II. Epidemiology

  1. Most often in children <15 years old (esp. infants and young children)
  2. Summer and Fall (temperate climates) or year round (tropical climates)
  3. Incidence: Paralytic Polio (U.S.)
    1. 1950s: 15,000 cases per year
    2. 1960s: <100 cases per year
    3. 1970s: <10 cases per year
    4. 1979: No wild-type cases onset in U.S. since this time
    5. 1993: Last internationally imported case of polio in U.S.
  4. Incidence: Worldwide
    1. Polio is still a risk to travelers to developing countries
      1. Those travelers may reintroduce Polio on their return to the U.S.
    2. Polio cases still occur in developing countries throughout the world
      1. Afghanistan, Pakistan and Syria
      2. Africa (Nigeria, Somalia, DR Congo, Niger, Mozambique, Cameroon, Chad, Central Africa Republic, Kenya)
      3. Papua New Guinea

III. Risk Factors

  1. Developing world
    1. Infants and young children
    2. Poor hygienic living conditions
    3. Under-immunized populations
  2. Travelers
    1. Unimmunized or under-immunized with Polio Vaccine
    2. Travel to remaining Polio endemic regions of the world (see above)
    3. Contact with persons traveling to Polio endemic regions of the world (see above)

IV. Pathophysiology

  1. Enterovirus infection (Picornaviridae)
  2. Only infectious to humans, with person to person spread
    1. Fecal-oral route
    2. Respiratory route

V. Presentations

  1. Incubation
    1. Non-paralytic polio: 3-6 days
    2. Paralytic polio: 7-21 days (from exposure to paralysis)
  2. Subclinical or asymptomatic (72%)
    1. Mild presentations
  3. Abortive Poliomyelitis (24%)
    1. Non-specific febrile illness for 2-3 days
    2. No CNS symptoms
  4. Aseptic Meningitis
    1. Rapid and complete recovery within a few days
  5. Paralytic Poliomyelitis (1%)
    1. Initial febrile illness resolves, followed a few days later by asymmetric Flaccid Paralysis

VI. Findings: Paralytic Poliomyelitis

  1. Prodrome: Fever and minor, non-specific symptoms (resolves within 2-5 days)
    1. Fever
    2. Pharyngitis
    3. Fatigue
    4. Headache
    5. Nausea
    6. Epigastric Pain
  2. Paralysis (onset 5-10 days after prodrome)
    1. Fever recurrence
    2. Meningeal Irritation
    3. Asymmetric Flaccid Paralysis
      1. Starts with cramping muscle pain, spasms and course muscle twitching
      2. Maximal paralysis occurs within days of onset
      3. Descending paralysis
        1. Starts proximally in affected limb, and progresses distally
    4. Distribution
      1. Age <5 years
        1. Paralysis of one leg
      2. Age 5-15 years
        1. Weakness of one arm or paraplegia
      3. Adults
        1. Quadriplegia
        2. Respiratory muscle dysfunction
        3. Bladder dysfunction
        4. Bulbar Paralysis (6-25% of cases)
  3. Other neurologic findings
    1. Deep Tendon Reflexes decreased or absent
    2. Sensation intact

VIII. Diagnosis: Probable Paralytic Polio Case

  1. Acute Flaccid Paralysis (one or more limbs) AND
  2. Decreased or absent Deep Tendon Reflexes (in affected limbs) AND
  3. No sensory loss AND
  4. No cognitive loss AND
  5. No other apparent cause

IX. Diagnosis

  1. Precautions
    1. Cerebrospinal fluid has poor Test Sensitivity for polio and does not exclude polio
  2. Poliovirus PCR, Viral Isolation, Intratypic Differentiation
    1. Obtain within 14 days of symptom onset (ideally)
    2. Sources: Obtain 2 of each source at least 24 hours apart
      1. Stool specimens
      2. Throat swabs

X. Management

  1. Supportive Care
  2. Isolate any patient suspected of polio to prevent transmission to others
  3. Immediately report any suspected case of polio to local health department
    1. Confirmed Polio cases require CDC report within 4 hours

