Polio around the world?

I grew up in India and although it’s been a few decades since I left my home country, I still clearly recall some of my early schoolmates. Some because they were exceedingly noisy. Others because they were funny, friendly, bright, nice or athletic. There was one girl who was funny, friendly, bright, and nice. Not athletic, however. She had a very distinctive limp due to paralytic polio, the worst outcome of being infected with Poliovirus. Another dear friend’s little brother had been infected with the measles virus and experienced encephalitis – an inflammation of the brain. Sadly, the infection destroyed enough of his brain to stunt his intellectual development. In his 40s now, he is heavily dependent on others for all aspects of his care.

  • What’s common to polio and measles is the fact that both of these are vaccine-preventable viral illnesses.

At 13 years of age, my twin and I both decided we would study Microbiology. The unseen world fascinated us. How could something so little cause so much destruction? My later deep dive into Microbiology would leave me thrilled at the science of vaccines. To introduce our immune system to a germ without its usual risk of maiming or killing, felt like a brilliant strategy. Personally seeing the downside of not getting vaccinated was a huge impetus for saying Yes to vaccinations as a child and now as an adult.

You’ve probably heard about the incident of paralytic polio in the United States.

After smallpox was declared eradicated in 1980, much concerted effort went into eradicating polio, globally. And we came very close to doing just that.

  • For a few years now, only Pakistan and Afghanistan had shown ongoing transmission of polio.
  • So, even though the will as well as science & technology exist to get rid of the Poliovirus, we are at the free throw line and have missed all the game winning free throws so far.

Even if one person remains infected with this virus, unvaccinated individuals everywhere are at risk of getting infected.

  • The latest case in the U.S. highlights the risky scenario of an unvaccinated person being exposed to the Poliovirus and suffering the worst outcome of this infection, which is paralytic polio.

Could there be more cases that are unaccounted for? If yes, what are the risks of unaccounted cases?

Let’s take a look at what the virus does once it’s inside the human body. 

  • Poliovirus infects our throat and our gut.
    • This means the virus can be transmitted via saliva droplets or aerosols – something an unvaccinated person can then inhale.
  • This virus is also eventually shed in fecal matter.
    • This means transmission in a community may occur through lack of proper hand hygiene and sanitation.
      • A person who is susceptible can be exposed via a handshake, touching a door knob or stair railing that has virus-laden fecal matter, or even inhaling infectious droplets.

Once Poliovirus enters a vulnerable individual, the virus can cause one of four outcomes:

  1. asymptomatic illness, which is seen about 90% of the time
  2. minor illness such as fever, headache, malaise, sore throat and even vomiting,
  3. aseptic meningitis – where the virus spreads to the central nervous system and causes not only symptoms of minor illness, but also back pain and muscle spasms, or
  4. paralytic polio, which is the most severe outcome, where an arm, leg, abdomen, back, diaphragm, bladder, etc. gets paralyzed.
    • Paralytic polio can lead to death, when breathing muscles are paralyzed.
      • Patients are contagious through all four outcomes.

Because the poliovirus is only found in humans, the existence of two types of highly effective polio vaccines should allow us to eradicate this virus.

  • However, geopolitical conflicts, deep distrust of outside healthcare agencies, resources under tremendous strain from the COVID-19 pandemic, war, and the ongoing pandemic of false information on vaccines, all conspire to ensure that the poliovirus continues to find non-immune individuals to infect.

If we understand what the virus does, we can counter that with our own strategies.

  • All a virus wants to do is find its host (human in this case), get inside the host, find the cells it can infect, and when it does – it is time to procreate – make more copies of itself.
    • Self-propagation.
      • Very similar to humans, actually.
  • Humans are very much interested and invested in self-propagation.
    • Who will win?
      • A virus unseen to the human eye and thriving in the rich environment of global warming & globalization, war & distrust, misinformation & disinformation?
      • Or the human, propped up by the best science and technology at her fingertips, and yet hobbled by a lack of belief and some say, even of common sense in some of her fellow humans?

The prevailing thought is that the young man from New York picked up the poliovirus in Europe before returning back home.

None of this is good.

  • Paralytic polio is the least frequent outcome of polio.
  • Less than 2% of infections result in this outcome.
  • Of the vast majority of infections that are asymptomatic, how many will end up in which corner of the globe?
    • The bad news is that individuals with any of the four outcomes of Poliovirus infection are contagious.

The good news is we have several measures to stop transmission of Poliovirus:

  1. Vaccination
    • 99% of recipients are immune after three doses of the inactivated polio vaccine.
  2. Good hand hygiene
    • Wash your hands before touching your eyes, nose or mouth.
      • This will protect you not only from the poliovirus, but multiple other viruses, including those that cause the flu or COVID-19.
  3. Good environmental hygiene
    • Poliovirus is extremely hardy outside the human body.
    • Adequately disinfecting common use areas that see high traffic – door knobs, nurse’s stations, common desks or telephones, etc. – can eliminate multiple viruses, including Poliovirus.
  4. Continued use of facemasks
    • We know the science behind them and we know the masks work.
      • Such a simple matter to continue using them, especially if you are in crowded places, indoors with people you don’t know, or just feel like adding a layer of protection to your everyday getup.

It’s not difficult to say no to infections.

  • The key is to stay informed and take actions that are grounded in science.
  • The purpose of this post is to keep you informed.

Say No to infections, my friends, and stay healthy.