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Polio - and then there were two

Gudrun Heise / cdOctober 28, 2015

Just two countries remain affected by the polio epidemic, the WHO says. But even where the disease is known to have been eradicated, further suffering occurs due to something known as post-polio syndrome.

A young child receives an oral vaccination against polio
Image: Global Polio Eradication Initiative

Polio and paralysis

Polio does not only affect children, even if it was first recognized as a disease primarily afflicting the young. In the 60s, the disease was widespread throughout the world, with many having contracted the virus before they'd turned five. In 1962, Germany launched the campaign "oral vaccination is sweet - polio is cruel." Since then, children have been comprehensively vaccinated in Germany.

How is polio spread?

The disease is spread through the polio virus. This usually happens through fecal-oral contact infection. The virus, excreted in the feces, travels from the hands (or in food and water) via the mouth and into the body. It then enters the gastrointestinal tract, and from there the blood vessels and eventually into nerve cells. Even the smallest drop of saliva can transmit polio - through the mouth or nose, for example. Polio is highly contagious.

Which countries are affected?

The WHO (World Health Organizatino) set itself a goal of eradicating the disease by the year 2018. Currently, the infectious disease is only present in Afghanistan and Pakistan. There are no nationwide vaccination programs in these countries, so the virus can easily spread. Since 1994, the entire American continent has been free of polio; since 2000, the Western Pacific region has also been polio-free. The WHO declared the European region polio-free in June 2002.

An infographic shows where polio was present between 2010 and 2015

What are the symptoms?

Polio can lead to paralysis. But the first symptoms are usually less than clear: fever, nausea, headache. There are different strains of polio, and the so-called abortive poliomyelitis strain does not affect the cells of the central nervous system. Paralytic poliomyelitis, however, can result in paralysis within days. This form of the disease occurs mainly in children, and often diagonally: left leg and right arm, or right leg and left arm. Ninety-five percent of people who become infected with the polio virus show no symptoms. They carry it in their body, but notice nothing and form antibodies. They are thus immune.

What are the effects?

Sometimes, the paralysis retreats after just one year. In the worst case, it leads to irreversible long-term nerve damage. Bones are then deformed, leading to stunted growth. An additional effect of this terrible form of polio is that the patient suffers from severe muscle pain, often tied to atrophy. Difficulty breathing or swallowing can also occur.

How is polio treated?

As early as the 1950s, people suffering from polio could be placed inside artificial respiratory systems called "iron lungs." But the only true protection from the disease is vaccination. Oral vaccinations were common in Germany beginning in the 1960s, but today, they are administered via syringe. There is still no drug to treat those suffering from polio.

What's post-polio syndrome?

Many who contracted the disease as children were later able to enjoy many years where the disease was virtually absent - even if its aftereffects still lingered. Nevertheless, polio can come back in the form of post-polio syndrome. In Germany alone, 70,000 suffer from PPS. Even 40 years after the original infection, they develop the symptoms of the disease once more.