The Re-Emerging Polio

On November 6, 2019 the Department of Health (DOH) confirmed the fourth case of polio in a 3-year-old girl in Sultan Kudarat. The first case was validated in September 2019, also in a female child, age 3, in Lanao Del Sur. The second and third cases of polio were respectively isolated in a 4-year-old child in Datu Piang, Maguindanao and in a boy, 5 years old, from Laguna. Recently, DOH declared that some sewers of Davao and Manila tested positive for poliovirus. All these polio incidents happened after the World Health Organization has declared the Philippines as a “polio-free” country some 19 years ago.

What is polio?

Polio or poliomyelitis is a communicable disease cause by virus – poliovirus. In its severe form, the virus can penetrate the central nervous system (brain) and the spinal cord and can result to nerve paralysis resulting to loss of function of the lower extremities and respiratory paralysis that can cause death. Although polio is no longer seen in the United States and Europe, it continues to infect children who are less than 5 years of age in Africa and Asia. Adults are not immune to polio.

Demonstration and isolation of poliovirus was first done in 1907. Immunization or vaccination against polio that had almost eradicated the disease became available in 1957. Prevention is done through proper hygiene, including hand washing and avoiding ingestion of contaminated drinks and water.

How do you get infected with polio?

Poliovirus is an enterovirus. In other words, it enters through the mouth or buccal cavity through ingestion of contaminated water, drinks, and food (fecal-oral route) and multiplies inside the gut (gastrointestinal system).

The cycle of infection

95% of people infected with poliovirus will show no symptoms at all. An infected person harboring the virus can emit the virus and initiate its spread from saliva and feces. The communication of sewer or drainage system and drinking water secondary to damaged pipes can start the spread of poliovirus. Unsanitary food preparation and poor hygiene augments the polio infectious process. Some people who are infected with poliovirus can become asymptomatic (relatively healthy) polio-passers via feces and mouth secretions for many years (in some people, more than 15 to 20 years).

Signs and symptoms of polio

Only 1% of cases of infected persons with polio suffer from paralysis (paralytic polio). When paralysis sets in, the condition is irreversible. Persons with non-paralytic polio suffer from sick feeling of fever, sore throat, headache, vomiting, fatigue, back pain or stiffness, neck pain or stiffness, pain and stiffness of the arms and legs, and muscle weakness and tenderness. Sick feeling lasts up to 10 days.