Does polio stay in your body forever?

Post-polio syndrome (PPS) is a poorly understood condition that only affects people who have had polio. It can affect people 10 to 40 years after recovering from the initial polio infection, staying in the body forever. Scientists aren’t sure why some polio survivors develop PPS and others don’t. It causes gradual muscle weakness and muscle atrophy (loss) and other symptoms. Read on to find out more.

📝 What is polio?

Polio, also called poliomyelitis is an infectious disease caused by any one of the three types of polio virus. There are three variations of poliovirus, called wild poliovirus type 1, 2 and 3 (WPV1, WPV2 and WPV3). Wild poliovirus type 2 was eradicated in 1999 and wild poliovirus type 3 was eradicated in 2020, but type 1 still exists.

How does polio spread?

The poliovirus is spread when food, water or hands contaminated with faeces, throat or nasal secretions of an infected person enter the mouth of an uninfected person.

What happens when polio attacks the body?

The nervous system is made up of small units called neurons or nerve cells. A typical neuron has three main parts; a cell body (soma), dendrites (branching fibres) and a single axon. This unit is often described as a tree:

• The axon is a tree root (where neurons talk to each other through an electrical message)
• The soma is a tree trunk (where the DNA lives in the nucleus)
• The dendrites are tree branches (where neurons receive messages from other cells)

When poliovirus infects your body, it affects a specific type of nerve cell called motor neurons. Motor neurons carry messages (electrical impulses) between your brain and your muscles, directly controlling all voluntary muscle movements throughout the body, including walking, breathing, eating, swallowing and fine motor skills, like writing and drawing. It is the final pathway for the brain to initiate movement by stimulating contractions.

Poliovirus particularly affects the motor neurons in the spinal cord. A polio infection often damages or destroys many of these motor neurons, preventing movements such as walking, leading to falls and other complications.

📊 Types of polio

Poliovirus infection is classified into four main types based on the severity of the disease and its symptoms.

Symptoms of abortive polio

Abortive poliomyelitis symptoms are a mild form of polio, affecting most people that contract the virus. Flu-like symptoms start three to seven days after you get infected and last a few days. Symptoms of abortive polio include:

• Fatigue
• Fever
• Headache
• Vomiting
• Diarrhoea or constipation
• Sore throat

Symptoms of non-paralytic polio

Non-paralytic poliomyelitis (also known as aseptic meningitis) starts with the same symptoms as abortive polio, then symptoms progress onto:

• Neck stiffness
• Pain or pins-and-needles in your arms and legs
• Severe headaches
• Sensitivity to light

Symptoms of paralytic polio

Paralytic poliomyelitis starts out with symptoms similar to abortive polio or non-paralytic polio. The polio virus then goes on to attack the brain and spinal cord, causing paralytic polio. Symptoms include:

• Sensitivity to touch
• Muscle pain
• Spinal poliomyelitis, preventing movement of arms or legs or both (paralysis)
• Bulbar poliomyelitis, which makes it hard to breathe, swallow and speak. If the breathing muscles are affected, it can be life threatening
• Bulbospinal poliomyelitis has symptoms of both spinal and bulbar polio

Symptoms of post-polio syndrome (PPS)

PPS can happen 10 to 40 years after people have recovered from the initial polio infection.

New symptoms related to prior polio infection include:

• Extreme tiredness
• New muscle weakness in both those originally affected by the polio infection and those previously unaffected
• Skeletal deformities, such as scoliosis
• Muscle pain and joint pain
• Sleeping problems
• Breathing or swallowing problems
• Inability to tolerate cold temperatures

Any combination of these symptoms may develop.

Diagnosis of PPS

Diagnosis is made by a healthcare professional based on:

• Medical history. Having had a polio infection in the past, with or without paralysis
• New symptoms of pain and weakness, continuing for at least a year
• No other clinical explanations for the symptoms (known as diagnosis of exclusion)

📝 Is polio a lifetime disease?

It is not clear why some polio survivors develop post-polio syndrome while others do not. It has been suggested that in some people, after initial infection, the remaining nerves and muscles in the body have worked harder to compensate over the years. This has resulted in nerves becoming exhausted and even dying, forcing the nerves and muscles that are left to work even harder. This gradual change can explain why it can take years for post-polio syndrome symptoms to appear.

🏥 How post-polio syndrome is treated

There is no cure for post-polio syndrome, but support and a range of treatments are available from your healthcare provider to help manage your symptoms and improve your quality of life.

Some of the ways that symptoms of post-polio syndrome may be managed include:

• Physical therapy/physiotherapy to help with any movement problems and to build up muscle strength
• Organising activities to prevent over-exertion and taking regular rests to help reduce fatigue
• Devices such as splints and braces to support weak limbs or joints
• Mobility aids such as walking sticks or scooters
• Weight control and healthy eating to avoid putting unnecessary strain on muscles and joints
• Medication for muscle or joint pain
• Wearing extra layers of clothing to try to stay comfortable due to intolerance to cold
• Psychological support such as discussions with a GP, on an online forum, or in a local support group

💉 The polio vaccine

Immunisation is the best protection against polio. The best way to prevent polio is to make sure you and your child are up to date with your vaccination schedule. Public health experts recommend children receive their routine vaccinations to protect them from serious life-threatening diseases and their complications. The vaccine produces an immune response to build up protection against polio by producing antibodies with very few serious side effects.

Two types of vaccine are available: An inactivated poliovirus vaccine (IPV) and a live attenuated oral polio vaccine (OPV). Inactivated polio vaccine is injected intramuscularly and recommended by the CDC and the NHS. Experts now recommend that the OPV not be given and that only IPV be used.

📉 Progress made with polio

The Global Polio Eradication Initiative, led by organisations such as the World Health Organization (WHO), UNICEF, Rotary International, and the Centers for Disease Control and Prevention (CDC) has made significant progress in reducing cases of polio.

Cases of polio still exist in some parts of the world today. Polio vaccination is essential to the eradication effort. Polio is still a significant problem in Afghanistan, Nigeria and Pakistan, and there’s a potential risk of infection in other parts of Africa and some Middle Eastern countries

📝 Conclusion

It is possible that the affects of a polio infection can show up decades later in some people. It is not understood fully why this is the case. It’s important to get medical advice as soon as possible if you experience symptoms of PPS, particularly if you have had polio in the past. As the symptoms of post-polio syndrome can be similar to those of several other conditions, your health care provider may be need to do tests to rule out any other possible causes of your problems.

Sources

• Polio – NHS
• Poliomyelitis
• NaTHNaC – Poliomyelitis
• Polio – NHS inform
• Polio – Symptoms and causes – Mayo Clinic
• Polio: Virus, Causes, Symptoms, Transmission & Treatment
• Disease factsheet about poliomyelitis