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Poliomielitis atau polio, adalah penyakit paralisis atau lumpuh yang disebabkan oleh virus.

Agen pembawa penyakit ini, sebuah virus yang dinamakan poliovirus (PV), masuk ke tubuh melalui mulut, mengifeksi saluran usus. Virus ini dapat memasuki aliran darah dan mengalir ke sistem saraf pusat menyebabkan melemahnya otot dan kadang kelumpuhan (paralisis).

Daftar isi
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1 Etimologi 2 Sejarah 3 Virus polio 4 Jenis Polio o 4.1 Polio non-paralisis o 4.2 Polio paralisis spinal o 4.3 Polio bulbar 5 Anak-anak dan polio 6 Vaksin efektif pertama 7 Usaha pemberantasan polio 8 Pranala luar

[sunting] Etimologi
Kata polio berasal dari [bahasa Yunani] atau bentuknya yang lebih mutakhir, dari "abu-abu" dan "bercak".

[sunting] Sejarah
Polio sudah dikenal sejak zaman pra-sejarah. Lukisan dinding di kuil-kuil Mesir kuno menggambarkan orang-orang sehat dengan kaki layu yang berjalan dengan tongkat. Kaisar Romawi Claudius terserang polio ketika masih kanak-kanak dan menjadi pincang seumur hidupnya. Virus polio menyerang tanpa peringatan, merusak sistem saraf menimbulkan kelumpuhan permanen, biasanya pada kaki. Sejumlah besar penderita meninggal karena tidak dapat menggerakkan otot pernapasan. Ketika polio menyerang Amerika selama dasawarsa seusai Perang Dunia II, penyakit itu disebut ‗momok semua orang tua‘, karena menjangkiti anak-anak terutama yang berumur di bawah lima tahun. Di sana para orang tua tidak membiarkan anak mereka keluar rumah, gedung-gedung bioskop dikunci, kolam renang, sekolah dan bahkan gereja tutup.

[sunting] Virus polio

Poliovirus adalah virus RNA kecil yang terdiri atas tiga strain berbeda dan amat menular. Virus akan menyerang sistem saraf dan kelumpuhan dapat terjadi dalam hitungan jam. Polio menyerang tanpa mengenal usia, lima puluh persen kasus terjadi pada anak berusia antara 3 hingga 5 tahun. Masa inkubasi polio dari gejala pertama berkisar dari 3 hingga 35 hari. Polio adalah penyakit menular yang dikategorikan sebagai penyakit peradaban. Polio menular melalui kontak antarmanusia. Polio dapat menyebar luas diam-diam karena sebagian besar penderita yang terinfeksi poliovirus tidak memiliki gejala sehingga tidak tahu kalau mereka sendiri sedang terjangkit. Virus masuk ke dalam tubuh melalui mulut ketika seseorang memakan makanan atau minuman yang terkontaminasi feses. Setelah seseorang terkena infeksi, virus akan keluar melalui feses selama beberapa minggu dan saat itulah dapat terjadi penularan virus.

[sunting] Jenis Polio
[sunting] Polio non-paralisis
Polio non-paralisis menyebabkan demam, muntah, sakit perut, lesu, dan sensitif. Terjadi kram otot pada leher dan punggung, otot terasa lembek jika disentuh.

[sunting] Polio paralisis spinal
Strain poliovirus ini menyerang saraf tulang belakang, menghancurkan sel tanduk anterior yang mengontrol pergerakan pada batang tubuh dan otot tungkai. Meskipun strain ini dapat menyebabkan kelumpuhan permanen, kurang dari satu penderita dari 200 penderita akan mengalami kelumpuhan. Kelumpuhan paling sering ditemukan terjadi pada kaki. Setelah virus polio menyerang usus, virus ini akan diserap oleh pembulu darah kapiler pada dinding usus dan diangkut seluruh tubuh. Virus Polio menyerang saraf tulang belakang dan syaraf motorik -- yang mengontrol gerakan fisik. Pada periode inilah muncul gejala seperti flu. Namun, pada penderita yang tidak memiliki kekebalan atau belum divaksinasi, virus ini biasanya akan menyerang seluruh bagian batang saraf tulang belakang dan batang otak. Infeksi ini akan memengaruhi sistem saraf pusat -- menyebar sepanjang serabut saraf. Seiring dengan berkembang biaknya virus dalam sistem saraf pusat, virus akan menghancurkan syaraf motorik. Syaraf motorik tidak memiliki kemampuan regenerasi dan otot yang berhubungan dengannya tidak akan bereaksi terhadap perintah dari sistem saraf pusat. Kelumpuhan pada kaki menyebabkan tungkai menjadi lemas -- kondisi ini disebut acute flaccid paralysis (AFP). Infeksi parah pada sistem saraf pusat dapat menyebabkan kelumpuhan pada batang tubuh dan otot pada toraks (dada) dan abdomen (perut), disebut quadriplegia.

[sunting] Polio bulbar
Polio jenis ini disebabkan oleh tidak adanya kekebalan alami sehingga batang otak ikut terserang. Batang otak mengandung syaraf motorik yang mengatur pernapasan dan saraf kranial, yang mengirim sinyal ke berbagai syaraf yang mengontrol pergerakan bola mata; saraf trigeminal dan saraf muka yang berhubungan dengan pipi, kelenjar air mata, gusi, dan otot muka; saraf auditori yang mengatur pendengaran; saraf glossofaringeal yang membantu proses menelan

dan berbagai fungsi di kerongkongan; pergerakan lidah dan rasa; dan saraf yang mengirim sinyal ke jantung, usus, paru-paru, dan saraf tambahan yang mengatur pergerakan leher. Tanpa alat bantu pernapasan, polio bulbar dapat menyebabkan kematian. Lima hingga sepuluh persen penderita yang menderita polio bulbar akan meninggal ketika otot pernapasan mereka tidak dapat bekerja. Kematian biasanya terjadi setelah terjadi kerusakan pada saraf kranial yang bertugas mengirim 'perintah bernapas' ke paru-paru. Penderita juga dapat meninggal karena kerusakan pada fungsi penelanan; korban dapat 'tenggelam' dalam sekresinya sendiri kecuali dilakukan penyedotan atau diberi perlakuan trakeostomi untuk menyedot cairan yang disekresikan sebelum masuk ke dalam paru-paru. Namun trakesotomi juga sulit dilakukan apabila penderita telah menggunakan 'paru-paru besi' (iron lung). Alat ini membantu paru-paru yang lemah dengan cara menambah dan mengurangi tekanan udara di dalam tabung. Kalau tekanan udara ditambah, paru-paru akan mengempis, kalau tekanan udara dikurangi, paru-paru akan mengembang. Dengan demikian udara terpompa keluar masuk paru-paru. Infeksi yang jauh lebih parah pada otak dapat menyebabkan koma dan kematian. Tingkat kematian karena polio bulbar berkisar 25-75% tergantung usia penderita. Hingga saat ini, mereka yang bertahan hidup dari polio jenis ini harus hidup dengan paru-paru besi atau alat bantu pernapasan. Polio bulbar dan spinal sering menyerang bersamaan dan merupakan sub kelas dari polio paralisis. Polio paralisis tidak bersifat permanen. Penderita yang sembuh dapat memiliki fungsi tubuh yang mendekati normal.

[sunting] Anak-anak dan polio
Anak-anak kecil yang terkena polio seringkali hanya mengalami gejala ringan dan menjadi kebal terhadap polio. Karenanya, penduduk di daerah yang memiliki sanitasi baik justru menjadi lebih rentan terhadap polio karena tidak menderita polio ketika masih kecil. Vaksinasi pada saat balita akan sangat membantu pencegahan polio pada masa depan karena polio menjadi lebih berbahaya jika diderita oleh orang dewasa. Orang yang telah menderita polio bukan tidak mungkin akan mengalami gejala tambahan pada masa depan seperti layu otot; gejala ini disebut sindrom postpolio.

[sunting] Vaksin efektif pertama
Vaksin efektif pertama dikembangkan oleh Jonas Salk. Salk menolak untuk mematenkan vaksin ini karena menurutnya vaksin ini milik semua orang seperti halnya sinar matahari. Namun vaksin yang digunakan untuk inokulasi masal adalah vaksin yang dikembangkan oleh Albert Sabin. Inokulasi pencegahan polio anak untuk pertama kalinya diselenggarakan di Pittsburgh, Pennsylvania pada 23 Februari 1954. Polio hilang di Amerika pada tahun 1979.

[sunting] Usaha pemberantasan polio
Pada tahun 1938, Presiden Roosevelt mendirikan Yayasan Nasional Bagi Kelumpuhan AnakAnak, yang bertujuan menemukan pencegah polio, dan merawat mereka yang sudah terjangkit. Yayasan itu membentuk March of Dimes. Ibu-ibu melakukan kunjungan dari rumah ke rumah,

anak-anak membantu melakukan sesuatu untuk orang lain, bioskop memasang iklan, semuanya bertujuan minta bantuan satu dime, atau sepuluh sen. Dana yang masuk waktu itu digunakan untuk membiayai penelitian Dokter Jonas Salk yang menghasilkan vaksin efektif pertama. Tahun 1952, di Amerika terdapat 58 ribu kasus polio. Tahun 1955 vaksin Salk mulai digunakan. Tahun 1963, setelah puluhan juta anak divaksin, di Amerika hanya ada 396 kasus polio. Pada tahun 1955, Presiden Dwight Eisenhower mengumumkan bahwa Amerika akan mengajarkan kepada negara-negara lain cara membuat vaksin polio. Informasi ini diberikan secara gratis, kepada 75 negara, termasuk Uni Soviet. Tahun 1988, Organisasi Kesehatan Dunia atau WHO mensahkan resolusi untuk menghapus polio sebelum tahun 2000. Pada saat itu masih terdapat sekitar 350 ribu kasus polio di seluruh dunia. Meskipun pada tahun 2000, polio belum terbasmi, tetapi jumlah kasusnya telah berkurang hingga di bawah 500. Polio tidak ada lagi di Asia Timur, Amerika Latin, Timur Tengah atau Eropa, tetapi masih terdapat di Nigeria, dan sejumlah kecil di India dan Pakistan. India telah melakukan usaha pemberantasan polio yang cukup sukses. Sedangkan di Nigeria, penyakit ini masih terus berjangkit karena pemerintah yang berkuasa mencurigai vaksin polio yang diberikan dapat mengurangi fertilitas dan menyebarkan HIV. Tahun 2004, pemerintah Nigeria meminta WHO untuk melakukan vaksinasi lagi setelah penyakit polio kembali menyebar ke seluruh Nigeria dan 10 negara tetangganya. Konflik internal dan perang saudara di Sudan dan Pantai Gading juga mempersulit pemberian vaksin polio. Meskipun banyak usaha telah dilakukan, pada tahun 2004 angka infeksi polio meningkat menjadi 1.185 di 17 negara dari 784 di 15 negara pada tahun 2003. Sebagian penderita berada di Asia dan 1.037 ada di Afrika. Nigeria memiliki 763 penderita, India 129, dan Sudan 112. Pada 5 Mei 2005, dilaporkan terjadi ledakan infeksi polio di Sukabumi akibat strain virus yang menyebabkan wabah di Nigeria. Virus ini diperkirakan terbawa dari Nigeria ke Arab dan sampai ke Indonesia melalui tenaga kerja Indonesia yang bekerja di Arab atau orang yang bepergian ke Arab untuk haji atau hal lainnya.

