Polio - Knowledge

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again for knee flexion when the swing phase is initiated. With the help of an orthotic treatment with a stance phase control knee joint, a natural gait pattern can be achieved despite mechanical protection against unwanted knee flexion. In these cases, locked knee joints are often used, which have a good safety function, but do not allow knee flexion when walking during swing phase. With such joints, the knee joint remains mechanically blocked during the swing phase. Patients with locked knee joints must swing the leg forward with the knee extended even during the swing phase. This only works if the patient develops compensatory mechanisms, e.g. by raising the body's center of gravity in the swing phase (Duchenne limping) or by swinging the orthotic leg to the side (circumduction).

992: 1508: 2249: 1110: 670: 8914: 8894: 9141: 2217:, were identified. It was the first outbreak in Syria since 1999. Doctors and international public health agencies report more than 90 cases of polio in Syria, with fears of contagion in rebel areas from lack of sanitation and safe-water services. A vaccination campaign in Syria operated literally under fire and led to the deaths of several vaccinators, but returned vaccination coverage to pre-war levels. Syria is currently free of polio, but is considered "at risk". 1228: 2433:. The World Health Organization estimates that there are 10 to 20 million polio survivors worldwide. In 1977, there were 254,000 persons living in the United States who had been paralyzed by polio. According to doctors and local polio support groups, some 40,000 polio survivors with varying degrees of paralysis were living in Germany, 30,000 in Japan, 24,000 in France, 16,000 in Australia, 12,000 in Canada and 12,000 in the United Kingdom in 2001. Many 2302: 64: 9129: 1598: 9117: 443:(weakened) live virus. Through the use of both types of vaccine, incidence of wild polio has decreased from an estimated 350,000 cases in 1988 to 30 confirmed cases in 2022, confined to just three countries. In rare cases, the traditional OPV was able to revert to a virulent form. An improved oral vaccine with greater genetic stability (nOPV2) was developed and granted full licensure in December 2023. 884: 9102: 9088: 2384:

one-third of the cases were reported in persons over 15 years of age. Accordingly, the rate of paralysis and death due to polio infection also increased during this time. In the United States, the 1952 polio epidemic became the worst outbreak in the nation's history. Of the nearly 58,000 cases reported that year, 3,145 died and 21,269 were left with mild to disabling paralysis.

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permanent; cells that are not destroyed, but lose function temporarily, may recover within four to six weeks after onset. Half the patients with spinal polio recover fully; one-quarter recover with mild disability, and the remaining quarter are left with severe disability. The degree of both acute paralysis and residual paralysis is likely to be proportional to the degree of

979:, which is known as nonparalytic aseptic meningitis. Penetration of the CNS provides no known benefit to the virus, and is quite possibly an incidental deviation of a normal gastrointestinal infection. The mechanisms by which poliovirus spreads to the CNS are poorly understood, but it appears to be primarily a chance event – largely independent of the age, gender, or 1641:(CFR) varies by age: 2 to 5 percent of children and up to 15 to 30 percent of adults die. Bulbar polio often causes death if respiratory support is not provided; with support, its CFR ranges from 25 to 75 percent, depending on the age of the patient. When intermittent positive pressure ventilation is available, the fatalities can be reduced to 15 percent. 1519:), it has been the vaccine of choice for controlling poliomyelitis in many countries. On very rare occasions, the attenuated virus in the Sabin OPV can revert into a form that can paralyze. In 2017, cases caused by vaccine-derived poliovirus (cVDPV) outnumbered wild poliovirus cases for the first time, due to wild polio cases hitting record lows. Most 958:, the presence of a virus in the bloodstream enables it to be widely distributed throughout the body. Poliovirus can survive and multiply within the blood and lymphatics for long periods of time, sometimes as long as 17 weeks. In a small percentage of cases, it can spread and replicate in other sites, such as 2269:, but this was the only attack. Local traditional and religious leaders and polio survivors worked to revive the campaign, and Nigeria was removed from the polio-endemic list in September 2015 after more than a year without any cases, only to be restored to the list in 2016 when two cases were detected. 2594:

Even if polio can be eliminated completely from the world population, vaccination programs should continue for at least ten years. The retention of live poliovirus samples in laboratories and vaccine manufacturing facilities (which carry a risk of escape of the virus) should progressively be reduced.

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were unknown before the 20th century; up until that time, polio was an endemic disease worldwide. Mothers who had survived polio infection passed on temporary immunity to their babies in the womb and through breast milk. As a result, an infant who encountered a polio infection generally suffered only

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In 2021, Types 2 and 3 were fully eradicated from every country, however type 1 cases still remain in Pakistan and Afghanistan. A majority of countries have successfully eradicated polio, with Pakistan and Afghanistan being the last countries with endemic cases of poliovirus. The following countries

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In 2021, there were just six confirmed cases of wild poliovirus — one in Pakistan, four in Afghanistan, and one in Malawi. The case in Malawi, the country's first in almost three decades and the first in Africa in five years, was seen as a significant setback to the eradication effort. 23 countries

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An improved oral vaccine (Novel oral polio vaccine type 2 - nOPV2) began development in 2011 and was granted emergency licencing in 2021, and subsequently full licensure in December 2023. This has greater genetic stability than the traditional oral vaccine and is less likely to revert to a virulent

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The likelihood of developing paralytic polio increases with age, as does the extent of paralysis. In children, nonparalytic meningitis is the most likely consequence of CNS involvement, and paralysis occurs in only one in 1000 cases. In adults, paralysis occurs in one in 75 cases. In children under

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Ninety or so afflicted children may sound like a small number, but they are only a tiny manifestation of an enormous problem, since for each crippled child up to one thousand more are silently infected. Polio is so contagious that a single case is considered a public health emergency. Ninety cases

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can be included in the therapy concept. Today, modern materials and functional elements enable the orthosis to be specifically adapted to the requirements resulting from the patient's gait. Mechanical stance phase control knee joints may secure the knee joint in the early stance phases and release

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were promising; the gamma globulin was shown to be about 80 percent effective in preventing the development of paralytic poliomyelitis. It was also shown to reduce the severity of the disease in patients who developed polio. Due to the limited supply of blood plasma gamma globulin was later deemed

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With prolonged transmission of this kind, the weakened virus can mutate and revert to a form that causes illness and paralysis. Cases of cVDPV now exceed wild-type cases, making it desirable to discontinue the use of the oral polio vaccine as soon as safely possible and instead use other types of

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orphaned muscle fibers that have been denervated by acute polio infection, restoring the fibers' capacity to contract and improving strength. Terminal sprouting may generate a few significantly enlarged motor neurons doing work previously performed by as many as four or five units: a single motor

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processes involved in recovery following acute paralytic poliomyelitis are quite effective; muscles are able to retain normal strength even if half the original motor neurons have been lost. Paralysis remaining after one year is likely to be permanent, although some recovery of muscle strength is

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OPV efficiently blocks person-to-person transmission of wild poliovirus by oral–oral and fecal–oral routes, thereby protecting both individual vaccine recipients and the wider community. The live attenuated virus may be transmitted from vaccinees to their unvaccinated contacts, resulting in wider

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Snider, Cynthia J.; Boualam, Liliane; Tallis, Graham; Takashima, Yoshihiro; Abeyasinghe, Rabindra; Lo, Ying-Ru; Grabovac, Varja; Avagyan, Tigran; Aslam, Syeda Kanwal; Eltayeb, Abu Obeida; Aung, Khin Devi; Wang, Xiaojun; Shrestha, Achyut; Ante-Orozco, Carla; Silva, Maria Wilda T. (23 March 2022).

