Polio - The Late Effects Reality

Medical History of Respondents

The disease Poliomyelitis cannot be accused of discrimination in the way it infects. It does so without fear or favour and affects all segments of society regardless of age, sex, occupation or social standing. Poliomyelitis had a rather more common name in the past, Infantile Paralysis, and that best describes where it hit hardest and with the most devastating effects. Out of the 224 survey respondents 132 (60%) were under the age of 5 when the disease struck.

Table 3 –Age at time of Polio diagnosis

Age Group	No’s
0 – 5	132
6-11	39
12 - 15	22
16 – 20	10
21 – 25	7
26+	8
Don’t know	5
Never properly diagnosed	1
Total	224

Interestingly,155 (69%) of respondents stated that the onset of the disease was very rapid. However, some caution must be placed on this figure due to the young age of most at the time of onset, but there is some evidence to suggest that their opinion is not unfounded.

Table 4 –Age at diagnosis of LEP

Age at onset of LEP	No’s
35-39	2
40-44	6
45-49	21
50-54	44
55-59	52
60-64	31
65-69	26
70-74	23
75-79	10
80-84	4
Age not stated	5
Total	224

For the purposes of the survey and due to the self-selection process of respondents, all those participating have had an incidence of paralytic Polio. The way that paralytic Polio affects those infected varies from one individual to another but, in general, there is a period of paralysis, recovery, plateau and then the progression into LEP in some 40% of cases (Halstead, 1998).

The paralytic effects at initial and subsequent stages are shown in Table 5 below:

Table 5 – Extent of weakness/paralysis – initial & subsequent

Extent of weakness/paralysis	Initial Paralytic Phase No’s	Subsequent Recovery Phase No’s
No paralysis	1	9
One leg	113	131
Both legs	93	67
One arm	45	0
Both arms	39	29
Two or more limbs/trunk	58	33
Chest – difficulty breathing	42	16
Swallowing difficulties	14	5

Note: Many respondents reported more than one area affected and this accounts for totals greater than the number of respondents in the survey.

It can be seen from Table 5 above, in the majority of cases respondents reported that they had recovered some function following the initial paralytic phase.

As stated in the introduction, the Late Effects of Polio (LEP) can occur 8 – 71 years (Government of the State of Queensland, 1998) after the initial paralytic phase. No one knows for sure what the time span between contraction of asymptomatic Polio and onset of LEP may be, but research would tend to suggest that the time span is probably similar (Government of the State of Queensland, 1998).

It is also apparent that those who were apparently unaffected, i.e. siblings or other close family members of respondents, who presented with paralytic Polio, can also have been affected (Falconer, 1999). Of the survey respondents, 25 (11%) reported that these relations experienced symptoms akin to their own, although they had never been diagnosed with Polio at the time. This has implications as to whether these relations will, or have already, developed LEP.

As previously stated, all the respondents were self-selecting. However, only 74 (34%) had an actual diagnosis and, of these, 48 (68%) had all been seen at the Beaumont Hospital by Dr. Orla Hardiman, Consultant Neurologist, Beaumont Hospital, Dublin.

Table 6 – Respondents in receipt of diagnosis of LEP

Total	No	Yes	Not stated
224	142	76	6

From all of the above, it can be seen that Polio is a long lasting and debilitating disease that can cause unforeseen effects many years after the initial paralytic stage in the form of LEP.Yet, it is not recognised in Ireland as a Long Term Neurological Illness, being perceived as being a stable condition after the initial incidence. This is manifestly incorrect and was shown to be so as far back as 50 years ago (Halstead, 1998). In consequence, a minority of the survey respondents under the age of 70 is in receipt of either a Long Term Illness List or Medical Card. As will be shown later, this is causing both distress and financial hardship to themselves, their families and carers.

Table 7a – Medical Card – all respondents

Age group of respondent	No Medical Card No’s	Have a Medical Card No’s
35-39	0	1
40-44	4	3
45-49	11	6
50-54	25	11
55-59	41	19
60-64	13	15
65-69	14	18
70-74	4	18
75-79	0	7
80+	0	7
Age not stated	2	0
Total	112	105

Table 7b – Respondents under 70 in receipt of Long Term Illness Card (LTI)

Age group of respondent	No, don't have LTI Card No’s	Yes, have LTI Card No’s
35-39	1	0
40-44	7	0
45-49	14	1
50-54	32	2
55-59	53	4
60-64	25	1
65-69	24	3
Total	156	11

Note: The survey did not explore whether those under 70 in receipt of an LTI Card may have qualified due to another condition.