Polio vaccine

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1. Polio vaccine

2. Presented By Iqbal Danish Fakiha javed Summiya Ikram

3. Polio Virus Vaccines Polio is an infectious disease cause by polio virus which effect spinal cord and brain stem ,it leads to paralysis and even leads to death Polio Virus is the causative agent of poliomyelitis Children under 5 year of age are more successeptible to this disease

4. Reservoir Human Spread through feces contaminated food and water So.it spread in the communities with Poor infrastructure Poor sanitation Crowded living conditions Young children are particularly at risk of infection

5. History and epidemiology: Polio virus was first described by Michael underwood in 1789.first outbreak described in U.S. in 1843.21000 paralytic cases were reported in the U.S. in 1952. Polioviruses are distributed globally before the availability of immunization, almost 100% of the population in developing countries before the age of 5.the availability of immunization and the poliovirus eradication campaign has eradicated poliovirus in most regions of the world except in the Indian subcontinent and Africa.

6. In 1908 transmission of polio to a monkey by Landsteiner was confirmed. Virus was grown on tissue culture in 1949.three types of polio virus were isolated and identified in 1951. Trials of Salk vaccine: First large scale trial of Salk was performed in 1954. Use of Sabin: In 1958 first general use of Sabin was done.

7. Epidemiology: As a result of massive global vaccination campaign over the past 20 years, polio exists only in a few countries in Africa and asia.in the Philippines, the last case was reported in 1993,and in 2000 the Philippines was certified as polio free country .

8. Paralytic polio • loss of reflexes • severe muscle aches or weakness • loose and floppy limbs Signs and symptoms

9. Fever Sore throat Headache Vomiting Fatigue Back pain or stiffness Muscle weakness or tenderness Meningitis Nonparalytic polio

10. Post-polio syndrome is a cluster of disabling signs and symptoms that affect some people several years — an average of 35 years — after they had polio. Common signs and symptoms include: Progressive muscle or joint weakness and pain General fatigue and exhaustion after minimal activity Muscle atrophy Breathing or swallowing problems Sleep-related breathing disorders, such as sleep apnea Decreased tolerance of cold temperatures Cognitive problems, such as concentration and memory difficulties Depression or mood swings Post-polio syndrome

11. Incubation period 7-10 days (4 -35 days) Feco-oral inhalation infects the pharynx and intestinal mucosa gains entry by binding to an immunoglobulin –like receptor known as the poliovirus receptor or cd155 ,on cell membrane

12. Epithelial cells of GIT lymphatic tissue-from tonsil to peyer’s patches spread to regionl lymph nodes enter blood stream cause primary viremia multiplies in reticulo-endothelial system enter blood stream again cause secondary viremia carried to spinal cord and brain multiply in neurons Pathogenesis

13. degradation of nissl’s body cause (chromatolysis ) nuclear changes follows when degeneration irreversible it is phagocytosed by leucocytes or macrophages lesions are in anterior horn of spinal cord cause flaccid paralysis can cause encephalitis involving Brainstem motor & premotor areas of cerebral cortex

14. Mechanism of action of polio vaccine

15. Types of polio vaccine There are two general types 1) Inactivated polio vaccine (IPV) 2) Oral polio vaccine (OPV) INACTIVATED POLIO VACCINE . Synonyms for IPV Vaccine e-IPV ep -IPV Salk vaccine IPV is a trivalent ( strains 1,2,3) vaccine

16. SALK POLIO VACCINE. Jonas firstly developed the salk vaccine 1) Formaldehyde-fixed 2) Non reversion ( this inactivated polio vaccine can not revert back , no side effects of this vaccine and safely to use.) 3 types of polio virus grown in monkey kidney tissue culture (MKTC) Procedure for preparation. Standard virulent strains used 3 types of polio vaccines grown separately in MKTC. Adequate titre filtered to remove debris and clumps. Inactivated with formalin at 37 ºC for 12-15 days.

17. Stringent tests to ensure complete inactivation. Issued for used. HISTORY In 1954 whole USA was vaccinated against polio and 80-90% population was protected. In 1955 100 cases of polio myelitis were reported due to the insufficiently inactivated vaccine.

18. IVP produces antibodies in the blood to all three types of poliovirus . As IPV is not a ‘live’ vaccine, it carries no risk of VAPP. IPV triggers an excellent protective immune response in most people. IPV is one of the safest vaccines in use. No serious systemic adverse reactions have been shown to follow vaccination . IPV is highly effective in preventing paralytic disease caused by all three types of poliovirus . Shipping and transport is easy. Merits

19. IPV induces very low levels of immunity in the intestine . As a result, when a person immunized with IPV is infected with wild poliovirus, the virus can still multiply inside the intestines and be shed in the faeces , risking continued circulation. IPV is over five times more expensive than OPV . Administering the vaccine requires trained health workers, as well as sterile injection equipment and procedures . Booster regime is required. Do not stimulate local and mucosal immunity. Demerits

20. In EPI, dose of IPV is given at the age of 14 months. Dose schedule

21. Oral polio vaccine Trivalent oral polio vaccine synonym is Sabin vaccine. developed by Albert Sabin in 1961. it is live attenuated virus vaccine oral administration of vaccine yields a local gastro intestinal infection . A major caution with TOPV is that it is a live vaccine and must never be injected

22. Attenuated by passage in foreign host (monkey kidney cell) . selection to grow in new in host makes virus less sited to original host. stabilizer such as sucrose or trehalose or arginine hydrochloride may be add to retain the antigencity . Preparation

23. Inactivation is carried out by adding formalin at 0.025% concentration. Incubation at 37centrigrade upto 48 hours and then at 2- 8 centigrade upto 12 days . Test for free formaldehyde content after 12 hours consistant inactivation of virus is monitored and verified. Preparation

24. Oral polio vaccines are easily administered as no need of highly trained personnel. Induce both hummoral and systemic immunity.Activate all phases of immune system,can get hummoral igG and local igA . Can induce local immunity in gut by stopping viral replication in GIT. Antibodies quickly produced as 1 or 2 doses of oral vaccine can give 90-100% results. A dvantages

25. Instability at high temperature. Very small residual neurovirulence in OPV. Frequent vaccine failure even with fully potent vaccine. Other adverse events following oral poliovaccines are; OPV carries the risk of vaccine associated paralytic poliomyelitis particularly in infants who receive vaccine for the first time. Disadvantages

26. OPV is a heat sensitive vaccine. Should be stored at -20 ºC Having shelf life…. 2 years at -20ºC 6 month at 2- 8 ºC 1-3 days at room temp . Storage of Polio vaccine( Opv and Ipv )

27. Vaccine (3) (4) < 0ºC 2ºC to 8ºC 2ºC to 8ºC 2ºC to 8ºC 2ºC to 8ºC Inactivated poliomyelitis vaccine (IPV) DO NOT FREEZE. Discard if exposed to temperature of 0ºC or below. Store for up to 2 years between 2ºC to 8ºC. Loses significant potency after 20 days. Destroyed after 20 days Not available. Oral poliomyelitis vaccine (OPV) opened vials (3) (4) May be stored for up to 2 years at around 20ºC. The freeze-thaw-refreeze cycle can occur until the vial is empty Can be stored at 2ºC to 8ºCbetween use as long as the expiry date has not passed Stable for at least 1week at 20ºC to 25ºC Not available. Remains potent for 24 hours. Stability of Polio vaccine at different temperature