During the 20th century poliomyelitis (polio) was a commonly contracted disease in Australia. During the peak polio epidemics from the 1930’s to the 1960’s, significant numbers of Australians experienced paralytic polio (between 20,000 and 40,000 people). This figure must be increased 200-fold [1] to obtain the estimated number of infected cases during the same period. The cases may be categorised as follows:

  • 89% were unaware of infection or were affected minimally short-term and were not expected to be affected long-term.
  • 10% appeared to recover short-term with no obvious resultant disability.
  • 1% did not recover short-term and were left with varying degrees of paralysis (minimal up to iron lung).
  • 0.1% died due to respiratory involvement.
  • While some polio patients appeared to recover from initial paralysis (diagnosis was probably “non-paralytic” polio), in reality, they still had neurological impairment.
  • This is because paralysis is only visible when 50%+ motor neurons are killed or damaged.
  • In addition, muscle weakness may not be perceived if the weakness is balanced (eg weakness affects both legs).

The same polio virus (3 strains) causes all categories of polio – “paralytic” polio is not caused by a “special” type of polio virus. Some of the discussion about polio is confusing because the term “polio” is used when referring to only “paralytic polio” – the 40,000 paralytic polio cases represent only 1% of the actual polio numbers [2].

The original epidemic population is now an ageing one, and an increasing number of these individuals (up to 400,000 people) are now living with a range of symptoms and chronic conditions which may be attributable to the original polio infection, as well as the challenges of living with the effects of ageing with disability [3,4].

Whilst global polio eradication efforts have been effective in stemming outbreaks, in Australia we are also now seeing younger people, particularly migrants from developing nations (or non-western nations), who contracted polio overseas. It may be anticipated that with an increasing global community, and ongoing immigration into Australia, in the years to come these people will likely present to health professionals with various chronic conditions related to their initial polio infection.

Although polio became a notifiable disease in this country in 1922, Australian records of polio infections are patchy. What records do exist are frequently incomplete and inconsistent. For example, after the introduction of the polio vaccines in 1956 (Salk) and 1966 (Sabin), polio was considered to be a solved problem and many hospital polio records were simply destroyed as “no longer required”.

Despite the best efforts of Polio Australia and its member state polio networks over many years, successive federal and state governments have shown no interest in commissioning research to quantify the number of polio survivors living in Australia today and to understand their service needs. This is not merely unfortunate. Ignorance by governments of the size of Australia’s polio community means that no active planning is being undertaken for polio services which are currently needed and which will be required well into the future.

The Australian Polio Register was established by Polio Australia in October 2010 to gather information on the numbers of polio survivors living in Australia today, whether or not they contracted polio in this country.

To make the Australian Polio Register truly reflective of the unmet need for polio services throughout Australia, we urge every Australian polio survivor to join the Polio Register. Our strength lies in our numbers – please help us to get you the services you need by adding your polio details to the Register.

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References

[1] World Health Organization, Global Polio Eradication Initiative.
[2] Polio Australia Position Paper, Numbers of polio survivors living in Australia, April 2014. (2 pages, 170.8 KB)
[3] Hall R (1993), ‘Notifiable diseases surveillance, 1917 to 1991’, Communicable Diseases Intelligence, vol. 17, pp. 226-236.
[4] Le Boeuf C (1991), The Late Effects of Polio: Information for Healthcare Providers, Commonwealth Department of Community Services and Health, Woodville.