RETURNS THU JAN 19 8|7c

Polio (Poliomyelitis)

By Meg Marinis, Director of Research | Feb 18th, 2010
In Episode 615, The Time Warp, Dr. Callie Torres lectures on one of her patients from residency, Sunder Atluri. Originally from India, Sunder suffered from polio as a little kid, living his entire life with a club foot and unable to walk. However, that all changed once he checked into Seattle Grace...

Since it's been gone for awhile... Here's a refresher on polio.

Poliomyelitis is a severely infectious disease that resides in humans, caused by a virus (the poliovirus) that invades the nervous system. The virus resides in the feces of infected patients, and the disease can spread through direct person-to-person contact, through infected mucus, or through contaminated food or water. Therefore, the disease flourished in environments with poor sanitation. Interestingly enough, the reason it became so widespread in America during the early-mid 1900's was because the way we dealt with sanitation got so much better. Before, people were exposed to it early in small amounts through the water, so they were able to build up antibodies to form a resistance (the same way vaccines work). With the improvement of sanitation, people no longer formed this resistance and therefore when the virus hit, it hit hard.

The virus invades the nervous system by entering through the mouth and multiplying in the intestines. Then, the body absorbs it through the blood, spreading it to the lymph system.

Why is it gone? Is there a cure?

There is no cure for polio—only prevention. And the most effective way to prevent the disease is through the polio vaccine. Most children in the US receive four doses of inactivated poliovirus (IPV) at the following ages: 2 months, 4 months, between 6 and 18 months, and a "booster" shot between the ages of 4 and 6 years – right when they begin attending school.

Is there more than one kind?

Three different "patterns" exist: subclinical, nonparalytic, and paralytic. And approximately 95% of polio infections fall under the subclinical category, which may never even present with actual symptoms. Or the following symptoms may exist over a period of seventy-two hours: Red throat, vomiting, slight fever, malaise, headache, and sore throat.

However, clinical infections, which include nonparalytic and paralytic, can develop after recovering from a subclinical episode. The nonparalytic form (abortive poliomyelitis) affects the majority of those that suffer from the illness; sometimes these patients never even exhibit symptoms or know they have polio. But when they do develop signs, the illness seems similar to any flu-like virus, lasting from two to ten days, with symptoms such as fever, sore throat, headache, vomiting, fatigue, back/neck pain or stiffness, pain or stiffness in the limbs, muscle spasms or tenderness, and meningitis.

Paralytic polio is the most severe form of the disease, often leading to paralysis of the limbs, sometimes even death. The symptoms advance to loss of reflexes, severe muscle aches or spasms, and loose or floppy limbs (otherwise known as acute flaccid paralysis). And tragically, in some cases, polio can advance to immobilizing one's respiratory system, causing death.

So, what's post-polio syndrome?

Post-Polio Syndrome affects some people who have recovered from polio, usually ranging from thirty to forty years after the initial infection. People with this condition suffer from disabling symptoms such as: muscle atrophy, decreased tolerance to cold temperatures, breathing or swallowing problems, progressive muscle or joint weakness and pain, general fatigue and exhaustion after minimal activity, and sleep-related breathing disorders (sleep apnea).

What's the current state of polio eradication?

The last known case of 'wild' polio in the US occurred in 1979. And since 1988, when the Global Polio Eradication Initiative was launched, cases have decreased by 99%. The initiative began with the support of the WHO, UNICEF, the Rotary International, and the CDC. It maintains three objectives:

- To interrupt transmission of the wild poliovirus
- To achieve certification of global polio eradication
- To contribute to health systems in the development and strengthening of routine immunization.

And in 2008, reports showed that the virus remained endemic in only parts of the following four countries—Pakistan, Nigeria, India, and Afghanistan. However, the WHO recommends that travelers (even if they have been vaccinated as a child) to areas where polio may still be a risk, should receive a single booster shot of IPV for added protection—this added booster shot lasts a lifetime.

To see a list of well-known polio patients, visit:

http://www.disabled-world.com/artman/publish/famous-polio.shtml

For more information, please visit:

http://www.who.int/mediacentre/factsheets/fs114/en/index.html

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