Polio - A Resurging Disease?

The Philippines has been polio-free since 2000. However, this has changed as of three months ago.

Polio, an incurable, irreversible, crippling, and potentially fatal disease, has been reported to have recurred in the country in September 2019. As part of a comprehensive response, the Philippine Department of Health (DOH) and its partners are conducting an ongoing mass polio immunisation drive. The World Health Organisation (WHO) is providing technical advice pertaining to the response, monitoring and supporting risk communication as well.

This resurgence of the polio outbreak is reportedly due to a circulating vaccine-derived poliovirus (cVDPV). An excreted vaccine-virus left to circulate in a poorly vaccinated community or population, cVDPV allows the spread of the virus, since there is no adequate protection.

Polio, or “Poliomyelitis”, is caused by a highly infectious virus that invades the nervous system, damaging nerves, and ultimately leading to paralysis. Some end up having difficulty in breathing, requiring being hooked up to machines to help them breath. Many such patients end up succumbing to the disease, due to the immobility of the respiratory muscles.

The virus is spread through the faecal-oral route and is caused by direct contact with an infected person or by the ingestion of contaminated food and beverage. Polio mainly affects children who are five years old and younger. However, anybody who has not been vaccinated is still susceptible to infection.

The good news is that it can be treated easily through administration of antibiotics, or in severe cases, intravenous fluids.

While some people do not develop visible symptoms despite being infected, one should be wary of signs and symptoms of polio, as they mimic those of a regular flu or other viral illnesses. These include:

• Fever
• Tiredness or fatigue
• Nausea and vomiting
• Headache
• Sore throat
• Pain and stiffness in neck, back, arms, and/or leg
• Weakening of muscles
• Stomach pain

There is no cure for polio and the paralysis it brings is permanent. The only answer to this disease is prevention via routine vaccination. Two types of vaccines can prevent polio:

1. Inactivated Polio Vaccine (IPV), which is the only vaccine used in the U.S. since 2000
2. Oral Polio Vaccine (OPV), which is still widely used in other countries

So, who needs the vaccination?

Children require at least 4 doses of the vaccine, shots given either on the arms or legs. The polio vaccine may be administered together with other vaccines.

It is important that all required doses be completed before travelling to a country where there is greater risk for polio. If completion is not feasible, an accelerated schedule must be taken as follows:

• 6 weeks or older
• 4 or more weeks after the 1st dose
• 4 or more weeks after the 2nd dose
• 6 or more months after the 3rd dose

If the accelerated schedule was taken, ensure that the booster dose is still administered at four years of age, so long as six months has lapsed from the last dose.

Although adults are most likely already vaccinated in their early years, vaccination is recommended for those:

• travelling to a country where polio is of great risk
• dealing with polio patients (e.g. healthcare workers)
• working in an environment or laboratories dealing with specimens that may contain polioviruses

Adults who fall within the above situations must be vaccinated following this schedule:

• 1st dose at any time
• 2nd dose at 1-2 months after the first
• 3rd dose at 6-12 months after the second

If vaccines were previously taken but are incomplete, it is advisable to get remaining doses, regardless of how long it has been since earlier dose/s. A one-off lifetime booster dose is also available for adults who may have completed the full routine.

People who are ill should delay the administration of the polio vaccine until they have recovered. Anybody who has had allergies after a dose of IPV should avoid getting this vaccine. Ask your healthcare provider for information about the vaccine and its content prior to receiving the shot.