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Polio in a 22 yof volunteer returning from Columbia and Costa Rica, South America where there had been a polio outbreak. The patient had no prior conventional polio vaccination. The patient presented with quadriparesis and required an ET tube and ventilator. The patient improved over the ensuing month and the ventilator was no longer needed.

The CDC isolated polio virus from a stool specimen. This was the "wild" polio virus infection and not the attenuated immunization variety. The USA uses "killed" virus vaccines, but many regions outside the USA use the live attenuated virus.

The differential diagnosis would include West Nile virus infection and related viruses and Guillain-Barre Syndrome, since both may rarely involve the cord. Other enteroviruses may have neurologic involvement.

Travelers are required to have immunizations prior to departure. This patient had previously received what was described as a "homeopathic" polio immunization which apparently wasn't sufficient for protection.