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Symptoms, effects and prevention of polio

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What is polio?

Poliomyelitis is an acute infectious disease caused by poliovirus, belonging to the family of picornaviruses, the genus of enteroviruses. Overt form of poliomyelitis is accompanied by damage to the nervous system: the emergence of paresis and paralysis result from the dysfunction of motor neurons of the anterior horns of the spinal cord.

The polio virus is widespread, but most often it manifests itself in Africa and Asia, where there is year-round circulation of his strains. In 1988. The who has set a goal in the next 12 years to completely eliminate this pathology. The only solution was to become vaccinated children group of population in excess of 85%. To achieve the goals completely failed, though, not to mention a huge reduction in the incidence of polio is not possible.

Currently periodically register individual cases of the disease. They are associated with the non-regulated timing of vaccination, and also with the failure of some parents to immunize their children against polio, when there is incomplete coverage of the population pripravujeme, low immune layer. All of this contributes to the preservation and circulation in nature "wild" strains of the virus.


The symptoms of polio

The duration of the incubation period is from 5 to 35 days (usually 1-2 weeks). The typical form of spinal.

It is characterized by the following periods:

  • preparationsto (3-6 days). Characterized by a twofold increase in body temperature at intervals of 2-3 days. Symptoms of upper respiratory tract: runny nose, nasal congestion, sore throat, dry cough. Possible diarrhoeal phenomenon: nausea, single, double vomiting, abdominal pain. In the future there is a migraine, myalgia, increased skin sensitivity.

  • paralytic period (lasting from several days to 2 weeks). It is characterized by the appearance of flaccid, asymmetrical paralysis and paresis. The temperature rises more is not observed, decrease symptoms of intoxication. In rare cases, suffers functionalthe condition of the pelvic organs. Depending on the level of the lesion spinal structures varies localization of paresis and paralysis. If you change the cervical and thoracic departments marked motor impairment in the arms, neck muscles. If the pathological lesion is lower, then there is paralysis of the lower extremities (most common). In unilateral paresis of the abdominal muscles that formed his asymmetrical protrusion, with bilateral - "frog" belly. Already in 10-14 days, patients show signs of muscle atrophy. The appearance of the paralysis always comes unexpectedly. They often appear in the morning, when the patient just woke up. The paralysis can wear transient in nature and pass without consequences or be persistent. In the latter case, the maximum severity of neurological symptoms mostly reaches to the second day.

  • recovery period (can last for several years). The rate restoration is carried out in the first six months, then his pace slowed down markedly. With deep lesions of the muscle tissue, i.e. death of the responsible motor neurons of the spinal cord, the process of reparation becomes impossible.

  • residual period or the period of residual phenomena. Characterized by persistent flaccid paralysis, muscle atrophy, contractures, bone deformities, osteoporosis. Even after many years persons who have had polio can suffer rapid muscle fatigue, fasciculation, atrophy of individual muscle groups.

Paralytic form occurs in one out of two hundred cases, but nevertheless, it is being the most difficult, is almost always to be the correct diagnosis.

In addition, there are other forms of this disease:

  1. Inapparently. Expressed in healthy virus. Clinically the pathology itself is absolutely not very and almost never diagnosed. The identification is only possible with virological examination.

  2. The abortive form. It is characterized by signs of General infectious disease without manifestation of neurological symptoms. There is an increase in body temperature, sneezing, sore throat, cough, headache, nausea, vomiting, abdominal pain. The patient recovers completely after 3-7 days.

  3. The meningeal form. Manifested symptoms of acute serous meningitis. In addition to the signs of common infectiousdiseases of, pain in back, legs, pathogenetically associated with involvement in the pathological process of the spinal cord roots. Full recovery could only be achieved 3-4 weeks after the occurrence of the disease.

Contagious polio? The pathogenesis (development) of its symptoms.

Poliomyeli? contagious (contagious) infectious disease most sensitive to which have children of preschool age.

The source of the infection? a sick person or a virus carrier, secreting the pathogenic virus with the stool or with mucus of the nasopharynx.

Ways of infection

  • fecal-oral. The cause of the infection are mainly contamination of microorganisms in foods. A big role in the dressing infections flies, perhaps that is why in countries with a temperate climate marked summer-autumn seasonality.
  • airborne. Patients secrete the virus through sneezing, coughing.

