Polio Survivors Face New Threat Although decades have passed since the scourge of polio was eradicated in most developed countries, rehabilitation professionals are now being called on to help those who survived the disease to combat a new malady: post-polio syndrome (PPS). But a variety of factors may make it difficult for those suffering from PPS to get the help they need. Characterized by fatigue, weakness, and muscle pain, a major cause of PPS is thought to be years of extra strain placed on remaining nerves to compensate for those lost to polio. "Post-polio syndrome really started becoming a problem in about 1978," says Jacquelin Perry, MD, of the Rancho Los Amigos National Rehabilitation Center in Downey, Calif. "We thought it would abate by now, but it hasn't." A recent report on PPS issued by the March of Dimes estimates that up to 250,000 US polio survivors may have PPS. But those to whom PPS sufferers turn for help may not recognize it. According to Julie Silver, MD, director of the International Rehabilitation Center for Polio at Spaulding Rehabilitation Hospital in Framingham, Mass, not enough attention is given in training programs to identifying and treating the disease. "People haven't had the opportunity to learn about PPS in training, which has hampered their ability to identify and treat it within their clinical practices," says Silver, whose book Post-Polio Syndrome: A Guide for Polio Survivors and Their Families was published by Yale University Press this year. And, while Silver herself has seen a "huge increase" in the number of people suffering from PPS among her own patient population, and receives a steady stream of requests for information from "therapists, doctors, and the general public," she notes that "there are few centers that see a lot of polio survivors, so there is often not an opportunity to see patients." This is echoed by Perry, who says that "within the total instance of pathology, [250,000] is really a small bump." Compounding the problem is the fact that PPS is difficult to diagnose, even by those trained to look for it. "It has no distinct diagnostic signs," says Perry. "You can't just do a test and say ‘this is post-polio syndrome.' Weakness is the primary symptom, and weakness is not unique." Perry will make a diagnosis only when a patient has "a history of polio and a random pattern of weakness, and when the patient moves in a good, precise manner, but is weak. A manual test of the key muscles is also an integral part of the workup." Further information on PPS is available at www.post-polio.org. Thailand Receives FDR International Disability Award
