Polio disease and eradication, vaccine benefit
January 20 2016 by
Ray Sahelian, M.D.

Polio disease caused by a viral infection involving the brain and spinal cord, can paralyze a child within hours. The polio virus enters the body through the mouth when people eat food or drink water contaminated with feces.

The care of patients with post-polio syndrome ought to be carried out by a multidisciplinary team of specialists, including medical professionals, specialists of rehabilitation, psychologists and social workers. Many therapeutic strategies might be employed to reduce the late effects of polio. Today, the management of post-polio syndrome is based on non-pharmacological intervention, including lifestyle modification, decrease of physical activity, rest periods during the day and an individually tailored training program.

Polio disease, which is incurable, leads to irreversible paralysis. Death occurs in about 5-10 percent of paralyzed patients when their breathing muscles are immobilized. Since the WHO eradication drive, cases have dropped from 350,000 in more than 125 endemic countries in 1951 to about 1,500 cases so far by November 2006 -- the lowest number ever. But as long as reservoirs of the polio virus exist, there is a danger of transmission to other countries. Twenty-five previously polio -free countries were reinfected between 2003-2005, according to the WHO.

Long term psychiatric complications of Polio disease
People who had polio in childhood seem to be at somewhat increased risk of being hospitalized for a psychiatric disorder later in life. Chronic and life-threatening diseases are known to be accompanied by increased risk of anxiety, depression, and suicide. Certain medical conditions such as childhood infections of the central nervous system could subsequently increase the risk of psychosis and schizophrenia.

Polio Eradication
The United Nations agency launched a worldwide campaign in 1988 to wipe out polio disease, but failed to reach its target of halting transmission worldwide by the end of 2005. It announced last month that Egypt and Niger were free of endemic polio, leaving only four countries where polio is endemic -- Nigeria, India, Pakistan and Afghanistan. Indonesia and Yemen were still fighting outbreaks which began in 2005.
   More than 250,000 people could contract polio every year if Nigeria, India, Pakistan and Afghanistan fail to eradicate the crippling virus. Steve Cochi, chair of an advisory panel that oversees international efforts to eliminate polio, faulted the last four countries where polio is endemic for failing to ensure children receive the cheap oral vaccine that stops its spread. "Polio continues in these few areas ... because authorities are persistently failing to reach every child," Cochi, a senior adviser on global immunizations at the U.S. Centers for Disease Control and Prevention (CDC).

Infect Dis Clin North Am. 2015 Dec;29(4):651-65. doi: 10.1016/j.idc.2015.07.003.The Challenge of Global Poliomyelitis Eradication.Garon JR1, Cochi SL2, Orenstein WA3.Author informationAbstractIn the United States during the 1950's, polio was on the forefront of every provider and caregiver's mind. Today, most providers in the United States have never seen a case. The Global Polio Eradication Initiative (GPEI), which began in 1988 has reduced the number of cases by over 99%. The world is closer to achieving global eradication of polio than ever before but as long as poliovirus circulates anywhere in the world, every country is vulnerable. The global community can support the polio eradication effort through continued vaccination, surveillance, enforcing travel regulations and contributing financial support, partnerships and advocacy.

New Polio Vaccine
New vaccine strategies could wipe out lingering reservoirs of polio virus infection in northern India and lead to global eradication of the crippling disease by the end of 2010. Polio virus infection has been eliminated in developed nations but persists in Uttar Pradesh and Bihar in India and in parts of Nigeria, Afghanistan and Pakistan. Aylward, Dr. Nicholas Grassly and Dr. Christophe Fraser of Imperial College London say that switching to a monovalent polio vaccine against the dominant strain in India from the standard trivalent polio vaccine that protects against three types of polio virus is the key. In a study published in the journal Science they said the virus has been so persistent, despite good immunization coverage in northern India, because of overcrowded living conditions and poor sanitation. The three strains in the trivalent vaccine can interfere with each other inside the body, producing immunity to one strain but not another.

Polio in Afghanistan
Afghanistan has found five cases of polio until April, 2006 compared with one this time last year largely because people in some conservative areas are suspicious of immunization.

Polio in Bangladesh
Bangladesh has reported its first case of polio virus in nearly six years, dealing a fresh blow to a global campaign to eradicate the polio disease, the World Health Organisation (WHO) said in March, 2006. A nine-year-old girl in the southern Chittagong province was paralysed in January. Genetic sequencing has confirmed it was the polio virus and that it was closely related to viruses detected in India. She was the first case reported since August 2000 in Bangladesh, which will launch a nationwide polio immunisation campaign on April 16, it said.

Polio in Namibia
Namibia's first suspected polio outbreak in more than a decade has killed seven people since early May, 2006 spurring the southern African nation to launch a mass vaccination program. "Preliminary results indicate a Polio Virus 1 (PV1) Wild Type," Kalumbi Shangula, permanent secretary for the Ministry of Health and Social Services, told reporters. Namibia was considered polio-free in the early 1990s but saw an outbreak of 53 cases of the disease in 1993, spurring another immunisation drive. Namibia's last reported polio case was in 1995, according to the World Health Organisation (WHO).

Somalia
Nearly 200 children in Somalia have been paralyzed with polio since the disease re-emerged in July 2005, and the polio virus is spreading in the lawless country, the World Health Organization (WHO) said in March, 2006. A nationwide vaccination campaign is being launched to try to reach 1.4 million Somali children under age five.

Questions
Are there any nutrients that could be helpful in polio?
   I have not seen such studies, but perhaps a small amount of creatine, such as 1 or 2 grams a day, could be tried to see if there is any muscle strength improvement.