As the name of the disease indicates, poliomyelitis, is an infection/ inflammation of the grey matter of the spinal cord (Polios, grey + myelos, marrow + itis, inflammation), causing paralysis of the muscles of the body, especially of the limbs.  The disease is still common, although it can pe prevented by vaccination.

The poliovirus is an enterovirus, i.e. the virus proliferates in the intestine (enter on, intestine) of the patient.

The infection occurs by ingestion of food/water contaminated with poliovirus from the faecal matter of a patient or a carrier (i.e. the one who carries the poliovirus in the gut, but does not show symptoms of the disease), is the true source of infection.  Flies may play an important role in the spread of the disease, so that epidemics of poliomyelitis may be more common in summer. However, sporadic cases are also seen.  Therefore, it is critically important to improve hygienic conditions in areas of the world where polio is still prevalent, to aid in the prevention of the disease.

The poliovirus may survive for months in the sewage, i.e., in the waste matter in underground pipes or in various passages. In addition,  the virus may be passing out in the faeces of patient carriers for many months, so that the source of infection remains almost continuous, especially during an epidemic.

The poliovirus multiplies in the gut of the man, and apart from passing out in the faeces, it reaches the spinal cord through the various nerve fibers.   It may also enter the bloodstream and infect the spinal cord.  The virus has a particular affinity for the anterior horn cells (i.e. the motor nerve cells in the anterior horns) of the spinal cord, and inflammation / damage of these cells is responsible for the paralysis of the muscles of the body. Since the anterior horns of the spinal cord are involved, the disease is also called anterior poliomyelitis, and since the disease occurs abruptly, it is more precisely called acute anterior poliomyelitis.

In the entire spinal cord, two of its regions, i.e., the lumbar and the cervical regions are usually involved, and it is particularly more frequent in the lumbar region so that inthe common case of poliomyelitis, the legs are more involved than the arms.  Since the polio virus affects only motor nerve cells,  there is no sensory loss/impairment in the involved limb.

In some infrequent cases,  the thoracic portion of the cord may also be damaged, leading to the paralysis of the muscles of the thorax, causing difficulty in breathing. Sometimes,respiratory paralysis may occur, and the patient may require a ventilator to aid in respiration.

In addition to the spinal cord, the lower portion of the brain, i.e. the brain stem may be affected in some of the cases. This may cause paralysis of the muscles of the face, of the larynx and of the throat, so that the patient may have both difficulties speaking and swallowing. In this rare occurence,  the patient's condition becomes very serious, and longterm treatment of such cases is only possible in a hospital setting.