In most cases, the patient may remain without any symptom. In others, the disease may pass off in about 3-4 days after a little fever, or upper respiratory tract infection, or a slight disturbance of the gastrointestinal tract.

In still another small group of cases, fever, headache, a stiff neck, vomiting (i.e. so-called meningitis) may occur. It is called the non-paralytic stage of the disease, or non-paralyticpoliomyelitis, since in a few cases this stage may be followed by, in about 3-4 days, the next stage of the disease, in which paralysis of the muscles may occur. This last stage is called the

paralytic stage of the disease, or paralytic poliomyelitis. Hence paralysis occurs only in a limited number of patients who are infected with poliovirus.

When the paralysis of various muscles, say of the limbs, is taking place, almost full recovery is the rule in most of the cases, as there may be only temporary involvement of the anterior horn cells. However, some permanent weakness may persist in some of the muscles. Therefore, during the acute phase of the disease, the patient and his attendants/family members must show patience. Once paralysis of the muscles has started, it continues for about a day, and may take more time in a few cases.

The extent of paralysis depends upon the degree of involvement of the spinal cord, i.e., of the motor nerve cells lying in the anterior horns of the spinal cord. And, therefore, the paralysis may be confined to only one small group of muscles of any of the limbs, i.e., only a part of the limb may be involved. While in others, either the whole limb, or even all four limbs may be involved.

Further, the paralysis of poliomyelitis is a highly irregular or asymmetrical/variable, to the extent that in a particular patient, if on one side the foot is involved, on the other side, either the whole or part of the arm may be involved, etc.

As stated above, in spite of the full recovery of most of the muscles that have been paralyzed, some residual paralysis can persist, leading to permanent paralysis of these affected muscles. The worst is that these muscles soon start wasting in about a week. Contractures in these muscles may develop, which become responsible for various deformities in a growing child.

Treatment of poliomyelitis

There is no specific treatment which can stop the paralysis of the muscles, once it occurs, or bring about the full recovery of the muscles that are going to be affected permanently.

Since in some of these paralyzed muscles, contractures are likely to occur, and to begin with, one cannot say, which of the muscle/s will be permanently damaged, all the paralyzed limbs or part/ s of the limb / s must be kept in their proper positions.

Early mobility/physiotherapy is the most important part of the treatment, to avoid contractures. However, surgical intervention may be required in some of the cases, so that the paralyzed limb can be used in the best possible way. Finally, orthopaedic appliances may also be required so that the person is able to live satisfactorily, as far as possible.

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