Polio eradication

2. An acute viral infection,
The word Poliomyelitis comes from two
Greek words:  polio, which means gray, and
myelitis means inflammation of the spinal
cord.

3. It is caused by poliovirus.
Placed in the enterovirus family of viruses
that live in the Gastrointestinal system.
Formed of a single strand of RNA enclosed
in a protein coat that protects it from
environmental attack (inactivation).
Quite small by viral standards (22-32
nanometers).

4. There are three serotypes of polio virus---
P1, P2, P3
P1 most typically causes outbreaks—is
the most likely virus to cause paralysis.
P2 is the easiest to eradicate followed by
P3.

5. The Virus is excreted in the stools for three
to six weeks.
It is more stable than most viruses ,can
stay alive for several weeks in
contaminated food or water.
It is one of the most contagious viruses.
If one family member is infected, nearly all
the rest of the family becomes infected.

6. The Poliovirus is transmitted from one
person to another through,
contact with feces-contaminated water
or food,
 or directly through saliva and the
droplets exhaled by an infected
individual during the first two weeks
following infection.

7. Portal of entry is the mouth.
Once the Poliovirus enters the body, it
multiplies in the cells of the mucous
membranes in the pharynx and
intestines.
The virus invades the local lymphoid
tissue

8. Enters the blood stream and infects the
CNS.
 The incubation period lasts from 07 - 21
days.
 the first symptoms of the disease usually
appear between seven and 14 days
after infection.

9. The major illness of poliomyelitis usually
develops suddenly,
• with fever,
• stiff neck and back,
• severe headache, and
• muscle pain.
Major illness can progress to loss of tendon
reflexes and asymmetrical weakness or
paralysis.

10. The paralysis produced by poliomyelitis
results from inflammation and destruction
of motor neurons in the gray matter of
the spinal cord and brain.

11. The type or degree of paralysis induced
depends upon the location and extent
of motor neuron destruction, and can
range from minor to severe limb
paralysis, to paralysis of the muscles that
allow us to breathe.

12. There are three types of paralytic polio
Spinal polio
Bulbar polio
Bulbospinal polio

13. Poliomyelitis is Generally Diagnosed
Clinically by….
The concurrent presence of acute &
high grade fever,
Asymmetrical flaccid paralysis, which
develops in 2-4 days following the fever
and muscle aches.

14. To detect poliovirus today, according to
CDC and WHO guidelines, two stool
samples should be collected from each
patient, 24 - 48 hours apart within 14
days of the onset of paralysis, and they
must arrive at the laboratory in "good
condition."

15. This new sequencing methodology was
immediately applied to poliovirus
research. During the 1970s, the CDC
began routinely performing genotypic
testing ("molecular sequencing" or "oligo-
nucleotide fingerprinting") on stool
samples collected in suspected
poliovirus outbreaks to determine
whether the virus was present.

16. Treatment is symptomatic:
Non-narcotic pain killers,
Application of hot packs, and
Physical therapy.

17. The injectable vaccine (IPV), developed
in 1954 by Jonas Salk – salk vaccine.
The oral vaccine (OPV), which is made
using live, attenuated strains of the virus,
was developed by several teams in the
late 1950s, but it was Albert Sabin's
vaccine that was adopted universally –
sabin vaccine

19. Among children who are
paralyzed by polio:
30% make a full recovery
30% are left with mild paralysis
30% have medium to severe
paralysis
10% die.

20. The World Health Organization (WHO)
defines polio eradication essentially as
‘zero incidence of wild poliovirus
transmission anywhere in the world’.

21. Humans are thought to be poliovirus's
only host,
Virus survival in the environment is limited.
Immunization with vaccines interrupts
virus transmission
which is why the WHO launched an
Eradication Program..

23. supports the Global Polio Eradication
Initiative through partnerships with the
World Health Organization (WHO), the
US Centers for Disease Control and
prevention (CDC)

24. Global Eradication of polio program was
established in 1989.
Today only 5 countries ---
Pakistan,
Nigeria,
India,
Niger,
Afghanistan
are endemic to polio.

25. On 13 May, 1988, the General Assembly of
the World Health Organization decided to
launch a campaign to eradicate polio.
 An extension of the Expanded Program on
Immunization (EPI), which aimed to
immunize as many children as possible
against the primary vaccine-preventable
diseases: measles, diphtheria, pertussis,
tetanus, tuberculosis and polio.

26. Routine immunization of young children.

National Immunization Days (NIDs)in countries
where the disease is endemic.
Surveillance of new cases of polio through
reporting of all cases of Acute Flaccid Paralysis,
the primary symptom of polio.
 "Mop-up" campaigns to eliminate remaining
reservoirs of disease where it continues to
spread.

27. The goal of Global Eradication of wild
polio virus is defined as no cases of
clinically poliomyelitis, associated with a
wild polio viruses and no polio virus found
worldwide despite intensive effort to do
so.

28. The primary strategies for achieving this
goal are..
Administration of the polio vaccine in the
manner most effective to interrupt
transmission of wild polio virus---this includes
Attaining high routine immunization
coverage with at least five doses of OPV
Conducting national immunization days
Mopping-up” immunization when polio is
reduced to focal transmission.

29. Surveillance for acute flaccid paralysis, the signal
condition for polio, is conducted in virtually all
countries, and stool samples from suspected
cases are delivered to an accredited laboratory
for poliovirus testing.

30. Implementation of action oriented
surveillance for all cases of polio. this
includes case investigation and isolation
of virus from stool specimens.

31. 
Milestones for future Target year
1.Establish comprehensive policy
for future management.
2003
2.Eliminate wild poliovirus
transmission.
2003
3.Certification of ‘eradication’ of
wild viruses.
2006
4.Introduction of IPV in routine
immunization.
2006
5.Complete withdrawal of OPV.2009
6.Certification of ‘true eradication’
of polioviruses.
2012
7.Discontinue polio immunization. 2015

32. The goal of polio eradication has
humanitarian and economic benefits.
The humanitarian goal is to ensure that
no child will ever get polio paralysis by
eliminating the infectious agents from
humans altogether.
The ‘victory point’ is when polio
vaccination can be stopped without risk
of re-emergence of polio.