India was declared a polio free country on March 27, 2014 by the World Health Organization as the last reported cases of wild polio had been in 2011 January. However, it is vital that you should be aware of how polio occurs, the line of treatment to be followed, and — most importantly — how it can be prevented. Since it is a highly contagious viral disease to which children under five and pregnant women are most susceptible, you should know how to recognize its symptoms. If you or some of your loved ones need to travel to countries where polio hasn’t been eradicated; then read on to know which preventive measures must be taken.
Polio is the layman’s term for poliomyelitis. Caused by the poliovirus, in its deadliest form polio is a potentially fatal disease as the infection might invade a person’s brain stem, motor cortex, and spinal cord. It is certainly crippling as it can cause paralysis when it attacks the motor neurons. One out of 200 people attacked by the paralytic poliovirus lose control over their legs and arms. There could be loss of eyesight, and sense of taste, even severe difficulty in breathing and swallowing caused by bulbar polio.
Polio is more dangerous because most carriers don’t present with any symptoms. The few who do, present with flu like symptoms of sore throat, fever, body pain with stiffness, nausea, vomiting, exhaustion, muscle spasms and tenderness, and in extreme cases meningitis. There might be a skin rash resembling measles in a few people in some cases of non-paralytic polio. Paralytic polio symptoms might be similar to non-paralytic polio with other symptoms like flaccid — floppy and loose — limbs, loss of reflexes, and intolerable pain emerging within a week.
Post-polio syndrome: With many patients, a bunch of disabling symptoms emerge several years later which is collectively called post-polio syndrome. These symptoms include extreme fatigue, sleep apnea, and other sleep related disorders; muscular atrophy (wasting), decreased tolerance to cold, often leading to difficulty in breathing, and swallowing.
The poliovirus spreads through the fecal route indicating that open defecation and poor hygiene are largely responsible for its spread; contaminated utensils, food, and water; and direct contact with someone who is carrying the virus. Keep in mind that the polio virus can only survive in the stomach of its host, and passes into the atmosphere through the feces of an infected person. It can never thrive in the open atmosphere. People with immunodeficiency, children below the age of five years, expectant mothers, laboratory technicians who need to work with live polioviruses, those undergoing chemotherapy, and caregivers of polio patients are particularly at risk.
Even in the 21st century, this is one of the rare diseases for which there is still no curative treatment via medication, or other interventions once a person is infected, though the disease has been around since the Egyptian civilization. Symptomatic patients might be diagnosed by laboratory culture of the patient’s stools, cerebrospinal fluid, and/or mucus. Your doctor might order serological tests to identify the presence of any poliovirus antibodies in the blood. Subsequently, there can only be rehabilitative treatment through complete bed rest for a period, nutritive diet, pain management, and physical therapy to relieve pain, prevent deformities in the limbs due to muscular atrophy, and increase movements of the limbs. For some patients, continuous care and support might become necessary. Braces for affected legs to prevent future deformities, reduce pain in the legs, and decrease muscle spasms; breathing assistance, and special diet for those who experience difficulty in swallowing might be required for patients who have been very badly impacted.
It is vital that healthcare professionals and the common people unite to prevent polio through a planned and sustainable campaign against it. Just because India has been declared polio free does not mean that you don’t immunize the little ones any longer. Vaccination is through oral polio vaccines (OPV), and injections. Polio drops are a weakened form of the poliovirus to enable the body to develop its own antibodies, and injections of inactivated poliovirus (IPV). They are given at various stages of life, though in India mostly OPV is given. Ideally, the first time polio vaccination should be given is when the baby is two months old. The next round should be at four months, with the third round between six and 18 months. There should be appropriate spacing between the polio drops and the MMR shots to prevent the child falling ill due to vaccination. Subsequently, the child should be given booster shots at ages five and ten.
Frequent hand washing, especially before eating anything, or cooking; using a hand sanitizer when soap is not available for washing; not sharing utensils with an infected person; not touching one’s eyes, nose, or mouth with contaminated hands; covering one’s mouth when coughing or sneezing; and avoiding food or drink which might have been contaminated by an infected person’s touch are some of the basic methods of preventing the spread of infection, especially polio.
If you or a loved one is traveling to any of the countries not yet identified by WHO as polio free, namely Nigeria, Pakistan, and Afghanistan; it would be advisable to take a booster polio shot to prevent infection even by chance. Anyone who didn’t receive polio immunization in childhood, are expecting, suffer low immunity, are undergoing chemotherapy, or are being treated with immunosuppressants should certainly take a booster shot before traveling to any of these countries, or to those countries which have recently been declared polio free.