eMedicine Specialties > Pediatrics: General Medicine > Infectious Disease

Poliomyelitis: Treatment & Medication

Author: Benjamin Estrada, MD, Professor, Department of Pediatrics and Adolescent Medicine, Division of Pediatric Infectious Diseases, University of South Alabama College of Medicine, University of South Alabama Children's and Women's Hospital
Contributor Information and Disclosures

Updated: Aug 31, 2009

Treatment

Medical Care

No antivirals are effective against polioviruses. The treatment of poliomyelitis is mainly supportive.

  • Analgesia is indicated in cases of myalgias or headache.
  • Mechanical ventilation is often needed in patients with bulbar paralysis.
  • Tracheostomy care is often needed in patients who require long-term ventilatory support.
  • Physical therapy is indicated in cases of paralytic disease.
    • In paralytic disease, provide frequent mobilization to avoid development of chronic decubitus ulcerations.
    • Active and passive motion exercises are indicated during the convalescent stage.
  • Fecal impaction is frequent in cases of paralytic disease and can be treated with laxatives as soon as it develops.

Surgical Care

  • Total hip arthroplasty is a surgical therapeutic options for patients with paralytic sequelae of poliomyelitis who develop of hip dysplasia and degenerative disease.6

Consultations

  • Physical therapist and rehabilitation therapist
  • Pulmonologist
  • Neurologist
  • Immunologist
  • Infectious diseases specialist

Diet

  • Because patients with poliomyelitis are prone to develop constipation, a diet rich in fiber is usually indicated.

Medication

No antiviral agents are effective against poliovirus.

More on Poliomyelitis

Overview: Poliomyelitis
Differential Diagnoses & Workup: Poliomyelitis
Treatment & Medication: Poliomyelitis
Follow-up: Poliomyelitis
Multimedia: Poliomyelitis
References
Further Reading
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References

  1. Heymann D, Aylward B. Polio will soon be history. Bull World Health Organ. Jan 2007;85(1):7-8. [Medline].

  2. CDC. Poliovirus infections in four unvaccinated children--Minnesota, August-October 2005. MMWR Morb Mortal Wkly Rep. Oct 21 2005;54(41):1053-5. [Medline]. [Full Text].

  3. Resurgence of wild poliovirus types 1 and 3 in 15 African countries, January 2008-March 2009. Wkly Epidemiol Rec. Apr 17 2009;84(16):133-40. [Medline].

  4. Stewardson AJ, Roberts JA, Beckett CL, Prime HT, Loh PS, Thorley BR, et al. Imported case of poliomyelitis, Melbourne, Australia, 2007. Emerg Infect Dis. Jan 2009;15(1):63-5. [Medline].

  5. Cashman NR, Maselli R, Wollmann RL. Late denervation in patients with antecedent paralytic poliomyelitis. N Engl J Med. Jul 2 1987;317(1):7-12. [Medline].

  6. Laguna R, Barrientos J. Total hip arthroplasty in paralytic dislocation from poliomyelitis. Orthopedics. Feb 2008;31(2):179. [Medline].

  7. Lund ML, Lexell J. Perceived participation in life situations in persons with late effects of polio. J Rehabil Med. Aug 2008;40(8):659-64. [Medline].

  8. McBean AM, Thoms ML, Albrecht P. Serologic response to oral polio vaccine and enhanced-potency inactivated polio vaccines. Am J Epidemiol. Sep 1988;128(3):615-28. [Medline].

  9. [Guideline] AAP. Prevention of poliomyelitis: recommendations for use of only inactivated poliovirus vaccine for routine immunization. Committee on Infectious Diseases. American Academy of Pediatrics. Pediatrics. Dec 1999;104(6):1404-6. [Medline].

  10. [Guideline] Conclusions and recommendations of the Advisory Committee on Poliomyelitis Eradication, November 2008. Wkly Epidemiol Rec. Jan 16 2009;84(3):17-28. [Medline].

  11. Weston WM, Klein NP. Kinrix: a new combination DTaP-IPV vaccine for children aged 4-6 years. Expert Rev Vaccines. Nov 2008;7(9):1309-20. [Medline].

  12. Jenkins PC, Modlin JF. Decision analysis in planning for a polio outbreak in the United States. Pediatrics. Aug 2006;118(2):611-8. [Medline].

