Poliomyelitis is a highly infectious disease caused by Enterovirus- Polio Type I, II, III. This is a disease of digestive tract but since it can cause paralysis and deformity. It is usually attack the children below 5 years.
What is epidemiology of Poliomyelitis?
- Poliovirus is an RNA virus with three distinct serotypes- type I, II, III.
- Type I is most common and Type II is least common.
Mode of infection
- It is infection of human alimentary tract but virus may infect CNS.
- Mode of infection is fecal-oral route.
Incubation period and transmission of infection
- Incubation period- 5-35 days
- Transmission of infection- Food and water born
Reservoir and host
- Man is the only host and reservoir of poliovirus.
What are the types of Poliovirus?
Polio can affect your body differently depending on where the virus multiplies and attacks. Types of polio include:
- Abortive poliomyelitis causes flu-like and intestinal symptoms. It only lasts a few days and doesn’t cause long-lasting issues.
- Non-paralytic poliomyelitis may cause aseptic meningitis, a swelling of the area around your brain. It causes more symptoms than abortive poliomyelitis and may require you to stay in the hospital.
- Paralytic poliomyelitis happens when poliovirus attacks your brain and spinal cord. It can paralyze the muscles that allow you to breathe, speak, swallow and move your limbs. Depending on what parts of your body are affected, it’s called spinal polio or bulbar polio. Spinal and bulbar polio can appear together (bulbospinal polio). Less than 1% of people with polio get paralytic poliomyelitis.
- Polioencephalitis is a rare type of polio that mostly affects infants. It causes brain swelling.
- Post-polio syndrome is when symptoms of polio come back years after a polio infection.
What are the symptoms of Poliomyelitis
Paralytic poliomyelitis- Abortive poliomyelitis symptoms are similar to many other illnesses. They start three to seven days after getting infected and last a few days. Symptoms of abortive poliomyelitis include:
- Diarrhea or constipation.
- Sore throat.
Non-paralytic poliomyelitis- Non-paralytic poliomyelitis starts with the same symptoms as abortive poliomyelitis. Additional symptoms start within a few days, including:
- Neck stiffness.
- Pain or pins-and-needles feeling in your arms and legs.
- Severe headache.
- Sensitivity to light (photophobia).
Paralytic poliomyelitis- Paralytic poliomyelitis starts out with symptoms similar to abortive poliomyelitis or non-paralytic poliomyelitis. Additional symptoms can appear days or weeks later, including:
- Sensitivity to touch.
- Muscle spasms.
- Spinal poliomyelitis makes it so you can’t move your arms or legs or both (paralysis).
- Bulbar poliomyelitis makes it hard to breathe, swallow and speak.
- Bulbospinal poliomyelitis has symptoms of both spinal and bulbar polio.
Polioencephalitis- You can have symptoms of polioencephalitis on their own or along with flu-like symptoms. Symptoms include:
- Extreme tiredness (fatigue).
- Trouble focusing.
What are the complications of poliomyelitis?
- Gastric dilatation
- Acute pulmonary edema
- Lifelong disability
How is polio diagnosed?
- Stool specimen culture for isolation of virus is best diagnostic test. The virus is usually found in feces from 72 hours prior to onset of paralysis, up to 6 weeks or more after infection.
- It can be confirmed through ELISA and PCR done on stool specimen.
- It should be suspected in incomplete and unimmunized child with paralysis, if occurs 7-14 days following OPV adminisration.
How is polio managed and treated?
You might be able to improve your symptoms by:
- Drinking fluids (such as water, juice and broth).
- Using heat packs to help muscle aches.
- Taking pain relievers, such as ibuprofen.
- Doing physical therapy and any exercise recommended by your healthcare provider.
- Getting plenty of rest.
Management is basically symptomatic and supportive:
- Analgesics may be given to relieve pain. Hot moist packs are applied to relieve pain and spasm.
- Laxatives for constipation.
- Penicillin for secondary infections.
- Physiotherapy to develop muscle power in non paralyzed muscles.
- Ventilatory support for respiratory paralysis.
How can I prevent polio?
- The best way to prevent polio is to get vaccinated. Vaccination is usually done in childhood. If you didn’t get vaccinated as a child or don’t know if you did, ask your healthcare provider if you should get vaccinated.
Recommended polio vaccination schedule
- Healthcare officials recommend four polio shots in children:
- First shot at 2 months old.
- Second shot at 4 months old.
- Third shot between 6 and 18 months old.
- Booster shot between 4 and 6 years old.
If you’ve never been vaccinated for polio and it’s recommended you get vaccinated as an adult, you’ll get three shots:
- Two doses one to two months apart.
- A third dose six to 12 months after the second.