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Enterovirus C, formerly known as Poliovirus, is the causative agent of Poliomyelitis, commonly known as Polio. There are three serotypes of this virus-- PV1, PV2, and PV3.

This virus is a non-enveloped icosahedral that is 30 nm in diameter, composed of a protein capsid, and contains a single-stranded RNA genome.

Most human cells present a receptor named CD155 that this specific virus binds to. When the virus binds to this receptor, it is engulfed through endocytosis, and, once inside, it can immediately begin replication due to its positive stranded RNA. This virus lyses its host cell after 4-6 hours releasing between 10,000 and 100,000 viral particles.

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14 seconds · Clipped by Tara DeLong · Original video "Supercomputer Modelling of a Complete Human Viral Pathogen: Poliovirus (Polio virus)" by The University...

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The virus that causes poliomyelitis is spread primarily through the oral-fecal route in infected food and drinks, though it can also be spread through virus-infected droplets when a person sneezes or coughs.

The virus is known to survive in acidic environments, such as that of the stomach, and replicates initially in the intestinal tract before entering the bloodstream. The viruses next paths are still being studied, but research suggests that the viruses makes its way to the muscles via the bloodstream and causes typical flu-like symptoms, and can be transported through retrograde axonal transport to the CNS, where it causes paralysis.

The incubation period for this virus is 3-21 days. Of those infected, approximately 70-75% of hosts will be asymptomatic, while 20-24% will develop fever, headache, sore throat, headaches, and other flu-like symptoms. Approximately 1% of people infected will develop irreversible paralysis, and 2-10% of those infections will result in death due to paralysis of the diaphragm.

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Testing, Treatment, and Post-Polio Syndrome

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Testing, Treatment, and Post-Polio Syndrome

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Poliomyelitis is typically diagnosed through a combination of history of symptoms and testing. The tests available for detection of the virus include throat swabs, feces analysis, and, less commonly, CSF. PCR testing is also available to confirm the genome of the virus and rule out infection from a live vaccine, which can happen in less than 1% of vaccinations.

Unfortunately, there is currently no cure for polio. Treatment consists of symptom management. Pain medication and muscle relaxers are available for muscle pain and muscular spasms, physical therapy is recommended to attempt to retain mobility, and ventilation assistance is available in the event of diaphragm paralysis. During the peak of polio cases, an iron lung was used to assist respirations in affected individuals. Today, patients have the options of portable ventilators or jacket-like positive pressure devices.

25-40% of adults who recovered from polio infections as children will develop noninfectious post-polio syndrome (PPS). This occurs 15-40 years after infection and can cause slow and irreversible weakness in previously infected muscles, as well as chronic muscle and joint pain.

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The first polio vaccine was developed in 1955, utilizing virons that were cultured in the cells of Henrietta Lacks.

Today, there are inactive and live-attenuated vaccines that are strain specific. If vaccination is started in childhood, four doses are recommended. If vaccination begins in adulthood, only three doses are recommended.

The WHO has several programs in place in an attempt to eradicate this disease. As of 2015, PV2 was declared eradicated, and as of 2019, PV3 was declared eradicated.

Unfortunately, due to the limitations caused by the COVID pandemic and the anti-vaccination movement, all three types of this virus have been detected in 28 countries throughout Europe, Africa, and Asia as recently as February of this year.

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In 1938, the National Foundation for Infantile Paralysis was founded by FDR. That foundation later became the March of Dimes.

As recently as 1988, more than 1,000 children each day were paralyzed due to polio. That's over 365,000 children each year!

Poliomyelitis is recognized as far back in human history as 1300 B.C., as evidenced by Egyptian drawings of afflicted individuals.

The word "orthopedic" was adapted during the peak of the polio outbreaks and, when broken down to its roots, loosely translates to "straighten children."

Former President Franklin D. Roosevelt was diagnosed with polio in 1921. However there is speculation that this may have actually been a misdiagnosis of Guillain-Barre Syndrome.

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Zhang, P., Mueller, S., Morais, M. C., Bator, C. M., Bowman, V. D., Hafenstein, S., Wimmer, E., & Rossmann, M. G. (2008). Crystal Structure of CD155 and Electron Microscopic Studies of Its Complexes with Polioviruses. Proceedings of the National Academy of Sciences of the United States of America, 105(47), 18284–18289. http://www.jstor.org/stable/25465453

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Wyatt, H. V. (1993). Poliomyelitis and Infantile Paralysis: Changes in Host and Virus. History and Philosophy of the Life Sciences, 15(3), 357–396. http://www.jstor.org/stable/23331730

LaVail, J. H., & LaVail, M. M. (1972). Retrograde Axonal Transport in the Central Nervous System. Science, 176(4042), 1416–1417. http://www.jstor.org/stable/1734581

Halstead, L. S. (1998). Post-Polio Syndrome. Scientific American, 278(4), 42–47. http://www.jstor.org/stable/26057741

GRIMSHAW, M. L. (1995). Scientific Specialization and the Poliovirus Controversy in the Years before World War II. Bulletin of the History of Medicine, 69(1), 44–65. http://www.jstor.org/stable/44444507