Post Polio Syndrome
Following the development and administration of Salk and Sabin polio virus immunization it was believed by medical professionals that polio had been permanently eradicated in the United States since in the early 1960s a series of inoculations were routinely administered to three-month-old infants to be followed by periodic booster inoculations until six-years of age. Unfortunately little did the medical profession realize a related condition PPS (post polio syndrome) was about to rear its ugly head affecting individuals who contracted and survived poliomyelitis.
According to the National Center for Health Statistics, of the 440,000 polio survivors in the United States 25 to 50 percent have begun to exhibit PPS signs and symptoms some 25 plus years after the initial onset of polio. Well-known author Arthur C. Clarke who contracted polio in 1959 was diagnosed with PPS in 1988. A thirty-four-year-old female nurse employed by the National Institute of Health who contracted polio as a young child was diagnosed with PPS in 2009.
While the actual cause of PPS is unknown, all indications are that it only affects polio survivors. Even signs/symptoms such as fatigue, joint or muscle pain and overall general weakness or lethargy which might lead polio survivors to seek medical advice are not necessarily definitive PPS indicators. One of the main difficulties of a true PPS diagnosis stems from the fact that most general practitioners may not recognize or fail to associate these symptoms with PPS. Current research appears to indicate that individuals who contracted polio between seven to ten years of age have a fifty percent higher risk of developing PPS.
Diagnosis of Post Polio Syndrome must begin with review and evaluation of the patient’s initial polio history by a neurology or orthopedics professional. Advancements in medical testing have made the only tool, electromyography, used in initial polio evaluation to be seriously passe. The next step involves the extent of physical functionality recovery within the first year following initial polio onset and the length of subsequent stability prior to the appearance of possible PPS symptomatic indicators. The required elimination of other medical conditions such as pulmonary, respiratory, orthopedic and neuro-muscular difficulties is a long and time-consuming process. Individuals diagnosed with osteoarthritis of the shoulder or wrist may actually have PPS especially if arm or leg braces and/or Canadian crutches were used during the initial recovery period. Patients experiencing ‘Depression’ may actually have PPS due to the fact that PPS and ‘Depression’ exhibit very similar symptomatic signs.
While there is no known cure for PPS, there is a plethora of theories regarding PPS treatment including the questionable reliability of MRI, CT, muscle biopsy, spinal fluid examination and pharmaceuticals. Massage and non-strenuous physical therapies only elicit short-term relief. Improvement gained from using steroids and anti-convulsive medications in terms of benefits versus known side effects is yet to be determined. From the perspective of Post Polio Syndrome management, patient acceptance of the condition is of paramount importance. Family Counseling is strongly urged to enable the patient, as well as relatives and friends to move forward.