Poliomyelitis or more commonly known as Polio is a highly contagious viral infection caused by the Polio Virus. It mostly affects children under the age of 5 years. Since Polio can target the nervous system, it can lead to total paralysis within hours of acquiring the infection. Polio being highly infectious spreads through faecal oral route or less commonly through contaminated food or water.
According to WHO, Polio has been eradicated in all of the countries around the globe except Pakistan, Afghanistan and Nigeria. Wild Polio has decreased by over 99% since 1988. In 2017, only 22 cases were reported in the Polio Endemic countries across the world.
Polio In Pakistan
Pakistan is one of the three unlucky countries in the world still affected by the hazards of Poliomyelitis. Although there is a great decrease in the incidence of this disease yet Pakistan is still not a labeled “Polio Free” country. According to WHO, there is a great decrease in prevalence of Polio in the last two decades. 350,000 were reported in the year 1988, which dropped to 54 in 2015 and 19 in the year 2016.
As per a report by END POLIO PAKISTAN, “Total 8 cases of poliomyelitis were reported in the year 2017 out of which 3 cases were from Baluchistan, 2 from Sindh, 1 each from Punjab, Gilgit- Baltistan and KPK and no cases from FATA and Kashmir.”
Signs & Symptoms
Polio is a highly contagious disease, however most of the people infected by Polio do not show any significant symptoms. Symptomatic Polio can be divided into two types according to their severity and clinical presentation:
1. Non Paralytic Polio.
2. Paralytic Polio.
1. Symptoms of Non Paralytic Polio
Non Paralytic Polio is the milder form of Poliomyelitis and is self-limiting. It mostly recovers within few days to one week and thus shows mild to now symptoms:
5.Body ache and stiffness
7. Abdominal Pain.
2. Symptoms of Paralytic Polio:
It occurs when the virus affects the anterior horn cells of the spinal cord and brainstem cells leading to irreversible paralysis. According to WHO, “1 in 200 Polio cases lead to irreversible paralysis. Among those paralyzed 5% to 10% die when their respiratory muscles become immobilized.” Symptoms of this severe form of Polio include:
1. Flaccid Paralysis (Loss of muscle tone making the limbs loose).
2. Severe muscle ache and spasm.
3. Loss of muscle reflexes.
4. Muscle weakness.
5. Asymmetrical atrophy.
In severe cases there is difficulty in swallowing and breathing that may lead to cessation of respiration and death.
Management & Prevention
There is no cure for Polio and once a child gets it can only be managed conservatively. Management focuses pain relief, increasing comfort and prevention of complications. This includes Physiotherapy, use of antibiotics to prevent superimposed bacterial infections, ventilator support etc.
As mentioned earlier, Poliomyelitis is a highly contagious incurable disease, and hence an integral part of management includes Prevention through effective vaccination. There are two Vaccines currently being used for Poliomyelitis:
1. Salk – Inactivated Poliovirus (IPV): Injectable form starting at the age of 2 months till the age of 4 years.
2. Oral polio vaccine (OPV): Oral form, more commonly used in Pakistan because of low cost.
Polio is a major issue Pakistan has been struggling against for a long time. Even after massive awareness programs and campaigns against Polio, a vast majority of the parents step back when it comes to timely vaccination of their children. We can only hope that with efficient campaigns at homes, schools, zoos and market places, soon we can label Pakistan a Polio Free Country.