An acute viral infection characterised by acute onset of flaccid paralysis of skeletal muscles. It is transmitted primarily by person to person through the faecal-oral route

Cause

• Polio virus (enterovirus) types I, II and III

Clinical features

• Majority of cases are asymptomatic

- only 1% result in flaccid paralysis

• Minor illness of fever, malaise, headache, and vomiting

• May progress to severe muscle pain

• Paralysis is characteristically asymmetric

• Paralysis of respiratory muscles is life threatening (bulbar polio)

• Aseptic meningitis may occur as a complication

• Strain and intramuscular injections precipitate and may worsen paralysis

Differential diagnosis

• Guillain-Barre syndrome
• Traumatic neuritis
• Transverse myelitis
• Pesticides and food poisoning

Investigations

Isolation of the virus from stool samples
Viral culture

Management
H

Acute stage

Poliomyelitis in this stage without paralysis is difficult to diagnose

If paralysis is recent, rest the patient completely

Note: do not give IM injections as they make the paralysis worse

Refer the patient to a hospital

After recovery (if partially/not immunised) complete the recommended immunization schedule (see p350)

Chronic stage
HC2

Encourage active use of the limb to restore muscle function

Prevention

• Isolate for nursing and treatment
• Caretaker should wash hands each time after touching the child
• Proper disposal of children’s faeces
• Immunization