  13. Grassly NC, Wenger J, Durrani S, et al. Protective efficacy of a monovalent oral type 1 poliovirus vaccine: a case-control study. Lancet. Apr 21 2007;369(9570):1356-62. [Medline].

  14. Aylward RB, Sutter RW, Heymann DL. Policy. OPV cessation--the final step to a "polio-free" world. Science. Oct 28 2005;310(5748):625-6. [Medline].

  15. Bernier RH. Improved inactivated poliovirus vaccine: an update. Pediatr Infect Dis. May-Jun 1986;5(3):289-92. [Medline].

  16. CDC. From the Centers for Disease Control and Prevention. Progress toward poliomyelitis eradication--African Region, 1999-March 2000. JAMA. Oct 11 2000;284(14):1781-2. [Medline].

  17. CDC. From the Centers for Disease Control and Prevention. Progress toward poliomyelitis eradication--Eastern Mediterranean Region, 1998-October 1999. JAMA. Jan 12 2000;283(2):195-6. [Medline].

  18. CDC. Progress toward poliomyelitis eradication--India, January 2004-May 2005. MMWR Morb Mortal Wkly Rep. Jul 8 2005;54(26):655-9. [Medline].

  19. Kew OM, Sutter RW, de Gourville EM, Dowdle WR, Pallansch MA. Vaccine-derived polioviruses and the endgame strategy for global polio eradication. Annu Rev Microbiol. 2005;59:587-635. [Medline].

  20. Lahariya C, Pradhan SK. Prospects of eradicating poliomyelitis by 2007: compulsory vaccination may be a strategy. Indian J Pediatr. Jan 2007;74(1):61-3. [Medline].

  21. Lim JY, Kim KE, Choe G. Myotonic dystrophy mimicking postpolio syndrome in a polio survivor. Am J Phys Med Rehabil. Feb 2009;88(2):161-4. [Medline].

  22. Prevots DR, Strebel PM. Poliomyelitis prevention in the United States: new recommendations for routine childhood vaccination place greater reliance on inactivated poliovirus vaccine. Pediatr Ann. Jun 1997;26(6):378-83. [Medline].

  23. Sutter RW, Prevots DR, Cochi SL. Poliovirus vaccines. Progress toward global poliomyelitis eradication and changing routine immunization recommendations in the United States. Pediatr Clin North Am. Apr 2000;47(2):287-308. [Medline].

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Further Reading

Oshinsky DM. Polio. An American Story. Oxford University Press, 2005.

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Keywords

poliomyelitis, flaccid paralysis, nonparalytic poliomyelitis, paralytic poliomyelitis, wild-type poliovirus, paralysis, anorexia, abdominal pain, polio, postpolio syndrome, meningitis, respiratory failure, HIV infection, severe combined immunodeficiency, SCID, B-cell dysfunction, treatment, diagnosis

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Contributor Information and Disclosures

Author

Benjamin Estrada, MD, Professor, Department of Pediatrics and Adolescent Medicine, Division of Pediatric Infectious Diseases, University of South Alabama College of Medicine, University of South Alabama Children's and Women's Hospital
Benjamin Estrada, MD is a member of the following medical societies: American Academy of Pediatrics, Infectious Diseases Society of America, and Pediatric Infectious Diseases Society
Disclosure: Sanofi-Pasteur Honoraria Speaking and teaching

Medical Editor

Leonard R Krilov, MD, Chief of Pediatric Infectious Diseases, Vice Chair, Department of Pediatrics, Professor of Pediatrics, Winthrop University Hospital
Leonard R Krilov, MD is a member of the following medical societies: American Academy of Pediatrics, American Pediatric Society, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, and Society for Pediatric Research
Disclosure: Medimmune Grant/research funds Cliinical trials; Medimmune Honoraria Speaking and teaching; Medimmune Consulting fee Consulting

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Larry I Lutwick, MD, Professor of Medicine, State University of New York, Downstate Medical School; Director, Infectious Diseases, Veterans Affairs New York Harbor Health Care System, Brooklyn Campus
Larry I Lutwick, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

CME Editor

Robert W Tolan Jr, MD, Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine
Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility
Disclosure: GlaxoSmithKline Honoraria Speaking and teaching; MedImmune Honoraria Speaking and teaching; Merck Honoraria Speaking and teaching; sanofi pasteur Honoraria Speaking and teaching; Baxter Healthcare Honoraria Speaking and teaching

Chief Editor

Russell W Steele, MD, Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine
Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association
Disclosure: None None None

 
 
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