[sunting] Pranala luar
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(Indonesia) Infografis TEMPO tentang polio (bagian 1) (Indonesia) Infografis TEMPO tentang polio (bagian 2)

Etimologi
Kata polio berasal dari [bahasa Yunani] atau bentuknya yang lebih mutakhir, dari "abu-abu" dan "bercak".

[sunting] Sejarah
Polio sudah dikenal sejak zaman pra-sejarah. Lukisan dinding di kuil-kuil Mesir kuno menggambarkan orang-orang sehat dengan kaki layu yang berjalan dengan tongkat. Kaisar

kolam renang. Seiring dengan berkembang biaknya virus dalam sistem saraf pusat. Infeksi ini akan memengaruhi sistem saraf pusat -. Meskipun strain ini dapat menyebabkan kelumpuhan permanen. Kelumpuhan paling sering ditemukan terjadi pada kaki. Virus masuk ke dalam tubuh melalui mulut ketika seseorang memakan makanan atau minuman yang terkontaminasi feses. muntah.menyebar sepanjang serabut saraf.Romawi Claudius terserang polio ketika masih kanak-kanak dan menjadi pincang seumur hidupnya. virus ini biasanya akan menyerang seluruh bagian batang saraf tulang belakang dan batang otak. biasanya pada kaki. Virus akan menyerang sistem saraf dan kelumpuhan dapat terjadi dalam hitungan jam. Polio dapat menyebar luas diam-diam karena sebagian besar penderita yang terinfeksi poliovirus tidak memiliki gejala sehingga tidak tahu kalau mereka sendiri sedang terjangkit. sekolah dan bahkan gereja tutup. otot terasa lembek jika disentuh. lesu. Sejumlah besar penderita meninggal karena tidak dapat menggerakkan otot pernapasan. lima puluh persen kasus terjadi pada anak berusia antara 3 hingga 5 tahun. [sunting] Virus polio Poliovirus adalah virus RNA kecil yang terdiri atas tiga strain berbeda dan amat menular. Terjadi kram otot pada leher dan punggung. virus akan menghancurkan syaraf motorik. [sunting] Polio paralisis spinal Strain poliovirus ini menyerang saraf tulang belakang. Pada periode inilah muncul gejala seperti flu. Polio adalah penyakit menular yang dikategorikan sebagai penyakit peradaban. menghancurkan sel tanduk anterior yang mengontrol pergerakan pada batang tubuh dan otot tungkai. Masa inkubasi polio dari gejala pertama berkisar dari 3 hingga 35 hari. sakit perut. Virus Polio menyerang saraf tulang belakang dan syaraf motorik -. gedung-gedung bioskop dikunci. karena menjangkiti anak-anak terutama yang berumur di bawah lima tahun. Ketika polio menyerang Amerika selama dasawarsa seusai Perang Dunia II. Namun. kurang dari satu penderita dari 200 penderita akan mengalami kelumpuhan. Polio menular melalui kontak antarmanusia. Di sana para orang tua tidak membiarkan anak mereka keluar rumah. virus ini akan diserap oleh pembulu darah kapiler pada dinding usus dan diangkut seluruh tubuh. Virus polio menyerang tanpa peringatan.yang mengontrol gerakan fisik. penyakit itu disebut ‗momok semua orang tua‘. Syaraf motorik tidak . pada penderita yang tidak memiliki kekebalan atau belum divaksinasi. [sunting] Jenis Polio [sunting] Polio non-paralisis Polio non-paralisis menyebabkan demam. dan sensitif. virus akan keluar melalui feses selama beberapa minggu dan saat itulah dapat terjadi penularan virus. Setelah virus polio menyerang usus. merusak sistem saraf menimbulkan kelumpuhan permanen. Polio menyerang tanpa mengenal usia. Setelah seseorang terkena infeksi.

Infeksi parah pada sistem saraf pusat dapat menyebabkan kelumpuhan pada batang tubuh dan otot pada toraks (dada) dan abdomen (perut). Dengan demikian udara terpompa keluar masuk paru-paru. saraf auditori yang mengatur pendengaran. mereka yang bertahan hidup dari polio jenis ini harus hidup dengan paru-paru besi atau alat bantu pernapasan. dan otot muka. kalau tekanan udara dikurangi. paru-paru akan mengempis. penduduk di daerah yang memiliki sanitasi baik justru menjadi lebih rentan terhadap polio karena tidak menderita polio ketika masih kecil. Kematian biasanya terjadi setelah terjadi kerusakan pada saraf kranial yang bertugas mengirim 'perintah bernapas' ke paru-paru.memiliki kemampuan regenerasi dan otot yang berhubungan dengannya tidak akan bereaksi terhadap perintah dari sistem saraf pusat. Infeksi yang jauh lebih parah pada otak dapat menyebabkan koma dan kematian. pergerakan lidah dan rasa. Vaksinasi pada saat balita akan sangat membantu pencegahan polio pada masa depan karena polio menjadi lebih berbahaya jika diderita oleh orang dewasa. kelenjar air mata. paru-paru akan mengembang. Batang otak mengandung syaraf motorik yang mengatur pernapasan dan saraf kranial. gusi. gejala ini disebut sindrom postpolio. Polio bulbar dan spinal sering menyerang bersamaan dan merupakan sub kelas dari polio paralisis. Alat ini membantu paru-paru yang lemah dengan cara menambah dan mengurangi tekanan udara di dalam tabung. Hingga saat ini. . saraf trigeminal dan saraf muka yang berhubungan dengan pipi. dan saraf yang mengirim sinyal ke jantung. [sunting] Anak-anak dan polio Anak-anak kecil yang terkena polio seringkali hanya mengalami gejala ringan dan menjadi kebal terhadap polio. yang mengirim sinyal ke berbagai syaraf yang mengontrol pergerakan bola mata. Namun trakesotomi juga sulit dilakukan apabila penderita telah menggunakan 'paru-paru besi' (iron lung). Tanpa alat bantu pernapasan. paru-paru. Kelumpuhan pada kaki menyebabkan tungkai menjadi lemas -. Orang yang telah menderita polio bukan tidak mungkin akan mengalami gejala tambahan pada masa depan seperti layu otot. saraf glossofaringeal yang membantu proses menelan dan berbagai fungsi di kerongkongan. Penderita yang sembuh dapat memiliki fungsi tubuh yang mendekati normal. dan saraf tambahan yang mengatur pergerakan leher. Penderita juga dapat meninggal karena kerusakan pada fungsi penelanan. Karenanya. polio bulbar dapat menyebabkan kematian. korban dapat 'tenggelam' dalam sekresinya sendiri kecuali dilakukan penyedotan atau diberi perlakuan trakeostomi untuk menyedot cairan yang disekresikan sebelum masuk ke dalam paru-paru.kondisi ini disebut acute flaccid paralysis (AFP). [sunting] Polio bulbar Polio jenis ini disebabkan oleh tidak adanya kekebalan alami sehingga batang otak ikut terserang. Lima hingga sepuluh persen penderita yang menderita polio bulbar akan meninggal ketika otot pernapasan mereka tidak dapat bekerja. Kalau tekanan udara ditambah. Polio paralisis tidak bersifat permanen. usus. disebut quadriplegia. Tingkat kematian karena polio bulbar berkisar 25-75% tergantung usia penderita.

semuanya bertujuan minta bantuan satu dime. Pennsylvania pada 23 Februari 1954. India 129. di Amerika terdapat 58 ribu kasus polio. dan sejumlah kecil di India dan Pakistan. yang bertujuan menemukan pencegah polio. Tahun 2004. termasuk Uni Soviet. Polio tidak ada lagi di Asia Timur. Yayasan itu membentuk March of Dimes. Sebagian penderita berada di Asia dan 1. kepada 75 negara. Meskipun pada tahun 2000. atau sepuluh sen. Timur Tengah atau Eropa. Tahun 1952. Salk menolak untuk mematenkan vaksin ini karena menurutnya vaksin ini milik semua orang seperti halnya sinar matahari. Tahun 1963. Nigeria memiliki 763 penderita. Polio hilang di Amerika pada tahun 1979. setelah puluhan juta anak divaksin.[sunting] Vaksin efektif pertama Vaksin efektif pertama dikembangkan oleh Jonas Salk. Sedangkan di Nigeria. Pada 5 Mei 2005.185 di 17 negara dari 784 di 15 negara pada tahun 2003. anak-anak membantu melakukan sesuatu untuk orang lain. Presiden Roosevelt mendirikan Yayasan Nasional Bagi Kelumpuhan AnakAnak. dan merawat mereka yang sudah terjangkit. Informasi ini diberikan secara gratis. Dana yang masuk waktu itu digunakan untuk membiayai penelitian Dokter Jonas Salk yang menghasilkan vaksin efektif pertama. tetapi masih terdapat di Nigeria. Ibu-ibu melakukan kunjungan dari rumah ke rumah. Tahun 1955 vaksin Salk mulai digunakan. Amerika Latin. di Amerika hanya ada 396 kasus polio. bioskop memasang iklan. tetapi jumlah kasusnya telah berkurang hingga di bawah 500. Inokulasi pencegahan polio anak untuk pertama kalinya diselenggarakan di Pittsburgh. Konflik internal dan perang saudara di Sudan dan Pantai Gading juga mempersulit pemberian vaksin polio.037 ada di Afrika. pada tahun 2004 angka infeksi polio meningkat menjadi 1. Meskipun banyak usaha telah dilakukan. Organisasi Kesehatan Dunia atau WHO mensahkan resolusi untuk menghapus polio sebelum tahun 2000. Pada tahun 1955. pemerintah Nigeria meminta WHO untuk melakukan vaksinasi lagi setelah penyakit polio kembali menyebar ke seluruh Nigeria dan 10 negara tetangganya. polio belum terbasmi. . dilaporkan terjadi ledakan infeksi polio di Sukabumi akibat strain virus yang menyebabkan wabah di Nigeria. India telah melakukan usaha pemberantasan polio yang cukup sukses. Pada saat itu masih terdapat sekitar 350 ribu kasus polio di seluruh dunia. dan Sudan 112. Namun vaksin yang digunakan untuk inokulasi masal adalah vaksin yang dikembangkan oleh Albert Sabin. Virus ini diperkirakan terbawa dari Nigeria ke Arab dan sampai ke Indonesia melalui tenaga kerja Indonesia yang bekerja di Arab atau orang yang bepergian ke Arab untuk haji atau hal lainnya. Presiden Dwight Eisenhower mengumumkan bahwa Amerika akan mengajarkan kepada negara-negara lain cara membuat vaksin polio. Tahun 1988. penyakit ini masih terus berjangkit karena pemerintah yang berkuasa mencurigai vaksin polio yang diberikan dapat mengurangi fertilitas dan menyebarkan HIV. [sunting] Usaha pemberantasan polio Pada tahun 1938.

