Highlights & Basics
- Poliovirus infection is usually asymptomatic. When symptomatic, the most common presentation is a minor gastrointestinal illness.
- Acute flaccid paralysis (AFP), or paralytic poliomyelitis, is the hallmark of the major illness. A minority of affected cases with AFP progress to life-threatening bulbar paralysis and respiratory compromise.
- Postpoliomyelitis syndrome may occur many years after the initial illness, and consists of weakness and fatigue in muscle groups previously affected in the acute illness.
- There is no cure for poliovirus infection or postpoliomyelitis syndrome, and treatment is mainly supportive.
- Early physical therapy is key to maximizing and restoring limb function in paralytic poliomyelitis and in postpoliomyelitis syndrome.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Citations
Heymann DL, Aylward RB. Eradicating polio. N Engl J Med. 2004 Sep 23;351(13):1275-7.[Abstract]
Global Polio Eradication Initiative. GPEI Strategy 2022-2026. 2021 [internet publication].[Full Text]
Farbu E, Gilhus NE, Barnes MP, et al. Post-polio syndrome: EFNS guidelines on post-polio syndrome. In: Gilhus NE, Barnes MP, Brainin M, eds. European Handbook of Neurological Management, Volume 1. 2nd ed. West Sussex, UK: Blackwell Publishing Ltd.; 2011:311-9.
Centers for Disease Control and Prevention. Polio: polio vaccination for international travelers. Jul 2024 [internet publication].[Full Text]
1. Heymann DL, Aylward RB. Eradicating polio. N Engl J Med. 2004 Sep 23;351(13):1275-7.[Abstract]
2. Centers for Disease Control and Prevention (CDC). International notes certification of poliomyelitis eradication - the Americas, 1994. MMWR Morb Mortal Wkly Rep. 1994 Oct 7;43(39):720-2.[Full Text]
3. Centers for Disease Control and Prevention. Yellow Book 2024: health information for international travel. Section 5: travel-associated infections & diseases - poliomyelitis. May 2023 [internet publication].[Full Text]
4. World Health Organization: Regional Office for Africa. Africa eradicates wild poliovirus. Aug 2021 [internet publication]. [Full Text]
5. Global Polio Eradication Initiative. Wild poliovirus list. 2023 [internet publication].[Full Text]
6. Lee SE, Greene SA, Burns CC, et al. Progress toward poliomyelitis eradication - worldwide, January 2021-March 2023. MMWR Morb Mortal Wkly Rep. 2023 May 12;72(19):517-22.[Abstract][Full Text]
7. Global Polio Eradication Initiative. GPEI statement on WPV1 in Malawi. Feb 2022 [internet publication].[Full Text]
8. Global Polio Eradication Initiative. Polio now: This week [internet publication].[Full Text]
9. Alleman MM, Jorba J, Henderson E, et al. Update on Vaccine-Derived Poliovirus Outbreaks - Worldwide, January 2020-June 2021. MMWR Morb Mortal Wkly Rep. 2021 Dec 10;70(49):1691-99.[Abstract][Full Text]
10. Global Polio Eradication Initiative. Outbreak countries. 2023 [internet publication].[Full Text]
11. Davlantes E, Jorba J, Henderson E, et al. Notes from the field: circulating vaccine-derived poliovirus type 2 emergences linked to novel oral poliovirus vaccine type 2 use - six African countries, 2021-2023. MMWR Morb Mortal Wkly Rep 2023 Sep 22;72(38):1041-2.[Full Text]
12. Global Polio Eradication Initiative. Updated statement on report of polio detection in United States. Jun 2022 [internet publication].[Full Text]
