A practical approach to the late effects of Polio
Charlotte Leboeuf

1 POLIO LOOKING BACK

Polio (poliomyelitis or infantile paralysis as it has also been called) is a viral disease that was common in the Western world until the early 1960s. There were two particularly large epidemic outbreaks, one in the late 1930s and early 1940s and the other about ten years later (1). It has been estimated that between 20,000 and 40,000 people had polio in Australia from 1930 onwards (2). Between 1930 and 1960 there were approximately 2,000 reported deaths due to acute polio (2).

If you are one of the many people who had polio, you may, at the time, have experienced some or all of the following:

• ACUTE POLIO INFECTION
  • mild and non-specific symptoms, resembling other viral infection such as influenza.
    The disease may not have progressed past this stage.

  • headaches, photophobia (=sensitivity to light). Again, the infection may not have gone any further.
  • neck and back stiffness due to meningeal irritation (meninges=the membranes covering the spinal cord and brain).

    According to medical textbooks about 1% of all polio infections progress to this stage.

  • paralysis.
    About 0.1% of all polio infections are said to progress to paralysis.

    The virus favours certain parts of the spinal cord and brain stem where neurones (=nerve cells) become destroyed. These areas are related to the motor (=movement) function of nerves. As a result muscles which are commanded by the nerve cells in these areas of the spinal cord become affected. Depending on the extent of destruction these muscles become totally or partially paralysed. Unlike most spinal cord injuries (supposedly) only the motor function is affected, leaving intact the ability to feel pain, touch, heat, cold etc.

  • breathing, speech and/or swallowing difficulties.
    This occurs if the brain stem is affected by the virus. Between 5% and 35% of all paralytic cases are said to reach this stage.

    Many mild infections went undetected but in obvious cases of polio during the large epidemics, isolation in infectious diseases hospitals was common. If you were unable to breathe properly your breathing may have been assisted with mechanical tank respiration or, in less severe cases, with other respiratory aids such as the "rocking bed". Between 5% and 10% of all paralytic cases resulted in death due to inability to breathe.

• RECOVERY
  • Partial or total recovery, after the acute phase, usually took place over a period of several months to years. During recovery "sprouting" from neighbouring intact nerve cells occurred. These nerve sprouts took over the job of the deceased nerve cells by increasing their own workload (i.e. by commanding more than one muscle fibre). Sometimes, however, there were no intact nerve cells left within (and usually part of) the. spinal cord from which sprouting could occur. Total paralysis of the muscles supplied from that (or those) area(s) would be the result.

    For many people the recovery period was a period of active rehabilitation. The main goals were to improve function and strength, to prevent deformities and to compensate for lost function. Sometimes surgery was necessary to provide functional improvement, e.g. through transfer of tendons, fusion of unstable joints and surgical correction of bony abnormalities. However, for most people, recovery was gradual and spontaneous.

Please note, that although I am talking about past acute polio as you may have experienced it, polio itself is not a thing of the past. The disease is still as common in other parts of the world as it once was in Australia.

© Copyright The Lincolnshire Post-Polio Network 1997 1998 1999 2000

This document comprises an index, introduction and sixteen other sections or subdocuments. Permission for printing copies is granted only on the basis that ALL sections are printed in their entirety and kept together as a single document.

Document preparation: Chris Salter, Original Think-tank, Cornwall, United Kingdom.
Document Reference: <URL:http://www.zynet.co.uk/ott/polio/lincolnshire/library/australia/paleop/sectn_01.html>
Created: 30th December 1997
Last modification: 6th June 2000