Summary
Definition
History and exam
Key diagnostic factors
- unimmunized 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
Other diagnostic factors
- age <36 months
- gastrointestinal prodrome
- fever
- malaise
- respiratory muscle atrophy and respiratory distress
Risk factors
- lack of vaccination
- poor sanitation
- poverty
- area of endemic infection
- immunosuppression
Diagnostic tests
Tests to consider
- virus culture from stool, CSF, or pharynx
- CSF analysis
- serum antibodies to poliovirus
- MRI of spinal cord
- electromyelogram (EMG) of affected limb
Treatment algorithm
gastrointestinal illness: poliovirus suspected
paralytic poliomyelitis (acute flaccid paralysis)
postpoliomyelitis syndrome (PPS)
Contributors
Authors
Omar A. Khan, MD, MHS, FAAFP
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.
Differentials
- Viral gastroenteritis in adults
- Transverse myelitis
- Guillain-Barre syndrome (GBS)
More DifferentialsGuidelines
- Recommended child and adolescent immunization schedule for ages 18 years or younger, United States, 2023
- Recommended adult immunization schedule for ages 19 years or older, United States, 2023
More GuidelinesPatient information
DTaP vaccine (diphtheria, tetanus, polio, and pertussis)
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