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Poliomyelitis
Poliomyelitis, often called polio or infantile paralysis, is a highly infectious virus which
enters the body through the mouth and then multiplies within the intestine. It invades the
nervous system and can cause paralysis. It mainly affects children under the age of 5.
In which countries have cases of polio been reported?
Polio is currently endemic in 3 countries:
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Afghanistan
Nigeria
Pakistan
In addition, sporadic polio cases have been reported in the following countries since 2012:
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Angola
Cameroon
Chad
Congo
Côte D’Ivoire
Democratic Republic of Congo
Ethiopia
Kenya
Niger
Somalia
Syria
Polio cases are reported in other countries from time to time. Cases may be imported from
endemic countries; border areas are particularly vulnerable. Conflict and civil unrest may
cause the national vaccination programme to be suspended. This causes a rise in
unvaccinated children and adults, making them more susceptible to outbreaks of polio and
other vaccine-preventable diseases.
There has been a great effort to eradicate polio in recent years. It has been eliminated
from the WHO Regions of the Americas, Western Pacific and Europe. There were 223
reported cases of polio globally in 2012, down from an estimated 350,000 in 1998.
The World Health Organisation has estimated that 10 million people are walking today who
would otherwise have been paralysed by polio. The eradication of polio would represent
savings of US$ 4-50 billion over the next 20 years, mainly in low-income countries.
What are the symptoms of polio?
Over 90% of people infected with the polio virus do not have any symptoms, but those that
do may experience the following:
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Fever
Fatigue
Headache
Vomiting & nausea
Flu-like symptoms
Neck & back stiffness
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Pain in the limbs
Irreversible paralysis, most commonly in the legs, in 1 in 200 cases
5-10% of cases who experience paralysis die when their breathing muscles become
paralysed
How might I become infected with polio?
Polio is spread by person-to-person contact and only affects humans. Transmission most
often occurs through contact with faeces from an infected person and less commonly via
cough and sneeze droplets. It can be contracted by eating or drinking contaminated food or
water, swimming in dirty water or by close contact with someone carrying the virus. Polio
can spread rapidly through a community, especially in conditions of poor hygiene and
sanitation.
An infected person may spread the virus to others immediately before and 1-2 weeks after
developing symptoms. As most people who are infected with polio have no symptoms of the
illness, they can “silently” spread the infection to many others before the first case of polio
paralysis emerges.
How is polio treated?
There is no cure for polio. Treatment is supportive to help alleviate the symptoms. Heat
therapy and physiotherapy are used to stimulate the muscles and medication is given to
help relax the muscles and improve mobility.
How can I protect myself from polio?
Basic hygiene precautions can prevent transmission. Ensure you and your family have
received a full course of polio vaccine. This is normally administered as part of each
country’s routine immunisation schedule.
The UK schedule for polio vaccine is detailed below. The number and timings of doses may
vary from country to country:
First dose at 2 months
Second dose at 3 months
Third dose at 4 months
Booster dose at 3 years and 4 months
Booster dose at 14 years of age
Travellers who have not had a dose of polio vaccine in the past 10 years and who are going
to countries where there are reported cases of polio are recommended to have a booster
dose. Previous polio disease does not necessarily protect against another episode of polio.
The risk to those working internationally and their families
Until complete eradication has been achieved worldwide, there remains a risk to travellers
from polio and the possibility that polio virus will re-emerge in countries previously
declared polio-free. The disease can be introduced to polio-free countries by infected
travellers. It is therefore important that adults and children complete their full course of
polio vaccinations as part of their country’s routine immunisation schedule.
If you are travelling to a country where there have been reported cases of polio and have
any doubts about your polio vaccination status, please contact InterHealth for further
advice.
Sources
Centers for Disease Control & Prevention
World Health Organisation
Global Polio Eradication Initiative
National Travel Health Network & Centre
Further advice and information
Further information and updates on polio and updates can be accessed from InterHealth
www.interhealth.org.uk and the following sources:
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World Health Organisation (WHO) www.who.int
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National Travel Health Network & Centre (NaTHNaC) www.nathnac.org
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Centers for Disease Control & Prevention (CDC) www.cdc.gov
InterHealth Authors
Cathy Travis & Daniel Campion
Last updated: December 2013