SCIENCE WRITING: POLIO VIRUS

DOH CONFIRMS NEW POLIO CASES IN THE COUNTRY

Press Release/16 January 2020

The Department of Health (DOH) today confirmed four more polio cases in the country, bringing the total
number of polio cases to 16 since the outbreak was declared in September 2019.

The Research Institute of Tropical Medicine (RITM) reported two additional polio cases from
Maguindanao, both males, ages two- and three-years old; one polio case from Sultan Kudarat, a two-
year old male; and one polio case from Quezon City, a three-year old male. They manifested with fever,
diarrhea, muscle pain, asymmetric ascending paralysis and weakness of extremities.

DOH extended its Sabayang Patak Kontra Polio (SPKP) campaign to ensure that no child is left
unvaccinated and to boost protection for those already vaccinated. The succeeding rounds are scheduled
on January 20 – February 2 in all regions of Mindanao, and on January 27 – February 7 in the National
Capital Region.

“I urge all parents and caregivers of children under five years old to take part in the coming SPKP
campaign rounds scheduled in your respective areas. Have your children, including those with private
physicians or pediatricians, vaccinated with oral polio vaccine by health workers and bakunators.
Additional polio doses can provide additional protection to your children. There is no overdose with the
oral polio vaccine,” the Health Secretary Francisco T. Duque III said.

DOH and the Local Government Units aim to accomplish 95% coverage in all identified areas for every
SPKP round.

DOH also urges all health facilities to strengthen their Acute Flaccid Paralysis (AFP) surveillance. All
health facilities must promptly report every case of AFP in any child under 15 years of age and gather
sufficient stool specimen samples.

“The outbreak must be put to a halt, and we can only do this if all our health facilities are achieving the
targets for all AFP surveillance indicators, and if every SPKP round, ALL of the target population are
reached and vaccinated. The DOH, its partners, and the LGUs will continue to work hand-in-hand to
ensure that no child is left behind in our fight against polio,” the Health Secretary concluded.

Poliomyelitis (polio) is a highly infectious viral disease that largely affects children under 5 years of age.
The virus is transmitted by person-to-person spread mainly through the faecal-oral route or, less
frequently, by a common vehicle (e.g. contaminated water or food) and multiplies in the intestine, from
where it can invade the nervous system and cause paralysis.

In 1988, the World Health Assembly adopted a resolution for the worldwide eradication of polio,
marking the launch of the Global Polio Eradication Initiative, spearheaded by national governments,
WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC), UNICEF, and
later joined by the Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance. Wild poliovirus
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cases have decreased by over 99% since 1988, from an estimated 350 000 cases in more than 125
endemic countries then to 175reported cases in 2019.

Of the 3 strains of wild poliovirus (type 1, type 2 and type 3), wild poliovirus type 2 was eradicated in
1999 and no case of wild poliovirus type 3 has been found since the last reported case in Nigeria in
November 2012. Both strains have officially been certified as globally eradicated. As at 2020, wild
poliovirus type 1 affects two countries: Pakistan and Afghanistan.

The strategies for polio eradication work when they are fully implemented. This is clearly demonstrated
by India’s success in stopping polio in January 2011, in arguably the most technically challenging place,
and polio-free certification of the entire WHO Southeast Asia Region in March 2014.

Polio

• Symptoms & causes

• Diagnosis & treatment

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Overview

Polio is a contagious viral illness that in its most severe form causes nerve injury leading to paralysis,
difficulty breathing and sometimes death.

In the U.S., the last case of naturally occurring polio was in 1979. Today, despite a worldwide effort to
wipe out polio, poliovirus continues to affect children and adults in parts of Asia and Africa.

The Centers for Disease Control and Prevention (CDC) advises taking precautions to protect yourself
from polio if you're traveling anywhere there's a risk of polio.

Adults who have been vaccinated who plan to travel to an area where polio is occurring should receive
a booster dose of inactivated poliovirus vaccine (IPV). Immunity after a booster lasts a lifetime.

