118: Poliomyelitis

Classification: ICD-9 045; ICD-10 A80

Syndromes and synonyms: Polioviral fever, infantile paralysis, acute flaccid paralysis (AFP), bulbar polio.

Agent: Poliovirus, an RNA enterovirus with three types; type 1 cases are most common, followed by type 3; wild type 2 disappeared in 1999. Rare cases of all three types occur in unimmunized contacts of children vaccinated with the Sabin live attenuated vaccine.

Reservoir: Humans, generally children with inapparent infections.

Transmission: Oro-fecal. 100% of susceptible contacts become infected. Virus appears in the throat < 36 hours after infection, for a week, and in the feces after 72 hours for 3–6 weeks. Transmission through contaminated water and food has been reported rarely.

Incubation period: 3–35 days; 6–20 for paralytic cases.

Clinical findings

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