Poliomyelitis (Polio)

KEY POINTS

1. Poliomyelitis is a viral infection of the central nervous system that can result in permanent neurological damage, such as paralysis. It may be fatal.
2. Polio-Endemic: Nigeria, India, Pakistan, Afghanistan
3. Vaccine targets,
   Anyone > 10yrs since last vaccine dose and traveling to areas where polio virus is endemic (naturally present)
4. Saudi Arabia has strict requirements on updated polio vaccination of travelers coming from polio endemic countries (check with their embassy, as these change).

Disease: Poliomyelitis is a viral infection of the central nervous system that can result in permanent neurological damage, such as paralysis. It may be fatal.

Prevalence:

1. Polio-Free: Western Hemisphere, Western Pacific Region, European Region (except for outbreaks in Turkmenistan, Tajikistan, and Russia)
2. Polio-Endemic: Nigeria, India, Pakistan, Afghanistan

Transmission: Fecal-oral or oral-oral (respiratory) contact

Treatment: NONE

Prevention: Vaccine (IPOL/eIPV)

1. An enhanced, killed vaccine
2. Primary vaccine series: 3 doses, starting at age 2 months, 4 months, and 6 – 18 months
3. This vaccine is sometimes given in combination vaccine products in childhood.
4. Dose: subcutaneously (can be intramuscular), 0.5cc
5. Booster: at 4-6 yrs-old
6. Travel Booster: If > 10yrs since last dose
   1. There are no data for more than one booster, beyond that at 4-6yrs-old, in a lifetime.
7. Side-effects: Minor pain, redness, swelling at injection site within 6-12hrs
8. Precautions/Contraindications
   1. Avoid vaccination if moderately ill.
   2. Do not take if history of serious allergy to neomycin, polymyxin B, or streptomycin.
   3. Avoid vaccination with pregnancy unless immediate protection is needed (disease exposure).
   4. Can take vaccine with breastfeeding.
9. Targets
   1. All U.S. children at 2 mo’s-old
   2. Travelers to areas where polio virus is endemic (naturally present),
   3. Anyone > 10yrs since last vaccine dose
   4. Under 6 mo’s-old, (and ≥ 6wks-old) to start accelerated vaccine series.
10. Special Considerations
    1. IPV is the only polio vaccine to be used in immune compromised persons.
    2. Saudi Arabia has strict requirements on updated polio vaccination of travelers coming from polio endemic countries (check with their embassy, as these change).
    3. Adults never vaccinated should receive a 3-dose series: day “O”, 1 – 2 mo’s, and 6 – 12 mo’s after #2.

Access the Injectable VIS Sheet here

Access the Oral VIS Sheet here

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