Poliomyelitis From Wikipedia. a condition of the hair being or becoming white or grey. search "Polio" redirects here. Not to be confused with poliosis. For the virus. 138 10209 001402 ped/1843 pmr/6 . B91 045. Poliomyelitis Classification and external resources A man with an atrophied right leg due to poliomyelitis ICD-10 ICD-9 DiseasesDB MedlinePlus eMedicine A80. see Poliovirus. the free encyclopedia Jump to: navigation.

was identified in 1908 by Karl Landsteiner. primarily via the fecal-oral route. Bulbar polio leads to weakness of muscles innervated by cranial nerves. much of the world experienced a dramatic increase in polio cases and epidemics became regular events.[5] Although major polio epidemics were unknown before the late 19th century.182. leading to muscle weakness and acute flaccid paralysis.[7] Enhanced vaccination efforts led by the World Health Organization. the disease has caused paralysis and death for much of human history. the virus enters the central nervous system. when major epidemics began to occur in Europe. and the suffix -itis. often called polio or infantile paralysis.[3] In about 1% of cases. and Rotary International could result in global eradication of the disease.[8][9] Contents [hide]       1 Classification 2 Cause 3 Transmission 4 Pathophysiology o 4.MeSH C02. meaning "grey".600. Polio epidemics have crippled thousands of people.700 Poliomyelitis (pōlee ō mī ə lītiss). mostly young children. polio vaccines are credited with reducing the global number of polio cases per year from many hundreds of thousands to around a thousand. affected individuals can exhibit a range of symptoms if the virus enters the blood stream. Developed in the 1950s. myelós (µυελός).[1] The term derives from the Greek poliós (πολιός).[6] By 1910. infectious disease spread from person to person. characterized by asymmetric paralysis that most often involves the legs. poliovirus.[2] Although approximately 90% of polio infections cause no symptoms at all.[5] Its causative agent. which denotes inflammation. polio was one of the most dreaded childhood diseases of the 20th century. referring to the "spinal cord". is an acute. viral.1 Paralytic polio 5 Diagnosis 6 Prevention o 6. soon after. primarily in cities during the summer months. depending on the nerves involved. preferentially infecting and destroying motor neurons. Polio had existed for thousands of years quietly as an endemic pathogen until the 1880s. UNICEF. widespread epidemics appeared in the United States. Bulbospinal polio is a combination of bulbar and spinal paralysis. Spinal polio is the most common form. Different types of paralysis may occur.1 Passive immunization .[4] Poliomyelitis was first recognized as a distinct condition by Jakob Heine in 1840. These epidemics—which left thousands of children and adults paralyzed—provided the impetus for a "Great Race" towards the development of a vaccine.

sometimes called abortive poliomyelitis. the infection produces minor symptoms. which may be paralytic or nonparalytic.        o 6. gastrointestinal disturbances (nausea. Two basic patterns of polio infection are described: a minor illness which does not involve the central nervous system (CNS). a poliovirus infection is asymptomatic. Rarely.[10] In most people with a normal immune system. diarrhea).2 Complications o 8.5% 79% of paralytic cases 19% of paralytic cases 2% of paralytic cases The term "poliomyelitis" is used to identify the disease caused by any of the three serotypes of poliovirus.1–0. and a major illness involving the CNS.2 Vaccine 7 Treatment 8 Prognosis o 8. vomiting. and influenza-like illness. these may include upper respiratory tract infection (sore throat and fever). constipation or.3 Post-polio syndrome 9 Eradication 10 History 11 See also 12 Notes and references 13 Further reading 14 External links [edit] Classification Outcomes of poliovirus infection Outcome Asymptomatic Minor illness Nonparalytic aseptic meningitis Paralytic poliomyelitis — Spinal polio — Bulbospinal polio — Bulbar polio Proportion of cases[4] 90–95% 4–8% 1–2% 0.1 Recovery o 8.[4] . abdominal pain. rarely.

and the one most closely associated with paralysis.[15] .[3] PV1 is the most commonly encountered form. with a more common span of six to 20 days. fever. and type 3 (PV3)—each with a slightly different capsid protein. seizures and spastic paralysis. The incubation time (to the first signs and symptoms) ranges from three to 35 days. bulbar.[2][11] About one to five in 1000 cases progress to paralytic disease. can occur in rare cases. Three serotypes of poliovirus have been identified—poliovirus type 1 (PV1). abdominal and extremity pain. composed of a single (+) sense RNA genome enclosed in a protein shell called a capsid. in which the muscles become weak. This group of RNA viruses colonize the gastrointestinal tract[1] — specifically the oropharynx and the intestine.[3] Its structure is very simple. or bulbospinal. neck. Most patients with CNS involvement develop nonparalytic aseptic meningitis. vomiting. this condition is known as acute flaccid paralysis. with symptoms of headache. headaches. and is usually restricted to infants.[14] All three are extremely virulent and produce the same disease symptoms. Encephalitis. changes in mental status. back. an infection of the brain tissue itself.The virus enters the central nervous system in about 3% of infections.[4] PV infects and causes disease in humans alone.[12] Depending on the site of paralysis. fever. and less commonly. and finally completely paralyzed.[3] In addition to protecting the virus‘s genetic material. floppy and poorly controlled. the capsid proteins enable poliovirus to infect certain types of cells. type 2 (PV2). lethargy and irritability.[13] [edit] Cause Main article: Poliovirus A TEM micrograph of poliovirus Poliomyelitis is caused by infection with a member of the genus Enterovirus known as poliovirus (PV). paralytic poliomyelitis is classified as spinal. It is characterized by confusion.

[25] Although the virus can cross the placenta during pregnancy. IgG and IgM antibodies against PV can prevent the spread of the virus to motor neurons of the central nervous system.[18] It is seasonal in temperate climates. public swimming pools were often closed in affected areas during poliomyelitis epidemics.[19] The disease is transmitted primarily via the fecal-oral route. It is occasionally transmitted via the oral-oral route.[16] Infection or vaccination with one serotype of poliovirus does not provide immunity against the other serotypes.[23] skeletal muscle injury due to injection of vaccines or therapeutic agents. providing passive immunity that protects the infant from polio infection during the first few months of life.[27] As a precaution against infection.[17] [edit] Transmission Poliomyelitis is highly contagious via the oral-oral (oropharyngeal source) and fecal-oral (intestinal source) routes. either through infection or by immunization with polio vaccine. with peak transmission occurring in summer and autumn.[20] malnutrition. is usually six to 20 days.Individuals who are exposed to the virus. wild polioviruses can infect virtually the entire human population. with a maximum range of three to 35 days.[15] Factors that increase the risk of polio infection or affect the severity of the disease include immune deficiency. nonpoliovirus poliomyelitis. and are able to block virus replication.[16] A rare condition with a similar presentation.[19] Virus particles are excreted in the feces for several weeks following initial infection. and full immunity requires exposure to each serotype.[16] In endemic areas.[18] The time between first exposure and first symptoms. the fetus does not appear to be affected by either maternal infection or polio vaccination.[15] a mode especially visible in areas with good sanitation and hygiene. by ingesting contaminated food or water. known as the incubation period.[26] Maternal antibodies also cross the placenta. but transmission is possible as long as the virus remains in the saliva or feces.[24] and pregnancy.[16] These seasonal differences are far less pronounced in tropical areas.[22] physical activity immediately following the onset of paralysis. IgA antibodies against poliovirus are present in the tonsils and gastrointestinal tract. may result from infections with nonpoliovirus enteroviruses.[21] tonsillectomy.[16] Polio is most infectious between seven and 10 days before and after the appearance of symptoms. develop immunity. In immune individuals. [edit] Pathophysiology .

This leads to the development of paralytic poliomyelitis.[29] Known as viremia.A blockage of the lumbar anterior spinal cord artery due to polio (PV3) Poliovirus enters the body through the mouth. on the cell membrane. which is known as nonparalytic aseptic meningitis.[31] This sustained replication causes a major viremia. and leads to the development of minor influenza-like symptoms.[28] The virus then hijacks the host cell's own machinery. infecting the first cells with which it comes in contact—the pharynx and intestinal mucosa. Rarely. and begins to replicate. where it multiplies abundantly. It gains entry by binding to an immunoglobulin-like receptor. the presence of virus in the bloodstream enables it to be widely distributed throughout the body. known as the poliovirus receptor or CD155. provoking a local inflammatory response.[2] Penetration of the CNS provides no known benefit to the virus. Poliovirus can survive and multiply within the blood and lymphatics for long periods of time. In around 1% of infections. and the deep cervical and mesenteric lymph nodes. preferentially replicating in and destroying motor neurons within the spinal cord. and is quite possibly an incidental deviation of a normal gastrointestinal infection. the intestinal lymphoid tissue including the M cells of Peyer's patches. Poliovirus divides within gastrointestinal cells for about a week.[30] In a small percentage of cases. sometimes as long as 17 weeks. and muscle. . this may progress and the virus may invade the central nervous system. this causes a selflimiting inflammation of the meninges. the various forms of which (spinal. such as brown fat. it can spread and replicate in other sites. the reticuloendothelial tissues. or socioeconomic position of the individual. but it appears to be primarily a chance event—largely independent of the age.[32] [edit] Paralytic polio Denervation of skeletal muscle tissue secondary to poliovirus infection can lead to paralysis. gender. The virus is subsequently absorbed into the bloodstream. In most cases. the layers of tissue surrounding the brain. brain stem. poliovirus spreads along certain nerve fiber pathways. from where it spreads to the tonsils (specifically the follicular dendritic cells residing within the tonsilar germinal centers). or motor cortex.[32] The mechanisms by which poliovirus spreads to the CNS are poorly understood.

