What is Polio (Poliomyelitis)? The Vital Importance of Vaccination

Polio, medically known as poliomyelitis, is a highly contagious viral disease that targets the nervous system and can lead to permanent paralysis within hours. Primarily affecting children under five, this disease poses a severe threat to public health when up-to-date vaccination schedules are not followed. Recent cases detected in our neighboring country, Syria, serve as a stark reminder to parents that unvaccinated or under-vaccinated children are at risk, and that vaccination is a life-saving shield.

At a glance:

• The cause is the poliovirus, transmitted through the mouth and feces.
• There is no definitive medical cure or healing drug for the disease.
• The single most effective prevention method is timely childhood vaccination.
• Permanent muscle weakness and respiratory failure develop in some cases.
• It is administered free of charge at healthcare facilities in Türkiye as part of the routine vaccination schedule.

What is Polio?

The clearest answer to what polio is, is that it is an acute infection that destroys motor neurons in the spinal cord. The virus enters the body through the mouth, multiplies in the intestines, and reaches the central nervous system by mixing with the bloodstream. Although the disease usually targets children under the age of five, it can affect people of any age who lack immunity. Even though case numbers have drastically decreased globally thanks to vaccination campaigns, the risk of outbreaks remains in regions where the virus has not been completely eradicated.

New cases reported, especially in neighboring Syria, make it imperative for parents in our country to strictly adhere to vaccination schedules due to regional migration movements and the risk of contact. Once the disease damages nerve cells, this damage is irreversible. Therefore, the fundamental approach of medicine is to prevent catching the disease rather than trying to treat it.

Causes and Risk Factors

The sole cause of the disease is a microorganism belonging to the enterovirus family called the poliovirus. This virus can survive for weeks outside the human body, particularly in contaminated waters and sewage systems. The biggest risk factor is a child being unvaccinated or having incomplete vaccine doses. Living in areas with inadequate hygiene conditions, lacking access to clean drinking water, and having poor hand-washing habits increase the likelihood of transmission.

Additionally, traveling to countries where the virus is actively seen or being in close contact with people coming from these regions poses a significant risk. Children with congenitally weak immune systems or those whose immunity is suppressed due to reasons like cancer treatment are prone to experiencing the disease much more severely when exposed to the virus. Spending long periods in crowded environments is also among the environmental factors that increase the rate of transmission.

Paralysis Symptoms in Children and the Course of the Disease

The vast majority of children infected with the poliovirus show no symptoms or overcome the disease like a mild cold. The incubation period generally ranges from 7 to 14 days. In the initial stage, general infection signs such as fever, fatigue, headache, vomiting, and stiffness in the neck and back appear. However, when the virus reaches the nervous system, paralysis symptoms in children begin to manifest.

In this critical stage, severe muscle aches, loss of reflexes, and sudden loss of strength in the arms or legs, known as flaccid paralysis, occur. The paralysis is usually asymmetrical; meaning it affects the leg or arm on only one side of the body. In advanced cases, life-threatening conditions such as difficulty swallowing and paralysis of the respiratory muscles can develop. The severity of the symptoms varies depending on how large an area the virus has destroyed in the nervous system.

Transmission Routes and the Hospital Diagnosis Process

The disease is primarily transmitted through the fecal-oral route. Drinking water contaminated with the feces of an infected person, consuming food washed with such water, or touching the mouth with unwashed hands after using the toilet are the most common ways of transmission. Rarely, it can spread as a droplet infection through sneezing or coughing. To make a diagnosis at the hospital, the physician first physically examines the child's reflexes, muscle strength, and neck stiffness.

Laboratory tests are essential for a definitive diagnosis. The presence of the virus is detected by examining samples taken from the child's stool, throat swab, or cerebrospinal fluid (CSF). Virus isolation in the stool is one of the most reliable diagnostic methods and is usually confirmed with samples taken on two different days. Early diagnosis is of great importance in ensuring the isolation of the patient and preventing the transmission of the virus to other children.

Treatment Methods and Home Care

There is no specific antiviral drug that will destroy the poliovirus or a definitive cure for polio. The main goal of treatment is to alleviate symptoms, ensure the patient's comfort, and minimize permanent damage. In the early stages, supportive care is provided in the hospital. Painkillers, medications to relieve muscle spasms, and warm compresses are used to soothe muscle aches. Children whose respiratory muscles are affected need to be connected to a breathing machine (ventilator) in the intensive care unit.

