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Feature Infectious disease

After eradication: India’s post-polio problem

BMJ 2014; 348 doi: (Published 31 March 2014) Cite this as: BMJ 2014;348:g2275
  1. Neena Bhandari, journalist, Sydney
  1. neena{at}

What of India’s forgotten survivors and the debilitating post-polio syndrome that can return decades later? Neena Bhandari reports

As India celebrates three years of being polio free there is an urgent need to invest in medical care for the thousands of people who made the most of life after having had poliomyelitis but are now facing the debilitating post-polio syndrome (PPS).1 2 PPS describes the sudden onset of muscle weakness or fatigability in people with a history of acute paralytic poliomyelitis, usually occurring 15 to 40 years later.3 Many thousands of polio survivors experience muscle weakness, fatigue, joint and muscle pain, intolerance to cold, and difficulties in sleeping, breathing, or swallowing.4

Fig 1 New Delhi celebrates India’s eradication of polio

The March of Dimes, an international non-profit agency based in the United States and founded in 1938 by President and polio survivor Franklin D Roosevelt, warned in 2001 that as many as 20 million people worldwide are at risk of PPS, which could leave them using wheelchairs or ventilators for the rest of their lives.3

Anita Ghai, a Delhi psychology professor now aged 55, had polio in both legs aged 2. She told the BMJ, “My legs have become more susceptible and less tolerant to cold and fatigue and I live with severe pain in muscles and joints. These are possibly symptoms of PPS, but there are few doctors in India who recognise and understand this condition.” Ghai has had a rich life and travelled the world, but about 30 years after having had polio she began to feel muscle weakness. Climbing stairs became difficult and she began using crutches with callipers. For the past eight years she has been using a wheelchair.

The first case of PPS may have been described in 1875. …

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