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In 2022, there were 30 confirmed cases of WPV1 reported to WHO, with two cases in Pakistan and 20 Afghanistan respectively, while eight non-endemic cases were recorded in Mozambique, the first cases in the country since 1992. The Mozambique cases derived from the strain of Pakistani origin that

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Patients with abortive polio infections recover completely. In those who develop only aseptic meningitis, the symptoms can be expected to persist for two to ten days, followed by complete recovery. In cases of spinal polio, if the affected nerve cells are completely destroyed, paralysis will be

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proportions in Europe, North America, Australia, and New Zealand during the first half of the 20th century. By 1950, the peak age incidence of paralytic poliomyelitis in the United States had shifted from infants to children aged five to nine years, when the risk of paralysis is greater; about

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The disease was very well publicized during the polio epidemics of the 1950s, with extensive media coverage of any scientific advancements that might lead to a cure. Thus, the scientists working on polio became some of the most famous of the century. Fifteen scientists and two laymen who made

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created during the recovery phase of the paralytic disease. Contributing factors that increase the risk of PPS include aging with loss of neuron units, the presence of a permanent residual impairment after recovery from the acute illness, and both overuse and disuse of neurons. PPS is a slow,

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closure, the legs are more equal in length. Alternatively, a person can be fitted with custom-made footwear which corrects the difference in leg lengths. Other surgery to re-balance muscular agonist/antagonist imbalances may also be helpful. Extended use of braces or wheelchairs may cause

1570:, was used to artificially maintain respiration during an acute polio infection until a person could breathe independently (generally about one to two weeks). The use of iron lungs is largely obsolete in modern medicine as more modern breathing therapies have been developed and due to the 2264:

was issued declaring that the polio vaccine was designed to render children sterile. Subsequently, polio reappeared in Nigeria and spread from there to several other countries. In 2013, nine health workers administering polio vaccine were targeted and killed by gunmen on motorcycles in

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Paralytic poliomyelitis may be clinically suspected in individuals experiencing acute onset of flaccid paralysis in one or more limbs with decreased or absent tendon reflexes in the affected limbs that cannot be attributed to another apparent cause, and without sensory or

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Paralysis, length differences and deformations of the lower extremities can lead to a hindrance when walking with compensation mechanisms that lead to a severe impairment of the gait pattern. In order to be able to stand and walk safely and to improve the gait pattern,

391:(e.g. poor hygiene, or by ingestion of food or water contaminated by human feces), or via the oral–oral route. Those who are infected may spread the disease for up to six weeks even if no symptoms are present. The disease may be diagnosed by finding the virus in the 2561:(GPEI) has coordinated efforts both to eliminate polio and to research means of improving surveillance and prevention. The At the peak of its work, the programme directly employed 4000 people across 75 countries and managed a budget of nearly U.S. $ 1 billion. 1719:

In some cases the growth of an affected leg is slowed by polio, while the other leg continues to grow normally. The result is that one leg is shorter than the other and the person limps and leans to one side, in turn leading to deformities of the spine (such as

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Between 25 percent and 50 percent of individuals who have recovered from paralytic polio in childhood can develop additional symptoms decades after recovering from the acute infection, notably new muscle weakness and extreme fatigue. This condition is known as

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of polio survivors. Hammon proposed the gamma globulin, which contained antibodies to poliovirus, could be used to halt poliovirus infection, prevent disease, and reduce the severity of disease in other patients who had contracted polio. The results of a large

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samples are tested for the presence of poliovirus - this is an effective method of detecting circulating virus which has not given rise to severe symptoms. Here is a summary of both wild polio (WPV) and variant polio (cVDPV) prevalence over the last 5 years:

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at the back of the foot retract and the foot cannot take on a normal position. People with polio that develop equinus foot cannot walk properly because they cannot put their heels on the ground. A similar situation can develop if the arms become paralyzed.

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tissue. A single dose of Sabin's trivalent OPV produces immunity to all three poliovirus serotypes in about 50 percent of recipients. Three doses of OPV produce protective antibody to all three poliovirus types in more than 95 percent of recipients.

1101: – is more likely. Paralysis rates also vary depending on the serotype of the infecting poliovirus; the highest rates of paralysis (one in 200) are associated with poliovirus type 1, the lowest rates (one in 2,000) are associated with type 2. 4626:

Hammon WM, Coriell LL, Ludwig EH, McAllister RM, Greene AE, Sather GE, Wehrle PF (September 1954). "Evaluation of Red Cross gamma globulin as a prophylactic agent for poliomyelitis. 5. Reanalysis of results based on laboratory-confirmed cases".

811:, transmission is limited, and the virus dies out. In communities with low vaccine coverage, this weakened virus may continue to circulate and, over time may mutate and revert to a virulent form. Polio arising from this cause is referred to as 2328:

paintings and carvings depict otherwise healthy people with withered limbs, and young children walking with canes. The earliest known case of polio is indicated by the remains of a teenage girl discovered in a 4000-year-old burial site in the

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have been considered polio-free, but not confirmed as of April 2024: Somalia, Djibouti, Sudan, Egypt, Libya, Tunisia, Morocco, Palestine, Lebanon, Syria, Jordan, Saudi Arabia, Bahrain, Qatar, Oman, Yemen, the UAE, Iraq, Kuwait, and Iran.

1085:(pins and needles), irritability, constipation, or difficulty urinating. Paralysis generally develops one to ten days after early symptoms begin, progresses for two to three days, and is usually complete by the time the fever breaks. 1019:. This leads to the development of paralytic poliomyelitis, the various forms of which (spinal, bulbar, and bulbospinal) vary only with the amount of neuronal damage and inflammation that occurs, and the region of the CNS affected. 966:

tissues, and muscle. This sustained replication causes a major viremia, and leads to the development of minor influenza-like symptoms. Rarely, this may progress and the virus may invade the central nervous system, provoking a local

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Sabin AB, Ramos-Alvarez M, Alvarez-Amezquita J, et al. (August 1960). "Live, orally given poliovirus vaccine. Effects of rapid mass immunization on population under conditions of massive enteric infection with other viruses".