XI. Complications: Acute

  1. Myocarditis
  2. Hypertension
  3. Pulmonary Edema
  4. Secondary Infections (e.g. Pneumonia, Urinary Tract Infection)
  5. Respiratory Failure (2-10% of paralytic polio cases)

XII. Complications: Chronic

  1. Post-Poliomyelitis Neuromuscular Atrophy (Post-Polio Syndrome)
    1. Onset 15-40 years after initial polio presentation in 25-40% of polio survivors
    2. Slow degeneration of axon terminals in surviving Motor Neurons, with late denervation of muscle
    3. Progressive and irreversible Muscle Weakness, Fatigue and Joint Pain

XIII. Prevention

XIV. Resources

XV. References

  1. (1991) Harrison Internal Medicine, 12th ed, p.713-4

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Ontology: Poliomyelitis (C0032371)

Definition (MSHFRE) Maladie infectieuse humaine aiguë, survenant plus particulièrement chez les enfants, due à un des trois sérotypes du virus polio humain. L'infection est dans la plupart des cas asymptomatique et limitée au nasopharynx et à l'appareil gastro-intestinal. Le système nerveux, principalement la moelle épinière, peut être infecté, entraînant une paralysie flasque progressive avec fasciculation et hyporéflexie. Les neurones moteurs sont principalement affectés. On peut également retrouver une encéphalite. La multiplication du virus dans le système nerveux entraîne une perte neuronale surtout au niveau du cordon médullaire. Une affection apparentée et rare, la poliomyélite à entérovirus non-poliovirus, a pu être décrite pour d'autres sérotypes d'entérovirus. (From Adams et al., Principles of Neurology, 6th ed, pp764-5)
Definition (MSHCZE) Poliomyelitida - dětská obrna. Infekční onemocnění způsobené virem (poliovirus), který poškozuje oblasti páteřní míchy odpovědné za svalový pohyb (šedou hmotu míšní v předních rozích). Virus dříve v intervalech několika let vyvolával epidemie. Většina onemocnění proběhla skrytě nebo jen s „chřipkovými“ příznaky a zanechala odolnost (imunitu). U části dětí pronikl virus do nervového systému a způsobil těžké obrny s následnými deformitami. Mohlo dojít rovněž k postižení mozku nebo prodloužené míchy, které vyvolalo selhání základních životních funkcí - dech, krevní oběh. Od zavedení očkování (Sabinova vakcína) se toto dříve obávané onemocnění u nás nevyskytuje. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ )
Definition (NCI) An acute infectious disorder that affects the nervous system. It is caused by the poliovirus. The virus spreads by direct contact, and can be prevented by prophylaxis with the polio vaccine.