After the acute period has passed, home care and a long-term physical therapy process begin. Regular physiotherapy is critical to prevent muscle wasting (atrophy) and maintain joint mobility. Orthopedic devices and splints can be used to support the child's mobility. During this challenging process, it is necessary not to neglect regular health screenings to closely monitor the children's general health status and to keep their immune systems strong.

Complications and Risk Groups

The most feared complication of the disease is respiratory failure and death resulting from the paralysis of the respiratory muscles. Some surviving children experience permanent deformities in the legs, delayed bone development, and loss of walking ability. Additionally, a condition called Post-Polio Syndrome can emerge decades (usually 15 to 40 years) after overcoming the disease.

This syndrome is characterized by new-onset weakness, severe fatigue, and joint pain in previously affected or unaffected muscles. The highest risk group is children under five years of age with incomplete vaccination schedules. Pregnant women and individuals with immunodeficiency are also at high risk of developing serious complications when they encounter the virus. It is vital for these groups to stay away from outbreak areas.

When is the Polio Vaccine Administered and Ways to Protect

The only way to protect against the poliovirus is to be vaccinated. Ensuring community immunity is the strongest shield that stops the spread of the virus. In Türkiye, two different vaccines are administered according to the Ministry of Health's vaccination schedule: the Live Attenuated Oral Polio Vaccine (OPV) given as drops in the mouth, and the Inactivated Polio Vaccine (IPV) given by injection into the arm or leg.

So, when is the polio vaccine administered? IPV, which is included in the combination vaccine, is administered to babies in their 2nd, 4th, 6th, and 18th months. Additionally, extra doses are given in the form of oral drops (OPV) at the 6th and 18th months. With the booster dose given in the 1st grade of primary school or at the 48th month, protection becomes permanent for life. Parents strictly following this schedule protect not only their own children but the entire community.

When to See a Doctor

Suspected polio is a condition that requires emergency medical intervention. You should monitor symptoms closely, especially if there is a history of travel to areas where the virus is present or if your child's vaccinations are incomplete. When you notice any of the following warning signs, you should consult a healthcare facility without delay:

• Sudden weakness and flaccidity in the arms or legs.
• The child's inability to perform walking, crawling, or standing actions they could previously do.
• Severe headache accompanied by neck stiffness (inability to touch the chin to the chest).
• Difficulty swallowing, hoarseness in the voice, or a feeling of choking while drinking liquids.

If your child has symptoms indicating that the respiratory muscles are affected, such as sudden shortness of breath, bruising, or rapid and shallow breathing, you must immediately call 112 emergency services and request an ambulance. Respiratory distress can become life-threatening within minutes.

Pediatrics Process at BHT CLINIC

At our hospital, all developmental processes, vaccination tracking, and the treatment of infectious diseases of children from birth are meticulously managed. In our Pediatrics department, our experienced physicians plan and administer vaccinations in accordance with the current vaccination schedule of the Ministry of Health. Personalized catch-up vaccination programs are created for our patients who have missed vaccines or who are visiting from abroad.

Our 24/7 emergency department and fully equipped pediatric intensive care unit provide the opportunity for rapid intervention in sudden neurological or respiratory emergencies. Bringing your child's vaccination card containing past vaccination records with you when coming for an examination will ensure the process proceeds much more efficiently.

Frequently Asked Questions

Is polio completely eradicated?

Although cases have drastically decreased worldwide, the virus continues to exist endemically in countries like Afghanistan and Pakistan. In recent years, new cases have also been seen in conflict zones like Syria due to disruptions in vaccination programs.

Is the poliovirus airborne?

The virus is primarily transmitted through the fecal-oral route, via contaminated water and food. Airborne transmission is very rare, but there is a possibility of transmission through droplets spread by an infected person's sneezing or coughing.

What should we do if we missed the vaccination schedule?

If you have missed one or more of your child's vaccine doses, there is no need to panic. You can have the missing doses completed with a plan called a catch-up schedule by consulting a pediatrician.

Is there a definitive cure for polio?

No, there is no definitive medical treatment that will eliminate the virus from the body or reverse paralysis. Current treatments are only aimed at alleviating symptoms, reducing pain, protecting muscles, and supporting respiration.

Can adults get the polio vaccine?

Yes, the inactivated polio vaccine (IPV) can be administered for protective purposes to adults who were unvaccinated in childhood, incompletely vaccinated, or who will travel to countries where the virus is prevalent. You can evaluate your risk status by consulting your physician before traveling.

You can easily book an appointment right now to have your child's vaccinations tracked and to consult with our specialist physicians.

This article is for informational purposes only; please consult your physician for diagnosis and treatment.