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Following the widespread use of poliovirus vaccine in the mid-1950s, new cases of poliomyelitis declined dramatically in many industrialized countries. Efforts to completely eradicate the disease started in 1988 and are ongoing.

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temperatures. The attenuated poliovirus in the Sabin vaccine replicates very efficiently in the gut, the primary site of wild poliovirus infection and replication, but the vaccine strain is unable to replicate efficiently within

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areas. Polio is most infectious between 7 and 10 days before and after the appearance of symptoms, but transmission is possible as long as the virus remains in the saliva or feces. Virus particles can be excreted in the

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These efforts have hugely reduced the number of cases; from an estimated 350,000 cases in 1988 to a low of 483 cases in 2001, after which it remained at a level of about 1,000–2000 cases per year for a number of years.

1953:, declared eradicated in 2011. In April 2012, the World Health Assembly declared that the failure to completely eradicate polio would be a programmatic emergency for global public health, and that it "must not happen." 1711:). This deformity develops when the muscles that pull the toes downward are working, but those that pull it upward are not, and the foot naturally tends to drop toward the ground. If the problem is left untreated, the 739:

and produce the same disease symptoms. WPV1 is the most commonly encountered form, and the one most closely associated with paralysis. WPV2 was certified as eradicated in 2015 and WPV3 certified as eradicated in 2019.

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Approximately 19 percent of all paralytic polio cases have both bulbar and spinal symptoms; this subtype is called respiratory or bulbospinal polio. Here, the virus affects the upper part of the cervical spinal cord

534:(CNS), sometimes called abortive poliomyelitis, and a major illness involving the CNS, which may be paralytic or nonparalytic. Adults are more likely to develop symptoms, including severe symptoms, than children. 9224: 9204: 9180: 1340:) and those that drive the muscles needed for swallowing. By destroying these nerves, this form of polio affects breathing, making it difficult or impossible for the patient to breathe without the support of a 2371:

disposal and clean water supplies. These changes drastically increased the proportion of children and adults at risk of paralytic polio infection, by reducing childhood exposure and immunity to the disease.

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deformities, tightening of the joints, and movement disability. Once the muscles in the limb become flaccid, they may interfere with the function of other muscles. A typical manifestation of this problem is

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Many cases of poliomyelitis result in only temporary paralysis. Generally in these cases, nerve impulses return to the paralyzed muscle within a month, and recovery is complete in six to eight months. The

582:, an infection of the brain tissue itself, can occur in rare cases, and is usually restricted to infants. It is characterized by confusion, changes in mental status, headaches, fever, and, less commonly, 7803: 1909:

The decade of the last recorded case of paralytic polio. Since the creation of this image, Nigeria has been certified free of wild polio as of August 2020 and one case was recorded in the US state of

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neuron that once controlled 200 muscle cells might control 800 to 1000 cells. Other mechanisms that occur during the rehabilitation phase, and contribute to muscle strength restoration, include

428:. Following the introduction of polio vaccines in the 1950s, polio incidence declined rapidly. As of October 2023, only Pakistan and Afghanistan remain endemic for wild poliovirus (WPV). 7698: 6950: 4878: 6994: 2122:. Subsequently, a further three polio cases were reported, with the last case reported in January 2020. Both outbreaks were found to be linked instances of vaccine-derived poliomyelitis. 1172:, becoming weak, floppy and poorly controlled, and finally completely paralyzed. Maximum paralysis progresses rapidly (two to four days), and usually involves fever and muscle pain. Deep 2392:

for patients unable to breathe without mechanical assistance. Respiratory centers designed to assist the most severe polio patients, first established in 1952 at the Blegdam Hospital of

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for polio, but there are treatments. The focus of modern treatment has been on providing relief of symptoms, speeding recovery and preventing complications. Supportive measures include

2047:. This destroyed trust in vaccination programs in the region. There were attacks and deaths among vaccination workers; 66 vaccinators were killed in 2013 and 2014. In Afghanistan, the 1678:

In addition to these physiological processes, the body can compensate for residual paralysis in other ways. Weaker muscles can be used at a higher than usual intensity relative to the

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Because the oral polio vaccine is inexpensive, easy to administer, and produces excellent immunity in the intestine (which helps prevent infection with wild virus in areas where it is

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of poliovirus have been identified – wild poliovirus type 1 (WPV1), type 2 (WPV2), and type 3 (WPV3) – each with a slightly different capsid protein. All three are extremely

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One mechanism involved in recovery is nerve terminal sprouting, in which remaining brainstem and spinal cord motor neurons develop new branches, or axonal sprouts. These sprouts can

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In about 1 percent of infections the virus can migrate from the gastrointestinal tract into the central nervous system (CNS). Most patients with CNS involvement develop nonparalytic

10795: 7671: 6923: 747:(from exposure to the first signs and symptoms) ranges from three to six days for nonparalytic polio. If the disease progresses to cause paralysis, this occurs within 7 to 21 days. 7309: 5666: 2564:

As of 2021, the GPEI had raised 18 billion dollars in funding, with annual contributions around 800 million to 1 billion dollars. Around 30% of the funding came from the

6238: 7143: 2453:, Georgia, US. In 2008 four organizations (Rotary International, the World Health Organization, the U.S. Centers for Disease Control and UNICEF) were added to the Hall of Fame. 6208: 3745: 1813:

progressive disease, and there is no specific treatment for it. Post-polio syndrome is not an infectious process, and persons experiencing the syndrome do not shed poliovirus.

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In Afghanistan, 80 cases of polio were reported from 35 districts during 2011. Incidence over the subsequent 10 years has declined to just 4 cases in 2 districts during 2021.

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reported that several children have shown symptoms consistent with polio, with laboratory tests confirming that a 10-month-old child is infected with the virus. Prior to the

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so that it cannot cause severe illness. The vaccine virus is excreted in the stool, and in under-immunized communities it can spread from person to person. This is known as

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2019 - 147 cases of WPV1 in Pakistan, and 29 cases in Afghanistan. None were reported elsewhere in the world. cVDPV was detected in 19 countries with 378 confirmed cases.

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by the now-dead neurons. With the destruction of nerve cells, the muscles no longer receive signals from the brain or spinal cord; without nerve stimulation, the muscles

368:. Approximately 75% of cases are asymptomatic; mild symptoms which can occur include sore throat and fever; in a proportion of cases more severe symptoms develop such as 11274: 11193: 11171: 2359:

Before the 20th century, polio infections were rarely seen in infants before six months of age, most cases occurring in children six months to four years of age. Poorer

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Poliomyelitis has existed for thousands of years, with depictions of the disease in ancient art. The disease was first recognized as a distinct condition by the English

7729: 7054: 2942: 793:. Infection or vaccination with one serotype of poliovirus does not provide immunity against the other serotypes, and full immunity requires exposure to each serotype. 8562: 4306: 7945: 2568:

30% from developed governments, 27% from countries at risk of polio, and the rest was made up of donations from nonprofits, private funders, and other foundations.

