Cause: Polioviruses are members of the family Picornaviridae, genus Enterovirus, in the species enterovirus C, and include 3 serotypes all of which can cause paralysis. Acute paralytic disease may be caused by naturally occurring (wild) polioviruses, and rarely by oral poliovirus (OPV) vaccine viruses.
Illness and treatment: Over 90% of infections are asymptomatic and 4-8% are minor illnesses. Nonparalytic aseptic meningitis with full recovery occurs in 1-2% of infections. Fewer than 1% of infections result in flaccid paralysis. Treatment is supportive.
Sources: Humans are the reservoir. Transmission is mainly through the fecal-oral route. Virus may be present in the stool of an infected person for 3-6 weeks.
Additional risks: Travel by susceptible persons to the few countries where polio is still endemic or to countries still routinely using oral polio vaccine can increase the risk of becoming infected.
Prevention: Universal immunization prevents infection. Only inactivated polio vaccine, IPV, is now used in the United States. This vaccine can prevent paralysis, but does not provide intestinal immunity.
Recent Washington trends: The last endemic transmission of wild polio virus infection in the United States was in 1979; the last case of wild virus infection identified in Washington occurred in 1977. In 1993, a case of vaccine-associated paralytic polio occurred in a state resident after a family member received live oral polio vaccine, which is no longer used in the United States.
Purpose of Reporting and Surveillance
- To detect importation of wild poliovirus into the United States
- To detect the presence of vaccine-derived poliovirus
- To prevent transmission of poliovirus and to distinguish between wild-type polio and vaccine-associated paralytic polio, if a case of poliomyelitis occurs
Legal Reporting Requirements
- Health care providers and health care facilities: immediately notifiable to local health jurisdiction
- Laboratories: Poliovirus, acute, by IgM positivity or PCR positivity immediately notifiable to local health jurisdiction; specimen submission is required – submission required – isolate or if no isolate available, specimen associated with positive result, within 2 business days
- Local health jurisdictions: immediately notifiable to the Washington State Department of Health (DOH) Communicable Disease Epidemiology (CDE): 1-877-539-4344
Paralytic polio is designated “immediately notifiable, extremely urgent”, requiring state and local health authorities to notify CDC within 4 hours of their notification.
Non-paralytic polio is designated “immediately notifiable and urgent” requiring state and local health authorities to notify CDC within 24 hours of their notification.