Polio laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]

Laboratory Findings

Viral Isolation

Poliovirus may be isolated from pharyngeal secretions during the first week of the disease, and from feces during several weeks.

Isolation of virus from the cerebrospinal fluid (CSF) is diagnostic, however this is rarely accomplished. If poliovirus is isolated from a person with acute flaccid paralysis, it must be further tested, using oligonucleotide mapping (fingerprinting) or genomic sequencing, to determine if the virus is “wild type” or vaccine type.

Serology

Neutralizing antibodies appear early and may be at high levels by the time the patient is hospitalized; therefore, a fourfold rise in antibody titer may not be demonstrated.

Cerebrospinal Fluid

In poliovirus infection, the CSF usually contains an increased number of white blood cells (10–200 cells/mm3, primarily lymphocytes) and a mildly elevated protein (40–50 mg/100 mL). However, these findings are similar to those of aseptic meningitis caused by other viruses.

In the absence of a viral isolate, the diagnosis of poliovirus infection can be established serologically by testing paired acute and convales- cent sera for neutralizing antibodies to each of the three poliovirus serotypes. Serologic tests cannot distinguish between wild-type virus and vaccine virus infection.