POLIOMYELITIS
Poliomyelitis is a highly contagious viral disease caused by a virus that attacks the nervous system.
- Poliomyelitis also referred to as polio mostly affects children younger than 5 years old. This age group is more likely to contract the virus than any other group.
- In its most severe form, it causes nerve injury leading to paralysis, difficulty breathing and sometimes even death.
- Due to the global polio eradication initiative that was put in place in 1988, the following regions are now certified polio-free: Americas, Europe, Western Pacific, and Southeast Asia.
- However, despite the worldwide effort to wipe out polio, poliomyelitis still affects children in parts of Asia and Africa.
- Two patterns of polio infections exist: non-paralytic or abortive polio, and paralytic polio.
- Non- paralytic polio is a minor illness that doesn’t involve the central nervous system and does not eventually lead to paralysis.
- Paralytic polio is the most serious form involving the central nervous system. This type is rare and affects about 1% of people with the condition. It may either progress to paralysis or not.
- About one to five in a thousand cases of paralytic poliomyelitis progresses to paralytic disease where the muscle becomes weak, poorly controlled, and finally completely paralyzed.
- There are three classifications of paralytic polio depending on the site of paralysis.
- Paralytic polio leads to paralysis in the spinal cord (spinal polio), paralysis in the brainstem (bulbar polio), paralysis in both the spinal cord and the brain stem (bulbospinal polio
- 79% of paralytic cases results from spinal polio, about 2% of paralytic cases are caused by bulbar polio, and about 19 % of paralytic cases results from bulbospinal polio.
- It should be known that it is possible for polio to return even after recovery. This can occur after 15 to 40 years and it is referred to as a post-polio syndrome.
CAUSES
Poliomyelitis is caused by the poliovirus. This virus is highly contagious and can be transmitted mainly from person-to-person through infected fecal matter entering the mouth or less commonly, through contaminated food and water containing human feces. It multiplies in the intestine, from where it can invade the nervous system and can cause paralysis.
The virus is so contagious that anyone living with someone who has the virus can catch it too.
Malnutrition, skeletal muscle injury due to injection of vaccines, immune deficiency, being young and pregnancy can make an individual susceptible to the poliovirus
If you have not been vaccinated, factors that can increase your risk of contracting polio are:
- Traveling to an area with a recent polio outbreak
- Taking care or living with someone infected with polio
- Handling a laboratory specimen of the virus
SYMPTOMS
Symptoms of non-paralytic poliomyelitis are:
- Fever
- Vomiting
- A headache
- Fatigue
- Meningitis
- Neck pain
- Back pain
- Irritability
- Abdominal pain
- Pain in the arms and leg
Symptoms of paralytic polio are:
Initial signs and symptoms such as fever and headache often mimic those of non-paralytic. After a week, more severe symptoms will appear. Such as:
- Loss of reflexes
- Severe muscle aches or weakness
- Loose and floppy limbs, sometimes on just one part of the body
- Sudden paralysis which may be temporary or permanent
- Deformed limbs, especially in the hips, ankles, and feet.
Symptoms of post-polio syndrome
- Muscle pain that gets worse
- Fatigue
- Muscle wasting also referred to as muscle atrophy
- Breathing or swallowing problems
- Sleep disorder such as sleep apnea
- Decreased tolerance of cold temperature
DIAGNOSIS AND TREATMENT
The doctor makes a diagnosis by looking at your symptoms. The doctor will perform a physical examination and look for neck and back stiffness, abnormal reflexes, or difficulty lifting the head while lying flat.
A confirmation is made by taking a sample of throat secretions, stool or a cerebrospinal fluid (a colorless fluid that surrounds the brain and spinal cord) to be checked for poliovirus.
TREATMENT
No cure exists for polio, the aim of treatment is on increasing comfort, speeding recovery and preventing complications.
The most common supportive treatments include:
- Bed rest
- Painkillers
- Portable ventilators to help with breathing
- Physical therapy to prevent loss of muscle function and deformity
- Heating pads or a warm towel to ease muscle aches
The best way to prevent polio is to get the vaccination. According to the vaccination schedule presented by the Centre for Disease Control and Prevention, children should get one dose at 2 months, 4 months, 6 to 18 months, and a booster dose between ages 4 to 6.
Adults should get a series of shots too before traveling to an area where polio is still prevalent.