Especially dangerous infectious terms are those that carry disease without symptoms (inapparent form) or with nonspecific manifestations (slight fever, General weakness, fatigue, headache, nausea, vomiting) without signs of CNS. These people could infect a large number of in contact with them, because the diagnosis of sick to put a very difficult, and therefore isolation these individuals practically are not exposed.

The poliovirus enters the human body through the nose, is the reproduction in the epithelial lining of the pharynx and intestine, then penetrate the cervical and abdominal lymph nodes. Further, the poliovirus hematogenous (through the blood) and lymphogenous (through lymphatic vessels) way gets to the liver, spleen, bone marrow and accumulate there. The second time when it enters the bloodstream, causing a repeated wave of fever, poliovirus seeps through the blood-brain barrier and causes Central nervous system.

IMPORTANT: the polio Virus mainly affects the motor neurons of the spinal cord and nuclei of the nerves of the brain stem. Pathological lesions can occur at different levels of the CNS, and therefore in each individual case clinic polio may be different.


The effects of polio

Depending on what form of the disease people suffered may vary and the effects of polio. Sothe abortive form takes place in an average 7 days, leaving absolutely no consequences. Full recovery occurs after suffering and meningeal forms of the disease, but after a much greater period of time.

Even the hardest of paralytic form may pass completely unnoticed and all functions affected by the poliovirus Central nervous system will be restored. However, if paralysis and paresis wore deep, strong character, to make a completely full recovery of the affected parts of the nervous system would be impossible. After a severe paralytic forms remain muscle atrophy, osteoporosis, deformation of limbs. In some cases, remain joint contractures with limitation of volume of active and passive movements in them, the usual sprains, paralytic curvature of the spine, deformities of the feet, clubfoot. Children are post-polio are usually strongly lag behind in physical development, often there is shortening of the affected limb.

In the event that the patient's Central and peripheral changes of breathing, disorders of the cardiovascular system, in paralysis of the smooth muscles of the gastrointestinal tract in most cases the disease is fatal.


Prevention of polio

Primary prevention measures which aim to prevent the occurrence of the disease, is subdivided into nonspecific and specific.

Nonspecific aimed at the General strengthening of an organism, increasing its resistance to various infectious agents (hardening, proper nutrition, timely readjustment of chronic foci of infection, regular exercise, optimization of sleep cycle-borrowstone, etc.), control of insects, which are carriers of pathogenic microorganisms (disinfection), personal hygiene (in the first place is washing your hands after the street and after visiting the toilet), a thorough treatment of vegetables, fruits and other produce before eating them for food.

Specific prevention is vaccination against poliomyelitis. In order to polio as a disease has been completely vanquished, the required coverage of 95% of the total population of the globe.

Currently, vaccination against polio introduced in the national mandatory immunization schedule and can be performed in children starting from the age of three. Vaccinated children three times in 45 days. The shortening of the time between vaccinations is unacceptable, except inemergency cases. Then, each child receives a booster protivognilostnymi vaccines at 18 months. 20 months old. 7 and 14 years.

The first two stages of vaccination carried out by injection inactivated preparations. The most common monovaccines is "Imovax-polio", but can be applied to complex vaccines, e.g. "My". Next child vaccinated and boosted orally by attenuated (weakened) live vaccine.

If a family at the time of immunizations with a live vaccine there are other not vaccinated against polio children, in order to prevent the occurrence of vaccine-associated diseases in contact persons should be suspended for a period of two months. Same applies to unvaccinated children, organized in educational institutions for children.

All polio vaccines are alloreactivity and is usually easily tolerated by children. Rarely there is a violation of General condition (temperature, diarrhea, lack of energy) and local changes (the appearance of infiltration and redness at the injection site). The treatment of such States is not required, are alone for three days.

In the case of establishing contact with people with polio is carried out emergency vaccination live attenuated vaccine without taking into account of early vaccinations. It is also possible the use of immune gamma globulin human.

After hospitalization of the sick (to prevent infecting other persons) in the room where he was, there must be a thorough disinfection. You need a General cleaning with application of disinfectants, all toys should be washed with soap and water, linen and dishes subject to boiling.

It is important to conduct timely disinfestation. Medical surveillance of persons in contact with patients with poliomyelitis is carried out for 3 weeks. Visit to educational institutions on all of the time imposed quarantine is strictly prohibited.