Polio or poliomyelitis is a highly infectious viral disease, which mainly affects young children. It is a crippling and potentially deadly infectious disease and it is caused by the poliovirus. The virus is transmitted from person-to-person through the faecal-oral route or, less frequently, by a common vehicle (e.g. contaminated water or food) and multiplies in the intestine, from where it can invade the nervous system and can cause paralysis. Following infection, the virus is shed intermittently in excrement for several weeks with little or no symptoms in majority of cases. The initial symptoms of poliomyelitis include fever, fatigue, headache, vomiting, neck stiffness and pain in the limbs. In a small proportion of cases, the disease causes paralysis, which is often permanent. There is no cure for polio, it can only be prevented by immunization.
In 1988, when WHO and partners established the Global Polio Eradication Initiative, aiming to eradicate polio, the disease was paralysing over 1000 children per day and was active in all countries of the Region. The African Region has not had wild polio cases in over a year.
Factors that have contributed to the progress in polio eradication in the Region include:
• Commitment of political leaders
• Implementation of intensive surveillance activities in all countries of the Region
• Polio laboratory network made up of 16 laboratories providing critical information, including genetic sequencing data
• Innovative approaches in social mobilization and communication to overcome misconceptions and rumours
• Cross-border collaboration and the implementation of synchronized immunization campaigns across large numbers of countries simultaneously
• Use of improved vaccines and new technologies to improve vaccination coverage
Most people who get infected with poliovirus (about 72 out of 100) will not have any visible symptoms.
About 1 out of 4 people with poliovirus infection will have flu-like symptoms that may include—
• Sore throat
• Stomach pain
These symptoms usually last 2 to 5 days then go away on their own.
A smaller proportion of people with poliovirus infection will develop other more serious symptoms that affect the brain and spinal cord:
• Paresthesia (feeling of pins and needles in the legs)
• Meningitis (infection of the covering of the spinal cord and/or brain) occurs in about 1 out of 25 people with poliovirus infection
• Paralysis (can’t move parts of the body) or weakness in the arms, legs, or both, occurs in about 1 out of 200 people with poliovirus infection
Paralysis is the most severe symptom associated with polio because it can lead to permanent disability and death. Between 2 and 10 out of 100 people who have paralysis from poliovirus infection die because the virus affects the muscles that help them breathe.
Even children who seem to fully recover can develop new muscle pain, weakness, or paralysis as adults, 15 to 40 years later. This is called post-polio syndrome.
Note that “poliomyelitis” (or “polio” for short) is defined as the paralytic disease. So only people with the paralytic infection are considered to have the disease.
Poliovirus only infects humans. It is very contagious and spreads through person-to-person contact. The virus lives in an infected person’s throat and intestines. It enters the body through the mouth and spreads through contact with the feces (poop) of an infected person and, though less common, through droplets from a sneeze or cough. You can get infected with poliovirus if you have feces on your hands and you touch your mouth. Also, you can get infected if you put in your mouth objects like toys that are contaminated with feces (poop).
An infected person may spread the virus to others immediately before and about 1 to 2 weeks after symptoms appear. The virus can live in an infected person’s feces for many weeks. It can contaminate food and water in unsanitary conditions.
People who don’t have symptoms can still pass the virus to others and make them sick.
Polio vaccine protects children by preparing their bodies to fight the polio virus. Almost all children (99 children out of 100) who get all the recommended doses of vaccine will be protected from polio.
There are two types of vaccine that can prevent polio: inactivated poliovirus vaccine (IPV) and oral poliovirus vaccine (OPV). Only IPV has been used in the United States since 2000; OPV is still used throughout much of the world.
Success story of Polio eradication in African
, made possible by devoted leaders, countries, communities, civil society, and parents
In 1996, poliovirus paralysed more than 75,000 children across the continent, in every single country. That year, Nelson Mandela launched ‘Kick Polio Out of Africa’, marking the launch of a unique, cross-sectoral and cross-continental movement to protect all children from paralysis.
Millions of health workers, often operating in difficult or dangerous conditions, have since worked tirelessly to reach and vaccinate all children and protect them from this entirely preventable disease. Between countries, cross-border collaboration and the implementation of synchronized immunization campaigns has reduced the chance of virus spread. Health workers are not only protecting children from poliovirus, but are also paving the way for other health programmes to reach the world’s most vulnerable children. Thanks to their work, poliovirus has been beaten back to its lowest ever levels across the continent. As of March 2018 there have been no cases of wild poliovirus type 1 reported in any country in the African Region for over one and half years.
A polio-free Africa will also be testimony to the efforts of donors and the Global Polio Eradication Initiative partners. In particular, Rotarians are truly inspirational advocates for a polio-free world, raising hundreds of millions of dollars, and volunteering countless hours to eradicate polio across the whole African region, and the globe.
However, the threat still remains. Over the last 30 years, time and time again, poliovirus has spread across west, central and the Horn of Africa. Until the whole region is certified poliovirus free, every country must remain vigilant.
To finish the disease in Africa once and for all, it is crucial for all countries to continue to take steps to reach all children with vaccines, strengthen surveillance, and stay fully committed at all levels to ending polio. It is also essential to maintain financial commitments. On the verge of one of the greatest public health achievements in history, the certification of Africa as poliovirus free will be testimony to the efforts of hundreds of thousands of people living in the region.