and paralysis occurs in only one in 1000 cases. progresses for two to three days.000) are associated with type 2. In children. these may also occur in the reticular formation.[33] The likelihood of developing paralytic polio increases with age. stiffness in the back and neck. and the region of the CNS affected. which are responsible for movement of the muscles. The destruction of neuronal cells produces lesions within the spinal ganglia. in adults. headache. the highest rates of paralysis (one in 200) are associated with poliovirus type 1. and bulbospinal) vary only with the amount of neuronal damage and inflammation that occurs. limbs and the intercostal muscles. asymmetrical weakness of various muscles. leading to . the lowest rates (one in 2.[32] Inflammation associated with nerve cell destruction often alters the color and appearance of the gray matter in the spinal column. muscle pain. difficulty swallowing. vestibular nuclei. Early symptoms of paralytic polio include high fever. results from viral invasion of the motor neurons of the anterior horn cells. constipation. or difficulty urinating.[32] The molecular mechanisms by which poliovirus causes paralytic disease are poorly understood.[34] In children under five years of age. cerebellar vermis. sensitivity to touch. nonparalytic meningitis is the most likely consequence of CNS involvement.[2] Other destructive changes associated with paralytic disease occur in the forebrain region. paralysis of one leg is most common. In adults.[36] [edit] Spinal polio The location of motor neurons in the anterior horn cells of the spinal column Spinal polio. paresthesia (pins and needles). specifically the hypothalamus and thalamus. and is usually complete by the time the fever breaks. including those of the trunk. irritability. as does the extent of paralysis. loss of superficial and deep reflexes. the most common form of paralytic poliomyelitis. or the ventral (front) gray matter section in the spinal column. Paralysis generally develops one to ten days after early symptoms begin. extensive paralysis of the chest and abdomen also affecting all four limbs—quadriplegia—is more likely.[35] Paralysis rates also vary depending on the serotype of the infecting poliovirus. paralysis occurs in one in 75 cases. and deep cerebellar nuclei.[12] Virus invasion causes inflammation of the nerve cells.bulbar. causing it to appear reddish and swollen.

gums. and muscles of the face. Paralysis is often more severe proximally (where the limb joins the body) than distally (the fingertips and toes). Due to the effect on swallowing. or both legs and both arms. is not affected. bulbar polio occurs when poliovirus invades and destroys nerves within the bulbar region of the brain stem.[11] Critical nerves affected are the glossopharyngeal nerve. and lungs. and abnormal respiratory rate. sensation (the ability to feel) in the paralyzed limbs.[29] Any limb or combination of limbs may be affected—one leg. which may be cervical. which controls upper neck movement. the vagus nerve. The destruction of these nerves weakens the muscles supplied by the cranial nerves. but more often the paralysis is asymmetrical. double vision.[37] With the destruction of nerve cells. among other structures.[29] [edit] Bulbar polio The location and anatomy of the bulbar region (in orange) Making up about 2% of cases of paralytic polio.[12] Progression to maximum paralysis is rapid (two to four days). When spinal neurons die. and are usually absent or diminished. tongue movement and taste.[38] The virus may affect muscles on both sides of the body. which sends signals to the heart. and the accessory nerve. becoming weak. causing suffocation.[37] The extent of spinal paralysis depends on the region of the cord affected. intestines. thoracic. floppy and poorly controlled.[37] Deep tendon reflexes are also affected. Wallerian degeneration takes place.[4] The bulbar region is a white matter pathway that connects the cerebral cortex to the brain stem. however.[33] Other signs and symptoms include facial weakness. or lumbar. and . caused by destruction of the trigeminal nerve and facial nerve. which innervate the cheeks. depth. one arm. and finally completely paralyzed. the muscles no longer receive signals from the brain or spinal cord. producing symptoms of encephalitis. and is usually associated with fever and muscle pain. which partially controls swallowing and functions in the throat. without nerve stimulation. speaking and swallowing. tear ducts. and causes difficulty breathing. the muscles atrophy. leading to weakness of those muscles formerly innervated by the nowdead neurons. secretions of mucus may build up in the airway.damage or destruction of motor neuron ganglia. difficulty in chewing.

The critical nerves affected are the phrenic nerve. and those that drive the muscles needed for swallowing. this form of polio affects breathing. and without sensory or cognitive loss. this subtype is called respiratory or bulbospinal polio.[39] [edit] Diagnosis Paralytic poliomyelitis may be clinically suspected in individuals experiencing acute onset of flaccid paralysis in one or more limbs with decreased or absent tendon reflexes in the affected limbs that cannot be attributed to another apparent cause. could be used to halt poliovirus infection. the gamma globulin was shown to be about 80% . William Hammon at the University of Pittsburgh purified the gamma globulin component of the blood plasma of polio survivors. it is further tested through oligonucleotide mapping (genetic fingerprinting). but rarely occurs. and reduce the severity of disease in other patients who had contracted polio. reveals an increased number of white blood cells (primarily lymphocytes) and a mildly elevated protein level.[43] Hammon proposed the gamma globulin. and may be fatal. It can lead to paralysis of the arms and legs and may also affect swallowing and heart functions. prevent disease. By destroying these nerves. which drives the diaphragm to inflate the lungs. Antibodies to poliovirus can be diagnostic.000 contagious asymptomatic carriers exist.[42] [edit] Prevention [edit] Passive immunization In 1950. Detection of virus in the CSF is diagnostic of paralytic polio. The results of a large clinical trial were promising. which contained antibodies to poliovirus.rhythm.[4] Analysis of the patient's cerebrospinal fluid (CSF). to determine whether it is "wild type" (that is. making it difficult or impossible for the patient to breathe without the support of a ventilator.[41] It is important to determine the source of the virus because for each reported case of paralytic polio caused by wild poliovirus. an estimated another 200 to 3. which is collected by a lumbar puncture ("spinal tap").[40] A laboratory diagnosis is usually made based on recovery of poliovirus from a stool sample or a swab of the pharynx. which may lead to respiratory arrest.[38] [edit] Bulbospinal polio Approximately 19% of all paralytic polio cases have both bulbar and spinal symptoms. the virus affects the upper part of the cervical spinal cord (cervical vertebrae C3 through C5).[4] If poliovirus is isolated from a patient experiencing acute flaccid paralysis. Pulmonary edema and shock are also possible. or more recently by PCR amplification.[4] Here. the virus encountered in nature) or "vaccine type" (derived from a strain of poliovirus used to produce polio vaccine). and are generally detected in the blood of infected patients early in the course of infection. and paralysis of the diaphragm occurs.

thereby protecting both individual vaccine recipients and the wider community (so-called herd immunity). and at least 99% are immune to poliovirus following three doses.[49] The Salk vaccine. based on one serotype of a live but attenuated (weakened) virus.[44] It was also shown to reduce the severity of the disease in patients who developed polio. Koprowski's prototype vaccine was given to an eight-year-old boy on February 27. leading to large-scale trials in the then Belgian Congo and the vaccination of seven million children in Poland against serotypes PV1 and PV3 between 1958 and 1960.[45] [edit] Vaccine Main article: Polio vaccine A child receiving an oral polio vaccine Two types of vaccine are used throughout the world to combat polio.[43] The gamma globulin approach was later deemed impractical for widespread use. Both types induce immunity to polio. 90% or more of individuals develop protective antibody to all three serotypes of poliovirus.effective in preventing the development of paralytic poliomyelitis. is based on poliovirus grown in a type of monkey kidney tissue culture (vero cell line).[46] The first candidate polio vaccine.[48] The second inactivated virus vaccine was developed in 1952 by Jonas Salk at the University of Pittsburgh. or inactivated poliovirus vaccine (IPV). so the medical community turned its focus to the development of a polio vaccine.[47] Koprowski continued to work on the vaccine throughout the 1950s. efficiently blocking person-to-person transmission of wild poliovirus. however. and announced to the world on April 12.[4] . was developed by the virologist Hilary Koprowski.[16] After two doses of IPV (given by injection). 1955. which is chemically inactivated with formalin. due in large part to the limited supply of blood plasma. 1950.

and surgical treatments.000 vaccine recipients). may recover within four to six weeks after onset. In those who develop only aseptic meningitis. if the affected nerve cells are completely destroyed. braces.[48] Because OPV is inexpensive.[12] Devices such as rigid braces and body casts—which tended to cause muscle atrophy due to the limited movement of the user—were also touted as effective treatments.[52] it rapidly became the only polio vaccine used worldwide. orthopedic surgery. moderate exercise and a nutritious diet.[53] On very rare occasions (about one case per 750. which cannot revert.[48] Licensed in 1962. but the vaccine strain is unable to replicate efficiently within nervous system tissue. paralysis will be permanent. including physical therapy. It was produced by the repeated passage of the virus through nonhuman cells at subphysiological temperatures.[50] The attenuated poliovirus in the Sabin vaccine replicates very efficiently in the gut. negativepressure ventilator. more commonly called an iron lung.Subsequently. Albert Sabin developed another live. by the US National Institutes of Health. in some cases. the symptoms can be expected to persist for two to ten days. Historically.[56] Other historical treatments for polio include hydrotherapy. Three doses of liveattenuated OPV produce protective antibody to all three poliovirus types in more than 95% of recipients. many polio survivors with permanent respiratory paralysis use modern jacket-type negative-pressure ventilators worn over the chest and abdomen.[51] A single dose of Sabin's oral polio vaccine produces immunity to all three poliovirus serotypes in about 50% of recipients. but lose function temporarily. . Today.[58] Half the patients with spinal polio recover fully. speeding recovery and preventing complications.[58] In cases of spinal polio. a noninvasive. Supportive measures include antibiotics to prevent infections in weakened muscles. massage and passive motion exercises. such as tendon lengthening and nerve grafting. either as the sole vaccine against poliomyelitis or in combination with oral polio vaccine. The focus of modern treatment has been on providing relief of symptoms.[55] Treatment of polio often requires long-term rehabilitation. the attenuated virus in OPV reverts into a form that can paralyze. cells that are not destroyed.[19] Most industrialized countries have switched to IPV. it has been the vaccine of choice for controlling poliomyelitis in many countries. analgesics for pain. electrotherapy. followed by complete recovery.[38] Portable ventilators may be required to support breathing. in competition with the live vaccines of Koprowski and other researchers. corrective shoes and.[52] and in 1958 it was selected.[57] [edit] Prognosis Patients with abortive polio infections recover completely. the primary site of wild poliovirus infection and replication.[54] [edit] Treatment There is no cure for polio.[4] Human trials of Sabin's vaccine began in 1957. oral polio vaccine (OPV). easy to administer. was used to artificially maintain respiration during an acute polio infection until a person could breathe independently (generally about one to two weeks). and produces excellent immunity in the intestine (which helps prevent infection with wild virus in areas where it is endemic).

