An Arizona woman contracted paralytic polio last year after being exposed to an infant in Costa Rica who had been administered a live oral polio vaccine just days earlier, health officials reported. The 22-year-old woman developed polio in March while participating in a university-sponsored study-abroad program and was transported back to the United States for treatment, according to a report in the current issue of the federal Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report. "This case highlights the previously unrecognized risk for paralytic polio among unvaccinated persons exposed to [oral polio vaccine] during travel abroad," the team of international, federal and state epidemiologists said.
The authors noted that polio is rare in the United States because of the success of a universal childhood immunization and the Global Polio Eradication Initiative.
The woman who contracted polio in Costa Rica had never been vaccinated against polio because of a religious exemption. The Costa Rican family with whom she lived included a mother, father and daughter with no young children. However, the couple's son and daughter-in-law, who had two children -- 2 months old and 3 years old -- lived next door and visited the host family frequently.
The host couple's infant grandson received his first dose of oral polio vaccine on Jan. 19, 2005, just four days after the Arizona woman arrived. Contact with that baby was her only known exposure to the oral vaccine during her travels, the authors said.
When she was transported to a Phoenix hospital, the woman had severe weakness in her lower extremities and was suffering respiratory failure. Magnetic resonance imaging showed abnormalities of the cervical and thoracic spine. The woman eventually recovered respiratory function and was sent home for out-patient therapy. But two months later, she still had residual weakness in both legs.
As of late 2004, polio remained endemic in six countries -- Egypt, Afghanistan, India, Niger, Nigeria and Pakistan -- and transmission had been re-established in six other African countries. The Americas were certified as being polio-free in 1994. But unvaccinated U.S. travelers or those incompletely vaccinated could still be at risk in countries where the live-virus oral polio vaccine remains in use, the authors said.
| An older friend of ours had polio as a kid. A milder case, she could walk with 2 canes - and had to do so for most of her life. If you haven't vaccinated your kids, it's playing with fire now that there is such easy travel between countries. |
| I take care of several patients with post-polio syndrome. It's a problem that crops up 20 to 40 years after the first polio infection has resolved, and leads to progressive weakness, deformity and (eventually) respiratory failure and death. Lotp is absolutely right: this isn't a time to stand on one's religious principles, it's a time to be vaccinated. |