Definition (MSH) An acute infectious disease of humans, particularly children, caused by any of three serotypes of human poliovirus (POLIOVIRUS). Usually the infection is limited to the gastrointestinal tract and nasopharynx, and is often asymptomatic. The central nervous system, primarily the spinal cord, may be affected, leading to rapidly progressive paralysis, coarse FASCICULATION and hyporeflexia. Motor neurons are primarily affected. Encephalitis may also occur. The virus replicates in the nervous system, and may cause significant neuronal loss, most notably in the spinal cord. A rare related condition, nonpoliovirus poliomyelitis, may result from infections with nonpoliovirus enteroviruses. (From Adams et al., Principles of Neurology, 6th ed, pp764-5)
Definition (CSP) acute infectious disease of humans, particularly children, caused by any of three serotypes of human poliovirus; infection is usually limited to the gastrointestinal tract and nasopharynx, and is often asymptomatic; the central nervous system, primarily the spinal cord, may be affected, leading to rapidly progressive paralysis, coarse fasciculation and hyporeflexia; motor neurons are primarily affected and encephalitis may also occur; replicates in the nervous system, and may cause significant neuronal loss, most notably in the spinal cord.
Concepts Disease or Syndrome (T047)
MSH D011051
ICD9 045, 045.9
ICD10 A80 , A80.9
SnomedCT 186481004, 54839009, 186475007, 154320008, 187390004, 367318001, 266189002, 398102009, 398256009
LNC LA17016-9
English POLIOMYELITIS, Acute poliomyelitis NOS, Acute poliomyelitis, unspecified, Acute poliomyelitis,unspcfd, Polio, Poliomyelitis acute, [X]Acute poliomyelitis, unspecified, [X]Acute poliomyelitis,unspcfd, poliomyelitis (diagnosis), poliomyelitis, Polio acute, Poliomyelitis (acute), Acute unspecified poliomyelitis, Acute Poliomyelitis, Epidemic, Epidemic Acute Poliomyelitis, Poliomyelitis, Epidemic Acute, Poliomyelitis, Acute, Polios, Poliomyelitis [Disease/Finding], acute poliomyelitis, acute polio, polio, polios, Poliomyelitis NOS, Heine-Medin disease, Acute poliomyelitis NOS (disorder), Poliomyelitis (disorder), [X]Acute poliomyelitis, unspecified (disorder), Polia, Poliomyelitis, Acute poliomyelitis, PM - Poliomyelitis, Epidemic acute poliomyelitis (disorder), Epidemic acute poliomyelitis, Acute poliomyelitis (disorder), Heine-Medin, Acute poliomyelitis, NOS, Epidemic acute poliomyelitis, NOS, Poliomyelitis, NOS, Acute Poliomyelitis
Portuguese POLIOMIELITE, Poliomielite aguda, Poliomielite aguda NE, Pólio, Poliomielite NE, Doença de Heine-Medin, Poliomielite, Polio