[58] The neurophysiological processes involved in recovery following acute paralytic poliomyelitis are quite effective. the mortality can be reduced to 15%.[33] A child with a deformity of her right leg due to polio Without respiratory support. its mortality rate ranges from 25 to 75%.[59] The degree of both acute paralysis and residual paralysis is likely to be proportional to the degree of viremia.[39] with support.one-quarter recover with mild disability. although modest recoveries of muscle strength are possible 12 to 18 months after infection.[12] Nerve impulses return to the formerly paralyzed muscle within a month.[32] Spinal polio is rarely fatal. 5–10% of patients with paralytic polio die due to the paralysis of muscles used for breathing. and recovery is usually complete in six to eight months. and inversely proportional to the degree of immunity.[61] [edit] Recovery Many cases of poliomyelitis result in only temporary paralysis.[62] Paralysis remaining after one year is likely to be permanent. depending on the age of the patient.[58] . The mortality rate varies by age: 2–5% of children and up to 15–30% of adults die. and the remaining quarter are left with severe disability. muscles are able to retain normal strength even if half the original motor neurons have been lost.[4] Bulbar polio often causes death if respiratory support is not provided.[4][60] When positive pressure ventilators are available.[56] Overall. consequences of poliomyelitis with respiratory involvement include suffocation or pneumonia from aspiration of secretions.

tightening of the joints and movement disability. A similar situation can develop if the arms become paralyzed. while the other leg continues to grow normally. and using ligaments for stability. urinary tract infections. in turn leading to deformities of the spine (such as scoliosis). kidneys and heart include pulmonary edema. Polio victims that develop equinus foot cannot walk properly because they cannot put their heel on the ground. myocarditis and cor pulmonale. in which remaining brainstem and spinal cord motor neurons develop new branches.[64][66] In addition to these physiological processes. kidney stones. The result is that one leg is shorter than the other and the person limps and leans to one side. These include the use of weaker muscles at a higher than usual intensity relative to the muscle's maximal capacity. as well as a loss of proper function of the veins in the legs. which enables greater mobility.[69] notably new muscle weakness and extreme fatigue. Other mechanisms that occur during the rehabilitation phase.[67] In some cases the growth of an affected leg is slowed by polio. the Achilles tendons at the back of the foot retract and the foot cannot take on a normal position.[70] The symptoms of PPS are thought to involve a failure of the over-sized motor .[64] restoring the fibers' capacity to contract and improving strength. Extended use of braces or wheelchairs may cause compression neuropathy.[39][68] [edit] Post-polio syndrome Main article: Post-polio syndrome Between 25% and 50% of individuals who survive paralytic polio in childhood develop additional symptoms decades after recovering from the acute infection. the body possesses a number of compensatory mechanisms to maintain function in the presence of residual paralysis.One mechanism involved in recovery is nerve terminal sprouting. paralytic ileus. or axonal sprouts. enhancing athletic development of previously little-used muscles.[39][68] Complications from prolonged immobility involving the lungs.[63] These sprouts can reinnervate orphaned muscle fibers that have been denervated by acute polio infection. but those that pull it upward are not. This deformity develops when the muscles that pull the toes downward are working. and contribute to muscle strength restoration. include myofiber hypertrophy—enlargement of muscle fibers through exercise and activity—and transformation of type II muscle fibers to type I muscle fibers. This condition is known as post-polio syndrome (PPS) or postpolio sequelae. and the foot naturally tends to drop toward the ground.[11] Muscle paresis and paralysis can sometimes result in skeletal deformities.[65] Terminal sprouting may generate a few significantly enlarged motor neurons doing work previously performed by as many as four or five units:[34] a single motor neuron that once controlled 200 muscle cells might control 800 to 1000 cells. If the problem is left untreated. Once the muscles in the limb become flaccid.[66] [edit] Complications Residual complications of paralytic polio often occur following the initial recovery process. they may interfere with the function of other muscles. due to pooling of blood in paralyzed lower limbs. A typical manifestation of this problem is equinus foot (similar to club foot). aspiration pneumonia.[67] Osteoporosis and increased likelihood of bone fractures may occur.

45 2. the presence of permanent residual impairment after recovery from the acute illness.[4] [edit] Eradication Disability-adjusted life year for poliomyelitis per 100.05-1.45-2.85 ≥ 3.7-1.1-2.35 0. and both overuse and disuse of neurons.4-1.75-2.5 3. and persons experiencing the syndrome do not shed poliovirus.units created during recovery from paralytic disease.1 2.75 1.[70] Post-polio syndrome is not an infectious process.35-0.7 0.15 3. no data ≤ 0.8 2.5-3.4 1.15-3.000 inhabitants.[71][72] Factors that increase the risk of PPS include the length of time since acute poliovirus infection.8-3.85 WHO 2002 Main article: Poliomyelitis eradication .05 1.

Pakistan. Subsequently. saying that the drops were designed to sterilize the true believers.[82] As of 2012. the country was taken off the WHO list of polio endemic countries.[74][83] although it continues to cause epidemics in other nearby countries due to hidden or reestablished transmission. after which it has remained at a level of about 1. polio is still endemic to South Asia and Nigeria. polio reappeared in Nigeria and spread from there to several other countries. despite eradication ten years prior.While now rare in the Western world. including China and Australia. the other being Guinea worm disease. it will be declared as a polio-free country. and The Rotary Foundation. and hence in February 2012. the incidence of poliomyelitis declined dramatically in many industrialized countries. UNICEF.[78] A number of eradication milestones have already been reached.[88] [edit] History Main article: History of poliomyelitis . from an estimated 350. the only diseases completely eradicated by humankind are smallpox.[84] For example.[80][81] Europe was declared polio-free in 2002.[77] and rinderpest in 2010. A global effort to eradicate polio began in 1988. polio remains endemic in only three countries: Nigeria.[74][75][76] Polio is one of only two diseases currently the subject of a global eradication program. It is reported that if there are no cases of polio in the country for two more years.[85] Since January 2011. which happened in 1979.000 cases in 1988 to a low of 483 cases in 2001. led by the World Health Organization.[73] These efforts have reduced the number of annual diagnosed cases by 99%. So far.[79] In 2000 polio was officially eliminated in 36 Western Pacific countries. there were no reported cases of the disease in India. and Afghanistan. and several regions of the world have been certified polio-free. an outbreak was confirmed in China in September of 2011 involving a strain prevalent in neighboring Pakistan. Following the widespread use of poliovirus vaccine in the mid-1950s.606 in 2009).000 cases per year (1. The Americas were declared polio-free in 1994.[86][87] Christopher Hitchens wrote that he learned in 2005 that in Northern Nigeria—a country which at that time was considered provisionally polio free—an Islamic Fatwah was issued declaring that the polio vaccine was a conspiracy by the United States and the United Nations against the Muslim faith.

which enhanced a natural immunity within the population. 18th Dynasty (1403–1365 BC) The effects of polio have been known since prehistory.000 cases reported that year 3. including better sewage disposal and clean water supplies.[5] The first clinical description was provided by the English physician Michael Underwood in 1789.[91] Small localized paralytic polio epidemics began to appear in Europe and the United States around 1900. improvements were made in community sanitation. where he refers to polio as "a debility of the lower extremities".[6] In the United States.An Egyptian stele thought to represent a polio victim. Egyptian paintings and carvings depict otherwise healthy people with withered limbs.[90] The disease was later called infantile paralysis.[89] The work of physicians Jakob Heine in 1840 and Karl Oskar Medin in 1890 led to it being known as Heine-Medin disease. the 1952 polio epidemic became the worst outbreak in the nation's history. Australia. about one-third of the cases were reported in persons over 15 years of age. the rate of paralysis and death due to polio infection also increased during this time. In developed countries during the late 19th and early 20th centuries. These changes drastically increased the proportion of children and adults at risk of paralytic polio infection.[6] Outbreaks reached pandemic proportions in Europe. when the risk of paralysis is greater.269 were left with mild to disabling paralysis. based on its propensity to affect children. By 1950 the peak age incidence of paralytic poliomyelitis in the United States had shifted from infants to children aged five to nine years.[92] Accordingly. most cases occurring in children six months to four years of age. and children walking with canes at a young age. polio infections were rarely seen in infants before six months of age.[91] Poorer sanitation of the time resulted in a constant exposure to the virus. Before the 20th century.[93] Intensive care medicine has its origin in the fight . North America. by reducing childhood exposure and immunity to the disease.145 died and 21. Of nearly 58. and New Zealand during the first half of the 20th century.

Respiratory centers designed to assist the most severe polio patients. McGraw-Hill Professional.). pp. which was dedicated in 1957 at the Roosevelt Warm Springs Institute for Rehabilitation in Warm Springs.). Sherris Medical Microbiology (4th ed. In Kasper DL. Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book) (11th ed. "Enteroviruses". 1859–70. ^ a b c d Ryan KJ. USA. The Gale Encyclopedia of Neurological Disorders. 231–44. the U. Wolfe S (eds. ^ a b c d e f g h i j k l m Atkinson W. 24. Hamborsky J.000 in France. ^ a b Cohen JI (2004). "Poliomyelitis" (PDF). Fifteen scientists and two laymen who made important contributions to the knowledge and treatment of poliomyelitis are honored by the Polio Hall of Fame.000 in Japan.000 polio survivors with varying degrees of paralysis live in Germany. pp. polio survivors also helped to advance the modern disability rights movement through campaigns for the social and civil rights of the disabled. Thus. 1144. "Chapter 175: Enteroviruses and Reoviruses". 12. ISBN 0-07-140235-7.000 in Australia.) (2005). and give rise to the modern field of rehabilitation therapy.). but also affected profound cultural changes. some 40.against polio.)[95] The polio epidemics changed not only the lives of those who survived them. Georgia. The World Health Organization estimates that there are 10 to 20 million polio survivors worldwide.[96] In 1977 there were 254.) (2004).000 in the United Kingdom. As one of the largest disabled groups in the world. 4. Detroit: Thomson Gale. the World Health Organization. Ray CG (eds. ISBN 0-8385-8529-9. ^ a b c d Chamberlin SL. pp. first established in 1952 at the Blegdam Hospital of Copenhagen by Danish anesthesiologist Bjørn Ibsen. (eds. 535–7. 30.) (2009). ISBN 0-7876-9150-X. Centers for Disease Control and UNICEF) were added to the Hall of Fame. with extensive media coverage of any scientific advancements that might lead to a cure.000 in Canada and 12. 16.). McGraw Hill. . were the harbingers of subsequent intensive care units (ICU). the scientists working on polio became some of the most famous of the century.S. 2. Washington DC: Public Health Foundation. spurring grassroots fund-raising campaigns that would revolutionize medical philanthropy.[96] Many notable individuals have survived polio and often credit the prolonged immobility and residual paralysis associated with polio as a driving force in their lives and careers.[97] According to doctors and local polio support groups. Fauci AS.[94] Most hospitals in the 1950s had limited access to iron lungs for patients unable to breathe without mechanical assistance. et al. Roosevelt's paralytic illness [edit] Notes and references 1. Narins B (eds.[98] The disease was very well publicized during the polio epidemics of the 1950s.[99][100] [edit] See also    List of poliomyelitis survivors March of Dimes Franklin D. In 2008 four organizations (Rotary International. Harrison's Principles of Internal Medicine (16th ed. p. 3.000 persons living in the United States who had been paralyzed by polio. (A year later. Braunwald E. Ibsen would establish the world's first dedicated ICU. McIntyre L.

