Epidemiology:According to research Poliomyelitis, also known as polio is an infectiousdisease caused by the poliovirus. Poliomyelitis is an acute communicabledisease caused by any of 3 poliovirus serotypes (types 1, 2 or 3). In the pre-vaccineera when poliovirus was the leading cause of permanent disability in children,almost all children became infected by polioviruses, with on average 1 in 200susceptible individuals developing paralytic poliomyelitis. Polioviruses arespread by fecal-to-oral and oral-to-oral transmission. The virus enters thebody by way of the mouth, invades the bloodstream, and may be carried to thecentral nervous system, where it causes lesions of the gray matter of thespinal cord and brain. Oral transmission of the virus is seen mostly in placeswhere sanitization is poorPathogen: Research show that Polioviruses are human enterovirusesof the Picornaviruses family. The 3 serotypes of polioviruses have differentantigenic sites in the capsid proteins.
Polioviruses share most of theirbiochemical and biophysical properties with other enteroviruses. They areresistant to inactivation by many common detergents and disinfectants,including soaps, but are rapidly inactivated by exposure to ultraviolet light.Viral infectivity is stable for months at +4 °C and for several days at +30°C.2. Type 1 was most often the cause of epidemics.
Infection from one typedoes not necessarily confer protection against the other 2 types. Type 2 is eradicatedglobally and type 3 is being distributed intermediately hence cases occurred ofpeople having a second attack. All 3 types are included in the vaccine. Mostvaccine related cases are type 2 or 3 (WHO, 1996). (Record, 2016) Type1 was most often the cause of epidemics. Infection from one type does notnecessarily confer protection against the other 2 types. Type 2 is eradicated globallyand type 3 is being distributed intermediately hence cases occurred of peoplehaving a second attack. All 3 types are included in the vaccine.
Most vaccinerelated cases are type 2 or 3 (WHO, 1996).Disease: According to research, most people infectedwith poliovirus do not have symptoms; viral replication in the pharynx andgastrointestinal tract results in virus excretion in saliva and feces. In someindividuals (approximately 4%) with this minor illness, signs of meningealirritation develop, with neck stiffness, severe headache, and pain in limbs,the back and the neck, suggestive of aseptic meningitis (non-paralytic polio).This form of polio lasts between 2 and 10 days and in almost all cases recoveryis complete. According to the WHO the world health organization,paralytic poliomyelitis is rare and result only when poliovirus enters thecentral nervous system by peripheral or cranial nerve axonal flow andreplicates in anterior horn cells (motor neurons) of the spinal cord. It isobserved in <1% of poliovirus infections in children <5 years of age,varying with serotype and age. The ratio of paralytic cases to infections wasestimated per 100 infections at approximately 0.
5 for serotype 1, 0.05 for serotype2, and 0.08 for serotype 3, based on data from 15 countries. Based on thedegree and level to which the motor neurons are affected, temporary orpermanent paralysis of the affected muscles may result. In some cases, viraldestruction of bulbar cells may cause respiratory paralysis and death. (Boyer & Tiffreau, 2010)clinicalmanifestation: Researchers have concluded that theactual disease caused by poliovirus is called poliomyelitis. The clinical manifestation of paralytic poliomyelitis iscalled acute flaccid paralysis (AFP) affecting the limbs, mainly the legs,usually lopsidedly, while sensation remains intact.
Signs and symptoms ofnon-paralytic polio can last from one to 10 days. These signs and symptoms canbe flu-like and can include: fever, sorethroat, headache, vomiting, fatigue, meningitis. About 1 percent of polio casescan develop into paralytic polio. Paralytic polio leads to paralysis inthe spinal cord (spinal polio), brainstem (bulbar polio), or both(bulbospinal polio). Initial symptoms are like non-paralytic polio. But after aweek, more severe symptoms will appear. These symptoms include: lossof reflexes, severe spasms and muscle pain looseand floppy limbs, sometimes on just one side of the body suddenparalysis, temporary or permanent deformed limbs, especially the hips, ankles,and feet.
Less than 1 percent of all polio cases will result inpermanent paralysis. In 5–10 percent of the polio paralysis cases, the viruswill attack the muscles that help you breathe and cause death. The clinicalparalysis affects the nervous system, once the virus reaches the cells in themedulla oblongata, it destroys the brain stem that controls respiration,leading to paralysis and arrest (Johnson, 2016)Diagnosis: Thediagnosis of paralytic poliomyelitis based on research is supported by:clinical course, virological testing, and residual neurologic deficit 60 daysafter onset of symptoms. Laboratory testing, such as the measurement ofantibodies especially pre- and post-onset of paralysis and other studies, suchas magnetic resonance imaging, electromyography, and/or nerve conduction tests,can help strengthen or exclude the diagnosis of poliomyelitis (Gonzalez, 2009)Treatment: According to research, there is no cure forpoliomyelitis but after President Roosevelt, whocontracted poliomyelitis himself in 1921 at the age of 39, Franklin Delano Roosevelt put his remarkable politicalskills to work on behalf of other poliovictims to develop a rehabilitation center ha Warm Springs, Georgia. In 1928,the demands of his campaign to become governor of New York led him to transferleadership of the rehabilitation center development to his law partner, BasilO’Connor. O’Connor made Warm Springs a nonprofit foundation, created theNational Foundation for Infantile Paralysis, and used the prestige of the Roosevelt name and position in hisfund-raising efforts. At first, these projects depended on charitable gifts aswell as a series of annual balls, pegged to Roosevelt’s birthday at the end of January and promotedwith the slogan “Dance so that others may walk.
” The funds were usedfor patient care at Warm Springs mad for financing research into the causes andprevention of polio (Helfand, 2001). So according to the research, PresidentRoosevelt initiated a campaign that, in 1955, resulted in the creation of the poliovaccines through intramuscular injection. In 1961, AlbertB. Sabin, MD, developer of theoral polio vaccine.
This vaccinewas created by growing theirpoliovirus on monkey kidney and testicle cells. OPV is administered orally,usually in the form of drops. “The March of Dimes” was the name of awordplay on the contemporary newsreel series “The March of Time” by EddieCantor who was a popular star of vaudeville, films, and radio. Through thepopular media of the day–radio, posters, broadsides, and film shorts-thecountry’s most popular entertainers backed a campaign for the public to sendtheir dimes directly to the White House in Washington. Postcards like this one,showing a well-dressed child with polio, accompanied a card into whichone could insert as many as twenty dimes; there was space for bills as well.
Adime in the 1930s was worth $1.27 in today’s money, and the March of Dimesproved to be worth its weight in gold (Helfand, 2001). Based onthe research, it is said that the polio virus has been eradicated from the UnitedStates since 1979 with the help of two vaccines that were created by the helpof President Roosevelt. No specific anti-viral drugs are available forpoliomyelitis, although some poliovirus antiviral compounds are currently beingdeveloped. Treatment consists of supportive, symptomatic care during the acutephase, including respiratory support in cases with respiratory muscleparalysis. Neuromuscular sequelae are mitigated by physiotherapy and orthopedictreatment.
Vaccines first developedand licensed in 1955, is given by injection and is available only in trivalentform containing the 3 virus serotypes PV1, PV2 and PV3.