The human body comes into contact with many environmental factors for the first time with the onset of childhood. For this reason, diseases may occur as a result of contact with body tissues and immune system of many microorganisms that the body has not encountered before. These health problems, also known as childhood infectious diseases, usually manifest with symptoms such as fever and skin rash, and often get better with lifelong immunity. However, since some diseases can leave permanent problems, it is very important to prevent them by vaccination while they are still in childhood. One of the childhood diseases that can leave permanent damage is polio.
What is Polio?
Polio disease or poliomyelitis is an infectious disease that is manifested by the development of paralysis due to the destruction of nerve cells in various parts of the body, which can be caused by viruses called polio virus and can be transmitted by the consumption of contaminated water or food, which can be life-threatening in severe situations. Although the disease may appear with symptoms similar to intestinal inflammation (gastroenteritis) such as diarrhea, abdominal pain and fever after the first infection, it may cause permanent neurological problems as a result of the spread of the virus to the nerve roots.
A significant portion of childhood infectious diseases occur due to viral infections. Since a significant portion of virus infections tend to be transmitted through contaminated food, air or droplets, they can be transmitted rapidly in public areas such as nurseries and schools and cause epidemics. For this reason, vaccine studies for the mentioned infectious diseases have been started and effective vaccines have been produced and applied to the routine vaccination programs of countries. Since the disease can cause serious health problems that affect a person’s whole life, important scientific studies have been carried out in the fight against polio and great efforts have been made to control the disease.
Thanks to the successful vaccination programs that have been going on for many years, an important part of childhood infections is not seen in the countries of the world that implement the vaccination program. In our country, as in many countries of the world, there has been no case of polio for many years. However, it is extremely important to continue the fight against this disease, as polio epidemics are known to continue in some Asian and African countries.
What Causes Polio?
The most important transmission route of polio is the consumption of food and fishery products contaminated with feces. For this reason, polio virus outbreaks can be seen frequently in people living in environments with poor hygiene conditions. People who carry the polio virus but do not show symptoms of the disease can also transmit the virus to others. People who are in contact with people living in the same house who are carriers of the polio virus can get polio virus.
What Symptoms Does Polio Cause?
Polio virus passes into the digestive system after ingestion of contaminated food in children and causes a non-paralytic polio picture accompanied by the following symptoms that occur within 7 to 10 days:
Fire
Throat ache
Weakness-fatigue, widespread muscle pain
nausea-vomiting
Stomach ache
Headache
In this picture, the disease is self-limiting and resolves within a few days with complete regression of symptoms. However, in a small part of the infected cases, the virus passes to nerve cells and causes damage to nerve tissues at the cerebrospinal level, causing paralytic polio. In the case of paralytic polio, the following symptoms may occur:
Loss of sensation, tingling, numbness, or electric sensation in various parts of the body
Loss of strength, loss of movement (paralysis) in various parts of the body
High fever, neck stiffness, confusion, epileptic seizure due to meningitis development
Neurological symptoms that develop in the case of paralytic polio can be lifelong. In cases where vitally important muscle groups such as respiratory muscles are affected, the disease can be life-threatening. In some of the children who have had paralytic polio, with the weakening of the symptoms of the disease, a post-polio syndrome picture with muscle pain, muscle weakness or loss of movement may occur after 15 to 40 years.
How is Polio Diagnosed?
The diagnosis of polio can be made by physician evaluation according to the clinical signs and symptoms of the disease. In addition, demonstrating the presence of poliovirus in the patient’s body fluids, blood or cerebrospinal fluid (CSF) aids the diagnosis. In order to exclude other factors that cause neurological symptoms and cause infectious diseases such as meningitis from the diagnosis, culture tests from blood and body fluid samples of the patients, computerized tomography or magnetic resonance imaging may be required.
In Polio Treatment
What to do?
In current clinical practice, there is no treatment modality that can be used for polio infection. In the case of non-paralytic polio infection, the approach is often to manage the patient with supportive treatment and to monitor the spontaneous regression of the disease. In paralytic polio, on the other hand, symptomatic treatment for neurological symptoms and physical therapy methods for muscle strength loss can be applied. In severe cases where the respiratory muscles are affected, respiratory support may be required.
The main method of combating polio infection is vaccination. Thanks to scientific studies carried out since the past, two different vaccines have been developed for polio virus infection. The inactivated polio vaccine (IPA), also known as the Salk vaccine, is a vaccine that is administered systemically under the skin and provides the initiation of antibody production against the virus. Since virus particles that have lost their ability to cause disease are used, the development of polio is not expected in patients after IPA administration, but antibody production is weak after vaccination.
The other polio vaccine is the oral polio vaccine (OPA), also known as the Sabin vaccine. The vaccine administered by instillation into the mouth aims to eliminate the virus in the way of transmission by initiating the production of antibodies throughout the gastrointestinal tract. Although it is highly effective because it provides more effective antibody production, it has a risk of post-vaccine infection since it is a live vaccine using weakened virus particles. In vaccine calendars applied in countries, IPA and OPA are used together on different dates to create a synergistic effect.
In our country, polio vaccine is routinely administered in the second, fourth, sixth, eighteenth and two-year-old periods in the vaccination calendar that begins with birth. IPA is administered in combination with vaccines developed to combat other childhood diseases. In the sixth and eighteenth months, besides IPA, OPA is administered to children without immune system deficiency. Thanks to the regular and successful application of vaccination, polio cases have not been encountered for a long time in our country and in many developed countries of the world. Thanks to the immunity of a significant part of the society against this disease, the virus cannot find the opportunity to multiply and cannot contaminate food products. In this way, the development of epidemics can be prevented and the development of paralytic polio tables can be prevented. However, polio virus outbreaks can be seen in some Asian and African countries due to insufficient vaccination studies and difficulties in maintaining hygiene in living areas due to economic reasons. In conditions where vaccine studies are disrupted, there is a possibility that polio infections can be seen again in our country or in other countries. In this respect, it is extremely important to continue vaccination studies regularly and effectively, for the protection of public health and the development of children’s health.