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Nigeria and Pakistan) remain polio-endemic. headache. Among those paralysed. can protect a child for life. Prevention There is no cure for polio.Poliomyelitis Fact sheet N°114 February 2012 Key facts         Polio (poliomyelitis) mainly affects children under five years of age. fatigue. The virus enters the body through the mouth and multiplies in the intestine. One in 200 infections leads to irreversible paralysis (usually in the legs). down from more than 125 in 1988. Initial symptoms are fever. to 1 352 reported cases in 2010. . only three countries (Afghanistan. In 2009-2010. Polio cases have decreased by over 99% since 1988. stiffness in the neck and pain in the limbs. given multiple times. and can cause total paralysis in a matter of hours. Polio vaccine. In most countries. children in all countries are at risk of contracting polio. the global effort has expanded capacities to tackle other infectious diseases by building effective surveillance and immunization systems. It invades the nervous system. from an estimated 350 000 cases then. vomiting. 23 previously polio-free countries were re-infected due to imports of the virus. 5% to 10% die when their breathing muscles become immobilized. As long as a single child remains infected. In 2012. People most at risk Polio mainly affects children under five years of age. The reduction is the result of the global effort to eradicate the disease. Polio and its symptoms Polio is a highly infectious disease caused by a virus. Among those paralysed. it can only be prevented. Success hinges on financing the next steps of the global eradication initiative. One in 200 infections leads to irreversible paralysis. 5% to 10% die when their breathing muscles become immobilized. Persistent pockets of polio transmission in northern Nigeria and the border between Afghanistan and Pakistan are the current focus of the polio eradication initiative.

Objectives The objectives of the Global Polio Eradication Initiative are:    to interrupt transmission of wild poliovirus as soon as possible. to 1352 reported cases in 2010. only three countries in the world remain polio-endemic. more than 361 million children were immunized in 40 countries during 273 supplementary immunization activities (SIAs). adopted a resolution for the worldwide eradication of polio. spearheaded by WHO. This followed the certification of the eradication of smallpox in 1980. In 1994. Rotary International. In 2010. the WHO Region of the Americas (36 countries) was certified polio-free. Globally. Progress Overall.Global caseload Polio cases have decreased by over 99% since 1988. only parts of three countries in the world remain endemic for the disease . the WHO Western Pacific Region also suffered an importation of poliovirus. the European Region suffered its first importation of polio after certification. the number of cases has fallen by over 99%. consisting then of delegates from 166 Member States. It marked the launch of the Global Polio Eradication Initiative. In 2012. progress during the 1980s towards elimination of the poliovirus in the Americas. In 2009. In 2012. the forty-first World Health Assembly. the US Centers for Disease Control and Prevention (CDC) and the United Nations Children‘s Fund (UNICEF). since the Global Polio Eradication Initiative was launched. The Global Polio Eradication Initiative Launch In 1988. In 2011. followed by the WHO Western Pacific Region (37 countries and areas including China) in 2000 and the WHO European Region (51 countries) in June 2002. as represented by the timely detection of cases of acute flaccid paralysis. to contribute to health systems development and strengthen routine immunization and surveillance for communicable diseases in a systematic way. Persistent pockets of polio transmission in northern Nigeria and along the border between Afghanistan and Pakistan are key epidemiological challenges. to achieve certification of global polio eradication. and Rotary International‘s commitment to raise funds to protect all children from the disease.the smallest geographic area in history and case numbers of wild poliovirus type 3 are down to lowest-ever levels. from an estimated 350 000 cases in more than 125 endemic countries then. polio surveillance is at historical highs. Strategies .

Turkey. Volunteers in developing countries also play a key role: 20 million people have participated in mass immunization campaigns. Australia. Denmark.g. the Netherlands. Iceland.g. Laboratory stocks must be contained and safe management of the wild virus in inactivated polio vaccine (IPV) manufacturing sites must be assured before the world can be certified polio-free. Saudi Arabia. Finland. determine the impact of any 'mid-course corrections' that are deemed necessary.There are four core strategies to stop transmission of the wild poliovirus in areas that are affected by the disease or considered at high risk of re-infection:     high infant immunization coverage with four doses of oral poliovirus vaccine (OPV) in the first year of life. Before a WHO region can be certified polio-free. New Zealand. Malaysia.g. The polio eradication coalition includes governments of countries affected by polio. the Republic of Korea. Sanofi Pasteur and Wyeth). Spain. surveillance for wild poliovirus through reporting and laboratory testing of all acute flaccid paralysis (AFP) cases among children under fifteen years of age. Monaco. Luxembourg. humanitarian and nongovernmental organizations (e. Qatar. Rotary International. Canada. and advise on additional measures when appropriate. Coalition The Global Polio Eradication Initiative (GPEI) is spearheaded by WHO. Germany. the Russian Federation. Italy. Austria. three conditions must be satisfied:    there are at least three years of zero polio cases due to wild poliovirus. France. CDC and UNICEF. donor governments (e. Japan. Norway. supplementary doses of OPV to all children under five years of age during SIAs. Portugal. disease surveillance efforts in countries meet international standards. Bill & Melinda Gates Foundation). targeted “mop-up” campaigns once wild poliovirus transmission is limited to a specific focal area. The eradication of polio is about equity in health and the moral imperative of reaching every child with an available health intervention. Belgium. United Nations Foundation. and each country must illustrate the capacity to detect. development banks (e. private sector foundations (e. the International Red Cross and Red Crescent societies and the Global Poverty Project) and corporate partners (e. Priorities for polio eradication . Switzerland. report and respond to “imported” polio cases. Sweden.g. the European Commission. United Arab Emirates. Oman. The Independent Monitoring Board (IMB) evaluates on a quarterly basis the progress towards each of the major milestones of the Global Polio Eradication Initiative Strategic Plan 2010-2012. the United Kingdom and the United States of America).g. the World Bank). Ireland.

the global priorities are: Stopping wild poliovirus transmission in endemic countries Polio today is more geographically restricted than ever before. state/provincial and district levels. all three countries initiated emergency action plans to address the situation and fill operational gaps. Success in carrying out the necessary vaccination campaigns and surveillance hinges on sufficient funds from financial stakeholders. fully exploiting new tools such as bivalent oral polio vaccine and strengthening health systems. countries must maintain high population immunity levels. As China. the poliovirus does not respect national borders.Angola. This strategic plan is based on district-specific planning to address the unique challenges of each of the infected areas. in addition to the obvious humanitarian benefits. Congo. economic modelling has demonstrated the financial benefits of polio eradication to be at least US$ 40-50 billion. These countries are treated with the same level of priority as the endemic countries. Impact of the initiative More than eight million people who would otherwise have been paralysed are walking today because they have been immunized against polio since the initiative began in 1988. Putting an end to re-established transmission Three countries . Chad and the Democratic Republic of the Congo . Closing the funding gap Substantial financial resources are required to support polio eradication. the Russian Federation and Tajikistan have learned. children in all countries are at risk of contracting the disease. To stop transmission of the wild poliovirus and optimize the benefits of polio eradication. based on lessons learned in the past years and an independent evaluation of the major barriers to stopping polio transmission. . To succeed. However. a new strategic plan was launched. In 2010.As long as a single child remains infected with polio. high levels of political commitment must be maintained at national. Preventing new outbreaks Poliovirus has a habit of finding pockets of inadequately vaccinated children. The highest priority is reaching all children during SIAs in the four countries which have never stopped transmission of polio. In early 2011.are classified as having 're-established transmission' because they have had ongoing transmission for over 12 months. To minimize the risk of outbreaks from importation.

int . By establishing the capacity to access children everywhere. the Global Polio Eradication Initiative has expanded the capacity to tackle other infectious diseases. On average. training local epidemiologists and establishing a global laboratory network.By preventing a debilitating disease. by building effective diseasereporting and surveillance systems. conflict-affected or poorest areas. fostering a culture of disease prevention. In most countries. Planning for SIAs provides key demographic data – ―finding‖ children in remote villages and households for the first time. Through the synchronization of SIAs. and "mapping" their location for future health services. such as avian influenza or Ebola. the world can celebrate the delivery of a major global public good that will benefit all people equally.2 million childhood deaths have been prevented through provision of vitamin A during polio SIAs. more than two billion children worldwide have been immunized during SIAs. Since 1988. mostly in lowincome countries For more information contact WHO Media centre Telephone: +41 22 791 2222 E-mail: mediainquiries@who. This capacity has also been deployed in health emergencies such as the 2010 floods in Pakistan and the 2011 drought in the Horn of Africa. Vitamin A is often administered during polio SIAs. and is giving children and their families a greater chance of leading healthy and productive lives. many countries have established a new mechanism for coordinating major cross-border health initiatives aimed at reaching all people – a model for regional and international cooperation for health. More than 20 million health workers and volunteers have been trained to deliver OPV and vitamin A. demonstrating that well-planned health interventions can reach even the most remote. the Global Polio Eradication Initiative is helping reduce poverty. no matter where they live. more than 1. transport and communications systems for immunization. Improving these services helped to lay the groundwork for highly successful measles vaccination campaigns that have saved millions of young lives. Routine immunization services have been strengthened by bolstering the cold chain. one in every 250 people in a country has been involved in polio immunization campaigns. Economic modelling has found that the eradication of polio in the next five years would save at least US$ 40-50 billion. Future benefits of polio eradication Once polio is eradicated.

polio exists only in a few countries in Africa and Asia. and then is absorbed and spread through the blood and lymph system. Since the development of polio vaccines. polio was a worldwide epidemic. SUBCLINICAL INFECTION SYMPTOMS    General discomfort or uneasiness (malaise) Headache Red throat . Causes Poliomyelitis is a disease caused by infection with the poliovirus. global vaccination campaign over the past 20 years. Risks include:   Lack of immunization against polio Travel to an area that has experienced a polio outbreak In areas where there is an outbreak. and paralytic. The virus spreads by:    Direct person-to-person contact Contact with infected mucus or phlegm from the nose or mouth Contact with infected feces The virus enters through the mouth and nose.35 days (average 7 .14 days). multiplies in the throat and intestinal tract. Polio has been wiped out in a number of countries. usually in groups of people who have not been vaccinated. Polio often occurs after someone travels to a region where the disease is common. As a result of a massive. those most likely to get the disease include children. Symptoms There are three basic patterns of polio infection: subclinical infections. the incidence of the disease has been greatly reduced. pregnant women. The disease is more common in the summer and fall. and the elderly. Children in the United States are now routinely vaccinated against the disease. There have been very few cases of polio in the Western hemisphere since the late 1970s. which may not have symptoms. Outbreaks still occur in the developed world. Between 1840 and the 1950s. The time from being infected with the virus to developing symptoms of disease (incubation) ranges from 5 . About 95% of infections are subclinical infections. nonparalytic.Poliomyelitis Poliomyelitis is a viral disease that can affect nerves and can lead to partial or full paralysis.

