Poliovirus infection

Last reviewed: 21 Apr 2022
Last updated: 06 Apr 2022

Summary

Definition

History and exam

Key diagnostic factors

  • unimmunised status
  • residence or travel in endemic area
  • decreased tone and motor function of affected limb
  • decreased tendon reflexes of affected limb
  • muscle atrophy of affected limb
More key diagnostic factors

Other diagnostic factors

  • age <36 months
  • gastrointestinal prodrome
  • fever
  • malaise
  • respiratory muscle atrophy and respiratory distress
Other diagnostic factors

Risk factors

  • lack of vaccination
  • poor sanitation
  • poverty
  • area of endemic infection
  • immunosuppression
More risk factors

Diagnostic investigations

Investigations to consider

  • virus culture from stool, CSF, or pharynx
  • CSF analysis
  • serum antibodies to poliovirus
  • MRI of spinal cord
  • electromyelogram (EMG) of affected limb
More investigations to consider

Treatment algorithm

INITIAL

gastrointestinal illness: poliovirus suspected

ACUTE

paralytic poliomyelitis (acute flaccid paralysis)

ONGOING

post-poliomyelitis syndrome (PPS)

Contributors

Authors

Omar A. Khan, MD, MHS, FAAFP
Omar A. Khan

President and CEO

Delaware Health Sciences Alliance

Physician Leader, Partnerships & Academic Programs

Christiana Care Health System

Associate Professor

Department of Family & Community Medicine

Sidney Kimmel Medical College of Thomas Jefferson University

Newark

DE

Disclosures

OAK is an author of a number of references cited in this topic.

David L. Heymann, MD, DTM&H

Professor of Infectious Disease Epidemiology

London School of Hygiene and Tropical Medicine

University of London

Head

Centre on Global Health Security - Chatham House

London

UK

Disclosures

DLH is an author of a number of references cited in this topic.

Peer reviewers

Javed M. Gilani, MD, FRCP, FACP

Assistant Clinical Professor

Jefferson Medical College

Philadelphia

PA

Disclosures

JMG declares that he has no competing interests.

Gregory Pappas, MD, PhD

The Nordin M. Thobani Professor and Chairman

Department of Community Health Sciences

Aga Khan University

Karachi

Pakistan

Disclosures

GP declares that he has no competing interests.

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