Polio Vaccine Program

Front 1

What is the pathogenesis of Polio?

Back 1

1) It is transmitted via the fecal-oral route (ingestion)
2) The virus replicates in the epithelial and lymphoid tissue as well as in the pharynx, tonsils, intestine and gut-associated lymphoid tissue
3) Viremia occurs transporting the virus to organs throughout the body (in some individuals the virus can continue to replicate in the liver, spleen, bone marrow and deep lymph nodes--> minor febrile illness)
4) The virus reaches the CNS via the blood
5) The virus attacks motor neurons, autonomic neurons, motor nuclei in the pons and medulla, and the meninges are affected. The virus also attacks the anterior horn cells of the spinal cord.

Front 2

What is the cause of death in most cases of polio virus encephalitis?

Back 2

Respiratory paralysis

Front 3

Are there any life-long impairments from Polio infection?

Back 3

Many patients have life-long loss of motor function due to the destruction of motor neurons.

Front 4

What is the inactivated polio vaccine?

Back 4

This vaccine is trivalent meaning that it contains antigens against the 3 polio virus serotypes. This vaccine induces neutralizing activity in the bloodstream but cannot do anything about infection in the GI tract and thus cannot prevent primary infection with polio virus.

Front 5

What is the live, oral polio vaccine?

Back 5

This vaccine is trivalent meaning that it contains antigens against the 3 polio virus serotypes. This vaccine can stimulate intestinal infection and induce immunity at the level of the GI tract, preventing the virus from causing infection in the future.

Front 6

Which Polio vaccine should be used in immunocompromised patients?

Back 6

The inactivated polio vaccine.

Front 7

Which Polio vaccine should be used as the primary immunization in adults?

Back 7

Enhanced-potency inactivated polio vaccine (due to the increased risk of paralytic poliomyelitis following immunization).

Front 8

What is one of the risks associated with administration of the oral, live polio vaccine?

Back 8

This vaccine can cause vaccine-associated paralytic poliomyelitis (albeit this risk is low).

Front 9

Why was the live, oral polio vaccine given to young children despite its severe risks?

Back 9

Young children can shed the virus in their stool assisting with the secondary spread of the virus and assisting with the eradication of polio in communities. IT IS NOT GIVEN ANYMORE TO CHILDREN

Front 10

What is the paradoxical situation in the US due to the almost complete eradication of polio?

Back 10

An individual is more likely to acquire polio from live polio vaccine than from a natural source.

Front 11

What is the CDC's recommendations for polio vaccination in children?

Back 11

Children should receive the inactivated polio vaccine at age 2, 4, and 6-18 months with a booster at 4-6 years old.

Front 12

When do we use the live, oral Polio vaccine?

Back 12

Only during outbreaks, for travel to polio-endemic countries, and if IPV injections do not work in patients. However, OPV is NEVER recommended for primary immunization of adults (and should be avoided for boosters if given a choice).

Front 13

Which form of the polio vaccine is the vaccine of choice for eradication of Polio internationally?

Back 13

OPV

Front 14

Which Polio vaccine is no longer available in the US?

Back 14

OPV

Front 15

Is it necessary to immunize all travelers against Polio?

Back 15

No, only those that will be staying for long periods of time or will be working with medical patients or small children.

Front 16

Will getting the Polio vaccine as a child result in life-time immunity?

Back 16

No, the protection wanes with time.

Front 17

Is routine booster immunization for Polio recommended for health care workers in the US?

Back 17

No, due to the rarity of Polio in the US. However, it is recommended that all health care workers have had at least some form of Polio immunization as a child or receive the primary series with IPV.

Front 18

When would a Polio booster vaccine be warranted?

Back 18

If patients were going to be:
- traveling for a prolonged period to time to an area where Polio is still an endemic
- If people were going to be involved with medical care of individuals who may be excreting polio virus
-If people are involved with laboratory work that involves handling polio virus.