2 weeks. It may occur after recovery from a subclinical infection. legs. fatigue Headache Irritability Leg pain (calf muscles) Moderate fever Muscle stiffness Muscle tenderness and spasm in any area of the body Neck pain and stiffness Pain in front part of neck Pain or stiffness of the back.7 days before other symptoms Abnormal sensations (but not loss of sensation) in an area Bloated feeling in abdomen Breathing difficulty Constipation Difficulty beginning to urinate Drooling Headache Irritability or poor temper control Muscle contractions or muscle spasms in the calf. abdomen Skin rash or lesion with pain Vomiting Symptoms usually last 1 . or back Muscle pain Muscle weakness that is only on one side or worse on one side o Comes on quickly o Location depends on where the spinal cord is affected o Worsens into paralysis Sensitivity to touch.   Slight fever Sore throat Vomiting People with subclinical polio infection might not have symptoms. and is divided into nonparalytic and paralytic forms. Clinical poliomyelitis affects the central nervous system (brain and spinal cord). arms. NONPARALYTIC POLIOMYELITIS               Back pain or backache Diarrhea Excessive tiredness. mild touch may be painful . neck. or their symptoms may last 72 hours or less. PARALYTIC POLIOMYELITIS              Fever 5 .

nonparalytic. stools. or orthopedic surgery to help recover muscle strength and function Outlook (Prognosis) The outlook depends on the form of the disease (subclinical. braces or corrective shoes. and spasms (narcotics are not usually given because they increase the risk of breathing trouble) Physical therapy. which is the case more than 90% of the time. or cerebrospinal fluid (CSF) Routine CSF examination Test for levels of antibodies to the polio virus Treatment The goal of treatment is to control symptoms while the infection runs its course. or paralytic) and the body area affected.  Stiff neck and back Swallowing difficulty Exams and Tests The health care provider may find:      Abnormal reflexes Back stiffness Difficulty lifting the head or legs when lying flat on the back Stiff neck Trouble bending the neck Tests include:    Cultures of throat washings. If the spinal cord and brain are not involved. muscle pain. warm towels) to reduce muscle pain and spasms Painkillers to reduce headache. Brain or spinal cord involvement is a medical emergency that may result in paralysis or death (usually from respiratory problems). People with severe cases may need lifesaving measures. especially breathing help. Symptoms are treated based on their severity. complete recovery is likely. . Treatment may include:      Antibiotics for urinary tract infections Medications (such as bethanechol) for urinary retention Moist heat (heating pads.

Principles and Practice of Infectious Diseases. disability. eds. usually 30 or more years after they are first infected. Post-polio syndrome References Modlin JF. Infection that is located high in the spinal cord or in the brain increases the risk of breathing problems. .Disability is more common than death. 2009:chap 171. Alternative Names Polio. Infantile paralysis. Pa: Elsevier Churchill Livingstone. Philadelphia. Bennett JE. Poliovirus. Dolin R. 7th ed. Muscles that were already weak may get weaker. In: Mandell GL. deformity Pulmonary edema Shock Urinary tract infections Post-polio syndrome is a complication that develops in some patients. Possible Complications             Aspiration pneumonia Cor pulmonale (a form of heart failure found on the right side of the circulation system) High blood pressure Kidney stones Lack of movement Lung problems Myocarditis Paralytic ileus (loss of intestinal function) Permanent muscle paralysis. When to Contact a Medical Professional Call your health care provider if:    Someone close to you has developed poliomyelitis and you haven't been vaccinated You develop symptoms of poliomyelitis Your child's polio immunization (vaccine) is not up to date Prevention Polio immunization (vaccine) effectively prevents poliomyelitis in most people (immunization is over 90% effective). Weakness may also develop in muscles that were not affected before.

nonparalytic poliomyelitis. Browse the Encyclopedia MedlinePlus Topics  Polio and Post-Polio Syndrome Images Fly Poliomyelitis Read More               Aspiration pneumonia Cor pulmonale Incidence Intestinal obstruction Kidney stones Lymph system Muscle function loss Myocarditis Pulmonary edema Respiratory Shock Stress and anxiety Tonsillectomy Poliomyelitis is an enteroviral infection that can manifest in 4 different forms: inapparent infection. Rizzo Jr TD. Pa: Saunders Elsevier. University of Washington School of Medicine. Harvard Medical School. Essentials of Physical Medicine and Rehabilitation. Assistant Professor in Medicine. Also reviewed by David Zieve. MD. MHA. PhD. Philadelphia. Post-poliomyelitis syndrome. MD. Silver JK. Department of Medicine. MEDEX Northwest Division of Physician Assistant Studies. 2nd ed. Update Date: 8/24/2011 Updated by: Linda Vorvick. eds. and paralytic disease. Massachusetts General Hospital. In: Frontera WR. abortive disease..A. Inc.Silver JK. MD. Before the . 2008: chap 137. Assistant in Medicine. Vyas. Medical Director.M. Medical Director. Division of Infectious Disease. A.D. Jatin M.

has just surpassed the milestone of a year without polio." said Banerjee. health agency leaders and others who have made significant contributions to the global polio eradication effort.000 AFP cases are identified and investigated across the country.As of 14 March 2012  UK Prime Minister Cameron honoured as Polio Eradication Champion by Rotary – this week." The award.[1]  Polio eradication this week:   In India. We would not be so close to achieving the goal of a polio free world without the longstanding support and continued leadership of the United Kingdom.19th century. poliomyelitis occurred sporadically. has helped bring this crippling and often deadly disease to the brink of eradication. "The commitment of Britain and the Global Polio Eradication Initiative. We encourage . India. Polio this week . "On behalf of Rotary's 1. to be presented by Rotary International President Kalyan Banerjee. I am honored to recognize the commitment of Prime Minister Cameron for his outstanding support of efforts to eradicate polio. reaching its peak in the mid 1950s. will be received by International Development Secretary Andrew Mitchell on behalf of Cameron. visited Nigeria this week. "We have a once-in-ageneration opportunity to rid the world of the evil of polio. for his leadership and dedication to a polio-free world. Director of the US Centers for Disease Control and Prevention (CDC). at a reception at the House of Commons. to discuss the importance of polio eradication with the Honourable Federal Minister of Health Professor CO Onyebuchi Chukwu. epidemic poliomyelitis was more frequently observed.2 million members worldwide. Dr Thomas Frieden. the Deputy Governor of Kano state. Eradication of this disease during the present decade is a top priority for the World Health Organization (WHO). The Polio Eradication Champion Award is the highest honour Rotary presents to heads of state. "My own country. Prime Minister of the United Kingdom David Cameron. The combination of high population immunity levels and strong disease surveillance is the best way for polio-free countries to protect themselves from polio. and in-country partners. Minister of State for Health Dr Mohammad Ali Pate. is being recognized as a Polio Eradication Champion award. approximately 5. while no cases have been reported since January 2011." said Prime Minister Cameron in a statement. Every month. ongoing eradication activities are being implemented to secure the gains achieved. The worldwide prevalence of this infection has decreased significantly since then because of aggressive immunization programs. Large-scale immunization activities and active surveillance for acute flaccid paralysis (AFP) cases is continuing. During the 19th and 20th centuries. with the support of millions of Rotarians.

while no cases have been reported since January 2011. in fact. Largescale immunization activities are being conducted in March. eradication activities are continuing strongly to secure the gains achieved. The extensive immunization and surveillance activities ongoing in India will need to continue. Director of the US Centers for Disease Control and Prevention (CDC). Every month.  other G8 countries to follow the UK's lead in continuing their support so that the world will soon be polio free.000 population (aged <15 years) are identified. visited Nigeria this week.09 billion through end-2013. The Global Polio Eradication Initiative continues to face a dangerous funding gap of US$1. an amount that urgently needs to be filled.in non-endemic countries Year-to-date 2012 25 24 1 Year-to-date 2011 55 18 37 Total in 2011* 650 341 79 Case breakdown by country Year-to-date 2012 Countries WPV1 WPV3 W1W3 Total Pakistan Afghanistan Nigeria 12 5 5 1 1 13 5 6 Year-to-date 2011 WPV1 WPV3 W1W3 Total 15 1 1 15 1 1 Total in 2011* 198 80 62 Date of most recent case 18-Feb-12 15-Feb-12 08-Feb-12 . approximately 5. Symptoms of AFP are caused by a number of different pathogens. Dr Thomas Frieden. poliovirus being just one of many potential causes. and active surveillance for acute flaccid paralysis (AFP) cases is continuing. the Deputy Governor of Kano state. as long as endemic poliovirus has not been eradicated in the remaining three countries.000 AFP cases are identified and investigated across the country. Minister of State for Health Dr Mohammad Ali Pate. reports of AFP cases is not unexpected or unusual – quite the opposite. and in-country partners. The combination of high population immunity levels and strong disease surveillance is the best way for a country to minimize the risk and consequences of polio re-emergence or re-introduction. Strong disease surveillance means that at least two AFP cases per 100. to ascertain the presence or absence of poliovirus circulation in a given environment. it means disease surveillance is working.in endemic countries . As such. Wild Poliovirus (WPV) cases Total cases Globally . to discuss the importance of polio eradication with the Honourable Federal Minister of Health Professor CO Onyebuchi Chukwu. Media reports of acute flaccid paralysis case in India: In India." The UK has been a strong supporter of the global polio eradication initiative with contributions and commitments totaling more than US$960 million through 2012.