Spanish POLIOMIELITIS, Poliomielitis (aguda), Poliomielitis no especificada aguda, Poliomielitis aguda, Poliomielitis aguda no especificada, Poliomielitis NEOM, Polio aguda, Enfermedad de Heine-Medin, poliomielitis, poliomielitis aguda epidémica, poliomielitis aguda, SAI (trastorno), [X]poliomielitis aguda, no especificada, polio, [X]poliomielitis aguda, no especificada (trastorno), poliomielitis aguda, SAI, poliomielitis aguda (concepto no activo), poliomielitis aguda (trastorno), poliomielitis aguda, poliomielitis epidémica aguda (trastorno), poliomielitis epidémica aguda, Poliomielitis, Polio
German POLIOMYELITIS, akute unspezifische Poliomyelitis, akute Poliomyelitis, akute Poliomyelitis, unspezifisch, Poliomyelitis NNB, Poliomyelitis (akut), Poliomyelitis akut, Polio akut, Akute Poliomyelitis [Spinale Kinderlaehmung], Akute Poliomyelitis, nicht naeher bezeichnet, Heine-Medin-Krankheit, Poliomyelitis, Polio
Dutch polio acuut, acute niet-gespecificeerde poliomyelitis, poliomyelitis acuut, poliomyelitis (acuut), poliomyelitis NAO, acute poliomyelitis, acute poliomyelitis, niet-gespecificeerd, polio, ziekte van Heine-Medin, Acute poliomyelitis, niet gespecificeerd, poliomyelitis, Acute poliomyelitis, Myelitis, polio-, Polio, Poliomyelitis
French Poliomyélite aiguë, non précisée, Poliomyélite aiguë non précisée, Polyo aiguë, Poliomyélite aiguë, Polyo, Poliomyélite SAI, Poliomyélite (aiguë), Poliomyélite aigüe, PAA (Poliomyélite Antérieure Aigüe), Poliomyélite antérieure aiguë, Poliomyélite antérieure aigüe, POLIOMYELITE, Maladie de Heine-Medin, Polio, Poliomyélite
Italian Poliomielite acuta non specificata, Poliomielite NAS, Poliomelite acuta, non specificata, Poliomielite (acuta), Polio, Poliomielite endemica acuta, Poliomielite acuta, Malattia di Heine-Medin, Poliomielite
Japanese 詳細不明の急性灰白髄炎, 灰白髄炎NOS, 急性灰白髄炎、詳細不明, 急性ポリオ, 灰白髄炎(急性), キュウセイカイハクズイエン, カイハクズイエン, キュウセイポリオ, カイハクズイエンキュウセイ, ショウサイフメイノキュウセイカイハクズイエン, カイハクズイエンNOS, ポリオ, 小児麻痺-脊髄性, 脊髄灰白質炎, 灰白髄炎, 灰白髄炎-急性, ポリオ, 脊髄灰白炎, 急性脊髄前角炎, 急性灰白髄炎, 小児麻痺, 脊髄性小児麻痺, ハイネ・メジン病, キュウセイカイハクズイエンショウサイフメイ, ハイネメディンビョウ, ハイネ・メディン病
Swedish Polio
Czech poliomyelitida, Akutní poliomyelitida, Poliomyelitida, Akutní obrna, Akutní poliomyelitida, blíže neurčená, Akutní blíže neurčená poliomyelitida, Poliomyelitida NOS, Poliomyelitida (akutní), Polio, Heine-Medinova nemoc, poliomyelitis anterior acuta, zánět šedé hmoty míšní
Finnish Poliomyeliitti
Russian DETSKII EPIDEMICHESKII PARALICH, POLIOMIELIT, DETSKII SPINAL'NYI PARALICH, EPIDEMICHESKII PARALICH, ДЕТСКИЙ СПИНАЛЬНЫЙ ПАРАЛИЧ, ДЕТСКИЙ ЭПИДЕМИЧЕСКИЙ ПАРАЛИЧ, ПОЛИОМИЕЛИТ, ЭПИДЕМИЧЕСКИЙ ПАРАЛИЧ
Korean 상세불명의 급성 회색질척수염, 급성 회색질척수염
Croatian POLIOMIJELITIS
Polish Porażenie dziecięce nagminne, Poliomyelitis, Choroba Heinego-Medina, Zapalenie rogów przednich rdzenia ostre
Hungarian acut poliomyelitis, poliomyelitis k.m.n., Poliomyelitis acut, heveny poliomyelitis, k.m.n., Polio acut, polio, Poliomyelitis (acut), poliomyelitis, nem meghatározott acut poliomyelitis, Heine-Medin-kór
Norwegian Poliomyelitt, Polio

