Poliomyelitis commonly known as polio is an infectious viral disease which attacks young children, particularly under the age of five. The causative organism is the polio virus and the disease spreads either orally or by faecal route or sometimes by a common vector such as contaminated food and/or water. There are three strains of the wild type polio virus (type 1, type 2 and type 3). The virus proliferates in the intestines of the victims. Hence, places of poor sanitation and hygiene become a breeding ground for polio. The earliest recorded evidence of polio is an Egyptian stele, probably belonging to the period of 1580–1350 B.C., that portrays a priest with a weakened leg suggesting that polio might have been around for centuries. However, the first modern day clinical documentation and description was given by a British physician, Dr. Michael Underwood in the year 1789. In 1908, the causative organism was identified by two Austrian physicians, Dr. Karl Landsteiner and Dr. Erwin Popper . The subsequent years saw outbreaks of polio in many parts of the world and children were affected in large numbers.
The symptoms of polio include fever, fatigue, headache, vomiting, stiffness in the neck, and pain in the limbs as initial signs. Since the virus attacks the nervous system predominantly, permanent paralysis is seen in a small share of the cases (one in 200). 5-10% of permanent paralysis victims whose lung muscles become immobilized face death.
Unfortunately polio has no cure. It can only be prevented by immunization. Since the major outbreak of polio in the United States around 1916, attempts were made at finding a preventive method. In 1929, Philip Drinker, an industrial hygienist and Louis Shaw, an instructor of physiology at Harvard University, developed the Drinker Respirator also called the “iron lung” to aid respiration. In 1953, Dr. Jonas Salk and his associates at the University of Pittsburgh developed the first polio vaccine. Later on Dr. Albert Sabin of Russia developed another polio vaccine that could be easily administered (the oral polio vaccine). Since then many mass administration camps have been held across the world in different countries. With the development and evaluation of bivalent oral polio vaccine in 2009, the Global Polio Eradication Initiative supported by the United Nations now has an armoury of five different vaccines to stop polio transmission: Inactivated polio vaccine (IPV), Trivalent oral polio vaccine (tOPV), Bivalent oral polio vaccine (bOPV) and Monovalent oral polio vaccines (mOPV1 and mOPV3). In May 2012, the World Health Assembly declared the completion of polio eradication a programmatic emergency for global public health and the Polio Eradication and Endgame Strategic Plan 2013-2018 was developed. According to the plan, there are four objectives:
Contain poliovirus and certify interruption of transmission
Plan polio’s legacy
The good news is that polio cases have been decreased by 99% since 1988. From a number of 350,000 cases only 359 cases were reported in 2014. With the exception of two countries, Pakistan and Afghanistan, all the other countries have stopped the transmission of polio; some of them are in fact polio-free. Wild poliovirus type 2 was eradicated in 1999 and case numbers of wild poliovirus type 3 are now at their lowest. The last report of wild type 3 was in the year of 2012 from Nigeria.
The geographical spread of polio in the current scenario can be shown as (countries excluded have no or very low incidence of polio)
as opposed to the spread in 1988
Today many national governments encourage the citizens to immunize their kids at least twice in their lifetimes to ensure that they are safe from polio. Immunizing as many kids as possible decreases the incidence of polio while skipping even one kid can increase its susceptibility. However, as of now the future for polio eradication looks stronger than it was a century and it would be just a matter of years before polio would completely disappear from the map. As responsible citizens we can play a part by spreading awareness on the importance of polio immunisation; thereby being the change that we wish to see.
REFERENCES
Anon. History of polio. Global Polio Eradication Initiative > Polio and prevention > [Internet]. [cited 2016 Feb 11]. Available from: http://www.polioeradication.org/polioandprevention/historyofpolio.aspx#sthash.2yfrhbn7.dpuf
Anon. Key publications. Global Polio Eradication Initiative > Home [Internet]. [cited 2016 Feb 11]. Available from: http://www.polioeradication.org/#sthash.6h39oaxr.dpuf
Anon. Polio Eradication and Endgame Strategic Plan 2013–2018. Global Polio Eradication Initiative > Resource library > Strategy and work [Internet]. [cited 2016 Feb 11]. Available from: http://www.polioeradication.org/resourcelibrary/strategyandwork.aspx#sthash.lw2kv68w.dpuf
Anon. Poliomyelitis (polio). World Health Organization [Internet]. [cited 2016 Feb 11]. Available from: http://www.who.int/topics/poliomyelitis/en/
