SCRIPT NUMBER 168
POLIO - 2
(ONE SPEAKER)
PROGRAM NAME: HEALTH NUGGETS
PROGRAM TITLE: POLIO - 2
PROGRAM NUMBER: 168
SUBJECT: CAUSE, SYMPTOMS, TREATMENT, PREVENTION OF POLIO
KEY WORDS: SANITATION, FECES, BODY WASTE, CONTAGIOUS, SPINAL
CORD, BRAIN, BREATHING MACHINE, ERADICATION
DATE OF SCRIPT: JUNE 13, 2014
AUTHOR: RICHARD YUKL, MD, FACS
The World Health Organization recently issued a global alert concerning a polio
outbreak in the Middle East. As of March 20, 2014, thirty-seven documented
cases of polio infection had been reported in the Syrian Arab Republic. Sadly, the
infection has been spreading in the region. A six-month-old boy who had not
been immunized against polio recently developed paralysis in Baghdad, Iraq, and
his three-year-old sister also became infected. Furthermore, one hundred eightysix samples of body waste in Israel recently tested positive for the virus. Risk of
further spread of the infection across the region remains high, although that risk
has somewhat lessened because of preventative actions that are being taken by
the countries of the Eastern Mediterranean Region. They have declared an
emergency, and have begun to immunize children who, as yet, are not
immunized against polio.
Polio is a virus infection found only in humans. It mainly affects children under
the age of five years, pregnant women and people with a weakened immune
system. In its most severe form, the infection causes irreversible muscle
paralysis. Paralysis of the breathing muscles can occur, and that causes the
death of 5-10% of those who become infected.
At one time, an extensive eradication effort almost eliminated polio around the
world. Why, then, should we be concerned about it now? Unfortunately, the virus
is so contagious that, as long as a single person remains infected, people
everywhere remain at risk of becoming infected. The virus is easily spread from
person to person, especially in areas of the world where sanitation is inadequate.
It remains active for weeks in the feces of an infected person, and it can spread
from the infected feces to the mouth of another person through water, through
food that has become contaminated by the feces, or by direct contact with the
infected feces. Polio is so contagious that anyone living with an infected person
is likely to become infected as well.
Symptoms of a poliovirus infection are the same as symptoms you would expect
to see with a common cold. They last for one to ten days, and include a fever,
sore throat, back and neck pain or stiffness, and a headache. Some who become
infected are unfortunate, developing spread of their infection to their spinal cord
or to their brain. About one week after the infection has spread, they develop
severe muscle aches and spasm, arms and legs that often weaken on one side
more than on the other, and then the sudden onset of permanent paralysis of the
involved muscles.
Polio must continue to be taken seriously because there is no cure for the
infection. Treatment can only increase an infected person’s comfort, speed
recovery from the symptoms, and prevent some of the infection’s complications.
Supportive treatments include bed rest with mild physical therapy, medicines to
relieve the pain, a nutritious diet, and assistance with breathing that may even
include the use of a breathing machine, should that become necessary.
Worldwide elimination of polio can only come through a coordinated, worldwide
program designed to prevent spread of the infection. A global plan to eradicate
polio has been developed and implemented under the direction of the World
Health Organization. Under that plan, infants receive polio vaccine as an
inactivated virus in four doses - when they are 2 months old, 4 months old, and
when the child is between 6-18 months of age. A fourth vaccine dose is given
when the child is entering school. Vaccination is 90% effective after three vaccine
doses have been given, and 99% effective in preventing a polio infection once all
four doses of the vaccine are given. As of 2009, the most recent year for which
we have statistics, over 20 million volunteers had participated in the mass
immunization campaign to eradicate the infection worldwide. More than 361
million children had already been vaccinated.
If you come into contact with someone who is infected with the virus, you can
follow some general guidelines to help prevent spread of the virus from that
person to others. Those guidelines include improving public sanitation and
personally taking care to avoid touching anything that could possibly be
contaminated. The most effective way to avoid infection, however, is to get a
polio vaccination as soon as possible. That means receiving two doses of polio
vaccine one to two months apart, followed by a third dose 6-12 months after the
second dose. If you are an adult who has been vaccinated against polio at some
time in the past, you should be revaccinated if you care for someone whom you
know to be infected with the virus, or if you travel to parts of the world where
polio still occurs regularly.
Let us review the strategy we should follow to help stop both children and adults
from becoming infected with poliovirus. First, we should immunize infants with
the polio vaccine during their first year of life. Then, supplement the
immunizations with an additional dose of vaccine when the child enters school.
Next, adults who live in any country where polio infection has been identified
should be immunized. Finally, any child below age fifteen who develops paralysis
for unknown reasons should be investigated for the possibility of a polio infection.
Coalitions of governments have been formed to follow this strategy, and over the
past 20 years, the number of cases of polio around the world has decreased by
over 99%. Final success depends on spending the money necessary to
vaccinate people around the world, and to build effective systems to monitor for
the outbreak of any new infections. Once polio is eradicated, the world can
celebrate a public good that will benefit all people equally, no matter where they
live.
Health Nuggets is written by Dr. Richard Yukl, a medical doctor working in the
United States. The medical views expressed in this program are his and may
differ for your particular health needs. If you need medical advice, please consult
a medical professional in your area.