Ontology: Poliomyelitis, Bulbar (C0032372)

Definition (MSHFRE) Poliomyélite paralytique affectant les neurones de la moelle bulbaire. Elle associe des troubles respiratoires, une hypertension, des troubles vasomoteurs et une dysphagie. En général, d'autres signes de poliomyélite sont associés tels que des paralysies des muscles des membres inférieurs et du tronc. (From Adams et al., Principles of Neurology, 6th ed, p765)
Definition (MSH) A form of paralytic poliomyelitis affecting neurons of the MEDULLA OBLONGATA of the brain stem. Clinical features include impaired respiration, HYPERTENSION, alterations of vasomotor control, and dysphagia. Weakness and atrophy of the limbs and trunk due to spinal cord involvement is usually associated. (From Adams et al., Principles of Neurology, 6th ed, p765)
Concepts Disease or Syndrome (T047)
MSH D011052
ICD9 045.0
SnomedCT 186475007, 54839009, 64764001, 398327006
English Bulbar Poliomyelitis, Poliomyelitis, Bulbar, Acute paralytic poliomyelitis specified as bulbar, BULBAR POLIO, Acute paralytic bulbar polio, POLIO BULBAR, paralytic bulbar poliomyelitis (diagnosis), paralytic bulbar poliomyelitis, Bulbar polio, Bulbar poliomyelitis, Bulbar Polio, Polio, Bulbar, Medullary Involvement Poliomyelitis, Poliomyelitis, Medullary Involvement, Poliomyelitis, Bulbar [Disease/Finding], acute anterior poliomyelitis, bulbar polio, bulbar poliomyelitis, Acute anterior bulbar polioencephalomyelitis, Acute anterior poliomyelitis, Acute infantile paralysis, Acute paralytic bulbar poliomyelitis, Acute paralytic poliomyelitis, bulbar (disorder), Acute paralytic poliomyelitis, bulbar, Anterior acute poliomyelitis (disorder), Anterior acute poliomyelitis, bulbar; poliomyelitis, poliomyelitis; bulbar, Anterior acute poliomyelitis, NOS, Acute bulbar polioencephalitis, Poliomyelitis specified as bulbar
French POLIOMYELITE BULBAIRE, Polyo bulbaire, Poliomyélite aiguë paralytique précisée bulbaire, Poliomyélite antérieure aiguë, Poliomyélite bulbaire, Polio bulbaire
Portuguese POLIOMIELITE BULBAR, Poliomielite anterior aguda, Pólio bulbar, Poliomielite paralítica aguda especificada como bulbar, Poliomielite bulbar, Poliomielite Bulbar
Spanish POLIOMIELITIS BULBAR, Poliomielitis anterior aguda, Poliomielitis paralítica aguda especificada como bulbar, Polio bulbar, parálisis infantil aguda, polioencefalitis bulbar aguda, polioencefalomielitis bulbar anterior aguda, poliomielitis aguda anterior (trastorno), poliomielitis aguda anterior, poliomielitis anterior aguda, poliomielitis paralítica aguda, bulbar, poliomielitis paralítica aguda, de tipo bulbar (trastorno), poliomielitis paralítica aguda, de tipo bulbar, Poliomielitis bulbar, Poliomielitis Bulbar
Dutch acute paralytische poliomyelitis gespecificeerd als bulbair, bulbaire polio, acute vroegere poliomyelitis, bulbair; poliomyelitis, poliomyelitis; bulbair, bulbaire poliomyelitis, Bulbaire poliomyelitis, Myelitis, bulbaire polio-, Poliomyelitis, bulbaire
German bulbaere Polio, akute paralytische Poliomyelitis spezifiziert als bulbaer, akute anteriore Poliomyelitis, BULBAERPARALYSE (POLIO), bulbaere Poliomyelitis, Bulbäre Poliomyelitis, Poliomyelitis, bulbäre
Italian Poliomielite anteriore acuta, Poliomielite paralitica acuta, specificata come bulbare, Poliomielite con interessamento midollare, Polio bulbare, Poliomielite bulbare
Japanese 延髄ポリオ, 急性麻痺性灰白髄炎、延髄と明示されたもの, 急性前角灰白髄炎, キュウセイマヒセイカイハクズイエンエンズイトメイジサレタモノ, エンズイポリオ, キュウセイゼンカクカイハクズイエン, エンズイカイハクズイエン, 延髄灰白髄炎, 灰白髄炎-延髄
Swedish Poliomyelit, bulbär
Czech poliomyelitida bulbární, Poliomyelitis anterior acuta, Akutní paralytická poliomyelitida určená jako bulbární, Bulbární poliomyelitida
Finnish Bulbaarinen poliomyeliitti
Russian POLIOMIELIT BUL'BARNYI, ПОЛИОМИЕЛИТ БУЛЬБАРНЫЙ
Polish Postać opuszkowa poliomyelitis
Hungarian acut anterior poliomyelitis, Acut paralyticus poliomyelitis, bulbaris típus, bulbaris polio, bulbaris poliomyelitis
Norwegian Bulbær poliomyelitt

Ontology: Postpoliomyelitis Syndrome (C0080040)

