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Centers for Disease Control and Prevention

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Polio, or poliomyelitis, is a disabling and life-threatening disease caused by the poliovirus.

The virus spreads from person to person and can infect a person's spinal cord, causing paralysis (can't move parts of the body).

Symptoms

Most people who get infected with poliovirus will not have any visible symptoms.

About 1 out of 4 people (or 25 out of 100) with poliovirus infection will have flu-like symptoms that can include:

Sore throat

Fever

Tiredness

Nausea

Headache

Stomach pain

These symptoms usually last 2 to 5 days, then go away on their own.

A smaller proportion of people with poliovirus infection will develop other, more serious symptoms that affect the brain and spinal cord:

Meningitis (infection of the covering of the spinal cord and/or brain)occurs in about 1-5 out of 100 people with poliovirus infection, depending on virus type

Paralysis (can't move parts of the body) or weakness in the arms, legs, or both occurs in about 1 out of 200 people to 1 in 2000 people, depending on virus type

Paralysis is the most severe symptom associated with poliovirus because it can lead to permanent disability and death. Between 2 and 10 out of 100 people who have paralysis from poliovirus infection die, because the virus affects the muscles that help them breathe.

Even children who seem to fully recover can develop new muscle pain, weakness, or paralysis as adults, 15 to 40 years later. This is called post-polio syndrome.

Note that "poliomyelitis" (or "polio" for short) is defined as the paralytic disease. So only people with the paralytic infection are considered to have the disease.

Polio has been around since ancient times. This ancient Egyptian tomb painting shows a man with a withered leg unable to bear weight without use of a walking stick. This means that most muscle fibers are replaced with scarring (muscle-wasting) that is permanent.

If someone had polio as a child or young adult but had kept or recovered some or all movement of weakened arms or legs, even to the point of being athletic afterward, they can become weaker in late adulthood. That is post-polio syndrome (PPS), a condition that can affect polio survivors decades after they recover from their initial poliovirus infection. Some PPS patients become wheelchair-bound when they had not been before.

Transmission

Poliovirus is very contagious and spreads through person-to-person contact.

It lives in an infected person's throat and intestines.

It can contaminate food and water in unsanitary conditions.

Poliovirus only infects people. It enters the body through the mouth. It spreads through:

Contact with the feces (poop) of an infected person

Droplets from a sneeze or cough of an infected person (less common)

You can get infected with poliovirus if:

You have picked up minute pieces of feces on your hands, and you touch your mouth.

You put in your mouth objects like toys that are contaminated with feces.

An infected person can spread the virus to others immediately before and up to 2 weeks after symptoms appear.

The virus can live in an infected person's intestines for many weeks. It can contaminate food and water in unsanitary conditions.

People who don't have symptoms can still pass the virus to others and make them sick.

Prevention

There are two types of vaccine that can prevent polio:

Inactivated poliovirus vaccine (IPV) given as an injection in the leg or arm, depending on the patient's age. Only IPV has been used in the United States since 2000.

Oral poliovirus vaccine (OPV) is still used throughout much of the world.

Polio vaccine protects children by preparing their bodies to fight the poliovirus. Almost all children (more than 99 percent) who get all the recommended doses of the inactivated polio vaccine will be protected from polio.

It is also very important to practice good hand hygiene and wash hands often with soap and water. Note that alcohol-based hand sanitizers do not kill poliovirus.

Diagnosis

Healthcare providers who suspect a patient has polio should hospitalize the patient right away, do a physical exam, take detailed medical history, including vaccination history and history of any recent travel, collect samples (stool, throat swab, blood, urine, and spinal fluid), and obtain a magnetic resonance imaging (MRI) to look at pictures of the spinal cord. Poliovirus is most likely to be detected in stool specimens.

Treatment

There is no cure for paralytic polio and no specific treatment.

Physical or occupational therapy can help with arm or leg weakness caused by polio and might improve long-term outcomes, especially if implemented early in the course of illness. Healthcare providers should consider consulting neurology and infectious disease experts to discuss possible treatments and recommend certain interventions on a case-by-case basis.

If you think you or someone in your family has symptoms of polio, please call your healthcare provider right away or go to an emergency room.

Diagnosis, Specimens, & Containment

CDC laboratories conduct testing for poliovirus including culture, PCR, genome sequencing, and serology.

CDC guidance on maintaining the integrity of specimens for collection, storage, and shipment.

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Polio is an infectious disease caused by a virus that can spread from person to person and cause paralysis. CDC is committed to polio eradication and protecting every child from vaccine-preventable diseases.

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Frida Khalo, a renowned artist, had polio and survived. Her right leg would end up being shorter than her left so she always had to wear built up shoes. 

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Another video, a patient who relies on the iron lung even to this day: she has sadly passed.
https://youtu.be/y6ezbEW9QZ4

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National University of Science & Technology, Islamabad, Pakistan.

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Mudassir Khan was one of the researchers/ authors concerning the poliovirus and COVID-19

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Patient in the iron Lund due to breathing difficulties

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Ways to diagnose:
To diagnose an individual suspected of having polio there are a few ways of confirmation.
1.Taking samples of throat secretions
2.Taking a stool sample
3. Taking samples of cerebrospinal fluid

Treatments:
There is no cure of polio, only vaccinations to prevent infection, however for those who do have it, there are ways to comfort the patients.
1. Pain relievers
2. Portable ventilators if patient has difficulty breathing
3. Physical exercise to prevent loss of muscle function and deformity.

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Quick overview from the CDC

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Emerging threats: How COVID-19 impacted the polio vaccine in Pakistan and Afganistan 

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Emerging threats: How COVID-19 impacted the polio vaccine in Pakistan and Afganistan 

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According to the article Impact of COVID-19 on polio vaccination in Pakistan: a concise overview, Pakistan and Afganistan are one of the only countries in the world to have not fully eradicated the wild poliovirus. There are three types of poliovirus and the one most common is wild poliovirus and cDVPDs is becoming increasingly more common due to COVID-19. But why? COVID-19 made the world prioritize it more than any other virus, illness, or vaccine. Pakistan and Afganistan already had a problem with polioviruses and COVID-19 disassembled any more movements to get children vaccinated thus polio infections went up during the COVID 19 pandemic.With that, 40 million children were not vaccinated. COVID-19 decreased polio immunization and increased the infection of the virus.

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Polio is spread through contact with feces or small amounts of feces of an infected person through the mouth. Coughs and sneezes can spread polio but those situations are more rare. Once a person has polio they have flu like symptoms. Within a few days after infections, some patients may experience paralyzation and/ meningitis. Those with more severe cases of polio can die as it causes the loss of the ability to breathe. The chances are between 2-10 people out of 100, for others it’s a life of permanent paralysis. Polio most notably became an increasing problem in the United States in the 1950s. In modern years Polio has been mostly eradicated except in a few countries.

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There is no cure for polio so we can only prevent it. There are two vaccines available.
1. IPV which is an injection in the arm or leg (depends on age). IPV has only been used in the United States.
2. OPV is through the mouth and is used more commonly in other parts of the world

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Symptoms:
* Headaches
* Vomiting
* Sore throat
* Abnormal reflexes
* Stiffness in the neck or back
* Any difficulty swallowing or breathing