definition – POLIOMYELITIS – is an acute viral infectious disease caused by three types of polio virus, most often spread by direct contact – mainly by oral route or to a lesser extent by droplets. Polio viruses, after getting into the nervous system, can cause nerve damage manifested by paralysis or muscle paralysis
terminology – the correct name is poliomyelitis or anterior spinal cord inflammation, obsolete and colloquial names:
- Heine-Medina disease
- common children’s paralysis
triggering factor – It is an RNA virus belonging to the genus Enterovirus of the Picornaviridae family. Polio virus occurs in the form of 3 separate serotypes (types 1, 2 and 3). Type 1 most often causing epidemics and causing severe paralysis. Type 2 is the easiest one to eradicate (probably already eliminated – the last time isolated in 1999) and considered endemic. Type 3 will most likely be eliminated last.
Hatching period – the period of development of infection from the failure of the viruses to the system through the mucous membranes, until the onset of symptoms is usually 7 – 14 days (3 – 21 days and longer). The virus begins to be excreted with throat secretion as early as 36 hours after infection (even before the onset of symptoms) and is detected in the faeces up to 2 months after being overrun.
Symptoms – the infection may occur under various clinical features, from the most common asymptomatic infections (90-95% of cases), through abortifacient infections (4-8%) and heavy-disease forms (0.5%) with multiple paralysis, including respiratory and death. Abortiform forms may occur in non-specific symptoms such as fever, headaches and symptoms of gastroenteritis. Sometimes the infection occurs in the form of serous meningitis with changes in the cerebrospinal fluid: mononuclear cytosis of approximately 100 cells / 1 mm3. Paralyzed characters occur once in several hundred cases. They run in the form of paralysis involving flaccid muscles covering different muscle groups, more often asymmetrically, although there are also paraplegia of both lower or upper limbs, as well as quadriplegia and paralysis of some torso muscles. In only a few cases of paralysis occur within the first 24 hours of the disease. Usually, paralysis very quickly reaches its peak – usually in less than 48 hours. They rarely develop in stages in 2 – 3 weeks.
Due to the location of lesions, 3 types of paralysis are distinguished: spinal, cerebral and bulbar.
core-form – in the core form, the muscles of the lower limbs, less often the upper, the muscles of the torso and the respiratory muscles are most often infested. The paralysis is usually asymmetrical, flaccid, with weakness in muscle strength and reflexes, from slight paresis to complete paralysis.
the cerebral form – occurs most often during epidemics and proceeds with rapid development of the clinical picture. Symptoms include fever, anxiety, increased excitability or drowsiness, varying depths, impaired consciousness, muscle stiffness, increased reflexes, cranial nerves palsy, muscle tremors, convulsions, sometimes aphasia and ataxia.
bulbul form – is the most dangerous form, giving about 30% mortality. The centers of the medulla are prolonged (pads), respiratory, circulatory and cranial nerves. There are numerous complications such as myocarditis, pulmonary edema, shock, and mental disorders. The healing period in this form is the longest and lasts on average about 2 years.
In addition, there may be cases with symptoms of acute flaccid paralysis, caused by an attenuated vaccine strain. they are cases of poliomyelitis accompanying the vaccination, abbreviated as a letter from the name in English – VAPP – Vaccine Associated Paralysys Polio. This is a set of symptoms similar to Poliomyelitis caused by an attenuated vaccine strain. They occur on average from 1: 750,000 doses of OPV vaccine, most often after the first dose of this vaccine. Symptoms develop from 4 to 30 days after vaccination. Muscle paralysis usually subside with time.
complications – Paralysis of respiratory muscles in the early stages of the disease or its complications may lead to death of the patient. Some infected people may come to the so-called post-polio team. These are growing muscle paralysis occurring many years after polyovirus infection.
risk factors – vaccination with less than 3 doses of polio vaccine and a trip to the endemic polio country in recent months, as well as high-risk groups (homeless, immigrants and non-vaccinated people).
treatment – No specific treatment, only symptomatic treatment.
prevention – Vaccination is the most effective way to prevent it. There are two types of poliomyelitis vaccines – a live vaccine (OPV) containing live attenuated (