Polio - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Nerve Disease

polio, spinal infantile paralysis, Heine-Medina disease - is the name of a heavy infectious disease.The causative agent of the disease - filterable virus, the smallest of enteroviruses, hitting the gray matter of the spinal cord anterior horn, motor nuclei of the brain stem and causes paralysis.

polio virus

Open pathogen Landsteiner and Popper, described the disease as early as the 80s of XIX century J. Heine, AY Kozhevnikov and A. Medina.The virus is stable in the environment is destroyed at a temperature of 56º for 30 minutes under UV irradiation and disinfectants - chloramines, chlorine bleach, potassium permanganate, formalin.Long stored in milk and dairy products (up to 3 months) in water (up to 4 months) in the stool (6 months).Three types of virus Found: 1 virus Brunhilde, Lansing virus 2, 3 -virus Leon.

In the middle of XX century increase in the incidence of polio has taken epidemic proportions in Europe and North America.Currently, there are isolated, sporadic cases of polio, the incidence

is reduced in countries where vaccination is carried out.In 2010, only Afghanistan, India, Nigeria, Pakistan remain polio-endemic, in 1988 these were 125 countries.In 1988, the World Health Assembly adopted a resolution to eradicate polio in the world.The Global Polio Eradication Initiative over the years reduced the incidence by 99%.And this is the merit of the active immunization of children.There remains the risk of virus importation of "disadvantaged" countries.

There is much talk about the advisability and the dangers of vaccinations for children.Before deciding to vaccinate your child or not - read - what a "polio".That terrible pictures underwent polio children in countries where vaccination is not practiced:

Photo adult who has had polio:

shed virus from the nasal mucosa and feces of the patient in the acute period and in healthy virus carriers.The source of the disease may become ill with erased, atypical, abortive forms, without the paralytic stage where polio occurs as usual ARI and not diagnosed.The virus is excreted in the faeces in the first 2 weeks of the disease, fecal carriage can take up to 3 - 5 months.Nasopharyngeal virus released in the first 3 - 7 days.

susceptibility is small - 0.2 - 1%.Ill mostly children under 7 years.

infection Path - through the gastrointestinal tract, dirty hands, water, food.Through the lymphatic system, the blood, the virus enters along the axons of autonomic fibers and the peripheral nerves in the central nervous system, causing dystrophic and necrotic changes, which leads to the development of motor disorders - paresis and paralysis.

marked seasonality of the disease with a peak in the summer-autumn period.

Symptoms of polio

The incubation period (the period before the onset of clinical signs of the disease) - 7 - 14 days.
Distinguish paralytic poliomyelitis - spinal, bulbar, Pontin, encephalitic, mixed and non-paralytic - bezsimptomno, visceral, meningeal.
flow ranges from very mild to severe forms of worn.

initial stage of the disease - preparaliticheskaya - is characterized by acute onset, fever, catarrhal symptoms and disorders of the gastrointestinal tract.From the nervous system possible - headache, vomiting, weakness, stiffness, fatigue, drowsiness or insomnia, muscle twitching, tremors, convulsions, symptoms of irritation of the meninges and roots - pain in the spine, extremities.It lasts a state of up to 5 days.In the best case (if vaccination has been carried out), the disease is not transferred to the next stage, and the patient is recovering.

next stage - paralytic - the temperature drops, pain in the muscles are, appear paresis and paralysis.Most often affects the lower limbs, deltoid, less muscles of the trunk, neck, abdominal, respiratory muscles.When stem form affects the muscles of the face, tongue, pharynx, larynx.Paralysis unbalanced, sluggish.Decreased muscle tone, tendon reflexes are reduced by 1 - 2 weeks developing muscle atrophy, joint sprains.

Restorative stage - lasts 4 - 6 months, and then the pace of recovery decreases - are muscle atrophy, contracture.

Residual effects - residual stage - a stage of persistent flaccid paralysis, atrophy, contractures, deformities and limb shortening, curvature of the spine.

spinal deformity - kyphoscoliosis resulting polio.

