What is polio?
Polio is an infectious disease, caused by the polio virus, which affects the brain and spinal cord. It can lead to paralysis and in some cases, death.
How is polio transmitted?
The polio virus is transmitted from person to person by mouth or the fecal-oral route. The infection commonly occurs when objects that may have come into contact with fecal matter are introduced into the mouth, although it can also spread via particles released into the air during sneezing. Infected people can infect others up to two weeks after they experience symptoms.
What are the symptoms of polio?
In most cases, poliovirus infections are asymptomatic. However, some people have the following symptoms, which usually pass within a week:
- Sore throat
- Fever
- Tiredness
- Nausea
- Headache
- Stomach pain
In serious cases, patients may also experience tingling or numbness in the legs, meningitis (an infection of the layers surrounding the brain, called meninges), and paralysis. Paralysis can be permanent and affect the muscles of the respiratory system, causing death.
Is polio curable?
There is no cure for polio, but vaccines are effective in stopping transmission. In 2013, a global health initiative was launched to eradicate the disease from the world.
How can you prevent polio?
The best way to protect against polio is by vaccination. MOH has made it compulsory for children in Singapore to be immunised against polio as part of the National Childhood Immunisation Schedule.
3 doses of the inactivated polio vaccine are administered to children at 3, 4 and 5 months. Following which a booster shot and an oral dose of the polio vaccine are administered at 18 months and 10-11 years respectively.
What are the infected areas in the world?
Routine immunisation against polio has eradicated the disease in many parts of the world, including Singapore. However is it still a problem in Afghanistan, Pakistan and Nigeria. There is also a risk of infection in some parts of Africa and the Middle East.
What is a polio certificate?
A polio vaccine certificate proves you have been vaccinated against poliovirus. Some high risk countries require travellers to provide proof of polio vaccination before they can leave the country. Travellers without proof may be required to have a polio booster jab before departure.
Who should get the polio vaccine?
Most Singaporeans have been vaccinated against polio as part of the National Childhood Immunisation Schedule. You are advised to get vaccinated or an additional booster jab if you:
- did not complete the full schedule of jabs as child
- are planning a trip to one of the countries where poliovirus remains active, including Afghanistan, Pakistan, and Nigeria
- care for patients who may be infected with the virus.
Who should not get the polio vaccine?
The vaccine is safe for almost everyone. However, the CDC does not recommend it if:
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- you have had an allergic reaction to previous doses of the vaccine, or any of its components
- you are feeling severely or moderately ill, in which case you will have to wait till you recover to get the vaccine
If you are down with a mild illness such as a cold or flu, you can speak to your health provider about getting the vaccine.
How long before travelling should I get the polio vaccine?
You should ideally begin immunisation two months before your trip to ensure you are on track to complete the full schedule.
Adults who are traveling to areas with increased risk of polio and who are unvaccinated, incompletely vaccinated, or whose vaccination status is unknown should receive a series of 3 doses:
- 2 doses separated by 1 to 2 months, and
- a third dose 6 to 12 months after the second dose.
Adults who completed the polio vaccine series as children and are traveling to areas with increased risk of polio should receive a one-time booster dose of vaccine (IPV).
You should complete the full schedule of doses as soon as you can.
What is the effectiveness of the polio vaccine?
The polio vaccine has proven very effective. Since the Global Eradication Program began in 1988, cases of polio have reduced by 99% worldwide.
What are the side effects of the polio vaccine?
There are no known major side effects of the polio vaccine. Some people may experience redness or soreness at the site of the injection, or develop a small, painless lump which usually disappears.
How long does it last for?
The exact duration of protection is unknown, but the vaccine offers protection against polio for many years after completing all the doses.
When and where was the last outbreak of polio?
Polio outbreaks have decreased since international efforts to eradicate the disease began in 1988. However, the disease is still endemic in Afghanistan, Pakistan and Nigeria.
Recent Polio Outbreaks
After being free of the poliovirus for 18 years, Papua New Guinea reported a re-emergence of the disease in June 2018. Low vaccination coverage in the country has been blamed for the outbreak of polio – infant coverage rates dropped to as low as 44% in 2017. The first case of the disease was reported in a six-year-old boy from Lae in the Morobe province – the boy later succumbed to paralysis. Subsequently, 19 cases that were reported were all in young children. The government of Papua New Guinea has been introducing new immunisation schemes to contain the outbreak and to provide better protection to its inhabitants against polio virus.
In September 2019, an outbreak of poliovirus was reported in the Philippines after the country enjoyed a 19-year period of being free of the disease. Two children in the Lae and Laguna provinces, which are 1,400km apart, have been confirmed to have been affected by polio. A major point of concern is that environmental samples from sewage in Manila and waterways in Davao have been found to have traces of poliovirus. Considering the low immunisation coverage rates in the country, this could result in the quick spread of the disease and a worsening of the outbreak. Philippine health officials have stepped up immunisation campaigns and are aiming to vaccinate all children under the age of 5 against polio as a response to the outbreak.
