Medicines for Polio

What it is

Polio (poliomyelitis) is an infectious disease caused by the poliovirus. It can, in a small proportion of cases, affect the nerves in the spinal cord and cause muscle weakness and paralysis, which can be permanent and, if it affects the muscles used for breathing, life-threatening. Historically, polio caused epidemics and left many people, particularly children, with lasting paralysis. The hugely important and reassuring point is that polio is now very rare, and has been eliminated from most of the world, thanks to highly effective vaccines — it no longer occurs naturally in the UK and most countries, and global efforts have brought it close to eradication, though it still occurs in a very small number of areas. Polio is spread mainly through contact with the faeces of an infected person (for example via contaminated food or water, or poor hygiene), and, less commonly, through droplets from coughs and sneezes. Most people infected with poliovirus have no symptoms or only a mild, flu-like illness (with fever, tiredness, headache, sore throat, and feeling unwell), and recover fully. In a small number of cases, however, the virus affects the nervous system and can cause muscle weakness or paralysis (which can affect the limbs or, in severe cases, the breathing muscles), which may be permanent. There is also a condition called post-polio syndrome, in which some people who had polio many years ago develop new muscle weakness, tiredness, and other symptoms decades later. The key to preventing polio is vaccination: the polio vaccine is highly effective and is part of the routine childhood immunisation programme (given in infancy and childhood, with boosters), and keeping vaccination up to date protects individuals and communities, and is essential to keeping polio away and working towards its global eradication. Because polio still exists in a few areas and the virus can be imported, maintaining high vaccination coverage remains important. The key messages are that polio is a viral infection that can, in a small number of cases, cause paralysis, that it is now very rare thanks to vaccination, and that keeping up immunisation is the key protection.

How it is treated

The approach to polio centres on prevention through vaccination (the key protection), which has made polio very rare, along with public health measures; for the rare cases, there is no cure, so treatment is supportive. Prevention through vaccination is the central and most important measure: the polio vaccine is highly effective and is part of the routine childhood immunisation programme — given to babies and children (with boosters) — and keeping vaccination up to date protects individuals from polio and, by maintaining high coverage in the community, protects the population and keeps polio away; this has eliminated polio from most of the world. Ensuring children receive their routine immunisations on schedule, and keeping vaccination up to date, are therefore the key actions, and are essential to preventing the return of polio and to the global effort to eradicate it. Because polio still occurs in a very small number of areas and the virus can be imported (and monitoring, such as of sewage, is done to detect any signs of the virus), maintaining high vaccination coverage remains important, and vaccination is also relevant for travel to any areas where polio is a risk (travel health advice covers this). There is no cure for polio itself, so for the rare cases where infection occurs, treatment is supportive — managing the symptoms, and, where the nervous system and muscles are affected, supporting the person (which may include support for breathing if the breathing muscles are affected, and rehabilitation, such as physiotherapy, to help with any weakness or paralysis and to maintain function). Public health measures respond to any detection of poliovirus, including boosting vaccination. For people affected by polio in the past, including those who develop post-polio syndrome (new symptoms decades later), supportive care and management of symptoms — such as physiotherapy, aids and adaptations, managing fatigue and pain, and support — help, and specialist input may be involved. The reassuring messages are that polio is now very rare thanks to highly effective vaccination, that keeping up routine childhood immunisation is the key protection (and essential to keeping polio away and eradicating it globally), and that, for the rare cases, supportive care and rehabilitation help, as does support for those affected by polio in the past; so vaccination and keeping immunisation up to date are the key points for the public.