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Alfaro-Murillo, Jorge A.; Ávila-Agüero, María L.; Fitzpatrick, Meagan C.; Crystal, Caroline J.; Falleiros-Arlant, Luiza-Helena; Galvani, Alison P. (4 April 2020).

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banned house-to-house polio vaccination between 2018 and 2021. These factors have set back efforts to eliminate polio by means of vaccination in these countries.

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Africa was declared free of wild polio in August 2020, although cases of circulating vaccine-derived poliovirus type 2 continue to appear in several countries.

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Early symptoms of paralytic polio include high fever, headache, stiffness in the back and neck, asymmetrical weakness of various muscles, sensitivity to touch,

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within the population. In developed countries during the late 19th and early 20th centuries, improvements were made in community sanitation, including better

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have switched to inactivated polio vaccine, which cannot revert, either as the sole vaccine against poliomyelitis or in combination with oral polio vaccine.

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mild symptoms and acquired a long-term immunity to the disease. With improvements in sanitation and hygiene during the 19th century, the general level of

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Corrado, A.; Ginanni, R.; Villella, G.; Gorini, M.; Augustynen, A.; Tozzi, D.; Peris, A.; Grifoni, S.; Messori, A.; Nozzoli, C.; Berni, G. (March 2004).

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urged for a weeklong cease-fire in Gaza to facilitate vaccinations and prevent a potential polio outbreak, emphasizing the risk faced by many children.

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declared a polio outbreak in the country after a single case in a 3-year-old girl. In December 2019, acute poliomyelitis was confirmed in an infant in

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at the University of Pittsburgh, and announced to the world on 12 April 1955. The Salk vaccine is based on poliovirus grown in a type of monkey kidney

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Yamazaki, S.; Toraya, H. (2001). "General News. Major Milestone reached in Global Polio Eradication: Western Pacific Region is certified Polio-Free".

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Aylward, Bruce (2011). "2. Lessons from the late stages of the global polio eradication initiative". In Cochi, Stephen L.; Dowdle, Walter R. (eds.).

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Sandberg A, Hansson B, Stålberg E (November 1999). "Comparison between concentric needle EMG and macro EMG in patients with a history of polio".

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Nathanson N, Martin JR (December 1979). "The epidemiology of poliomyelitis: enigmas surrounding its appearance, epidemicity, and disappearance".

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during pregnancy, the fetus does not appear to be affected by either maternal infection or polio vaccination. Maternal antibodies also cross the

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and other researchers, by the US National Institutes of Health. Licensed in 1962, it rapidly became the only oral polio vaccine used worldwide.

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Bigouette, John Paul; Wilkinson, Amanda L.; Tallis, Graham; Burns, Cara C.; Wassilak, Steven G. F.; Vertefeuille, John F. (27 August 2021).

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Cashman NR, Covault J, Wollman RL, Sanes JR (May 1987). "Neural cell adhesion molecule in normal, denervated, and myopathic human muscle".

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in May 2022 were both of a strain imported from Pakistan and do not affect the African region's wild poliovirus-free certification status.

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reported a polio case for the first time in almost a decade in the country; this was attributed to a vaccine-derived strain of the virus.

435:, with multiple doses required for lifelong protection. There are two broad types of polio vaccine; an injected polio vaccine (IPV) using 7301: 5674: 2065:

to vaccinate more than ten million children, changes in the military situation, and arrests of some of those who attacked polio workers.

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In around one percent of infections, poliovirus spreads along certain nerve fiber pathways, preferentially replicating in and destroying

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viruses that can replicate. On rare occasions, these may be transmitted from the vaccinated person to other people; in communities with

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disease, in which the muscles become weak, floppy and poorly controlled, and, finally, completely paralyzed; this condition is known as

11260: 9589: 9420: 5815: 2692: 2082: 731:. In addition to protecting the virus' genetic material, the capsid proteins enable poliovirus to infect certain types of cells. Three 7139: 5528:

Agre JC, Rodríquez AA, Tafel JA (October 1991). "Late effects of polio: critical review of the literature on neuromuscular function".

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and often credit the prolonged immobility and residual paralysis associated with polio as a driving force in their lives and careers.

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On 27 March 2014, the WHO announced the eradication of poliomyelitis in the South-East Asia Region, which includes eleven countries:

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community immunity. IPV confers good immunity but is less effective at preventing spread of wild poliovirus by the fecal–oral route.

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Despite eradication ten years earlier, an outbreak was confirmed in China in September 2011, involving a strain common in Pakistan.

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Making up about two percent of cases of paralytic polio, bulbar polio occurs when poliovirus invades and destroys nerves within the

8770: 8625: 6841:"How Drone Strikes and a Fake Vaccination Program Have Inhibited Polio Eradication in Pakistan: An Analysis of National Level Data" 5081: 4548: 3816: 2696: 1208: 6884: 4907:"Transmissibility and persistence of oral polio vaccine viruses: implications for the global poliomyelitis eradication initiative" 3893: 2783: 11533: 11153: 10330: 8483: 6818: 6592: 6359: 3231: 3032: 2761: 643:, i.e., inflammation of the spinal cord's grey matter. The word was first used in 1874 and is attributed to the German physician 11489: 8426:"Louise Reisner-Sénélar (2009) The Danish anaesthesiologist Björn Ibsen a pioneer of long-term ventilation on the upper airways" 8054: 6179: 2413:

The polio epidemics not only altered the lives of those who survived them, but also brought profound cultural changes, spurring

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In 2000, polio was declared to have been officially eliminated in 37 Western Pacific countries, including China and Australia.

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In 2023, twelve cases of WPV1 were reported, six each in Afghanistan and Pakistan. 32 countries reported cVDPV, with 524 cases.

576:, or bulbospinal. In those who develop paralysis, between 2 and 10 percent die as the paralysis affects the breathing muscles. 161: 6083: 2041: 1736:

on the distal femoral and proximal tibial/fibular condyles, so that limb's growth is artificially stunted, and by the time of

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Mueller S, Wimmer E, Cello J (August 2005). "Poliovirus and poliomyelitis: a tale of guts, brains, and an accidental event".

4061: 3914: 3495: 3458: 3419: 3330: 3244: 3178: 2975: 2930: 2902: 2228:, 99% of Gaza's 2.2 million residents were vaccinated against polio, but that rate has since fallen to 86%, according to the 1991:

2020 - 84 WPV1 cases in Pakistan, 56 in Afghanistan. 32 countries reported cVDPV detection, and there were 1,103 cVDPV cases.

