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Poliomyelitis

Updated : February 5, 2024





Background

Poliomyelitis is a contagious disease which spreads through lymphatic replication and fecal-oral contamination. It caused considerable mortality and morbidity in children throughout many epidemics prior to global health initiatives. Consider rapid serologic testing because, if left untreated, this disease can induce static flaccid paralysis in a small percentage of people affected.

Epidemiology

Before global health measures, about 1 in every 200 people infected with poliomyelitis had irreversible paralysis. Type 1 poliovirus is the wild type still in existence, and it is exclusively found in Afghanistan and Pakistan.

Recent cases of type 2 poliovirus obtained from oral vaccinations have been reported in portions of Asia and Sub-Saharan Africa. Poor program adherence and access to healthcare in isolated endemic areas are some challenges to total eradication.

Routine childhood vaccine administration has successfully combated viral transmission globally, with a 99% drop in cases from 350,000 in 1988 to 33 in 2018.

Anatomy

Pathophysiology

Poliovirus is typically transmitted through fecal-oral contamination, but oral transmission is also potential. Viral replication in the gastrointestinal and oropharynx lymphatic tissues can result from primary infection.

Peak viral excretion occurs two to three days before symptoms appear and lasts for one week. In almost 95% of cases, the infection is non-paralytic and manifests as a flu-like sickness. Complete motor paralysis can develop in about 5% of patients.

The virus’s spread to the central nervous system is inadequately known. If the virus spreads, it may trigger anterior horn neuronal death, concluding in a physical test showing intact sensibility and pure motor impairments.

Etiology

The virus that causes acute polio and post-polio syndrome belong to the species Enterovirus C. The Picornaviridae family, the Wild Poliovirus, has three serotypes. Until immunizations became widely available, most paralytic polio cases were caused by type 1 wild poliovirus. As of 2015, wild subtypes 2 and 3 were believed extinct.

Vaccination-associated paralytic poliovirus is rare, occurring only around 3.8 instances out of every million cases in countries that use the oral poliovirus vaccine. It is linked to serotype 3 and immunodeficiency in the patient. The risk of developing polio is understood to be affected by circulation in maternal antibodies and the first oral polio vaccine period.

Poliomyelitis caused by vaccination is generated by alterations of the attenuated virus within the oral polio vaccine. This can result in advanced virulence and naturally selected growth in populations with inadequate herd immunity.

Because of this risk, there has been a global campaign to enhance the usage of inactivated polio vaccine and eliminate attenuated type 2 polio from oral polio vaccine formulations to generate a bivalent oral polio vaccine containing types 1 and 3.

Genetics

Prognostic Factors

Polio can manifest from viral symptoms without paralysis to quadriplegia and even respiratory collapse. Polio patients who appear with merely viral prodromes are likely to have their symptoms entirely resolved.

The degree of paralysis in a person with acute paralysis is frequently unchanging. The post-polio syndrome affects 30% to 40% of polio patients decades after the primary illness.

This trend is complex and is affected by factors such as acute paralysis severity, age of onset, and even socioeconomic level.

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

Media Gallary

References

https://www.ncbi.nlm.nih.gov/books/NBK558944/

Poliomyelitis

Updated : February 5, 2024




Poliomyelitis is a contagious disease which spreads through lymphatic replication and fecal-oral contamination. It caused considerable mortality and morbidity in children throughout many epidemics prior to global health initiatives. Consider rapid serologic testing because, if left untreated, this disease can induce static flaccid paralysis in a small percentage of people affected.

Before global health measures, about 1 in every 200 people infected with poliomyelitis had irreversible paralysis. Type 1 poliovirus is the wild type still in existence, and it is exclusively found in Afghanistan and Pakistan.

Recent cases of type 2 poliovirus obtained from oral vaccinations have been reported in portions of Asia and Sub-Saharan Africa. Poor program adherence and access to healthcare in isolated endemic areas are some challenges to total eradication.

Routine childhood vaccine administration has successfully combated viral transmission globally, with a 99% drop in cases from 350,000 in 1988 to 33 in 2018.

Poliovirus is typically transmitted through fecal-oral contamination, but oral transmission is also potential. Viral replication in the gastrointestinal and oropharynx lymphatic tissues can result from primary infection.

Peak viral excretion occurs two to three days before symptoms appear and lasts for one week. In almost 95% of cases, the infection is non-paralytic and manifests as a flu-like sickness. Complete motor paralysis can develop in about 5% of patients.

The virus’s spread to the central nervous system is inadequately known. If the virus spreads, it may trigger anterior horn neuronal death, concluding in a physical test showing intact sensibility and pure motor impairments.

The virus that causes acute polio and post-polio syndrome belong to the species Enterovirus C. The Picornaviridae family, the Wild Poliovirus, has three serotypes. Until immunizations became widely available, most paralytic polio cases were caused by type 1 wild poliovirus. As of 2015, wild subtypes 2 and 3 were believed extinct.

Vaccination-associated paralytic poliovirus is rare, occurring only around 3.8 instances out of every million cases in countries that use the oral poliovirus vaccine. It is linked to serotype 3 and immunodeficiency in the patient. The risk of developing polio is understood to be affected by circulation in maternal antibodies and the first oral polio vaccine period.

Poliomyelitis caused by vaccination is generated by alterations of the attenuated virus within the oral polio vaccine. This can result in advanced virulence and naturally selected growth in populations with inadequate herd immunity.

Because of this risk, there has been a global campaign to enhance the usage of inactivated polio vaccine and eliminate attenuated type 2 polio from oral polio vaccine formulations to generate a bivalent oral polio vaccine containing types 1 and 3.

Polio can manifest from viral symptoms without paralysis to quadriplegia and even respiratory collapse. Polio patients who appear with merely viral prodromes are likely to have their symptoms entirely resolved.

The degree of paralysis in a person with acute paralysis is frequently unchanging. The post-polio syndrome affects 30% to 40% of polio patients decades after the primary illness.

This trend is complex and is affected by factors such as acute paralysis severity, age of onset, and even socioeconomic level.

https://www.ncbi.nlm.nih.gov/books/NBK558944/