Definition (MSH) A syndrome characterized by new neuromuscular symptoms that occur at least 15 years after clinical stability has been attained in patients with a prior history of symptomatic poliomyelitis. Clinical features include new muscular weakness and atrophy of the limbs, bulbar innervated musculature, and muscles of respiration, combined with excessive fatigue, joint pain, and reduced stamina. The process is marked by slow progression and periods of stabilization. (From Ann NY Acad Sci 1995 May 25;753:68-80)
Concepts Disease or Syndrome (T047)
MSH D016262
ICD10 G14
SnomedCT 367094007, 31097004
English Muscular Atrophies, Post-Poliomyelitis, Muscular Atrophies, Postpoliomyelitis, Muscular Atrophy, Post-Poliomyelitis, Muscular Atrophy, Postpoliomyelitis, Post Poliomyelitis Muscular Atrophy, Post Poliomyelitis Syndrome, Post-Poliomyelitis Muscular Atrophies, Post-Poliomyelitis Muscular Atrophy, Post-Poliomyelitis Syndrome, Postpoliomyelitis Muscular Atrophies, Postpoliomyelitis Muscular Atrophy, Postpoliomyelitis Syndrome, PPMA, MUSCULAR ATROPHY POSTPOLIO, POSTPOLIO SYNDROME, POST POLIO MUSCULAR ATROPHY, POST POLIO SYNDROME, post-polio syndrome, post-polio syndrome (diagnosis), Post polio syndrome, Post-Polio Syndrome, Post-Polio Syndromes, Postpoliomyelitis Syndrome [Disease/Finding], postpoliomyelitis syndrome, post polio syndrome, post poliomyelitis syndrome, polio post syndrome, Post-polio Syndrome, Postpolio syndrome (disorder), Post poliomyelitis syndrome, Postpolio muscular atrophy, Postpolio syndrome, Post poliomyelitis syndrome (disorder), postpolio syndrome
Swedish Postpoliosyndrom
Japanese ポリオゴショウコウグン, 灰白髄炎後遺症症候群, ポストポリオ症候群, ポリオ後症候群, ポリオ後筋萎縮, 小児麻痺後遺症症候群, 灰白髄炎後筋萎縮, 筋萎縮-ポリオ後, 筋萎縮-灰白髄炎後
Czech postpoliomyelitický syndrom, Postpolio syndrom, post-polio syndrom, postpoliomyelitická svalová atrofie, postpolio syndrom
Spanish Síndrome Postpoliomielitis, atrofia muscular secundaria a poliomielitis, síndrome secundario a poliomielitis (trastorno), síndrome secundario a poliomielitis, Síndrome postpolio, atrofia muscular postpolio, síndrome pospolio, síndrome postpolio, atrofia muscular pospolio, Atrofia Muscular Pospoliomielitis, Síndrome Post Poliomielitis, Síndrome Post Polio
Finnish Polionjälkeinen oireyhtymä
Russian POSTPOLIOMIELITNYI SINDROM, MYSHECHNAIA ATROFIIA POSTPOLIOMIELITNAIA, ATROFIIA MYSHECHNAIA POSTPOLIOMIELITNAIA, АТРОФИЯ МЫШЕЧНАЯ ПОСТПОЛИОМИЕЛИТНАЯ, МЫШЕЧНАЯ АТРОФИЯ ПОСТПОЛИОМИЕЛИТНАЯ, ПОСТПОЛИОМИЕЛИТНЫЙ СИНДРОМ
Italian Atrofia muscolare post poliomielitica, Sindrome post-poliomielitica, Sindrome post-polio, Sindrome post polio, Atrofia muscolare post-poliomielitica, Sindrome post poliomielitica
Polish Zespół po rdzeniowym porażeniu dziecięcym, Zanik mięśni po zakażeniu polio, Zespół po poliomyelitis
Hungarian Postpolio syndroma
Norwegian Postpoliosyndrom
Portuguese Síndrome pós-poliomielite, Atrofia Muscular Pós-Poliomielite, Síndrome Pós-Poliomielite, Síndrome Pós-Pólio
Dutch postpoliosyndroom, Postpolio-spieratrofie, Postpoliomyelitissyndroom, Postpoliosyndroom, Spieratrofie, postpoliomyelitis-, Syndroom, postpolio-
French Séquelles tardives de poliomyélite, Atrophie musculaire post-poliomyélitique, Atrophie musculaire postpoliomyélitique, Syndrome de la postpoliomyélite, Syndrome post-poliomyélitique, Syndrome post-polio, Syndrome postpoliomyélitique, Syndrome postpolio
German Post Polio Syndrom, Postpoliomyelitissyndrom, Post-Poliomyelitissyndrom, Postpoliomyelitische Muskelatrophie, Postpoliosyndrom, Muskuläre Atrophie, postpoliomyelitische

Ontology: Human poliovirus (C0206435)

