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Poliomyelitis (Polio) Information for Patients

Poliomyelitis (polio) is an infection of the nervous system caused by a virus. It is spread from person to person. Most people who get the polio virus will have no symptoms. In some people, the virus causes short-term symptoms including fever, fatigue, nausea, headache, neck and back stiffness, and limb pain. In some people, the virus causes more serious disease with long-term effects such as paralysis. If the person cannot breathe due to paralysis of the respiratory muscles, death can result. The risk of death increases with age.

Most people in the United States got the polio vaccine as children and do not need another vaccine in adulthood. Those adults who are at risk for polio infection should receive a booster dose. These adults include:

  • Those traveling to countries with high rates of the disease, such as Afghanistan, India, Pakistan and Nigeria

  • Health care workers in contact with patients who may have polio virus

  • Members of groups that do not vaccinate and have had an outbreak of even a single case of polio, especially after traveling to at-risk areas

  • Lab workers handling specimens that may contain polio virus

Polio vaccine is safe for pregnant and breastfeeding women. Those who are at risk should get the vaccine because pregnancy makes them more likely to become ill if they get infected.

All current polio vaccines protect against all three types of the polio virus. The vaccine is given to high-risk adults in three doses on the following schedule:

  • First dose at anytime

  • Second dose 1–2 months later

  • Third dose 6–12 months following the second dose.

Visit the Center for Disease Control and Prevention's page on polio vaccination for more information.

Last Updated: 8/7/2013

Poliomyelitis (Polio) Information for Ob-Gyns

Most U.S. adults are at low risk for polio exposure and are likely to have received polio immunizations. Therefore, routine immunization for adults 18 years or older is not recommended.  However, some U.S. adults are at increased risk for polio exposure.  Adults in any of the four groups listed below should be assessed for immunity and offered any additional doses:

  • Individuals traveling to countries where polio is endemic (Afghanistan, India, Pakistan and Nigeria) need to be immunized, or if previously immunized will generally need a one-time booster immunization. 

  • Health care personnel in close contact with patients shedding polio virus (unlikely in the United States).

  • Groups that do not vaccinate, and have had an outbreak of even a single case of polio, especially after traveling to endemic areas.

  • Lab workers handling specimens that may contain polioviruses (unlikely in the United States).

The polio vaccine should be given to pregnant/breastfeeding women who are at risk; the attack rate of polio is greater in pregnant versus nonpregnant women.

All current polio vaccines are trivalent, designed to protect against all three serotypes of poliovirus.  Two inactivated polio vaccines (IPV) are licensed in the United States, but only the IPOL (Sanofi Pasteur) is actually distributed.  IPV is given to adults in three doses on the following schedule:

  • Initial dose at anytime

  • Second dose 1-2 months later

  • Third dose 6-12 months following the second dose.

Due to the frequency and speed of worldwide travel, continued immunization and vigilance are required to maintain any area’s freedom from polio.  Clinicians are the most likely to first suspect a case of breakthrough polio.  Even a single suspected paralytic polio case should be reported immediately to state and local health departments and then to the CDC at 404-639-8255.  Be prepared to give preliminary clinical and other information, such as the patient’s vaccine history and any patient contact with the oral polio vaccine.  Two cases of suspected paralytic polio suggest the presence of virus in 200 asymptomatic or mildly symptomatic persons.  Also, this would suggest a potential for wild polio transmission and should be reported as above, with urgency.  Two cases of suspected paralytic polio would require outbreak control, with vaccination of everyone in the epidemic area whose vaccine histories are uncertain, from the age of 6 weeks and older. Persons who have a history of polio disease also should be immunized with IPV, as the likelihood that they have had all three serotypes of polio is low; they may be susceptible to the other two serotypes and need vaccine protection.

The need to obtain specimens early in the disease course is vital.  Two stool specimens, 24 hours apart, during the first 14 days after the onset of paralytic disease give the highest likelihood of poliovirus isolation; two pharyngeal swabs, 24 hours apart, give an intermediate likelihood of poliovirus isolation.  Any suspected polio case in a member of a group (religious or otherwise) abstaining from vaccination must be assigned the highest priority for urgent follow-up and specimen collection.

Due to United States’ success in eliminating polio, the more powerful oral polio vaccine is no longer used in this country, although this vaccine is still appropriately in use globally.  In countries where polio is currently endemic or during polio outbreaks, the oral polio vaccine remains the best strategy for reducing the total number of cases of polio infection.

Visit CDC's section on polio vaccination for more information.

Last Updated: 8/7/2013

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