Summary

• Usually asymptomatic. When symptomatic, the most common presentation is a minor gastrointestinal illness.
• Acute flaccid paralysis (AFP), or paralytic poliomyelitis, is the hallmark of the major illness. A minority of affected cases with AFP progress to life-threatening bulbar paralysis and respiratory compromise.
• Post-poliomyelitis syndrome may occur many years after the initial illness, and consists of weakness and fatigue in muscle groups previously affected in the acute illness.
• There is no cure for poliovirus infection, and treatment is mainly supportive.
• Early physiotherapy is key to maximising and restoring limb function in paralytic poliomyelitis and in post-poliomyelitis syndrome.
• Oral attenuated poliovirus vaccine (OPV) (Sabin) in disease-endemic and outbreak-affected areas of the world, and inactivated poliovirus vaccine (IPV) (Salk) in the rest of the world, are the cornerstones of the poliomyelitis eradication initiative.