Definition (NCI_CDISC) Any viral organism that can be assigned to the species Poliovirus.
Definition (NCI) An enterovirus comprised of an single-stranded positive sense RNA genome and a protein capsid. This virus is the human pathogen that causes poliomyelitis.
Definition (MSH) A species of ENTEROVIRUS which is the causal agent of POLIOMYELITIS in humans. Three serotypes (strains) exist. Transmission is by the fecal-oral route, pharyngeal secretions, or mechanical vector (flies). Vaccines with both inactivated and live attenuated virus have proven effective in immunizing against the infection.
Definition (CSP) a common infection of the gastrointestinal tract which is usually silent; when the CNS is infected there is damage to the anterior horn cells and motor paralysis; causes similar disease in chimpanzees and monkeys when injected.
Concepts Virus (T005)
MSH D017955
SnomedCT 44172002
LNC LP18878-6
English Poliovirus, Human poliovirus, Polioviruses, poliovirus, poliomyelitis virus, polio virus, enterovirus polio, POLIOVIRUS, Human enterovirus C, Enterovirus C, Polio virus, Human poliovirus (organism), Human poliovirus, NOS, Polio Virus
Russian ЗОНДЕРС ВИРУС, ЛУГОВСКОГО ВИРУС, ОВЧИННИКОВА ВИРУС, ПОЛИОМИЕЛИТА ВИРУСЫ, OVCHINNIKOVA VIRUS, BRUNGIL'D VIRUS, LUGOVSKOGO VIRUS, POLIOMIELITA VIRUS, LANSING VIRUS, POLIOMIELITA VIRUSY, POLIOVIRUS, POLIOMIELITA VIRUSY CHELOVEKA 1-3, POLIOVIRUSY CHELOVEKA 1-3, LEON VIRUS, ZONDERS VIRUS, БРУНГИЛЬД ВИРУС, ЛАНСИНГ ВИРУС, ЛЕОН ВИРУС, ПОЛИОВИРУС, ПОЛИОВИРУСЫ ЧЕЛОВЕКА 1-3, ПОЛИОМИЕЛИТА ВИРУС, ПОЛИОМИЕЛИТА ВИРУСЫ ЧЕЛОВЕКА 1-3
Italian Poliovirus, Virus della poliomielite
French Poliovirus
Swedish Poliovirus
Czech Poliovirus
Finnish Poliovirus
Japanese 灰白髄炎ウイルス, 小児麻痺ウイルス, ヒトポリオウイルス2, ヒトポリオウイルス1-3, ランシングウイルス, レオンウイルス, ポリオウイルス-ヒト1-3, ポリオウイルス属, ヒトポリオウイルス3, ヒトポリオウイルス1, Brunhildeウイルス, ポリオウイルス, ポリオウイルス類
Croatian POLIOVIRUS
Polish Poliovirus
Spanish poliovirus humano (organismo), poliovirus humano, SAI, poliovirus humano, virus de la polio, Poliovirus
German Poliovirus
Dutch Humane 1-3-poliovirussen, Poliovirus, Poliovirussen, humane 1-3-, Virus, polio-
Portuguese Poliovirus

Ontology: Abortive poliomyelitis (C0343542)

Concepts Disease or Syndrome (T047)
SnomedCT 240459003
English Abortive poliomyelitis, Abortive poliomyelitis (disorder), abortive; poliomyelitis, poliomyelitis; abortive
Dutch abortief; poliomyelitis, poliomyelitis; abortief
Spanish poliomielitis abortiva (trastorno), poliomielitis abortiva

Ontology: Acute paralytic poliomyelitis (C0348776)

Concepts Disease or Syndrome (T047)
ICD10 A80.30
SnomedCT 186477004, 240460008
English Ac paralyt poliomyelitis, unsp, Acute paralytic poliomyelitis, unspecified, Acute paralytic poliomyelitis, unspecified (disorder), Acute paralytic poliomyelitis, Acute paralytic poliomyelitis (disorder)
Spanish poliomielitis paralítica aguda, no especificada (trastorno), poliomielitis paralítica aguda, no especificada, poliomielitis paralítica aguda (trastorno), poliomielitis paralítica aguda