Note: Individuals infected with the poliovirus are often asymptomatic. In approximately 25% of cases, polio presents as a mild to moderate illness marked by headache, fever, sore throat, vomiting, diarrhea, and fatigue. Polio affects the central nervous system only infrequently with inflammation and sometimes destruction of the motor neurons in the gray matter of the spinal cord and brain stem. Central nervous system involvement results in temporary or permanent muscle weakness or motor paralysis especially of the limbs and typically the legs. Polio may become life-threatening when paralysis affects the muscles involved in breathing and swallowing.