References:
- Global Infectious Diseases and Epidemiology Online Network: Infectious Diseases of the Philippines, 2013 eBook Edition, ISBN 978-1-61755-582-4, by Stephen Berger. Accessed here.
| Agent | VIRUS - RNA. Picornaviridae, Picornavirus: Polio virus |
| Reservoir | Human |
| Vector | None |
| Vehicle | Fecal-oral Dairy products Food Water Fly |
| Incubation Period | 7 to 14 days (As early or late as 3 to 35 days) |
| Diagnostic Tests | Viral culture (pharynx, stool) Serology Nucleic acid amplification |
| Typical Adult Therapy | Stool precautions; supportive |
| Typical Pediatric Therapy | As for adult |
| Vaccines | Poliomyelitis - injectable Poliomyelitis - oral |
| Clinical Hints | Sore throat, headache, vomiting and myalgia followed by flaccid paralysis; meningeal involvement in 1% of cases - paralysis in only 0.1%. paralysis tends to be more extensive in adult patients. |
| Synonyms | Acute flaccid paralysis, Heine-Medin disease, Infantile paralysis, Kinderlahmung, Kinderverlamming, Paralisi infantile, Paralisis flaccida, Paralisis flacida aguda, PFA (Paralisis Flacidas Agudas), Polio, Poliomyelite, Poliomyelitt. |
CDC Case Definition for Surveillance
Case definition of paralytic poliomyelitis requires, “Acute onset of a flaccid paralysis of one or more limbs with decreased or absent tendon reflexes in the affected limbs, without other apparent cause, and without sensory or cognitive loss.”
- A ‘confirmed case’ requires persistence of the neurological deficit 60 days after onset of initial symptoms, fatal illness or unknown follow-up status.
WHO Case Definition for Surveillance
Case definition for surveillance includes any child under fifteen years of age with acute, flaccid paralysis or any person with paralytic illness at any age when poliomyelitis is suspected.
Poliomyelitis is typically a late summer illness in temperate climates, and often begins as a mild upper respiratory tract infection.
- In some cases, the disease follows vaccination (live vaccine) or recent contact with a vaccinee.
- Patients have been known to excrete virus for as long as ten years following an episode of poliomyelitis
- Antecedent injection in a given site may precipitate paralytic poliomyelitis in the same limb.
90% to 95% of poliomyelitis infections are asymptomatic.
- Symptoms include fever, sore throat, headache, vomiting and still neck.
- Paralysis is typically asymmetrical, and most often involves the lower extremities.
- Bulbar paralysis or encephalitis may occur in patients in the absence of limb paralysis.
- 4% to 8% experience minor symptoms, and 1% to 2% develop paralysis.
- Paralysis is most common in the very young and very old, following minor blunt trauma to a limb, and among persons who had undergone tonsillectomy.
- The case/fatality rate for paralytic poliomyelitis in 2% to 10%.