13. Link-Gelles R, Lutterloh E, Schnabel Ruppert P, et al. Public health response to a case of paralytic poliomyelitis in an unvaccinated person and detection of poliovirus in wastewater - New York, June-August 2022. MMWR Morb Mortal Wkly Rep. 2022 Aug 19;71(33):1065-8.[Abstract][Full Text]
14. Ryerson AB, Lang D, Alazawi MA, et al. Wastewater testing and detection of poliovirus type 2 genetically linked to virus isolated from a paralytic polio case - New York, March 9-October 11, 2022. MMWR Morb Mortal Wkly Rep. 2022 Nov 4;71(44):1418-24.[Abstract][Full Text]
15. UK Health Security Agency. Polio: detection of VDPV2 in London sewage samples. Nov 2022 [internet publication].[Full Text]
16. Klapsa D, Wilton T, Zealand A, et al. Sustained detection of type 2 poliovirus in London sewage between February and July, 2022, by enhanced environmental surveillance. Lancet. 2022 Oct 29;400(10362):1531-8.[Abstract][Full Text]
17. New York State Department of Health and Rockland County Department of Health.New York State Department of Health and Rockland County Department of Health alert the public to a case of polio in the county. Jul 2022 [internet publication].[Full Text]
18. World Health Organization. Poliovirus IHR emergency committee. Feb 2023 [internet publication].[Full Text]
19. Centers for Disease Control and Prevention. Epidemiology and prevention of vaccine- preventable diseases: chapter 18: poliomyelitis. May 2024 [internet publication].[Full Text]
20. World Health Organization. Poliomyelitis. Jul 2022 [internet publication].[Full Text]
21. Sawyer MH. Enterovirus infections: diagnosis and treatment. Pediatr Infect Dis J. 1999 Dec;18(12):1033-9.[Abstract]
22. World Health Organization. Two out of three wild poliovirus strains eradicated. Oct 2019 [internet publication].[Full Text]
23. World Health Organization. Weekly epidemiological record. Polio vaccines: WHO position paper. Jun 2022 [internet publication].[Full Text]
24. Heymann D, Aylward B. Polio will soon be history. Bull World Health Organ. 2007 Jan;85(1):7-8.[Abstract][Full Text]
25. Aylward RB. Eradicating polio: today's challenges and tomorrow's legacy. Ann Trop Med Parasitol. 2006 Jul-Sep;100(5-6):401-13.[Abstract]
26. Aylward RB, Acharya A, England S. Global health goals: Lessons from the worldwide effort to eradicate poliomyelitis. Lancet. 2003 Sep 13;362(9387):909-14.[Abstract]
27. Lahariya C, Pradhan SK. Prospects of eradicating poliomyelitis by 2007: compulsory vaccination may be a strategy. Indian J Pediatr. 2007 Jan;74(1):61-3.[Abstract]
28. Cochi SL, Kew O. Polio today: are we on the verge of global eradication? JAMA. 2008 Aug 20;300(7):839-41.[Abstract][Full Text]
29. Cuba IPV Study Collaborative Group. Randomized, placebo-controlled trial of inactivated poliovirus vaccine in Cuba. N Engl J Med. 2007 Apr 12;356(15):1536-44.[Abstract][Full Text]
30. Global Polio Eradication Initiative. Oral poliovirus vaccine. [internet publication].[Full Text]
31. Centers for Disease Control and Prevention. Child and adolescent immunization schedule. Jun 2024 [internet publication].[Full Text]
32. Oliver SE, Moore KL. Licensure of a diphtheria and tetanus toxoids and acellular pertussis, inactivated poliovirus, haemophilus influenzae type b conjugate, and hepatitis B vaccine, and guidance for use in infants. MMWR Morb Mortal Wkly Rep. 2020 Feb 7;69(5):136-39.[Abstract][Full Text]
33. UK Health Security Agency. Polio: the green book, chapter 26. Apr 2013 [internet publication].[Full Text]
34. Centers for Disease Control and Prevention. Polio vaccination recommendations for specific groups. Sep 2024 [internet publication].[Full Text]
