Poliomyelitis

Poliomyelitis (polio) is a viral infection that can invade the nervous system and cause permanent paralysis in a small proportion of those infected. It is preventable through vaccination, and global eradication efforts have made it rare in most parts of the world.

• Most infections cause no symptoms or a mild flu-like illness with fever, sore throat, and fatigue
• A small proportion of infections progress to more serious illness with severe muscle pain and stiffness
• Paralytic polio, which is rare, causes sudden weakness or paralysis, often asymmetric and affecting the legs more than the arms
• Paralysis affecting the breathing muscles is life-threatening

• Caused by poliovirus, spread mainly through the faecal-oral route via contaminated water or food, and less commonly through respiratory droplets.
• Risk is essentially confined to unvaccinated or incompletely vaccinated individuals.

• Suspected clinically in anyone with acute flaccid paralysis, particularly in an unvaccinated person or during a known outbreak.
• Stool testing for the virus is the standard method used to confirm infection and supports public health surveillance.

There is no specific antiviral treatment for polio; management is entirely supportive.

Paralytic polio requires hospital care, with close monitoring of breathing function, as paralysis affecting the chest muscles can be life-threatening and may require assisted ventilation.

Physiotherapy and rehabilitation support recovery of muscle function where possible, and ongoing rehabilitation support is often needed for residual weakness.

• Complete the full routine polio vaccination schedule for infants and children.
• Support supplementary immunisation campaigns and polio surveillance activities in the community.
• Ensure safe water and sanitation to reduce faecal-oral transmission.
• Report any case of sudden, unexplained limb weakness in a child promptly, as this is a key part of polio surveillance.