Poliomyelitis or simply Polio is an infectious disease mostly affecting children younger than 5 years of age and is caused by Poliovirus. It is usually transmitted from one person to another by infected fecal material, by food or water containing human feces. Those who are infected by poliovirus can spread the disease for up to six weeks even if no symptoms are present.
WHAT IS POLIO VIRUS?
Poliovirus is icosahedral in shape i.e. it is a polyhedron with 20 faces. It is an RNA virus belonging to family Enterovirus.
Poliovirus infects and cause disease in human alone. It is mostly seasonal having a peak infection rate in summer and autumn. Other factors that may increases the risk of poliovirus infection are malnutrition and immune deficiency.
After transmission, poliovirus enters the body through the mouth and attacks the cells of pharynx or intestine where it invades inside the cell and starts to multiply in number. After a sufficient number, they spread to tonsils, intestinal lymphoid tissues, mesenteric and cervical lymph nodes where they multiply rapidly increasing in number and being released in the bloodstream (the presence of the virus in blood without causing any symptoms is called viremia). Once in the blood, it now gets distributed to all parts of the body. After the the virus has multiplied a certain number it may cause flu-like symptoms or it may even invade the central nervous system and brain causing meningitis. It habitat and resides in the gastrointestinal tract particularly oral cavity, pharynx and intestine.
SIGNS & SYMPTOMS:
About 95 percent of people affected by polio are asymptomatic. These individuals may not show any signs and symptoms but can transmit the virus to others. This is known as “subclinical polio”.
The another type of polio that mostly affects throat is called non-paralytic polio or abortive polio showing only flu-like symptoms which can last for around 10 days.
The signs and symptoms include
· Fever
· Headache
· Vomiting
· Fatigue
· Meningitis
· Sore throat
In 1 percent of individuals infected by polio can lead to paralysis of the brainstem (bulbar polio), spinal cord (spinal polio) or both. This type is obviously called Paralytic polio.
Initially, the signs and symptoms are similar to abortive polio, but more severe symptoms can appear after 7-10 days which are
· Loss of reflexes
· Severe spasms and muscle pain
· Loose and floppy limbs, sometimes on just one side of the body
· Sudden paralysis, temporary or permanent
· Deformed limbs, especially the hips and feet
In less than 1 percent to individuals, paralysis of the whole body can occur. In some of the cases, the virus may attack the respiratory muscles which can result in death.
Even after the polio infection is recovered, it is estimated that in 25-50% of people, the poliovirus can reactivate again after 15-40 years, this can result in Post-polio syndrome.
The signs and symptoms may include
· Breathing problems during sleeping (sleep apnea)
· Fatigued or exhausted
· Muscle pain and joint weakness
· Trouble breathing and swallowing
· Cold intolerance
IS THERE ANY CURE TO POLIO?
There is no cure to polio; the best way to treat is by prevention or by vaccination.
The schedule for polio shot as recommended by the Center of Disease Control and Prevention in children are as under:
·
2
months 
One dose
·
4
months One dose
·
6-18
months Booster dose
In some children, mild or severe allergic reactions can take place after a polio shot.
The symptoms might be:
· Swollen throat
· High fever
- Dizziness
· Hives
· Breathing problems
Adults in the US are not at risk of contracting polio. However, it is necessary to get a series of shots if:
· You are traveling to an area that had a polio outbreak recently
· You are taking care or living with someone infected with polio
· You handle a laboratory specimen of the virus
· You have your tonsils removed
Furthermore, pregnant women, children and immunocompromised individuals are also at great risk of contracting poliovirus.
POLIO IN THE WORLD:
Polio was the most feared diseases in the the early 1970s and it was prevalent in developing as well as underdeveloped countries.
However, in 1985 a global effort to eradicate polio was launched by Rotary International. When the Global Polio Eradication Initiative was established in 1988, around 1000 children were paralyzed by polio every day.
Since then, more than 2.5 million children were immunized and in 32 years the reported cases have declined to more than 99%.
The completely polio-free regions are Europe, North and South America, Western Pacific and South East Asia. Out of In 195 countries only 3 countries are still polio-endemic areas. These countries are Afghanistan, Pakistan, and Nigeria.
POLIO ERADICATION CHALLENGES IN PAKISTAN
The major issues faced by Pakistan in the eradication of polio is a high percentage of environmental water samples being tested positive for poliovirus, vaccine refusal, misconception about the polio vaccine, and killing of polio workers.
Many people of northern regions of Pakistan believe that the polio vaccine is derived from pork, which is forbidden in Islam. While others think that it may cause sterility in their children or that the polio vaccine was against the sovereignty of the country.
Awareness regarding polio vaccine is required in Pakistan from the government as well as from religious scholars so that the country can fight the battle against Polio.
POLIO ERADICATION CHALLENGES IN AFGHANISTAN
There is no parental refusal against immunization in Afghanistan.
However, political instability and ongoing conflicts are making it difficult to reach the hard access area and migration of people from Afghanistan to Pakistan is making it difficult for both countries to contain the disease.
According to 2017 polio results of Afghanistan
· 9.9 million children targeted to receive polio vaccines during every national campaign.
· 10 campaigns, including 4 National Immunization Days and smaller campaigns in priority districts.
· More than 65,000 frontline workers deployed, including vaccinators and social mobilizers.
- 111.2 a million doses of vaccines procured.
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