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or combination of limbs may be affected – one leg, one arm, or both legs and both arms. Paralysis is often more severe

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Managing risks associated with vaccine-derived polioviruses and vaccine-associated paralytic polio (including OPV cessation)

2490:. Since then, international cooperation led by GPEI has reduced polio worldwide by 99 percent, and the campaign is ongoing. 11559: 10996: 10984: 10446: 9553: 8326:"The Spatial Dynamics of Poliomyelitis in the United States: From Epidemic Emergence to Vaccine-Induced Retreat, 1910–1971" 7165: 6355: 6321: 5965:"The Spatial Dynamics of Poliomyelitis in the United States: From Epidemic Emergence to Vaccine-Induced Retreat, 1910–1971" 5879:

Irby SE, Bernhardt KA, Kaufman KR (December 2005). "Gait of stance control orthosis users: the dynamic knee brace system".

4428: 2185:. With the addition of this region, 80 per cent of the world population was considered to be living in polio-free regions. 1905: 1204: 8114: 7024: 6261: 1859:

of polio became frequent. It is estimated that epidemic polio killed or paralysed over half a million people every year.

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poliovirus given by mouth. Both types induce immunity to polio and are effective in protecting individuals from disease.

11523: 9610: 8592: 8411: 7871: 7195: 4549:"Case definitions for infectious conditions under public health surveillance. Centers for Disease Control and Prevention" 3906: 2558: 2475: 2330: 1922: 1578: 1566:

may be required to support breathing. Historically, a noninvasive, negative-pressure ventilator, more commonly called an

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for pain, moderate exercise and a nutritious diet. Treatment of polio often requires long-term rehabilitation, including

17: 8823:

Lopez Cavestany, Rocio; Eisenhawer, Martin; Diop, Ousmane M.; Verma, Harish; Quddus, Arshad; Mach, Ondrej (April 2024).

3512: 1637:. Overall, 5 to 10 percent of patients with paralytic polio die due to the paralysis of muscles used for breathing. The 11283: 11215: 11148: 10703: 7587: 7270: 2201:

led to a return of polio, probably in 2012, acknowledged by the WHO in 2013. 15 cases were confirmed among children in

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Spinal polio, the most common form of paralytic poliomyelitis, results from viral invasion of the motor neurons of the

6747: 3947:"Antibodies against vaccine-preventable diseases in pregnant women and their offspring in the eastern part of Germany" 10918: 10721: 9929: 9455: 9412: 8268: 6027: 2471: 1918: 1749:

in the legs, due to pooling of blood in paralyzed lower limbs. Complications from prolonged immobility involving the

1054:, causing it to appear reddish and swollen. Other destructive changes associated with paralytic disease occur in the 835:, by ingesting contaminated food or water. It is occasionally transmitted via the oral–oral route. It is seasonal in 684:

Poliomyelitis does not affect any species other than humans. The disease is caused by infection with a member of the

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of Sabin's vaccine began in 1957, and in 1958, it was selected, in competition with the live attenuated vaccines of

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A treatise on the diseases of children, with general directions for the management of infants from the birth (1789)

7770: 7721: 2682: 1972:, although it continued to cause outbreaks in other nearby countries due to hidden or re-established transmission. 674: 387:

Polio occurs naturally only in humans. It is highly infectious, and is spread from person to person either through

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may occur, with a slow development of muscle weakness similar to what the person had during the initial infection.

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could mean some 90,000 people infected, each a carrier invisibly spreading the disease to others for weeks on end.

2085:

recommends polio vaccination boosters for travelers and those who live in countries where the disease is endemic.

895:

Poliovirus enters the body through the mouth, infecting the first cells with which it comes in contact – the

11554: 11528: 11037: 3845:"Reduced secretory antibody response to live attenuated measles and poliovirus vaccines in malnourished children" 3062: 2296: 948: 7937: 1589:, massage and passive motion exercises, and surgical treatments, such as tendon lengthening and nerve grafting. 1360:

A laboratory diagnosis is usually made based on the recovery of poliovirus from a stool sample or a swab of the

10552: 10528: 10358: 9514: 9500: 8140:. Yale studies in the history of science and medicine. New Haven, Conn: Yale University Press. pp. 16–18. 7248: 7113: 5833: 5417: 3617: 839:, with peak transmission occurring in summer and autumn. These seasonal differences are far less pronounced in 11382: 6566: 3097: 568:. The weakness most often involves the legs, but may less commonly involve the muscles of the head, neck, and 530:

of poliovirus. Two basic patterns of polio infection are described: a minor illness that does not involve the

11333: 11231: 11116: 11032: 10974: 10744: 10523: 9875: 8647: 8186: 7830: 7302:"How polio came back to New York for the first time in decades, silently spread and left a patient paralyzed" 5924:"Effect of carbon-composite knee-ankle-foot orthoses on walking efficiency and gait in former polio patients" 4571: 2871: 2337: 406: 11637: 9952: 7556: 11200: 10574: 9719: 9713: 9624: 9618: 9508: 6673: 796:

A rare condition with a similar presentation, nonpoliovirus poliomyelitis, may result from infections with

702: 9145: 8756: 1156:. Virus invasion causes inflammation of the nerve cells, leading to damage or destruction of motor neuron 10710: 10082: 10008: 10002: 9675: 8795: 5314: 4948:"The case for replacing the live oral polio vaccine with the inactivated vaccine throughout the Americas" 3639:

Gorson KC, Ropper AH (September 2001). "Nonpoliovirus poliomyelitis simulating Guillain-Barré syndrome".

2058: 2033: 1478:

developed a polio vaccine that can be administered orally (oral polio vaccine - OPV), comprising a live,

1376:

to determine the serotype (i.e., 1, 2, or 3), and whether the virus is a wild or vaccine-derived strain.

1129: 1118: 11387: 9133: 8704: 5700: 3769:"Factors influencing the occurrence of illness during naturally acquired poliomyelitis virus infections" 2425:. As one of the largest disabled groups in the world, polio survivors also helped to advance the modern 1411:

impractical for widespread use and the medical community focused on the development of a polio vaccine.

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Centers for Disease Control Prevention (CDC) (October 2006). "Update on vaccine-derived polioviruses".

2426: 1742: 425: 7126:

It shows that the number of annual polio cases has decreased by 97 per cent from 306 reported in 2014.

6157: 5730: 5667:"Poliomyelitis virus (picornavirus, enterovirus), after-effects of the polio, paralysis, deformations" 5249:"Polio: its impact on the people of the United States and the emerging profession of physical therapy" 2718: 556:, with symptoms of headache, neck, back, abdominal and extremity pain, fever, vomiting, stomach pain, 11700: 11617: 11467: 11138: 11106: 11080: 11058: 10907: 10486: 10139: 9746: 4492: 4486: 2685:. In Hall, Elisha; Wodi, A. Patricia; Hamborsky, Jennifer; Morelli, Valerie; Schillie, Sarah (eds.). 2479: 2229: 1926: 1900: 1694:

Residual complications of paralytic polio often occur following the initial recovery process. Muscle

924: 718: 5287:

Reproduced online with permission by Post-Polio Health International; retrieved on 10 November 2007.

