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Poliomyelitis or polio
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- Polio is an infection that can affect the whole body, but always affects the nerves and muscles. It is often transmitted from one person to another by the fecal (i.e. from feces) to oral (mouth) route. In severe cases, Polio can lead to paralysis and death.
- Since the advent of the Polio vaccine in the 1950s there are fewer cases of Polio in the developed nations. There is still no cure for Polio.
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In some cases, the patient may not
initially feel any symptoms.
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Others will
have:
- Flu like symptoms
- Abdominal pain
- Diarrhea
- Vomiting
- Sore throat
- Mild fever
- Headache
- With moderate infection and
involvement of the central nervous system (brain and
spine):
- Symptoms of mild infection
- Moderate fever
- Neck stiffness
- Muscle tenderness and pain in various parts of the body such as the calf (behind the leg)
- Back pain
- Abdominal pain
- Muscle stiffness
- Diarrhea
- Skin rash
- Excessive weakness or
fatigue
- With severe infection of brain and
spine:
- Symptoms of moderate infection
- Muscle weakness and rapid progression to paralysis (loss of function) depending on the nerve involved (i.e., arm, leg)
- Muscle pain, tenderness, and spasm (neck, back, arms, or legs)
- Inability to bend the neck, keep the neck straight, or lift the arm or leg
- Irritability
- Abdominal Bloating
- Choking
- Difficulty making faces or facial expressions
- Problems with urinating or bowel movements (Constipation)
- Swallowing difficulties
- Breathing difficulties
- Drooling
- Infections -- urine, lung.
- Coma
- Difficulty breathing or swallowing may lead to the need of mechanical ventilation (machine that breathes for you) or tube feeding.
- Death
- Myocarditis -- inflammation of the heart muscle
- Post Poliomyelitis Progressive
Muscle Atrophy or weakness (PPMA) and motor (controls
movements) neuron disease can occur years after the
initial infection.
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- Virus infection -- the Polio virus is transmitted
via ingestion of a virus commonly found in human feces and
sewage. In areas where human sewage is allowed to
contaminate the drinking water via dumping (pools, lakes,
and rivers) the virus can infect older children and adults
who come in contact with these waters when swimming,
bathing, or ingesting.
- The virus may enter through the
nose or mouth, then invade the intestine, where it
moves into intestinal cells and multiplies into thousands of
new virus particles. These are then excreted through the
stool (for weeks), thereby renewing the cycle and
endangering the entire community with the risk of infection.
- Infection is usually mild with only symptoms of Diarrhea and minor
discomfort. The infection resolves on its own without much
damage to the body. However, in about 1% of all cases, the
virions (virus particles or offspring) enter the blood stream and infect the cells of the nervous system, causing more severe problems, such as muscle wasting, paralysis, Coma, or even death.
- Most patients often have full or
partial improvement of their muscle
function.
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- History of the illness, symptoms, risk
factors, and vaccination
- Medical exam:
- Fever
- Breathing problems
- Difficulty with making faces, swallowing
- Muscle wasting
- Absent reflexes, such as the knee jerk reflex
- Muscle tenderness or stiffness
- Neck stiffness or pain
- Collect the secretions from the throat, obtain stool samples, or perform a spinal tap -- and send to laboratory to confirm diagnosis of Polio by demonstrating presence of virions.
- Spinal tap done by inserting a needle in between the vertebral bones of the spine and removing a small amount of cerebrospinal fluid (CSF) for analysis.
- CSF will show increased white blood cells (cells that fight infection), protein, and pressure.
- MRI, CAT scan, and X-Rays done if infection, tumor, or other conditions suspected
- The physician will consult with
an infectious disease physician, a neurologist (nerve and
muscle doctor), and notify the local public health
officials.
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- Children at high risk
- Especially young children not yet toilet trained
- Adults who have not been vaccinated
- Travel to areas where sanitation and hygiene are inadequate and Polio is present
- Low socio-economic (poor, under- privileged) class
- Regions where flies from infected feces are allowed to contaminate food
- Infected water sources (near sewage dumping grounds)
- Low body defenses (immunodeficiency syndromes) such as AIDS and cancer
- Injections -- intramuscular (e.g., DPT vaccine)
- Injury
- Pregnancy
- Tonsillectomy (removal of tonsils)
- Emotional or physical
stress
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- Is aimed at treating symptoms until the illness runs its course
- For severe illness or new onset, admit to the hospital
- Bed rest with frequent turning, good skin care, and a good mattress to prevent development of bed (pressure) sores
- Tylenol and other medications for pain and fever
- Avoid use of addictive drugs for pain and spasm
- Antibiotics may be needed for bacterial infections.
- Medications for Muscle Spasms, urinary problems, or Constipation
- Dietary evaluation and good diet is necessary.
- Mechanical ventilation and oxygen therapy, if needed.
- Respiratory therapists consulted for those with breathing problems
- Physical therapy works with weak or wasted (atrophic) muscles and to prevent contractures (freezing in one place) of knees and elbows, or to reduce spasm and pain.
- Speech therapist may be consulted if there are problems with swallowing.
- Occupational therapist helps the patient with activities of daily living (e.g., eating, bathing, dressing).
- Braces, special shoes, walkers, canes, wheel chairs, special safety bars for bathrooms, special toilet seats, special beds, and other devices may be ordered for home use.
- Therapy and nursing may continue to
care for the patient after discharge from hospital.
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- If you have any symptoms, seek immediate medical attention.
- Vaccination is recommended for all children. Ask your doctor for more information on vaccine type and risks. The vaccine is given worldwide at ages 2, 4, and 6 months and again at 15 and18 months (but only if Polio is prevalent in the region).
- If your child has Polio and you have not been vaccinated, you must receive a vaccine ASAP.
- Vaccines have side effects and are contraindicated in certain conditions (AIDS, cancer, Lymphoma, Leukemia, other immune deficiencies, etc.).
- If you are pregnant, the oral form
of the vaccine is safe, so advise your doctor accordingly.
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