What is polio?
Polio (also known as poliomyelitis) is a highly contagious disease caused by a virus that attacks the nervous system. Children younger than 5 years old are more likely to contract the virus than any other group.
According to the World Health Organization (WHO), 1 in 200 polio infections will result in permanent paralysis. However, thanks to the global polio eradication initiative in 1988, the following regions are now certified polio-free:
- Americas
- Europe
- Western Pacific
- Southeast Asia
The polio vaccine was developed in 1953 and made available in 1957. Since then cases of polio have dropped in United States. But polio is still persistent in Afghanistan, Pakistan, and Nigeria. Eliminating polio will benefit the world in terms of health and economy. The eradication of polio can save at least $40–50 billion over the next 20 years.
Abstract
Vaccination prepares the body’s immune system ready to recognise, destroy and remember foreign disease-causing agents when it encounters them. It is the most effective way of averting communicable diseases if fully accepted and demanded by the population at risk of spreading contagious diseases. Social mobilisation has been a critical way of encouraging demands, as well as acceptance and compliance, by the general public for immunisation services. Vaccination campaign against poliovirus by WHO since 1988 was a huge success across the globe except in three countries: Nigeria, Afghanistan and Pakistan. Up until 3 years ago, polio eradication remained a challenge in Nigeria due mainly to non-acceptance of the vaccination by the hard-to-reach (HtoR) group. In this study, carried out at the height of the epidemic in Nigeria, we investigated the effects that social mobilisation on polio vaccination had on the hard-to-reach group. The participants were selected based on three criteria: age of the child, religion and social status. Semi-structured interview was employed and data analysed using the thematic content analysis. The results revealed that religion, service factor-distance to health facility and health staff behaviour are the key factors limiting the social mobilisation effort among the HtoR group. Nigeria began to make success only when one of the most respected Muslim leaders took ownership of the campaign for the elimination of polio, which has now placed Nigeria among the polio-free countries. Therefore, effective social mobilisation for vaccination programs of the HtoR group could be achieved faster with the involvement of religious leaders because of the enormous influence they have on their followers. This revelation is very important to note for the success of the upcoming vaccination campaign against COVID-19 disease, now that effective vaccines against the disease have been developed and ready for distribution.
It’s estimated that 95 to 99 percent of people who contract poliovirus are asymptomatic. This is known as subclinical polio. Even without symptoms, people infected with poliovirus can still spread the virus and cause infection in others.
Non-paralytic polio
Signs and symptoms of non-paralytic polio can last from one to 10 days. These signs and symptoms can be flu-like and can include:
Non-paralytic polio is also known as abortive polio.
Paralytic polio
About 1 percent of polio cases can develop into paralytic polio. Paralytic polio leads to paralysis in the spinal cord (spinal polio), brainstem (bulbar polio), or both (bulbospinal polio).
Initial symptoms are similar to non-paralytic polio. But after a week, more severe symptoms will appear. These symptoms include:
- loss of reflexes
- severe spasms and muscle pain
- loose and floppy limbs, sometimes on just one side of the body
- sudden paralysis, temporary or permanent
- deformed limbs, especially the hips, ankles, and feet
It’s rare for full paralysis to develop. Less than 1 percentTrusted Source of all polio cases will result in permanent paralysis. In 5–10 percent of the polio paralysis cases, the virus will attack the muscles that help you breathe and cause death.
Post-polio syndrome
It’s possible for polio to return even after you’ve recovered. This can occur after 15 to 40 years. Common symptoms of post-polio syndrome (PPS) are:
- continuing muscle and joint weakness
- muscle pain that gets worse
- becoming easily exhausted or fatigued
- muscle wasting, also called muscle atrophy
- trouble breathing and swallowing
- sleep apnea, or sleep-related breathing problems
- low tolerance of cold temperatures
- new onset of weakness in previously uninvolved muscles
- depression
- trouble with concentration and memory
Talk to your doctor if you’ve had polio and are starting to see these symptoms. It’s estimated that 25 to 50 percentTrusted Source of people who survived polio will get PPS. PPS can’t be caught by others having this disorder. Treatment involves management strategies to improve your quality of life and reduce pain or fatigue.
As a highly contagious virus, polio transmits through contact with infected feces. Objects like toys that have come near infected feces can also transmit the virus. Sometimes it can transmit through a sneeze or a cough, as the virus lives in the throat and intestines. This is less common.
People living in areas with limited access to running water or flush toilets often contract polio from drinking water contaminated by infected human waste. According to the Mayo Clinic, the virus is so contagious that anyone living with someone who has the virus can catch it too.
Pregnant women, people with weakened immune systems — such as those who are HIV-positive — and young children are the most susceptible to the poliovirus.
If you have not been vaccinated, you can increase your risk of contracting polio when you:
- travel to an area that has had a recent polio outbreak
- take care of or live with someone infected with polio
- handle a laboratory specimen of the virus
- have your tonsils removed
- have extreme stress or strenuous activity after exposure to the virus.
Your doctor will diagnose polio by looking at your symptoms. They’ll perform a physical examination and look for impaired reflexes, back and neck stiffness, or difficulty lifting your head while lying flat.
Labs will also test a sample of your throat, stool, or cerebrospinal fluid for the poliovirus.
Doctors can only treat the symptoms while the infection runs its course. But since there’s no cure, the best way to treat polio is to prevent it with vaccinations.
The most common supportive treatments include:
- bed rest
- painkillers
- antispasmodic drugs to relax muscles
- antibiotics for urinary tract infections
- portable ventilators to help with breathing
- physical therapy or corrective braces to help with walking
- heating pads or warm towels to ease muscle aches and spasms
- physical therapy to treat pain in the affected muscles
- physical therapy to address breathing and pulmonary problems
- pulmonary rehabilitation to increase lung endurance
In advanced cases of leg weakness, you may need a wheelchair or other mobility device.
Keywords: Poliovirus, COVID-19, vaccination, social mobilisation, hard-to-reach population.