Poliomyelitis

It contains cause,symptoms & prevention.

1. SEMINAR ON COMMUNICABLE DISEASE Topic : POLIOMYELITIS Prepared by: Himangshu Sharma Dept. of Pharmaceutical Sciences Dibrugarh University

2. CONTENTS: P O L I O M Y E L I T I S Introduction Different Types Causative Agent Mode of Transmission Clinical Features Diagnosis and Test Treatment Outlook Possible Complication Prevention Risk Reference

3. INTRODUCTION : Poliomyelitis often called Polio or infantile paralysis is an acute, viral, infectious disease spread from person to person, primarily via the fecal-oral route. The term “Poliomyelitis” derives from the ancient Greek word Polio’s means “grey” and myelos meaning “marrow” referring to the grey matter of the spinal cord. The suffix itis denotes inflammation, i.e. inflammation of the spinal cord’s grey matter. A severe infection can extend into the brain stream and even higher centre resulting in Polio encephaletis and apnea.

4. DIFFERENT TYPES : In about 1% of cases, the virus enters the central nervous system, preferentially infecting and destroying motor neurons leading to muscle weakness and acute flaccid paralysis.Depending on the nerves involved , Poliomyelitis can be classified as follows- i.Spinal Polio: It is the most common form characterised by asymmetric paralysis that most often involves the legs. ii. Bulbar Polio : This leads to weakness of muscles innervated by cranial nerves. iii.Bubospinal Polio : It is a combination of bulbar and spinal paralysis.

5. CAUSATIVE AGENT :- Poliomyelitis is a communicable disease caused by a virus named Poliovirus . Three Polio virus serotypes (type 1,2,3) are the most important enteroviruses.

6. MODE OF TRANSMISSION : Poliovirus is transmitted by the fecal-oral route through ingestion. Inhalation or entry through conjunctiva of droplets of respiratory secretions may also be possible modes of entry in close contacts of patients in early stage of disease. The virus multiplies initially in the epithelial cells of the alimentary canal and the lymphatic tissues. It then spreads to the lymph nodes and enters the blood stream. After further multiplication in the reticulo-endothelial system, the virus enters the blood stream again and it is carried to the spinal cord and brain. Incubation Period : The time from being infected with the virus to developing symptoms of disease ranges from 5-35 days(average 7-14 days).

7. CLINICAL FEATURES : Three basic patterns of Polio infections are as follows:- a. Subclinical infections b. Paralytic infection c. Non-paralytic infection a . Subclinical infections :- It includes symptoms like- General discomfort or uneasiness(malaise), headache, red throat, slight fever, sore throat, vomiting etc. b . Paralytic infection & Non-paralytic infection (clinical ):-It includes development of flaccid paralysis and affects the central nervous system.

8. Diagnosis and Tests : The health care provider may find:- Abnormal reflexes, Back stiffness, Difficulty in lifting the head or legs when lying flat or the back stiff neck, trouble bending the neck. Tests includes- Cultures of throat washing, stools or spinal fluid, spinal tap and examination of the spinal fluid (CSF exam.) using PCR. Test for levels of antibodies to the Polio virus.

9. TREATMENT: The goal of the treatment is to control symptoms while the infection runs its course as there are no specific treatment for this viral infection. People with severe cases may need lifesaving measures, especially breathing help. Symptoms are treated based on their severity. Treatment may include- - Antibiotics for urinary tract infection - moist heat to reduce pain and spasms. - Pain killers to reduce headache, muscle pain and spasms - Physical therapy or orthopedic surgery are also provided to help in recovering muscle strength and function.

10. OUTLOOK: The outlook depends on the form of the disease and the body area affected. Most of the time, complete recovery is likely if the spinal cord and brain are not involved. Brain and spinal cord involvement is a medical emergency that may result in paralysis or death. Disability is more common than death. Infection that is located high in the spinal cord or in the brain increases the risk of breathing problems.

11. POSSIBLE COMPLICATION : Various possible complications may occur such as- Aspiration Pneumenia, cor pulmonale, lack of movement, lung problems, myocarditis, paralytic ileus, permanent muscle paralysis, disability, deformity, pulmonary edema, shock, urinary tract infections etc. Post-polio syndrome is a complication that develops in some patients, usually 30 or more years after they are first infected. Muscles that were already weak may get weaker. Weakness may also develop in muscles that were not affected before.

12. PREVENTION: Polio immunization(vaccine) effectively prevents poliomyelitis in most people. There are mainly two types of vaccines that are widely used to prevent poliomyelitis. They are- i. Inactivated Poliovirus Vaccine(IPV ): It is given as an injection in the leg or arm, depending on the patient age. ii. Oral Polio Vaccine(OPV): It is also called as trivalent oral polio vaccine.OPV consists of a mixture of live attenuated poliovirus strains of all three poliovirus types. It produces antibodies in the blood to all three types of poliovirus. In the event of infection, these antibodies protect against paralysis by preventing the spread of poliovirus to the nervous system. Moreover, the mucosal antibodies limit the replication of the poliovirus inside the intestine. This intestinal immune response to OPV is thought to be the main reason why mass campaigns with OPV can rapidly stop person to person transmission of poliovirus. …DOH BOONDH ZINDAGI KI…

13. Contd……….. Advantages: i. OPV is administered orally and it can be given volunteers. ii.OPV is save, effective and induces long lasting immunity to all three types of poliovirus. Disadvantages: Although it is safe and effective, in extremly rare cases the live attenuated vaccine virus in OPV can cause paralysis. Recommended dose :- A single dose i.e. two drop is given at a time. Immunization recommendation for polio vaccine : IPV: 2,4 & 6-18 months, and 4-6 yrs of age. OPV: Infants at 2 month with first DPT inj. 2 nd and 3 rd dose are given at 2 months interval. 4 th dose – at 18 month of age.

14. RISK: Lack of immunisation against polio travel to an area that has experienced a polio outbreak. Outbreak still occur in the developed world, usually in groups of people who have not been vaccinated. Polio often occurs after someone travels to a region where there has been an outbreak of disease. As a result of a massive, global vaccination campaign over the past 20 years, polio exists only in a few countries in Africa and Asia.

15. REFERENCE: i. A Textbook of Microbiology by R. Ananthanarayan, C K Jayaram Paniker, seventh edition, 2005, Page no: 491-494. ii. A Textbook of Microbiology by P. Chakraborty, 3 rd edition, 2013, Page No: 555-559.

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