Polio (Poliomyelitis)

Poliomyelitis – colloquially called polio – (synonyms: Atrophic spinal paralysis; abortive poliomyelitis; acute polioencephalitis; acute polioencephalomyelitis; acute poliomyelitis; ascending progressive poliomyelitis; bulbar paralytic poliomyelitis; bulbar polioencephalitis; endemic poliomyelitis; Encephalitis due to poliovirus; epidemic polio; epidemic poliomyelitis; Heine-Medin disease; infantile bulbar paralysis; infantile paralysis; infantile spinal paralysis; meningitis due to poliovirus; myeloid bulbar polioencephalitis; nonepidemic poliomyelitis; paralysis acuta infantum; paralytic poliomyelitis due to indigenous wild virus; paralytic poliomyelitis due to imported wild virus; paralytic bulbar polio; polio; polioencephalitis; polioencephalomyelitis; Polioencephalomyelitis anterior; Poliomyelitis anterior; Poliomyelitis anterior acuta; Poliomyelitis epidemica anterior acuta; Poliomyelitis with bulbar paralysis; Spinal atrophy with acute infantile paralysis; Spinal polio; ICD-10 A80. -: Acute Poliomyelitis [Spinal Infantile Paralysis]) refers to an infection with poliovirus. This virus belongs to the enteroviruses. Polioviruses can be divided into three serotypes (I, II, III). The pathogens predominantly affect the spinal cord. Humans are currently the only relevant pathogen reservoir. Occurrence: Polioviruses used to be prevalent worldwide before the World Health Organization (WHO) launched a global eradication program. The last reported case was in Germany in 1990. Later, imported cases occurred only very sporadically. In addition, individual cases of vaccine-associated poliomyelitis occurred until 1998. The use of a new vaccine eliminated this complication. Since 2002, the WHO has declared Europe polio-free. In 2015, WHO confirmed two cases of polio in Ukraine. Today, there are only a few countries where poliomyelitis is endemic. These mainly include Afghanistan, Nigeria, Pakistan, Somalia and Syria. In order to quantify the contagiousness mathematically, the so-called contagiousness index (synonyms: contagiousness index; infection index) was introduced. It indicates the probability of a non-immune person becoming infected after contact with a pathogen. The contagiousness index for poliomyelitis is 0.1, which means that 10 out of 100 unvaccinated persons become infected after contact with a poliomyelitis-infected person.Manifestation index: Approximately 1-(5) percent of poliomyelitis-infected persons develop typical symptoms of paralysis. Transmission of the pathogen (route of infection) occurs by smear infection (fecal-oral: infections in which pathogens excreted with feces (fecal) are absorbed through the mouth (oral)), e.g., through contaminated drinking water and contaminated food. The incubation period (time from infection to outbreak of the disease) is between 3 and 35 days. Different courses of poliomyelitis can be distinguished:

  • Non-paralytic myelitis – in this case, meningitis (meningitis) occurs after abortive poliomyelitis.
  • Paralytic myelitis – most severe form of poliomyelitis; here it comes after the symptoms of non-paralytic myelitis to paresis (paralysis) and severe back and muscle pain; this form can be distinguished in turn into a spinal, bulbopontine and encephalitic form (see symptoms)
  • Abortive poliomyelitis – presents with symptoms of a flu-like infection; there are no symptoms on the central nervous system (CNS).

To be distinguished from these forms is the so-called post-polio syndrome. In this case, there is an increase in paralysis many years after the primary infection. Frequency peak: the disease occurs mainly in children between the ages of 3 and 8 years. The duration of infectivity (contagiousness) lasts as long as the virus is excreted. Excretion of the virus in the stool begins after 72 hours and can last up to 6 weeks. Course and prognosis: More than 90% of polio infections are asymptomatic (without noticeable symptoms). Only about 1% of symptomatic cases end in “classic” polio, paralytic myelitis. If the respiratory muscles are affected by the paresis, the affected persons die. For further information on the course of the disease, see above under “Different forms of poliomyelitis”. The lethality (mortality in relation to the total number of people suffering from the disease) of paralytic myelitis is 2 to 20%.Vaccination: A vaccination against poliomyelitis is available. In Germany, the disease is notifiable according to the Infection Protection Act (IfSG). Notification must be made by name in the event of suspected illness, illness and death. Suspicion is any acute flaccid paralysis unless traumatically induced.