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Symptoms
By Mayo Clinic staff
Although polio can cause paralysis and death, the vast majority of people who are infected with the poliovirus don't become sick and are never aware they've been infected with polio.
Nonparalytic polio
Some people who develop symptoms from the poliovirus contract nonparalytic polio — a type of polio that doesn't lead to paralysis (abortive poliomyelitis). This usually causes the same mild, flu-like signs and symptoms typical of other viral illnesses.
Signs and symptoms, which generally last two 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 spasms or tenderness
- Meningitis
Paralytic polio
Fewer than 1 percent of people infected with poliovirus develop paralytic polio, the most serious form of the disease. Initial signs and symptoms of paralytic polio, such as fever and headache, often mimic those of nonparalytic polio. Between one and 10 days later however, signs and symptoms specific to paralytic polio appear, including:
- Loss of reflexes
- Severe muscle aches or spasms
- Loose and floppy limbs (acute flaccid paralysis), often worse on one side of the body
The onset of paralysis may be sudden.
Classifications of paralytic polio
Paralytic polio has historically been divided into several types, depending primarily on which part of the body is affected. These classifications aren't rigid, and overlap may occur among the different forms.
- Spinal polio. This most common form of paralytic polio attacks certain nerve cells (motor neurons) in your spinal cord and may cause paralysis of the muscles that control breathing and those in your arms and legs. Sometimes the neurons are only damaged, in which case you may recover some degree of muscle function. But if the neurons are completely destroyed, the paralysis is irreversible, although you still retain your sense of feeling, unlike after many spinal cord injuries.
- Bulbar polio. In this severe type of polio, the virus affects the motor neurons in your brainstem, where the centers of the cranial nerves are located. These nerves are involved in your ability to see, hear, smell, taste and swallow. They also affect the movement of muscles in your face and send signals to your heart, intestines and lungs. Bulbar polio can interfere with any of these functions but is especially likely to affect your ability to breathe, speak and swallow and can be fatal without respiratory support.
- Bulbospinal polio. A combination of both bulbar and spinal paralytic polio, this form can lead to paralysis of your arms and legs and may also affect breathing, swallowing and heart function.
Post-polio syndrome
Affecting some people who have recovered from polio, post-polio syndrome is a cluster of disabling signs and symptoms that appears decades — an average of 30 to 40 years — after the initial illness. Common signs and symptoms include:
- Progressive muscle or joint weakness and pain
- General fatigue and exhaustion after minimal activity
- Muscle atrophy
- Breathing or swallowing problems
- Sleep-related breathing disorders, such as sleep apnea
- Decreased tolerance of cold temperatures
When to see a doctor
Be sure to check with your doctor for polio vaccination recommendations before traveling to a part of the world where polio may still occur naturally or where oral polio vaccine (OPV) is still used, such as Central and South America, Africa and Asia. In countries that use the OPV — vaccine made with live, but weakened (attenuated) polio virus — the risk of paralytic polio to travelers is extremely low, but not zero.
Additionally, call your doctor if:
- Your child hasn't completed the series of polio vaccinations
- Your child experiences an allergic reaction after receiving polio vaccine
- Your child has problems other than a mild redness or soreness at the vaccine injection site
- You have questions about adult vaccination or other concerns about polio immunization
- You had polio years ago and are now experiencing unexplained weakness and fatigue
- Polio disease - Questions and answers. Centers for Disease Control and Prevention. http://www.cdc.gov/print.do?url=http://www.cdc.gov/vaccines/vpd-vac/polio/dis-faqs.htm. Accessed Jan. 16, 2009.
- Poliomyelitis. World Health Organization. http://www.who.int/mediacentre/factsheets/fs114/en/index.html. Accessed Jan. 16, 2009.
- Simmons Z. Polio and infectious diseases of the anterior horn. http://www.uptodate.com/home/index.html. Accessed Jan. 9, 2009.
- Howard RS. Poliomyelitis and the postpolio syndrome. British Medical Journal. 2005;330:1314.
- Atkinson W, et al. Poliomyelitis. In: Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine-Preventable Diseases. 10th ed. Washington D.C.: Public Health Foundation; 2008:101.
- Shefner JM, et al. Post-polio syndrome. http://www.uptodate.com/home/index.html. Accessed Jan. 9, 2009.
- Risk factors. Global Polio Eradication Initiative. http://www.polioeradication.org/risk.asp. Accessed Jan. 19, 2009.
- Sorenson EJ, et al. Electrophysiological findings in a cohort of old polio survivors. Journal of the Peripheral Nervous System. 2006;11:241.
- Modlin JF. Poliovirus vaccination. http://www.uptodate.com/home/index.html. Accessed Jan. 9, 2009.
- Polio vaccine: What you need to know. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-IPV.pdf. Accessed Jan. 16, 2009.
- Pediarix (prescribing information). Research Triangle Park, N.C.: GlaxoSmithKline; 2008.
