Post Polio Syndrome

Oct 25, 2019

World Polio Day was earlier this week– on October 24, 2019.  Many people do not realize that polio still exists.  There are currently two countries that are polio endemic—Afghanistan and Pakistan. Efforts toward the complete eradication of this disease are continuing and, as of October 16, the Global Polio Eradication Initiative reports that there have only been 88 cases of wild poliovirus in 2019. 

Polio, or poliomyelitis, is an infectious viral disease that can strike at any age and affects a person’s nervous system.  Between the late 1940s and early 1950s, polio crippled around 35,000 people each year in the United States.  The first safe and effective polio vaccine was approved in the U.S. in 1955.

While the United States was declared polio free in 1979, people who had the virus in their youth are now at risk of Post Polio Syndrome.  Post Polio Syndrome refers to symptoms that appear decades — an average of 30 to 40 years — after the initial polio illness.

Factors that can increase your risk of developing Post Polio Syndrome include:

  • Severity of polio infection. The more severe the initial infection, the more likely that you’ll have signs and symptoms of post-polio syndrome.
  • Age of initial illness. If you developed polio as an adolescent or adult rather than as a child, your chances of developing post-polio syndrome increase.

Common signs and symptoms of Post Polio Syndrome include:

  • Progressive muscle and joint weakness and pain
  • General fatigue and exhaustion with minimal activity
  • Muscle atrophy
  • Breathing or swallowing problems
  • Sleep-related breathing disorders
  • Decreased tolerance of cold temperatures

In most people, post-polio syndrome tends to progress slowly, with new signs and symptoms followed by periods of stability.

There are no laboratory tests specific for Post Polio Syndrome and symptoms vary greatly among individuals.  Physicians diagnose Post Polio Syndrome after completing a comprehensive medical history and physical examination, and by excluding other disorders that could explain the symptoms. Post Polio Syndrome may be difficult to diagnose in some people because other medical conditions can complicate the evaluation.  Depression, for example, is associated with fatigue and can be misinterpreted as Post Polio Syndrome.   

Post-polio syndrome is rarely life-threatening, but severe muscle weakness can lead to complications:

  • Falls due to weakness in leg muscles
  • Malnutrition, dehydration and pneumonia due to weakness in the muscles involved in chewing and swallowing
  • Chronic respiratory failure due to weakness in the diaphragm and chest muscles
  • Osteoporosis due to prolonged inactivity and immobility. A person with post-polio syndrome should discuss bone-density screening with their physician.

Falling is often a concern as we age, but is a person with Post Polio Syndrome is at great risk of falling. Fall prevention hints include:

  • Have your hearing and vision checked regularly.
  • If prescribed a new medication, check with your doctor about side effects that might affect your balance.
  • Wear rubber-soled and low-heeled shoes that fit well.
  • Avoid wearing socks when walking inside on hardwood or linoleum flooring.
  • Be careful when walking outdoors in wet or icy conditions. Take your cell phone with you on walks.
  • Exercise regularly to maintain strong bones, strength, and flexibility. Ask your doctor or health care provider about the best type of exercise program for you.
  • Keep your home safe – remove things you can trip over from stairs and high traffic areas.
  • Install handrails or grab bars in your bathroom or other areas where you may need extra support, such as stairs and hallways.
  • Make sure to have adequate lighting throughout your home.

Regular doctors visits are important as we age. If you are a polio survivor, make sure this is noted in your medical records and discuss with your doctor what you should watch for given your personal history.