1. What is polio?
Poliomyelitis (polio) is a highly infectious disease caused by the polio virus. It invades the nervous system, and can cause paralysis or even death in a matter of hours.
2. How is polio transmitted?
Poliovirus enters the body through the mouth, in water or food that has been contaminated with faecal material from an infected person. The virus multiplies in the intestine and is excreted by the infected person in faeces, which can pass on the virus to others.
3. What are the symptoms of polio?
Initial symptoms of polio are:
4. Who is at risk of catching polio?
Polio mainly affects children under 5 years of age.
5. What are the effects of polio?
One in every 200 persons infected with polio leads to irreversible paralysis (usually in the legs).
Among those paralysed, 5%-10% die when their breathing muscles are immobilized by the virus.
6. Is there a cure for polio?
No there is no cure for polio. Polio can only be prevented by immunization. Safe and effective vaccines exist – the oral polio vaccine (OPV) and the inactivated polio vaccine (IPV).
7. What is the Global Polio Eradication Initiative?
The Global Polio Eradication Initiative (GPEI) is a partnership that aims to consign polio to the history books. It is led by national governments with five partners – the World Health Organization (WHO), Rotary International, the US Centers for Disease Control and Prevention (CDC), the United Nations Children’s Fund (UNICEF), the Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance. Since the GPEI was founded, polio cases have fallen worldwide by over 99%. As recently as 30 years ago, 1000 children EVERY SINGLE DAY were paralysed by polio. By 2015, all countries but two had stopped polio transmission, and in 2021 the wild poliovirus was geographically constrained and caused 6 cases of wild poliovirus in the entire year. Failure to eradicate polio however will lead to a global resurgence of the disease. Within ten years, 200 000 new cases could occur every single year, all over the world. That is why it is critically urgent to complete the job of polio eradication once and for all.
8. Where does wild poliovirus continue to circulate today?
There are just two countries which have never stopped polio transmission – Afghanistan and Pakistan. However, polio can and does spread from these countries to their neighbours and beyond. It must be remembered that polio anywhere is a threat to children everywhere. It does not respect borders or social class, and travels with ease.
9. Could polio spread to other polio-free countries?
Polio does not respect borders – any unimmunized child is at risk. For every case of paralysis there are between 200 and 1000 children infected without symptoms. So it is hard to detect polio and hard to prevent the virus from travelling. Children living in areas where immunity levels are low are particularly vulnerable. The best defence against polio importations is to eradicate the virus. Only then will all children be safe.
10. What will it take to eradicate polio?
To stop polio we need to:
11. Why is so much focus placed on polio, but not on other diseases?
Polio is one of only a few diseases which can be completely eradicated, such as was the case with smallpox. By eradicating polio, children across the entire world will benefit, and no child need ever again know the pain of polio-paralysis. Most diseases, such as HIV and malaria for example, cannot be eradicated, because the tools to eradicate these are not available. Polio does not have an intermediate host (i.e. it does not affect animals, and the virus cannot live in animals, in the way that malaria, for example, does in mosquitoes), a safe and effective vaccine is available to protect children from polio, it does not survive for extended periods of time in the environment, and while it is contagious, its infection period is relatively short. Polio eradication activities are also strengthening routine health services. Thanks to polio eradication activities, an active disease surveillance network has been established in all countries, into which other diseases – including measles – are now being integrated. Polio eradication infrastructures are also used for the provision of other health services such as deworming tablets, vitamin A and bednets.
12. Why are children given oral polio vaccines?
Polio vaccine is the only protection against polio, a paralysing disease for which there is no cure. It is essential that every child under five is immunized against polio. Oral polio vaccine is safe and effective, and because it is administered orally, it can be given by volunteers. Its method of action ensures that person-to-person spread of the virus can be interrupted.
13. Does the oral polio vaccine have any side effects?
Oral polio vaccine (OPV) is one of the safest vaccines ever developed. It is so safe it can be given to sick children and newborns. It has been used all over the world to protect children against polio, saving at least 18 million children from permanent paralysis by polio. On extremely rare occasions, the attenuated virus in oral polio vaccine can mutate and regain virulence. However, children are far more at risk from polio than any side effects from the polio vaccine.
14. What is the Islamic guidance on polio vaccine?
Oral polio vaccine (OPV) is safe and has been declared halal by Islamic leaders all over the world – the Grand Sheik Tantawi of Al-Azhar University, the Grand Mufti of Saudi Arabia and the Majelis Council of Ulemmas in Indonesia.
15. Is it safe to administer multiple doses of OPV to children?
Yes, it is safe to administer multiple doses of polio vaccine to children. The vaccine is designed to be administered multiple times to ensure full protection. In the tropics, several doses of polio vaccine are required for a child to be fully protected – sometimes more than ten. This vaccine is safe for all children. Each additional dose further strengthens a child’s immunity level against polio.
16. How many doses of OPV does a child need before they are protected?
Oral polio vaccine needs to be administered multiple times to be fully effective. The number of doses it takes to immunize a child depends entirely on the child’s health and nutritional status, and how many other viruses that child has been exposed to. Until a child is fully immunized they are still at risk from polio. This just emphasizes the need for all children to be immunized during every round of national immunization days. Every missed child is a place for the polio virus to hide.
17. Should a child receive OPV during polio campaigns and routine immunization?
Yes. Oral polio vaccine (OPV) is safe and effective and every extra dose means a child gets extra protection against polio. It takes multiple doses of OPV to achieve full immunity against polio. If a child has received the vaccine before, then extra doses given during the National or Sub National Immunization Days (NIDs/SNIDs) will give valuable additional immunity against polio.
18. Is OPV safe for sick children and newborns?
Yes. Oral polio vaccine is safe to be given to sick children. In fact it is particularly critical that sick children are immunized during the campaigns, and newborn babies, because their immunity levels are lower than other children. All sick children and newborns should be immunized during the coming campaigns to give them the protection against polio that they desperately need.
19. What is the role of Inactivated Polio Vaccine (IPV)?
Every country in the world except two (Sweden and Iceland) used oral polio vaccine (OPV) to eliminate polio and continued using OPV, usually until the late 1990s, when some switched to inactivated polio vaccine due to progress towards polio eradication (when the risk of wild poliovirus was diminished). Most countries use OPV as it has a unique ability to induce intestinal, local immunity, meaning that it can actually interrupt wild poliovirus transmission in an environment. This is not possible with IPV, an inactivated polio vaccine, which induces only very low levels of immunity to poliovirus inside the gut, and as a result provides individual protection against polio, but unlike OPV, cannot prevent the spread of wild poliovirus. IPV is being introduced into all routine immunization programmes around the world, as part of ongoing activities for the phased removal of OPVs.