Treatment algorithm

Please note that formulations/routes and doses may differ between drug names and brands, drug formularies, or locations. Treatment recommendations are specific to patient groups: see disclaimer

INITIAL

gastrointestinal illness: poliovirus suspected

1st line – supportive care with rehydration + neurologic monitoring

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INITIAL
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gastrointestinal illness: poliovirus suspected
1st line – 

supportive care with rehydration + neurologic monitoring

Oral rehydration and/or intravenous fluids should be given to prevent volume depletion.

The patient should be monitored for acute flaccid paralysis (AFP), which indicates progression to paralytic poliomyelitis.

When poliovirus infection is suspected, the local health authority should be immediately notified: in the US, the local health department or the Centers for Disease Control and Prevention (CDC); in disease-endemic countries, the local office of the WHO.[1]

ACUTE

paralytic poliomyelitis (acute flaccid paralysis)

1st line – supportive care with physical therapy + mobilization

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ACUTE
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paralytic poliomyelitis (acute flaccid paralysis)
1st line – 

supportive care with physical therapy + mobilization

Supportive treatment entails early physical therapy and mobilization.

The patient should be monitored for progression of limb paralysis to respiratory paralysis.

When poliovirus infection is diagnosed or suspected, the local health authority should be immediately notified. In the US, this will be the local health department or the Centers for Disease Control and Prevention (CDC); in disease-endemic countries, the local office of the WHO.[1]

Plus – transfer to specialized center ± intubation

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ACUTE
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paralytic poliomyelitis (acute flaccid paralysis)
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with bulbar poliomyelitis (respiratory paralysis)
Plus – 

transfer to specialized center ± intubation

Treatment recommended for ALL patients in selected patient group

Respiratory paralysis is a life-threatening condition requiring expert medical assistance, and immediate transport to a specialized center for treatment is required..

Respiratory support measures include intubation and ventilation as needed.[1][48]

ONGOING

postpoliomyelitis syndrome (PPS)

1st line – supportive care with physical therapy + mobilization

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ONGOING
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postpoliomyelitis syndrome (PPS)
1st line – 

supportive care with physical therapy + mobilization

PPS may develop many years or even decades following paralytic poliomyelitis, and consists of fatigue, weakness, and wasting of affected muscles. Ongoing physical therapy and mobilization are required.[43][49][50]

A systematic review on pharmacologic and nonpharmacologic therapies found insufficient good-quality evidence to make definite recommendations concerning the various treatments used for PPS.[51]

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Choose a patient group to see our recommendations

Please note that formulations/routes and doses may differ between drug names and brands, drug formularies, or locations. Treatment recommendations are specific to patient groups. See disclaimer

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