Polio
Polio Playbook – Updated January 2024
To help infection preventionists quickly activate polio prevention efforts, APIC’s Emerging Infectious Diseases Task Force has created a Polio Playbook that IPs can download and customize for use in their facilities. The Playbook is a concise workflow document that is designed to be user-friendly and operational for busy IPs. Access the APIC Polio Playbook.
About Polio
- Polio is caused by poliovirus, an enterovirus that infects the gastrointestinal tract and can attack the nervous system, sometimes causing paralysis
- There are three serotypes of wild poliovirus (WPV1, WPV2, WPV3), though WPV2 ad WPV3 are now globally eradicated
- The primary mode of transmission is through ingestion of contaminated food or water (fecal-oral route)
- The secondary mode of transmission is through respiratory droplets (oral-oral)
- Poliovirus can survive in wastewater and on surfaces for extended periods, which enables community-level spread, especially in undervaccinated populations
- Incubation Period: 7 to 21 days
- About. 70-75% of infections are asymptomatic or cause mild symptoms
- Paralytic disease occurs in <1% of infections
- Polio was once one of the most feared childhood diseases in the United States, leading to tens of thousands of paralysis cases annually
- The introduction of the injectable vaccine (IPV) in 1955 and the oral vaccine (OPV) in 1961 led to the elimination of polio transmission in the United States by 1979
- Global Eradication efforts have reduced cases by <99%, yet wild poliovirus continues to circulate in Afghanistan and Pakistan, and vaccine-derived poliovirus (VDPV) outbreaks occur where oral vaccine use and low immunity overlap
- Vaccination remains the only effective measure to prevent paralysis and halt transmission
Current Situation
- July 2022: An unvaccinated adult in New York State developed paralytic polio. Subsequent wastewater testing confirmed circulating poliovirus in multiple New York counties, indicating local transmission
- CDC warns that polio remains a risk in under-vaccinated United States communities, particularly where childhood vaccination rates fall below 90%
- Click here for more information about Polio in the United States
Polio is a high-consequence, vaccine-preventable disease for which healthcare facilities must remain prepared, which includes a plan for:
- Verify vaccination status of staff and patients
- Screen for febrile or neurologic illness with travel or vaccination gaps for possible acute flaccid paralysis
- Coordinate with laboratories and public health for stool or respiratory specimen collection when polio is suspected
- Reinforce hygiene and environmental cleaning practices for fecal-oral pathogen control
- Collaborate with local health departments on vaccination outreach if wastewater detection or imported cases are reported
APIC Resources and Tools
Click here to download the APIC Polio Playbook
- Developed by the APIC Emerging Infectious Diseases Task Force to help infection preventionists rapidly activate Polio prevention efforts
- The playbook is a concise workflow document that is designed to be user-friendly and operational for busy IPs
Additional External Resources
