Poliomyelitis


Poliomyelitis

Description, Causes and Risk Factors:

An inflammatory process involving the gray matter of the cord. The incubation period for poliomyelitis is commonly 6 to 20 days with a range of 3 to 35 days.

Poliomyelitis is an infectious disease caused by a virus called the Poliovirus. The virus has the potential to cause a serious neurological illness with paralysis that can be fatal. Cases of poliomyelitis of sudden onset (acute infection) are now almost unknown in the UK and other developed countries, due to highly successful vaccination programmes and other public health measures.

Poliovirus is highly infectious, with seroconversion rates among susceptible household contacts of children nearly 100%, and greater than 90% among susceptible household contacts of adults. Persons infected with poliovirus are most infectious from 7 to 10 days before and after the onset of symptoms, but poliovirus may be present in the stool from 3 to 6 weeks.

The virus enters through the mouth, and primary multiplication of the virus occurs at the site of implantation in the pharynx and gastrointestinal tract. The virus is usually present in the throat and in the stool before the onset of illness. One week after onset there is less virus in the throat, but virus continues to be excreted in the stool for several weeks. The virus invades local lymphoid tissue, enters the bloodstream, and then may infect cells of the central nervous system. Replication of poliovirus in motor neurons of the anterior horn and brain stem results in cell destruction and causes the typical manifestations of poliomyelitis.

One time poliovirus infection occurred throughout the world. Transmission of wild poliovirus was interrupted in the United States in 1979, or possibly earlier. A polio eradication program conducted by the Pan American Health Organization led to elimination of polio in the Western Hemisphere in 1991. The Global Polio Eradication Program has dramatically reduced poliovirus transmission throughout the world. In 2009, only 1,579 confirmed cases of polio were reported globally and polio was endemic in four countries.

Symptoms:

In 90 per cent of cases, the illness has no symptoms. If symptoms do occur they can take between 3 and 21 days after infection to show. Where symptoms do occur they can include:

    Headache.

  • Tiredness.

  • Neck and back stiffness.

  • Severe muscle pain.

  • Paralysis.

Diagnosis:

Laboratory diagnosis:

    Viral Isolation: Poliovirus may be recovered from the stool or pharynx of a person with poliomyelitis. Isolation of virus from the cerebrospinal fluid (CSF) is diagnostic, but is rarely accomplished.If poliovirus is isolated from a person with acute flaccid paralysis, it must be tested further, using oligonucleotide mapping (fingerprinting) or genomic sequencing, to determine if the virus is "wild type" (that is, the virus that causes polio disease) or vaccine type (virus that could derive from a vaccine strain).

  • 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).

Treatment:

Poliomyelitis is a vaccine preventable disease. Poliomyelitis vaccination is recommended as part of routine childhood immunization. It is listed on the National Immunization Program (NIP). To receive polio immunization, visit your local doctor or immunization provider. It is important to note that the vaccine is provided at no cost. Doses of vaccine are given at 2, 4 and 6 months of age, with a booster dose at 4 years. Immunization against polio is achieved using single-disease or combination vaccines.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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