INTRODUCTION

Polio is an acute viral infectious disease contracted predominantly by

children that can lead to acute flaccid paralysis and can ultimately cause
death by paralyzing the respiratory muscles.

It is primarily an infection of the. human alimentary

tract but the virus may infect the central nervous system in a
very small percentage (about 1 per cent) of cases resulting in
varying degrees of paralysis, and possibly death.
 HISTORY & Key milestones of Polio :

Although major Polio epidemics were unknown before the20th century, history of Polio infections began during prehistory.
Ancient Egyptian paintings and carvings depict otherwise healthy people with withered limbs, and children walking with canes at a young age.
• In 1789, British physician Michael Underwood provided first clinical description of
polio disease.
• In 1908, Karl Landsteiner and Erwin Popper identified virus as cause of polio by
transmitting disease to monkey.
• In 1953, Salk and his associates developed a potentially safe inactivated (killed) IPV
vaccine for polio.
• In 1962 Sabin OPV vaccine replaced Salk IPV for easier administration and less
expense.
• In 1988, WHO started the Global Polio Eradication Initiative, which led to the
decline of polio cases globally, i.e. from 350,000 cases in 1988 in more than 125
countries to 15 cases in the endemic countries in 2018 as per WHO report.
• Worldwide trend of polio cases

• India successfully stopped polio transmission from January 13 , 2011

th

• No Cases were reported of Type-2 and Type-3 strains since 1999 & 2012
EPIDEMIOLOGY:
• AGENT:

This is caused by polio virus belonging to human Enterovirus of Picornaviridae family.

• It is non-enveloped RNA type of virus consists of intranuclear Cowdry B inclusion
bodies.
• It is of three serotypes. They differ in capsid protein:
•
-Type 1 is the most common wild type responsible of cause epidemics.
-Type 2 is the most antigenic and cause endemic infection
-Type 3 is the most common cause for VAPP, and mostly associated with Sabin
OPV.

• Reservoir: Man (subclinical cases).

• Infective material: Stools and oropharyngeal secretions of infected human being.
• Period of communicability: 7-10 days before and after onset of paralysis.
•

•
 Host Factors
Age: Children are more susceptible than adult; children <15 years are at high
risk.
Sex: Males are more prone than female in the ratio of 3:1
Risk factors: Unvaccinated children, immunodeficiency malnutrition, traveling
to endemic areas. Factors that precipitate the risk of developing paralytic
poliomyelitis a infection with poliovirus.
Immunity: Maternal antibodies are protective until six months of age
 Environmental factors
• Polio is more likely to occur during the rainy season.
• Approximately 60 per cent of cases recorded in India were during June to
September.
• The environmental sources of infection are contaminated water, food and flies
(feco-oral route) .
• Polio virus survives for a long time in a cold environment.
• Overcrowding and poor sanitation provide opportunities for exposure to infection.
• Mode of transmission
Clinical subtypes:
• 91-96% constitute in apparent infection
• 4-8% cause abortive infection, and
• <1% cause paralytic cases
paralytic polio firther subdivided into
o Spinal (80%)
o Bulbospinal (20%)
o Bulbar paralysis (2%)