5111: 5047: 4421:"A photomicrograph of the thoracic spinal cord depicting degenerative changes due to Polio Type III" 4339:

Reproduced online with permission by Lincolnshire Post-Polio Library; retrieved on 10 November 2007.

3891: 2757: 1808:(PPS) or post-polio sequelae. The symptoms of PPS are thought to involve a failure of the oversized 1344:. It can lead to paralysis of the arms and legs and may also affect swallowing and heart functions. 11649: 11569: 11424: 11205: 10979: 10393: 9848: 9760: 9665: 9495: 9468: 9440: 9373: 9244: 8296: 7743: 6676:(Press release). Global Polio Eradication Initiative - World Health Organization. 17 February 2022. 6445:"Progress toward interruption of wild poliovirus transmission—worldwide, January 2007 – April 2008" 6013: 4049: 3487: 3322: 2340:

in 1789, where he refers to polio as "a debility of the lower extremities". The work of physicians

2292: 2257: 2225: 1626: 1394: 1267:(which partially controls swallowing and functions in the throat, tongue movement, and taste), the 991: 7632: 5003: 4451: 3291: 1507: 919:. Poliovirus divides within gastrointestinal cells for about a week, from where it spreads to the 11632: 11402: 11310: 11210: 11143: 10899: 10717: 10569: 10559: 10403: 9644: 9061:

Polio voices: an oral history from the American polio epidemics and worldwide eradication efforts

5727:"Post-Polio Syndrome Fact Sheet: National Institute of Neurological Disorders and Stroke (NINDS)" 4783:

Sabin AB, Boulger LR (1973). "History of Sabin attenuated poliovirus oral live vaccine strains".

4757: 4098: 2995: 2493:

In 2010, wild poliovirus was discovered through importation in 13 different countries. They were

2434: 2385: 1980: 1770: 828: 178: 10322: 9310: 6544: 6487: 1667: – enlargement of muscle fibers through exercise and activity – and transformation of 11353: 11075: 11067: 11022: 10698: 10670: 10518: 10038: 10016: 9895: 9891: 9887: 9883: 9838: 9776: 9670: 9631: 9434: 9121: 8190: 8076: 7555:(Press release). European Region of the World Health Organization. 21 June 2002. Archived from 7416: 5838:. AAOS Atlas of Orthoses and Assistive Devices. Philadelphia: Mosby/Elsevier. pp. 411–17. 5248: 4664:"Passive immunization against poliomyelitis: the Hammon gamma globulin field trials, 1951–1953" 3892:

Joint Committee on Vaccination and Immunisation, Salisbury A, Ramsay M, Noakes K, eds. (2006).

3711: 3411: 1961: 1615: 1516: 1264: 1161: 790: 774: 531: 35: 9284: 8936: 8917: 8897: 6750:(Press release). Global Polio Eradication Initiative - World Health Organization. 18 May 2022. 2875: 1089:

five years of age, paralysis of one leg is most common; in adults, extensive paralysis of the

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and low fever. These symptoms are temporary and full recovery occurs within one or two weeks.

11090: 10964: 10782: 10760: 10675: 10598: 10508: 10495: 10420: 10023: 9604: 9474: 9445: 9193: 9189: 9059: 9038: 8991: 6382: 4278: 4272: 4120:

Sabin AB (June 1956). "Pathogenesis of poliomyelitis; reappraisal in the light of new data".

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has its origin in the fight against polio. Most hospitals in the 1950s had limited access to

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In Pakistan, cases dropped by 97 percent from 2014 to 2018; reasons include 440 million

1934: 968: 652: 542: 11419: 9197: 8509:

Frick NM, Bruno RL (1986). "Post-polio sequelae: physiological and psychological overview".

5792: 4849: 3479: 3403: 3314: 1875:, while highly effective, has the disadvantage that it contains a live virus which has been 11429: 11027: 10844: 10733: 10287: 10119: 9754: 9583: 7340: 4322: 4207:

Punsoni, Michael; Lakis, Nelli S.; Mellion, Michelle; de la Monte, Suzanne M. (June 2023).

4129: 3605: 3346: 2460: 2441:

important contributions to the knowledge and treatment of poliomyelitis are honored by the

2221: 2062: 2037: 1766: 1634: 1548: 1464: 1027: 951:, where it multiplies abundantly. The virus is subsequently absorbed into the bloodstream. 944: 832: 388: 213: 7079: 6299: 2248: 1999:

caused two confirmed cases in Malawi in 2021. 24 countries detected cVDPV, with 881 cases.

1195:. The virus may affect muscles on both sides of the body, but more often the paralysis is 376:. These symptoms usually pass within one or two weeks. A less common symptom is permanent 8: 11363: 10956: 10603: 10458: 10398: 9705: 9426: 9228: 8617: 7210: 6444: 3480: 3315: 2596: 2407: 1979:(AFP) are tested for the presence and type of poliovirus. In addition, environmental and 1942: 1805: 1798: 1482:

virus. It was produced by the repeated passage of the virus through nonhuman cells at sub

1434: 1365: 1312: 1031: 963: 436: 381: 191: 8859: 8824: 7521: 7486: 7344: 6795: 6724: 4243: 4208: 4133: 3285: 2686: 2403: 2237: 1183:

The extent of spinal paralysis depends on the region of the cord affected, which may be

11126: 11111: 11099: 10849: 10800: 10637: 10500: 10388: 10099: 10094: 9808: 9564: 8538:

The Polio Paradox: Understanding and Treating "Post-Polio Syndrome" and Chronic Fatigue

8462: 8350: 8325: 8258: 8234: 8209: 8046: 7534: 6876: 6674:"GPEI Statement on WPV1 in Malawi: Wild poliovirus type 1 detected in Lilongwe, Malawi" 6650: 6617: 6384:

Poliomyelitis: intensification of the global eradication initiative. Agenda item A65/20

5989: 5964: 5904: 5645: 5593: 5507: 5464: 5387: 5370: 4980: 4947: 4923: 4906: 4688: 4663: 4397: 3976: 3920: 3869: 3844: 2775: 2595:

To support these two objectives, vaccines are under development which either utilise a

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of poliovirus, and at least 99 percent are immune to poliovirus following three doses.

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to the brain stem. The destruction of these nerves weakens the muscles supplied by the

1153: 940: 804: 759: 572:. Depending on the site of paralysis, paralytic poliomyelitis is classified as spinal, 569: 553: 440: 361: 168: 8457: 8440: 6840: 6762: 6691: 5452: 4963: 4711:

World Health Organization (2016). "Polio vaccines: WHO position paper – March, 2016".