. This newly-reported case from Paktya province (Jadran district) is in the east of the country (across the border with Pakistan). an area which has not seen a polio case in more than ten years. with onset of paralysis on 15 February. Afghanistan   One new case was reported in the past week (type WPV1 from Paktya province). or cross-border transmission from Pakistan. bringing the total number of cases for 2012 to five.Countries India Chad DR Congo Niger CAR China Guinea Kenya Côte d'Ivoire Angola Mali Congo Gabon Total Total in endemic countries Total outbreak 23 22 1 1 Year-to-date 2012 1 1 12 21 Year-to-date 2011 1 1 13 21 Date of Total in most 2011* recent case 1 13-Jan-11 132 93 5 4 21 3 1 36 09-Jan-12 20-Dec-11 12-Dec-11 08-Dec-11 09-Oct-11 03-Aug-11 30-Jul-11 24-Jul-11 07-Jul-11 23-Jun-11 22-Jan-11 15-Jan-11 1 1 5 7 1 1 1 1 0 1 1 0 25 24 1 54 18 36 1 0 1 0 0 0 1 1 55 18 37 1 1 650 341 79 Data in WHO as of 14 Mar 2011 for 2011 data and 13 Mar 2012 for 2012 data. The total number of cases for 2011 remains 80. ie whether it is linked to endemic transmission from the country's Southern Region. Genetic sequencing is ongoing to determine the origin of this case. This is the most recent case in the country.

convened a meeting this week with chairpersons of the State Task Forces to discuss concrete measures all parties need to take to fully and rapidly implement the national polio emergency plan. Nigeria       One new case was reported in the past week with onset on 27 January (type WPV1 from Zamfara State). This is the most recent . Efforts are already underway to engage all parties.   While endemic transmission continues to be highly focalized to high-risk districts in Southern Region (due primarily to hampered access associated with insecurity). on 31 March to 3 April. For this reason. Strategies to ensure ongoing implementation of polio activities continue to be implemented. and administer additional doses of OPV to communities living in otherwise hard-to-reach areas. including by introducing 'permanent polio teams' in high-risk. Pakistan  One new case was reported in the past week (type WPV1 from Federally Administrated Tribal Areas). bringing the total number of cases for 2012 to 13. Dr Mohammad Pate. bringing the total number of cases for 2012 to six. in between large-scale national and subnational immunization days. it is critical that high population immunity levels are maintained in all other provinces of the country to prevent polio from regaining a foothold in non-endemic areas of Afghanistan. to try to secure increased safe passage of vaccination teams to all communities. the upcoming national immunization days .scheduled for 25-27 March are critical. The next Expert Review Committee on Polio Eradication and Routine Immunization will meet on 28-29 March. including in close collaboration with UNDSS. Following last week's official launching of the Presidential Task Force. The security situation continues to be assessed in the country. The use of global position systems (GPS) to more adequately track and assess individual vaccination team performance (in relation to pre-prepared microplans) is being evaluated this month in Jigawa state. to review latest epidemiology and put forward key recommendations for implementation of the national polio emergency plan. The total number of cases for 2011 remains 62. Technical support is being prioritized to key local government areas in the eight identified high-risk states in the north. The plan aims to address ongoing challenges. Minister of State for Health and Chair of the Presidential Task Force. The most recent case had onset of paralysis on 8 February (type WPV1 from Jigawa State). Preparations are underway to ensure the highest quality activity can be achieved. security-compromised districts. Such teams would be able to circulate on a rolling basis. A national polio emergency action plan is currently being finalized by the Ministry of Health and partners. Technical support is being scaled up to help with planning and monitoring of the activity in the highest-risk districts of Southern Region. Preparations are ongoing for the next national immunization plus days.

and provide a clearer epidemiological picture. such as potentially and periodically immunizing older age groups (<15 years) in and near conflict-affected areas with access problems. had been conducted for the immunization campaign. Angola     No new cases were reported in the past week. As part of the augmented national polio emergency plan. frequent messages distributed throughout the campaign via electronic media. including through a press briefing by parliamentarians regarding vaccine safety. Significant social mobilization activities preceeded the campaign launches. The Technical Advisory Group will convene on 21-22 March to review epidemiology of polio transmission and impact of the augmented national polio emergency plan. and. Sagheer Ahmed and the eminent social worker Mr. the most recent of which had onset of paralysis on 7 July in Uige in the country's north. with onset of paralysis on 18 February. Abdul Sattar Edhi launched the activity in Karachi. Supplementary immunization activities are planned for 30 March–1 April. Plans are underway to introduce environmental surveillance in key areas. in April.      case in the country. Such activities will be key to supplementing surveillance for acute flaccid paralysis (AFP) cases. May. Extensive preparations. highlighting the need for OPV to protect from lifelong polioparalysis. notably in and around Luanda. The group will also discuss a number of technical issues. including the monitoring of the campaign. notably in Luanda. The total number of cases for 2011 remains 198. and 22– 24 June. The campaigns were officially launched and supported both nationally and subnationally by key supporters and partners. including at the critical district and union-council level. participation of leaders at this critical level is now being tracked and actively evaluated. Provincial inaugurations were held by Senator Farhat Abbas in Peshawar and the renowned religious leader Maulana Samiul Haq at Jamia Haqqania (religious school) in Nowshera (Khyber Pakhtunkhwa). The country has reported a total of five cases in 2011. Provincial Health Minister Dr. . to further boost population immunity levels. while Federal Minister for Religious Affairs Syed Khurshid Ahmed Shah presided over a conference in Karachi on 11 March. including by the Prime Minister‘s Focal Person for Polio Eradication Ms Shahnaz Wazir Ali and the Chairman Senate Mr. Part of preparations included ensuring engagement of district heads during the activity. Subnational immunization days are ongoing this week to reach more than 23 million children under the age of five years with bivalent OPV. No cases have been reported in 2012. Mop-up immunization activities are currently ongoing in key municipalities. This latest case is in a district with confirmed transmission of both wild poliovirus type 1 and wild poliovirus type 3. Nayyar Hussain Bukhari in Islamabad. urging religious leaders to publicly support the polio eradication effort. electronic and print media advertisements placed.

despite challenges such as inaccessibility. Overall. The most recent case had onset of paralysis on 20 December in Maniema province. At the same time. Rapid subnational reviews are now being planned. The most recent had onset of paralysis on 9 October from Akesu prefecture. The total number of cases for 2011 remains 136 (132 in Chad and four in Central African Republic). immunization activities continue to be planned both in Cameroon and in Central African Republic. The total number of cases for 2012 remains one (from Chad). with onset of paralysis on 9 January. The most recent case was a WPV1 case in Chad (Logone Oriental). some subnational variation was noted. China has a total of 21 cases for 2011. to review the performance of the February immunization activity and discuss corrective steps which need to be taken. western China. In the Central African Republic. The Honourable Minister of Health last week convened an urgent meeting with all regional delegates. A November case from Cameroon has now been officially re-classified as a Nigerian case. Per recommendations from the recent Technical Advisory Group in February. Democratic Republic of the Congo (DRC)   No new cases were reported in the past week. Chad is the only non-endemic country to report polio cases. surveillance is functioning. With ongoing. as well as Equateur. and measures implemented to help fill residual subnational surveillance gaps. However. The total number of cases for 2011 is 93 (all WPV1). Supplementary immunization activities in Chad that were planned for 16–18 March and 13–15 April have been shifted by 10 days. particularly in areas with recent polio transmission. Orientale and South Kivu. to fully assess the impact of outbreak response activities and the risk to populations from any potential renewed international spread of polio.Chad and CAR       No new cases were reported in the past week. No cases have been reported in 2012. The March activity will now take place on 29 March. In 2012. China  No new cases were reported in the past week. BasCongo. to minimize the risk and consequences of reinfection. Katanga and Maniema. all WPV1. This will include ensuring training of surveillance staff and obtaining more accurate population denominator data (against which a more accurate non-polio AFP rate can then be calculated). An in-depth assessment of national surveillance sensitivity was conducted in February in DR Congo. No cases have been reported in 2012. insecurity and vast geographic expanses. a three-month outbreak response assessment is currently underway in the country. such as Bandundu. active transmission in both Chad and Nigeria. efforts are underway to help fill residual subnational surveillance gaps in the country. respectively. Xinjiang province. . NGOs are increasingly being engaged to help support eradication efforts.

National Immunization Days are planned for 23–26 March in key countries of the region. polio) Last Reviewed: January 2012   Versión en español Poliomielitis . In 2008. using a strategic mix of vaccines. How is polio spread? . and will mean that four campaigns have been held in Katanga since the most recent wild poliovirus case (using a combination of bivalent and trivalent OPV). and five from Niger). and the Eastern Mediterranean. Poliomyelitis (infantile paralysis. In Niger. It is an appropriate response. these areas include Africa. three from Guinea. Southeast Asia. Paralysis is more common and more severe when infection occurs in older individuals. The activity is being conducted with trivalent OPV. usually from hands contaminated with the stool of an infected person. West Africa   No new cases were reported in the past week.Medline Plus Información de Salud para Usted What is polio? Polio is a viral disease which may affect the spinal cord causing muscle weakness and paralysis.  An additional round of supplementary immunization activities is planned for the end of March. The polio virus enters the body through the mouth. Travelers to countries where polio cases still occur should know they are immune or be fully immunized. Who gets polio? The number of cases of polio decreased dramatically in the United States following the introduction of the polio vaccine in 1955 and the development of a national vaccination program. All cases are WPV3. two doses of trivalent OPV in the province will have been administered to communities. Polio is more common in infants and young children and occurs under conditions of poor hygiene. to address both wild poliovirus type 1 and the cVDPV type 2. The last cases of naturally occurring polio in the United States were in 1979. and in response to last year's type 2 cVDPV. seven from Mali. Additional national immunization days are anticipated for May and June. Most of the world's population resides in areas considered free of wild poliovirus circulation. a comprehensive post outbreak response assessment is ongoing. The total number of cases for 2011 in West Africa remains 51 (36 from Côte d'Ivoire. except for three WPV1 cases from Niger.

infected persons without symptoms can still spread the virus and cause others to develop polio. What are the complications associated with polio? Complications include paralysis.Polio is spread when the stool of an infected person is introduced into the mouth of another person through contaminated water or food (fecal-oral transmission). Lifelong immunity usually depends on which type of virus a person contracts. When and for how long is a person able to spread polio? Patients are most infectious from seven to ten days before and after the onset of symptoms. The virus persists in the throat for approximately one week after the onset of illness and is excreted in the feces for three to six weeks. However. As of January 2000. The recommended schedule for childhood . Second attacks are rare and result from infection with a polio virus of a different type than the first attack. given as an injection. most commonly of the legs. Does past infection with polio make a person immune? There are three types of polio virus. tOPV is no longer recommended for immunization in the United States. headache. How soon after infection do symptoms appear? The incubation period is commonly six to 20 days with a range of three to 35 days. What is the treatment for polio? There is presently no cure for polio. Less than one percent of polio cases result in paralysis. Paralysis of the muscles of breathing and swallowing can be fatal. patients are potentially contagious as long as the virus is present in the throat and feces. Treatment involves supportive care. About four to five percent of infected people have minor symptoms such as fever. Oral-oral transmission by way of an infected person's saliva may account for some cases. Is there a vaccine for polio? There are two types of polio vaccine: trivalent oral polio vaccine (tOPV). What are the symptoms of polio? Up to 95 percent of people infected with polio have no symptoms. and inactivated polio vaccine (IPV). nausea and vomiting. muscle weakness. One to two percent of infected persons develop severe muscle pain and stiffness in the neck and back. given by mouth. However.

Joint pain and bone deformities are common. There is no known cause or effective treatment for PPS. Adults traveling to countries where polio cases are occurring should review their immunization status to make sure they are immune. How can polio be prevented? Maintaining high levels of polio immunization in the community is the single most effective preventive measure. Symptoms include fatigue. and six to 18 months of age and between four to six years of age.immunization is for IPV to be given at two. In New York State. PPS is characterized by further weakening of muscles that were previously affected by the polio infection. slowly progressive muscle weakness and deterioration. four. polio vaccine is required for all children enrolled in pre-kindergarten programs and schools. . PPS is generally not life-threatening. What is post-polio syndrome (PPS)? PPS is a condition that affects polio survivors ten to 40 years after recovery from an initial infection.