see also:

• viruses

• a once common viral infection which can infect the spinal cord (transverse myelitis) and cause permanent paralysis
• now re-emerging in Africa, Pakistan and the Middle East

• often asymptomatic
• symptomatic patients have:
  • incubation period 3-21 days
  • initial prodrome:
    • fever
    • malaise
    • headache
    • nausea
    • vomiting
    • muscle stiffness
  • later rapid onset paralysis:
    • usually assymetric limb involvement causing acute flaccid paralysis
    • may have respiratory muscle or swallowing muscles affected

• all infants should be vaccinated for polio at 2,4 and 6 months and have a booster at 4 yrs age
• travellers to high risk areas should have proof of vaccination and may be required to have a booster before travel if staying greater than 4 weeks
• those likely to be exposed (eg. healthcare workers in high risk areas or likely to Rx a returned traveller), should have had full vaccination and a booster every 10 years
• as of 2014, high risk areas include:
  • Pakistan, Cameroon, Syria, Afghanistan, Equatorial Guinea, Ethiopia, Iraq, Israel, Somalia, and Nigeria