16 Poliomyelitis

Key information

Mode of transmission Faecal–oral route or by ingestion of pharyngeal secretions.
Incubation period Paralytic disease usually 7–14 days, with a reported range of 3–35 days.
Period of communicability Most infectious in the days immediately before and after the onset of any symptoms.

Transmission is possible as long as the virus is shed (can be years in the immune compromised).
Global burden of disease Endemic in Afghanistan, Nigeria and Pakistan. Outbreaks are still frequent (see
Funded vaccines As inactivated polio vaccine (IPV), in combination with other antigens, or on its own:
  • DTaP-IPV-HepB/Hib (Infanrix-hexa)
  • DTaP-IPV (Infanrix-IPV)
  • ​IPV (IPOL).
Funded vaccine indications and schedule Usual childhood schedule:
  • at age 6 weeks, 3 months and 5 months: DTaP IPV-HepB/Hib (primary series)
  • ​at age 4 years: DTaP-IPV (booster).
For non-immune adults, 2 doses of IPV 4 weeks apart, followed by a third dose 6 months later.

For (re-)vaccination of eligible patients.
Vaccine efficacy/effectiveness Greater than 90 percent.
Precautions Non-immune pregnant women may be immunised if they are travelling to a region where polio is endemic.