POLIOMYELITIS ( ‘Infantile Paralysis’ )

Polio is an extremely contagious viral infection of the gut. Following infection some people will develop variable degrees of paralysis which may result in permanent disability or death. Polio was very common in Australia until around 1960 when immunisation dramatically reduced its incidence – however it is still common in some countries.

Recently oral polio vaccine was replaced for childhood immunisation by the inactive IPV vaccine which is now incorporated in the Triple Antigen IPV vaccine.

Previously, and for those not eligible for Triple Antigen IPV or IPV vaccine an oral polio vaccine is, or, was used

Unlike most vaccines, oral polio vaccine (OPV) is a live vaccine. The usual course is given as 2 drops of OPV medicine at 2,4 and 6 months with a booster at 4 years.

Reactions to oral polio vaccine are uncommon, but precautions need to be taken because live virus is excreted in the child’s stool for approximately 6 weeks after each dose – an infection could be picked up by susceptible people from the faeces.
Very rarely (there have been 2 cases in Australia in the past 13 years) the vaccine can cause a form of paralytic polio in the person receiving it – vaccine associated paralytic poliomyelitis (VAPP).

The following people should NOT be vaccinated with oral polio vaccine :

- Fever more than 38.5 (delay immunisation)
- Severe reaction to a previous dose of polio
- Severe allergy to neomycin, polymyxin or streptomycin

- In the presence of vomiting or diarrhoea (delay immunisation)

-*In individuals or where there are house-hold contacts :

-Taking high dose steroids or on immunosuppressive medication or whole body radiotherapy

-With a malignancy of their immune system (lymphoma, leukaemia or Hodgkins Disease)
-HIV infection
-During pregnancy

An alternate to oral polio is available – a non live vaccine (IPV), given by injection, can be used in the *above instances.

Because the live vaccine virus is excreted in faeces for 6 weeks, carers should be very careful with hygiene, particularly when changing nappies - which should be safely disposed of.