35. Centers for Disease Control and Prevention. Adult immunization schedule. Nov 2024 [internet publication].[Full Text]
36. Kidd S, Clark T, Routh J, et al. Use of inactivated polio vaccine among U.S. adults: updated recommendations of the Advisory Committee on Immunization Practices - United States, 2023. MMWR Morb Mortal Wkly Rep. 2023 Dec 8;72(49):1327-30.[Abstract][Full Text]
37. el-Sayed N, el-Gamal Y, Abbassy AA, et al. Monovalent type 1 oral poliovirus vaccine in newborns. N Engl J Med. 2008 Oct 16;359(16):1655-65.[Abstract][Full Text]
38. Global Polio Eradication Initiative. nOPV2: Frequently asked questions (FAQ). October 2021 [internet publication].[Full Text]
39. Global Polio Eradication Initiative. GPEI press release on nOPV2 prequalification. Jan 2024 [internet publication].[Full Text]
40. Global Polio Eradication Initiative. GPEI Strategy 2022-2026. 2021 [internet publication].[Full Text]
41. Ciapponi A, Bardach A, Rey Ares L, et al. Sequential inactivated (IPV) and live oral (OPV) poliovirus vaccines for preventing poliomyelitis. Cochrane Database Syst Rev. 2019 Dec 5;12:CD011260.[Abstract][Full Text]
42. Khan OA. Polio and post-polio syndrome. In: Zhang Y, ed. Encyclopedia of global health.Thousand Oaks, CA: Sage; 2008.
43. Ramaraj R. Post-poliomyelitis syndrome: clinical features and management. Br J Hosp Med. 2007 Dec;68(12):648-50.[Abstract]
44. Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases: chapter 22: laboratory support for surveillance of vaccine-preventable diseases. Mar 2024 [internet publication].[Full Text]
45. Howard RS. Poliomyelitis and the postpolio syndrome. BMJ. 2005 Jun 4;330(7503):1314-8.[Abstract]
46. Centers for Disease Control and Prevention. National Notifiable Diseases Surveillance System (NNDSS): poliovirus, paralytic poliomyelitis and nonparalytic poliovirus infection 2024 case definition. Feb 2024 [internet publication].[Full Text]
47. Neumann DA. Polio: its impact on the people of the United States and the emerging profession of physical therapy. J Orthop Sports Phys Ther. 2004 Aug;34(8):479-92.[Abstract]
48. Miller AH, Buck LS. Tracheotomy in bulbar poliomyelitis. Calif Med. 1950 Jan;72(1):34-6.[Abstract][Full Text]
49. Bruno RL. Post-polio syndrome. Neurology. 1996 Nov;47(5):1359-60.[Abstract]
50. Farbu E, Gilhus NE, Barnes MP, et al. Post-polio syndrome: EFNS guidelines on post-polio syndrome. In: Gilhus NE, Barnes MP, Brainin M, eds. European Handbook of Neurological Management, Volume 1. 2nd ed. West Sussex, UK: Blackwell Publishing Ltd.; 2011:311-9.
51. Koopman FS, Beelan A, Gilhus NE, et al. Treatment for postpolio syndrome. Cochrane Database Syst Rev. 2015 May 18;(5):CD007818.[Abstract][Full Text]
52. Farbu E. Update on current and emerging treatment options for post-polio syndrome. Ther Clin Risk Manag. 2010 Jul 21;6:307-13.[Abstract][Full Text]
53. Hammon WM, Coriell LL, Ludwig EH, et al. Evaluation of Red Cross gamma globulin as a prophylactic agent for poliomyelitis. 5. Reanalysis of results based on laboratory-confirmed cases. J Am Med Assoc. 1954 Sep 4;156(1):21-7.[Abstract]
54. Centers for Disease Control and Prevention. Polio: polio vaccination for international travelers. Jul 2024 [internet publication].[Full Text]
55. Global Polio Eradication Initiative. Guidelines for implementing poliovirus surveillance among patients with primary immunodeficiency disorders (PIDs). May 2022 [internet publication].[Full Text]
