Poliomyelitis

What is polio? Poliomyelitis is a systemic infectious-contagious disease that primarily affects the central nervous system and sometimes causes paralysis. The clinical picture may range from non-specific respiratory or digestive manifestations to severe, encephalitis or meningoencephalitis with paralysis and respiratory disturbances. Polio infection typically reaches the peak in summer months in temperate climate countries. In tropical climate countries there is no segregation in seasons. The frequency of severe manifestations is one case of paralysis in 200 subclinical infections. Etiology: - Type 1, 2, 3 poliomyelitis virus, Picornaviridae family, Enterovirus genus; .

Prodromul or minor illness lasts for 2-4 days and is characterized by fever, bluish skin signs (cortisol, pharyngitis), muscle aches ( The infection can stop at this stage (abortive forms). In 5-10% of cases, more often in children, there is no prodrome, polio starting with Longevity: 2-4 days The period of the condition or major disease characterized by high fever and nerve phenomena fractured in a preparative stage and a paralytic stage. Laboratory diagnosis Pathological products: pharyngeal exudate or preferably nasopharyngeal wash liquid sterile, faeces (because the excretion of the virus can be intermittent, faecal matter recurrence is repeated in case of an initial negative result), blood, cerebrospinal fluid. Harvesting is done at the patient's hospitalization with suspicion of poliomyelitis, and the serological examination is repeated 2 weeks after admission. Transport of samples to the reference laboratory is done as quickly as possible in an ice container.

The CSF exam is important, but the changes noted are not characteristic, as they may also occur in other viral meningitis (clear, slightly hypertensive CSF, cytology: 5-6-100 elements / mm3, initially dominated by PMN, then lymphocytes greater than . What are the stages of poliomyelitis? Preparative stage that lasts from a few hours to 5 days and is manifested by fever, headache, malaise, irritability, neuralgia, myalgia, paraesthesia, hyperesthesia dermatitis. Skin fasciculations may be present; . Skin reflexes may disappear and osteotonic reflexes are altered (hyper or hypo-reactivity). Consciousness is preserved (not in polio encephalitis).

Meningean syndrome is present. The paralytic stage in which meningean syndrome is maintained, along with the installation of phyllo-hypotonic paralysis, with the reduction to abolition of ROT that are asymmetric, unequal and predominates in the limb roots. Neurovegetative disorders also occur as abnormal sweating, limb cooling, bladder paresis with urine retention accompanied by pain not yielding to antalgic but warm compresses and leading to antalgic positions or frequent changes in position. Muscle spasms are also present in the antagonist muscles of the paralyzed (reflex and exaggerated contraction by ganglio-radiculitis lesions), psychomotor coordination, paradoxical movements, vicious, deforming attitudes. Consciousness is preserved, but the patient is anxious and suffers from insomnia.

Cardiovascular involvement is manifested by tachycardia, extrasystole, precordial pain, and changes in myocarditis ECG. The period of restitution and recovery begins after 10-14 days from the onset of major illness and lasts for months to 1-2 years; . Retrospection of paralysis is done in reverse order to their appearance; . Recovery is maximum within the first 3 months. Period of sequelae with definitive paralysis, muscle atrophy, deformations, trophic disorders such as varus equine, valgus, deformities of the column and basin.

Trophic disorders, lead to shortening of the limb in growing children; . After 10-20 years of acute illness, a post-myelitis post-progressive muscular atrophy syndrome. top Prevention and treatment of poliomyelitis Prophylaxis and control Measures against the source of infection. Any case of PAF occurring in the child up to 15 years of age is declared in the first 24h, nominally and isolated within 24h. Samples of faecal matter and nasopharyngeal secretions will be collected to be dispatched to ice containers at the reference laboratory.

Samples should be collected and dispatched within maximum 14 days of onset (2 samples at 24-48h from each other). It is recommended to collect samples of faeces from 5 children aged up to 5 years for each case of PAF. In case of wild-type poliomyelitis, isolation is 6 weeks and is performed in infectious diseases. It is recommended to supervise contacts for 21 days. Children will be isolated at home, indicating rest, avoiding crowds, parenteral treatments.

Feces for virological diagnosis will be collected. Adults working in risk sectors will be removed during peak incubation. As appropriate, vaccination or revaccination will be carried out. Child reunion will take place within 1 month of discharge and of adults at 3 months of onset (those in risk sectors having the obligation to decontaminate the seats for 6 months). Measures against transmission pathways will include continuous disinfection for nasopharyngeal secretions, faecal matter and objects of the patient (chlorine-based), terminal disinfection through cleansing and molding; .

Measures towards the susceptible population target active immunization with live attenuated antipoliticized vaccine (VPOT), orally or inactivated vaccine, parenterally (immunosuppressed, pregnant). Health education aims at adopting proper hygienic behavior and healthy eating. The occurrence of cases of wild-type virus poliomyelitis and vaccine coverage with VPOT of less than 80% at county level are epidemiological risk situations when vaccinating with 2 doses of VPOT of all children up to 5 years of age . Treatment. There is no effective antiviral treatment.