Poliomyelitis

A Vaccine Preventable Illness

What is poliomyelitis?

Poliomyelitis is an infection caused by the poliovirus, called polio for short. The poliovirus only infects humans and can be spread through person-to-person contact. If the virus invades a persons spinal cord or brain, paralysis can occur. Polio does not always cripple the host, however, and many people contracted the virus with no permanent damage. The polio vaccine protects against infection by this virus and should be administered four times to children between 2 months and 6 years old.

What Is Polio? (2014, October 15). Retrieved January 17, 2016, from http://www.cdc.gov/polio/about/index.htm

History of Polio

Although the first epidemic in the United States was in June of 1894, poliomyelitis was not determined to be caused by a virus until 1908. Two physicians in Vienna isolated the virus. From the 1940's to the 1950's, 35,000 people were crippled by polio. Two vaccines were developed simultaneously for this disease. Jonas Salk developed the vaccine still used in the U.S. today, called the inactivated poliovrus vaccine (IPV), which contains viruses that have been inactivated, or killed. This is given as a shot. The other type of vaccine, used around the world in preventative efforts, was developed by Albert Sabin. Sabin's vaccine, called the oral poliovirus vaccine (OPV) is given in droplet form and contains an attenuated, or weakened virus. These were both administered widespread in 1955. Both Salk and Sabin did not patent their vaccines and the rights donated. Polio has not been a concern in the U.S. since 1979, thanks to appropriate vaccination efforts by the population.

NMAH | Polio: Two Vaccines. (n.d.). Retrieved January 17, 2016, from http://amhistory.si.edu/polio/virusvaccine/vacraces2.htm

Signs and Symptoms of Polio

The majority of persons infected with poliovirus do not show any symptoms. About 1 in 4 will show flu-like symptoms, such as:
  • Sore throat
  • Fever
  • Tiredness
  • Nausea
  • Headache
  • Stomach pain

These symptoms last 2-5 days and then go away on their own.


When poliovirus affects the brain or spinal cord, the following more serious symptoms occur:

  • Feeling of pins and needles in the legs
  • Meningitis (1 in 25 will experience this infection of the covering of the spinal cord and/or brain)
  • Paralysis (1 in 200 people affected) if paralysis of the muscles that allow a person to breathe occurs, death will follow

http://www.cdc.gov/polio/about/index.htm

Transmission of Polio

The poliovirus resides in the throat and intestines of its host (the infected person) and can be spread via coughing or sneezing as well as the feces (poop) of the host. Fecal contamination is much more common than transmission via droplets from sneezing or coughing. Items that can carry pathogens, called fomites, can also pass the infection along. Toys that touch infected feces, or unsanitary conditions that allow feces to stay in the open, then come in contact with the mouth cause infection by the poliovirus. The virus can be spread by a person with no symptoms, as well as 1 to 2 weeks after symptoms appear. It can survive in an infected persons feces for several weeks.

Our Progress Against Polio. (2014, May 1). Retrieved January 16, 2016, from http://www.cdc.gov/polio/progress/index.htm

Complications of Polio

The poliovirus does not always cause paralysis. When it does, it can be temporary or permanent, and it affects the hips, ankles, and feet. Physical therapy and surgery can help alleviate or correct some of the deformities, but in developing countries that contract polio more commonly, this is not a viable treatment option. If paralysis of the diaphragm or intercostal muscles occurs (muscles that perform breathing actions) then death will occur.


Post-polio syndrome can occur in those originally infected with poliovirus, with paralysis and muscle weakness up to 40 years after the initial infection.

Polio. (2014, March 11). Retrieved January 17, 2016, from http://www.mayoclinic.org/diseases-conditions/polio/basics/complications/con-20030957

Control Measures for Polio

Poliovirus can be prevented using both IPV (used exclusively in the United States) and OPV (used globally) methods.
About 99 out of 100 children who get the four recommended doses of the vaccine are protected from polio.
The Unites States has been polio free for over 30 years, but poliovirus is still seen globally.
Around the world, efforts are being made to eradicate polio. In 1988, some 350,000 cases of infection by polio were seen, down to 402 in 2013. That is a 99% decrease!

Should polio vaccines be mandatory?

In the case of poliovirus, which can cause death or permanent disability, I believe vaccines should be mandatory if the child plans on interacting with other children. While I understand the constitutional rights of individuals, this disease has not been seen in the United States for 30 years. This is overwhelming evidence for a mandatory vaccination for those children who might be able to pass along this illness. There have also been no contraindications with current polio vaccines, both IPV and OPV types.