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Symptoms

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Although polio can cause paralysis and death, the majority of people who are infected with the virus
don't get sick and aren't aware they've been infected.
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Nonparalytic polio

Some people who develop symptoms from the poliovirus contract a type of polio that doesn't lead to
paralysis (abortive polio). This usually causes the same mild, flu-like signs and symptoms typical of
other viral illnesses.

Signs and symptoms, which can last up to 10 days, include:

• Fever

• Sore throat

• Headache

• Vomiting

• Fatigue

• Back pain or stiffness

• Neck pain or stiffness

• Pain or stiffness in the arms or legs

• Muscle weakness or tenderness

Paralytic syndrome

This most serious form of the disease is rare. Initial signs and symptoms of paralytic polio, such as
fever and headache, often mimic those of nonparalytic polio. Within a week, however, other signs and
symptoms appear, including:

• Loss of reflexes

• Severe muscle aches or weakness

• Loose and floppy limbs (flaccid paralysis)

Post-polio syndrome

Post-polio syndrome is a cluster of disabling signs and symptoms that affect some people years after
having polio. Common signs and symptoms include:

• Progressive muscle or joint weakness and pain

• Fatigue
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• Muscle wasting (atrophy)

• Breathing or swallowing problems

• Sleep-related breathing disorders, such as sleep apnea

• Decreased tolerance of cold temperatures

When to see a doctor

Check with your doctor for polio vaccination recommendations before traveling to a part of the world
where polio still occurs naturally or where oral polio vaccine (OPV) is used, such as Central and South
America, Africa and Asia.

Additionally, call your doctor if:

• Your child hasn't completed the vaccine series

• Your child has an allergic reaction to the polio vaccine

• Your child has problems other than a mild redness or soreness at the vaccine injection
site

• You had polio years ago and are now having unexplained weakness and fatigue
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Causes

Poliovirus can be transmitted through direct contact with someone infected with the virus or, less
commonly, through contaminated food and water. People carrying the poliovirus can spread the virus
for weeks in their feces. People who have the virus but don't have symptoms can pass the virus to
others.

Risk factors

Polio mainly affects children younger than 5. However, anyone who hasn't been vaccinated is at risk of
developing the disease.

Complications

Paralytic polio can lead to temporary or permanent muscle paralysis, disability, bone deformities and
death.
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Prevention

The most effective way to prevent polio is vaccination.

Polio vaccine

Most children in the United States receive four doses of inactivated poliovirus vaccine (IPV) at the
following ages:

• Two months

• Four months

• Between 6 and 18 months

• Between ages 4 and 6 when children are just entering school

IPV is safe for people with weakened immune systems, although it's not certain just how protective the
vaccine is in cases of severe immune deficiency. Common side effects are pain and redness at the
injection site.

Allergic reaction to the vaccine

IPV can cause an allergic reaction in some people. Because the vaccine contains trace amounts of the
antibiotics streptomycin, polymyxin B and neomycin, it shouldn't be given to anyone who's reacted to
these medications.

Signs and symptoms of an allergic reaction usually occur within minutes to a few hours after the shot.
Watch for:

• Difficulty breathing

• Weakness

• Hoarseness or wheezing

• Rapid heart rate

• Hives

• Dizziness

If you or your child has an allergic reaction after any shot, get medical help immediately.
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Adult vaccination

In the U.S., adults aren't routinely vaccinated against polio because most are already immune, and the
chances of contracting polio are minimal. However, certain adults at high risk of polio who have had a
primary vaccination series with either IPV or the oral polio vaccine (OPV) should receive a single
booster shot of IPV.

A single booster dose of IPV lasts a lifetime. Adults at risk include those who are traveling to parts of
the world where polio still occurs or those who care for people who have polio.

If you're unvaccinated or your vaccination status is undocumented, get a series of primary polio
vaccination shots — two doses of IPV at four- to eight-week intervals and a third dose six to 12 months
after the second dose.