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World Health Organization (2016). "Polio vaccines: WHO position paper – March, 2016".

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may occur. An intervention to prevent or lessen length disparity can be to perform an

11581: 11343: 11252: 10889: 10855: 10827: 10818: 10750: 10726: 10593: 10441: 10272: 10223: 10204: 10185: 9975: 9971: 9967: 9963: 9880: 9785: 9489: 9367: 9255: 9065: 9044: 9020: 9013: 8997: 8976: 8969: 8953: 8864: 8846: 8736: 8541: 8518: 8378: 8355: 8341: 8264: 8239: 8166: 8141: 8050: 8038: 8022: 7838: 7778: 7538: 7526: 7508: 7375: 7222: 6915: 6868: 6860: 6800: 6782: 6729: 6711: 6655: 6637: 6456: 6425: 6125: 6121: 6033: 6023: 5994: 5980: 5945: 5896: 5849: 5839: 5807: 5773: 5637: 5585: 5545: 5541: 5499: 5456: 5392: 5351: 5304: 5271: 5189: 5181: 5138: 5025: 4985: 4967: 4928: 4828: 4824: 4796: 4730: 4693: 4644: 4640: 4608: 4563: 4528: 4496: 4401: 4366: 4282: 4248: 4230: 4189: 4145: 4067: 4057: 4025: 3968: 3910: 3874: 3798: 3693: 3656: 3609: 3491: 3454: 3415: 3404: 3326: 3295: 3240: 3174: 3140: 3136: 2971: 2898: 2260: – a country that at that time was considered provisionally polio free – a 2012: 1976: 1571: 1520: 1275:(which controls upper neck movement). Due to the effect on swallowing, secretions of 1043: 1039: 1035: 916: 900: 856: 836: 778: 744: 587: 573: 565: 377: 230: 187: 152: 9237: 9233: 8466: 6880: 5597: 5511: 5468: 5160:"Iron lung versus conventional mechanical ventilation in acute exacerbation of COPD" 4011: 3980: 3590:"Vaccine-derived polioviruses and the endgame strategy for global polio eradication" 3195: 2841: 2810: 526:

The term "poliomyelitis" is used to identify the disease caused by any of the three

11587: 11484: 11012: 10883: 10878: 10663: 10658: 10247: 9957: 9637: 9569: 9450: 9381: 9295: 8854: 8836: 8452: 8345: 8337: 8229: 8221: 8030: 7915: 7893: 7516: 7498: 7458: 7348: 6987:"House-to-house polio vaccination set to recommence across Afghanistan in November" 6947:"Pakistan's fight against polio clashes with battle against Taliban – The National" 6852: 6790: 6774: 6763:"Progress Toward Poliomyelitis Eradication — Worldwide, January 2022–December 2023" 6719: 6703: 6645: 6629: 6117: 5984: 5976: 5935: 5908: 5888: 5765: 5649: 5627: 5577: 5537: 5491: 5448: 5382: 5341: 5263: 5171: 5015: 4975: 4959: 4918: 4820: 4792: 4720: 4683: 4675: 4636: 4393: 4358: 4318: 4238: 4220: 4185: 4181: 4137: 4015: 4007: 3958: 3864: 3856: 3788: 3784: 3780: 3683: 3648: 3601: 3440: 3132: 2922: 2678: 2565: 2422: 2345: 2198: 2089: 1910: 1737: 1668: 1552: 1497: 1300: 1284: 875:

that protects the infant from polio infection during the first few months of life.

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Once infected, there is no specific treatment. The disease can be prevented by the

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in 1789, and the virus that causes it was first identified in 1909 by the Austrian

284: 88: 10211: 8676: 7503: 6012:

Yin-Murphy M, Almond JW (1996). "Picornaviruses". In Baron S, et al. (eds.).

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may build up in the airway, causing suffocation. Other signs and symptoms include

789:

antibodies against PV can prevent the spread of the virus to motor neurons of the

11397: 10934: 10625: 10171: 10076: 9996: 9985: 9856: 9820: 9740: 9526: 9387: 9249: 9093: 8730: 7157: 6329: 5213: 5209:"America's last iron lung users on their lives spent inside obsolete ventilators" 5176: 5159: 4420: 3371: 3167: 2456: 2363:

of the time resulted in constant exposure to the virus, which enhanced a natural

2044: 1778: 1762: 1712: 1651: 1602: 1308: 1280: 1272: 1248: 996: 932: 928: 714: 545:. In about 25% of cases, the infection produces minor symptoms which may include 538: 262: 183: 11414: 6692:"Progress Toward Poliomyelitis Eradication — Worldwide, January 2021–March 2023" 6442: 2599:, or which derive from a modified virus which cannot reproduce in a human host. 11680: 11594: 11329: 10991: 10940: 10768: 10477: 10354: 9407: 9260: 9107: 8106: 8034: 7187: 7046:

World Health Organization, Global Polio Eradication Initiative (30 June 2022).

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Manual for the Surveillance of Vaccine-Preventable Diseases (5th Edition, 2012)

3652: 3123:

Falconer M, Bollenbach E (2000). "Late functional loss in nonparalytic polio".

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began to appear in Europe and the United States around 1900. Outbreaks reached

2233: 1733: 1586: 1493: 1488: 1449: 1407: 1398: 1390: 1373: 1200: 1149: 980: 936: 912: 904: 644: 11409: 8841: 8600: 7863: 6845:

International Journal of Health Services: Planning, Administration, Evaluation

5892: 4225: 3996:"Complexes of poliovirus serotypes with their common cellular receptor, CD155" 3963: 3946: 2410:(ICU). (A year later, Ibsen would establish the world's first dedicated ICU.) 1467:), 90 percent or more of individuals develop protective antibody to all three 11674: 11017: 10969: 10839: 10608: 10564: 10415: 9402: 9397: 9345: 8850: 8225: 7842: 7804:"WHO, UNICEF call for cease fire in Gaza to allow polio vaccination | CIDRAP" 7782: 7579: 7512: 7278: 6919: 6864: 6856: 6786: 6715: 6641: 5853: 5185: 4971: 4679: 4349:

Young GR (February 1989). "Occupational therapy and the postpolio syndrome".

