Musculoskeletal System Diseases

Key Facts:

• Polio (poliomyelitis) mainly affects children under five years of age, but it may affect unvaccinated adults as well.
• Polio is a fast spreading viral infection, with no symptoms in most cases.
• One in 200 infections leads to irreversible paralysis (usually in the legs). Among those paralyzed, 5% to 10% die when their breathing muscles become immobilized.
• Polio cases have decreased by over 99% since 1988, from an estimated 350 000 cases then, to 1604 reported cases in 2009. The reduction is the result of the global effort to eradicate the disease.
• In 2010, only four countries in the world remain polio-endemic, down from more than 125 in 1988. The remaining countries are Afghanistan, India, Nigeria and Pakistan.
• Persistent pockets of polio transmission in northern India, northern Nigeria and the border between Afghanistan and Pakistan are the current focus of the polio eradication initiative.
• As long as a single child remains infected, children in all countries are at risk of contracting polio. Between 2009 and 2010, 23 previously polio-free countries were re-infected due to imports of the virus.
• In most countries, the global effort has expanded capacities to tackle other infectious diseases by building effective surveillance and immunization systems. Knowledge of the poliovirus has expanded with aggressive research carried out under the eradication effort.
• Success for the effort hinges on closing a substantial funding gap to finance next steps of the global eradication initiative.

What Is Polio?

• Polio is a highly infectious viral disease, which mainly attacks the nervous system. It usually enters the human body (child or adult) through the mouth and multiplies in the intestine. The virus causes paralysis and may lead to death when the breathing muscles become immobilized. It may also kill many of those infected before developing the vaccine.

Symptoms:

• 90% of persons infected with polio will have no symptoms.
• About 4% to 8% of infected persons have flu-like symptoms, such as fever, fatigue, nausea, as well as headache, stiffness in the neck and back, and pain in the limbs.
• 1% of polio cases result in permanent paralysis of the limbs.
• 5% to 10% die when the paralysis strikes the respiratory muscles.

Complications:
Paralysis can lead to permanent disability and death.

Transmission:
Paralysis is transmitted from the infected person to the healthy person through direct contact.

Treatment and Prevention:
There is no cure for polio, it can only be prevented. The physical therapy along with the anti-spasm medicines can help relax muscles. Polio vaccine, given multiple times, can protect a child for life.

Vaccine:
There are two types of vaccine that can prevent polio:

• Inactivated Polio Vaccine -IPV
• Oral Polio Vaccine-OPV

Who needs to be vaccinated?
Does my infant or child need this vaccine?
Children should be vaccinated with inactivated polio vaccine (IPV) at the following ages:

• A dose at 2 months
• A dose at 4 months
• A dose at 6-8 months
• A booster dose at 4-6 years

As an adult, do I need this vaccine?
Most adults do not need polio vaccine because they were already vaccinated as children. But three groups of adults are at higher risk and should consider polio vaccination in the following situations:

• You are traveling to polio-endemic areas of the world.
• You are working in a laboratory and handling specimens that might contain polioviruses.
• You are a healthcare worker treating patients who could have polio or have close contact with a person who could be infected with poliovirus.

Adults in these three groups should get 3 doses:

• The first dose: at any time.
• The second dose: 1 to 2 months later.
• The third dose: 6 to 12 months after the second.