected oropharyngeal secretions or stool.

The virus usually enters the body through the alimentary tract, multiplies in the oropharynx and lower intestinal tract, and then spreads to regional lymph nodes and blood. Factors that increase the probability of paralysis include pregnancy, old age, unusual physical exertion at or just before the clinical onset of poliomyelitis, and localized trauma, such as a recent
tonsillectomy, tooth extraction, or inoculation.

Most major cases in the United States are related to the oral poliovirus vaccine (OPV) and occur in children under age 4. Infection occurs 3 to 6 days after administration of OPV and usually is associated with the first dose of the vaccine.

Signs and symptoms

Infection ranges in severity from an inapparent infection to a paralytic disease which may result in death. Symptoms include fever, malaise, headache, nausea and vomiting, excruciating muscle pain and stiffness in the neck and back.

Diagnostic tests 

In addition to a complete medical history and physical examination, diagnostic procedures for poliomyelitis may include the following:

  • cultures of the throat, urine, and stool
    lumbar puncture (spinal tap) - a special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems. CSF is the fluid that bathes your child's brain and spinal cord.
  • history of the child not receiving the polio vaccine or not completing the series of polio vaccines


Poliomyelitis calls for supportive treatment, including analgesics to ease headache, back pain, and leg spasms. Morphine is contraindicated because of the danger of additional respiratory depression. Moist heat applications also may reduce muscle spasm and pain.

Bed rest is necessary until extreme discomfort subsides. It also helps prevent increased paralysis. Patients with paralytic polio may be bedridden for a longtime and then require long-term rehabilitation using physical therapy, braces, and corrective shoes. Orthopedic surgery also may be necessary.

Bladder involvement may require catheterization, and respiratory muscle involvement may require mechanical ventilation. Postural drainage and suction may be sufficient to manage pooling of secretions in patients with non-paralytic polio.


Polio immunization (vaccine) effectively prevents poliomyelitis in most people (immunization is over 90% effective).

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