Mortality in polio epidemics of 5 - 25%, mostly from respiratory disorders, paralysis of respiratory muscles.

remaining spinal deformity, limb can cause lifelong disability.


diagnostically significant symptoms - acute febrile beginning, the rapid development of flaccid paralysis, paralysis asymmetry, with more proximal lesion.lumbar puncture is done to confirm the diagnosis, laboratory diagnostics - serological and virological.

investigated paired serum collected 3-4 weeks apart.Suitable "color" test - based on the capacity indicator (phenol red) to change the color in the pH change of cell culture medium infected with the polio virus.Result within 48 hours.

The differential diagnosis is carried out with meningitis, myelitis, Guillain-Barre, encephalitis, poliomielitopodobnymi diseases.

Polio Treatment

specific antiviral treatment of polio exists .

treatment is carried out in a hospital - boxing infectious hospital.Isolation of the patient for 40 days.Use symptomatic therapy, gamma globulin, vitamin C, B1, B6, B12, amino acids.With the defeat of the respiratory muscles - mechanical ventilation.Required bed rest for 2 - 3 weeks.

Much attention should be paid to the care of paralyzed limbs.All movements have to be careful, slow foot should not hang down, legs and spine position should be correct.The patient lies on a bed on a hard mattress, legs are placed parallel, slightly bent at the knee and hip joints by means of rollers.The feet are placed at a right angle to the lower leg, the sole of a thick cushion to put the stop.Hand drawn off to the side and bent at the elbows at right angles.To normalize the nerve - muscle conductivity using Neostigmine, neuromidin, Dibazolum.

During recovery a priority role to play physical therapy, exercises with orthopedic massage, hydrotherapy, physiotherapy - UHF, paraffin baths, electrical stimulation.Displaying sanatorium - resort treatment - Yevpatoria, Odessa, Anapa, Saki.Used sea baths, sulfur, mud baths.

The residual period conducted orthopedic treatment - conservative, operative for the purpose of correction of developed contractures and deformities.

whole world is united in the fight against the virus.The world must not remain any child infected with polio.And while risk of developing against children in any country .For Russia, the actual risk of importation of wild poliovirus in connection with migration from Tajikistan.In this regard, intensified surveillance of the implementation of sanitary rules and polio prevention.It is planned at checkpoints across the state border of the Russian Federation arrived in Tajikistan once vaccinated and to inform about the necessity of the second and third vaccination. Keep this in mind when deciding whether vaccination of their child!

Prevention Polio

Polio Prevention - vaccination of live attenuated vaccine Sebino (Chumakov, Smorodintsev) 3 months three times a month - drops in the mouth on the lymphoid tissue, the surface of the tonsils, revaccination at 18 months, 3 years, 6 years,14 years.

intramuscular injections of inactivated vaccine containing killed by wild polio viruses.

produced in the syringe - the dispenser of 0.5 milliliters.We introduce kids subcutaneously in the subscapular area (less in the shoulder), older children in the shoulder.2-3 do administration at intervals of 1.5 - 2 months, a year performed first booster, the second after 5 years.Later booster is not required.Both vaccines contain all three types of polio virus.

The outbreak of the disease is carried out sanitary - hygienic measures - disinfection of utensils, clothes, all of the items that might be contaminated.Contact children are quarantined to 15 - 20 days.

medical consultation neurologist polio:

Question: Can a sick adult who is not vaccinated people?
Answer: can any ill adult immunocompromised vaccine-associated poliomyelitis.Parents with AIDS who take drugs that suppress the immune system can become infected by a child.To avoid this, you need to observe good personal hygiene, wash hands, no kissing on the mouth of the child.

Question: What is the difference in vaccines?
A: Inactivated vaccine has several advantages compared with the vaccine, which is administered through the mouth: completely exclude the possibility of the development of such complications as a vaccine-associated polio, no intestinal disorders, provides 100% immunity.After the baby drops within two months allocates live vaccine virus, which is a danger to others.
Prick painless.The droplets of salty-bitter, baby can belch, snatch and graft disappear.

Question: complications of vaccination against polio?
A: vaccine-associated poliomyelitis may develop in the case of live vaccine (oral drops) weakened child, allergic reactions - urticaria, angioedema, gastrointestinal dysfunction.

neurologist Kobzev SV