Poliomyelitis and Post Polio Syndrome

Brief History:  Polio has plagued humans since ancient times. The first polio epidemic was in 1887, in Sweden.  In 1952, the polio epidemic peaked, counting nearly 60,000 cases with over 3,000 deaths in the United States (Nemours Foundation, 2000). During the latter part of the twentieth century, polio was practically eliminated from the Western hemisphere.

Definition:  Polio (also called poliomyelitis) is a contagious, potentially deadly disease. In 95% of cases, polio produces no symptoms at all (asymptomatic polio). Polio appears in three forms when the disease is symptomatic. Abortive polio is a mild form in which most people make a full recovery. Nonparalytic polio is more severe and is associated with aseptic meningitis. As with abortive polio, most individuals have a full recovery. The third form, the most severe, is paralytic polio. Paralytic polio is a virus that attacks the nerves that control the muscles of the limbs and the muscles necessary for breathing. This causes muscle paralysis that may result in death.

Transmission:  Polio is transmitted through the fecal-oral route, the oral ingestion of material contaminated with fecal microorganisms (stool). Likelihood of transmission would increase if an individual does not wash hands after using the bathroom and by drinking contaminated water. Infected objects, such as eating utensils, can also spread the virus.

Duration: The mild form of the polio illness usually lasts less than 2 weeks. Some of the people who fully recovered from the disease may eventually develop post-polio syndrome (PPS) 30 to 40 years after contracting polio (Klein, 2000). During the 1952 epidemic, children ages 5 to 9 years contracted polio after their initial immunity was gone.

Prevention:  In the United States, children between the ages of 2 months and 6 years are recommended to have four doses of inactivated polio vaccination (IPV).

The Centers for Disease Control and Prevention (CDC) and American Academy of Pediatrics recommend 3 spaced doses of IPV given to the child before the age of 18 months, and an IPV booster given between the ages of 4 to 6, when children are entering school (Klein, 2000).

Future of Polio:  Between 1988 and 1998, wild-type polio was eliminated from North America, South America, and Europe. Polio still exists in Africa, Asia, and other locations in the world.

Resources

Klein, J. (2000). Infections: Polio. Kids health for parents. [Online]. http://kidshealth.org/parent/infections/bacterial_viral/polio.html

Nemours Foundation, 2000

Infectious Facts

What is post polio syndrome?  Post polio syndrome (PPS) also known as infantile paralysis is a neuromuscular disease.

Cause:  PPS is caused by the death of individual nerves that remain damaged after the initial polio attack.

Symptoms:  Symptoms include fatigue, slowly progressive muscle weakness, muscle and joint pain, and muscular atrophy. The severity of PPS depends upon how seriously the survivors were affected by the first polio attack. Joint pain and increasing skeletal deformities such as scoliosis are common. Some people experience minor symptoms, while others develop spinal muscular atrophy, and rarely a type of Lou Gehrig's disease. PPS is rarely life-threatening.

Prevalence:  Over 300,000 survivors of the polio disease in the United States may be at risk for PPS. It is estimated that the disease affects 25 to 50 percent of the infected living population, or possibly more, depending on how the disorder is defined. No prevention has been found as of yet. It is recommended that polio survivors follow standard healthy lifestyle practices: consuming a well-balanced diet, exercising in moderation, and visiting a doctor regularly.

Exercise Suggestions

Willen and Sunnerhagen (2001), conducted a study on the effects of warm water exercising on people with polio. Fifteen people with polio's late effects worked out in a pool for 40 minutes twice a week for 5 months. At the end of the study, participants reported an increased sense of pain relief and increased physical fitness. Additionally, at the end of the 5-month period, their heart rates during exercise were down. The study's investigators recommend this program of pool exercises in heated water (Roller & Maynard, 2002).

Selected References on Post-Polio

Links

Information Sheet Home

Information on this sheet contains only suggested guidelines. Each person must be considered individually, and in many cases, a physician's written consent should be obtained.

Created by Andrea D. Woodson, 2002.  Texas Woman's University, Ph.D. Student in Adapted Physical Education.