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The Immune SystemPoliomyelitis Synonyms : Infantile Paralysis, Polio Clinical features, Diagnosis, Management, Prognosis, Nutrition, Herbs, The
disease is caused by one of three related polioviruses (type 1 being the most
common) which comprise a subdivision of the group of enteroviruses.
It is much less common following the widespread use of oral vaccines but is
still a major problem in developing countries. Infection is very contagious
and usually occurs through the nasopharynx (the virus is found in throat and
faeces of affected individuals). Unapparent infections (the main source of
spread) are common in non-immunised populations, but overt disease is
generally rare (the ration between unapparent and overt infections is more
than 100:1). The incubation period
is 7-14 days. The virus affects the neurons of the spinal cord, brain stem and cortex and has a particular tendency to cause damage of the anterior horn neurons, especially in the lumbar segment. Clinical features: < BACK TO TOP >
The
initial symptoms are fever, myalgia, sore throat and headache for 2-6 days.
Several
symptom-free days are followed by recurrent fever and signs of aseptic meningitis (headache, stiff neck and back, nausea).
Many
cases resolve completely without progression to paralytic stage.
In
other patients characteristic muscle
weakness develops, which can later progress to widespread paralysis.
Flaccid paralysis can affect swallowing (dysphagia, nasal regurgitation), speech (nasal
voice), and respiratory function (breathing difficulties progressing to
respiratory failure), accounting for most deaths.
Bladder
distension and marked bowel constipation characteristically accompany lower
limb paralysis.
Sensation
remains intact, and
hyperaesthesia of skin overlying paralysed muscles is common and
pathognomonic.
Muscle
weakness is maximal at the end of the first week and gradual recovery may then
take place over several months.
Usually
after 6 months it will be possible to tell more about the extent of permanent
disability.
Overall,
paralysis is mild in about 30%, permanent in 15%, and results in death in
5-10% of cases. Postpolio muscular atrophy occurs in 30-40% of affected patients 20-30 years later, characterised by increasing muscle fatigue, paralysis and fasciculations in partially recovered limbs. Diagnosis: < BACK TO TOP >
Clinical
diagnosis is usually difficult before the onset of the paralytic stage.
Poliovirus
can be isolated from cerebro-spinal fluid, throat or stool. Serologic tests can confirm a rise in the antibody titre. Management < BACK TO TOP >
Therapy
is supportive and symptomatic.
Intubation
or tracheostomy with assisted ventilation, as well as feeding though a
nasogastric tube may be needed.
Majority
of patients eventually recover, sometimes with some permanent damage.
Disease
in worse in adults and pregnant women than in children. Prevention: Oral polio vaccine (OPV or Sabin vaccine) is claimed to provide effective protection. It is however contraindicated in immunocompromised children (they should receive Salk inactivated polio vaccine). Prognosis < BACK TO TOP >
Nutrition < BACK TO TOP > Nutrition that alleviate or prevent Poliomyelitis :- Herbs < BACK TO TOP > Herbs that alleviate or prevent Poliomyelitis :- (source : -) |
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7 April 2010 
10 December 2004 - International Human Rights Day
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