Approximately 95% of poliovirus infections are asymptomatic. Nonspecific illness with low-grade fever and sore throat (minor illness) occurs in 4% to 8% of people who become infected. Aseptic meningitis, sometimes with paresthesias, occurs in 1% to 5% of patients a few days after the minor illness has resolved. Rapid onset of asymmetric acute flaccid paralysis with areflexia of the involved limb occurs in 0.1% to 2% of infections, and residual paralytic disease involving the motor neurons (paralytic poliomyelitis) occurs in approximately two thirds of people with acute motor neuron disease. Cranial nerve involvement and paralysis of respiratory tract muscles can occur. Findings in cerebrospinal fluid (CSF) are characteristic of viral meningitis with mild pleocytosis and lymphocytic predominance.
Adults who contracted paralytic poliomyelitis during childhood may develop the noninfectious postpolio syndrome 30 to 40 years later. Postpolio syndrome is characterized by slow and often significant onset of muscle pain and exacerbation of weakness.
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