4234: 3524: 3444: 3436: 2325: 2306: 1852: 1786: 1729: 1483: 1420: 1364:. Rarely, it may be possible to identify poliovirus in the blood or in the 1361: 1333: 1252: 1173: 1141: 1122: 1051: 896: 808: 755: 603: 432: 421: 251: 9298: 9217: 9213: 7208: 6415: 5769: 5632: 5615: 5346: 5329: 5267: 4945: 1144:, which are responsible for movement of the muscles, including those of the 1050:

destruction often alters the color and appearance of the gray matter in the

10513: 10383: 10366: 10263: 10113: 9791: 9652: 8868: 8359: 8243: 8042: 8023:"Africa declared free from wild polio — but vaccine-derived strains remain" 7530: 7379: 7352: 6872: 6804: 6778: 6733: 6707: 6659: 6633: 6460: 6429: 6037: 5998: 5949: 5900: 5811: 5753: 5589: 5460: 5396: 5355: 5275: 5193: 4989: 4932: 4832: 4734: 4697: 4648: 4612: 4252: 4193: 4149: 4071: 4029: 3972: 3860: 3802: 3697: 3660: 3613: 3475: 3299: 3144: 2926: 2688:

Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book)

2538: 2418: 2313: 1774: 1725: 1582: 1475: 1456: 1402: 1288: 1256: 1244: 1188: 1114: 1098: 1059: 1016: 1004: 860: 751: 669: 640: 579: 410: 8522: 7366:

D' Souza RM, Kennett M, Watson C (2002). "Australia declared polio free".

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Wild Poliovirus case list 2000–2010; data in WHO/HQ as of 9 November 2010

6129: 5940: 5923: 5777: 5641: 5549: 5503: 5495: 5200: 5029: 5020: 4567: 4370: 3878: 2897:(1st ed.). Rochester, NY: University of Rochester Press. p. 11. 1109: 11654: 11574: 10472: 10433: 10375: 10303: 10252: 10240: 10235: 10228: 10216: 10190: 10160: 10062: 9901: 9813: 9796: 9731: 9392: 9279: 8825:"The Last Mile in Polio Eradication: Program Challenges and Perseverance" 7992:"Government of Nigeria reports 2 wild polio cases, first since July 2014" 6510:"Wild poliovirus type 1 and Circulating vaccine-derived poliovirus cases" 6108:

Hinman A (1984). "Landmark perspective: Mass vaccination against polio".

5330:"Noninvasive mechanical ventilation at home: building upon the tradition" 4405: 4362: 2341: 2266: 2182: 2150: 2022: 1969: 1782: 1659: 1630: 1540: 1268: 1137: 1082: 1008: 976: 797: 750:

Individuals who are exposed to the virus, either through infection or by

689: 630: 546: 373: 220: 9140: 7245:"Polio Declared Eliminated from the Americas | History of Vaccines" 5922:

Brehm MA, Beelen A, Doorenbosch CA, Harlaar J, Nollet F (October 2007).

4725: 4277:. Diseases and People. Berkeley Heights, NJ: Enslow Publishers. p. 3688: 1180:(the ability to feel) in the paralyzed limbs, however, is not affected. 819:

in order to distinguish it from the natural or "wild" poliovirus (WPV).

11463: 10583: 10453: 10153: 9937: 9694: 8732:

Disease Eradication in the 21st Century: Implications for Global Health

6618:"Progress Toward Polio Eradication — Worldwide, January 2019–June 2021" 5793:"Post-poliomyelitis syndrome: case report and review of the literature" 5416:(PhD thesis). Maastricht: Universitaire Pers Maastricht. Archived from 4527:. Hagerstown, MD: Lippincott Williams & Wilkins. pp. 3264–65. 2534: 2506: 2464: 2414: 2400: 2393: 2360: 2321: 2301: 2280: 2206: 2142: 2018: 1950: 1821: 1809: 1563: 1544: 1445: 1433:

Two types of vaccine are used throughout the world to combat polio: an

1337: 1240: 1012: 766: 706: 694: 677: 664: 396: 365: 240: 209: 31: 5581: 1937:. Polio is one of only two diseases currently the subject of a global 1227: 635: 10693: 10644: 10632: 10615: 10547: 10198: 10179: 10146: 10134: 10128: 10107: 10053: 9981: 9867: 9829: 9598: 9577: 9483: 9361: 9353: 9341: 9290: 8993:

The death of a disease: a history of the eradication of poliomyelitis

7553:"Europe achieves historic milestone as Region is declared polio-free" 5568:

Trojan DA, Cashman NR (January 2005). "Post-poliomyelitis syndrome".

2467:, who led the first team to develop a vaccine against poliomyelitis. 2389: 2336:

The first clinical description was provided by the English physician

2174: 2158: 1834: 1825: 1721: 1708: 1567: 1453: 1354: 1292: 1212: 1196: 1165: 1070: 1055: 959: 852: 736: 710: 698: 618: 606: 561: 403: 157: 9172: 7771:"Gaza faces public health crisis with first confirmed case of polio" 7105: 6231:"The decade of the last recorded case of paralytic polio by country" 5719: 4491:. Hagerstown, MD: Lippincott Williams & Wilkins. 2005. pp. 3589: 3588:

Kew OM, Sutter RW, de Gourville EM, Dowdle WR, Pallansch MA (2005).

11659: 11627: 11306: 11168:

Spinal muscular atrophy with lower extremity predominance (SMALED)

10873: 10865: 10831: 10685: 10588: 10296: 9943: 9685: 9541: 7453: 4809: 3945:

Sauerbrei A, Groh A, Bischoff A, Prager J, Wutzler P (March 2002).

3538: 2502: 2430: 2380: 2376: 2210: 2178: 2162: 2119: 2077:

were declared polio-free in 1994. The last known case was a boy in

2074: 2026: 1965: 1946: 1945:. So far, the only diseases completely eradicated by humankind are 1856: 1847: 1699: 1683: 1468: 1460: 1296: 1271:(which sends signals to the heart, intestines, and lungs), and the 1157: 1063: 972: 868: 864: 803:

The oral polio vaccine, which has been in use since 1961, contains

557: 417: 369: 8822: 11434: 11392: 11349: 10352: 10049: 9340: 9128: 7938:"Nigeria marks polio-free year, raising global eradication hopes" 7421: 3821:, Department of Health, State Government of Victoria, Australia, 3435:

Cohen JI (2004). "Chapter 175: Enteroviruses and Reoviruses". In

2530: 2510: 2397: 2166: 2048: 1695: 1611: 1597: 1260: 1169: 1133: 1094: 1074: 971:. In most cases, this causes a self-limiting inflammation of the 955: 920: 888: 732: 583: 560:, and irritability. About one to five in 1,000 cases progress to 527: 72: 63: 8295:. World Health Organization. Geneva, Switzerland. Archived from 7140:"17 million children to be vaccinated against polio in Pakistan" 5080:. School of Public Health and Community Medicine. Archived from 4599:

Hammon WM (1955). "Passive immunization against poliomyelitis".

3233:

The late effects of Polio: Information For Health Care Providers

2935:

Zeitschrift für Immunitätsforschung und experimentelle Therapie

2571:

The GPEI has identified six directions for continuing research:

1625:

Without respiratory support, consequences of poliomyelitis with

10912: 10653: 10620: 9658: 9208: 9184: 9157: 9116: 8925: 8905: 8800: