Polio

Polio
myeli
myeli
tis
tis
A report of
A report of

Abarca, Mark
Abarca, Mark

Nerza, Lourelie
Nerza, Lourelie


bsn3-a
bsn3-a
polio= gray matter
Myelitis=
inflammation of the
spinal cord
This disease result in
the destruction of
motor neurons caused
by the poliovirus.
Polio is caused by a
virus that attacks the
nerve cells of the brain
& spinal cord although
not all infections result
in severe injuries and
paralysis.
Poliomyelitis, often
called polio or
infantile
paralysis, is an
infectious disease
caused by a virus.
An infectious disease
caused by one of the
three polioviruses.
Poliovirus
This virus is a member
of the enterovirus
subgroup of the
Picornaviridae family
and has three
serotypes P!", P!#
and P!$.
%mmunity to one
serotype of the virus
does not provide
significant protection
against the other
serotypes.
The principal mode of
transmission is from
person to person, by
the fecal&oral route.
Transmission via oral
secretions, such as
saliva is possible and
may account for some
cases.
'nter through Mouth,
Multiplies in
(ropharyn) tonsils
and %ntestines,
')creted in *tool.
'nters the +,* from
-lood.
*pread along the
A)ons of peripheral
nerves to +,*.
Progress along the
fibers of the lo.er
motor neurons spinal
cord or brain.
/estroy the Anterior
horn cells of the *pinal
+ord
/o not Multiply in
Muscles only muscles
manifest .ith
.eakness and flaccid
paralysis result is
secondary.
(ccasionally produce
& Myocarditis,
& 0ymphatic
hyperplasia.
Paralytic
Poliomyelitis
,onparalytic
Poliomyelitis
1Abortive
Poliomyelitis2
*pinal polio is the most common form
of paralytic polio3 it results from viral
invasion of the motor neurons of the
anterior horn cells, or the ventral
1front2 gray matter section in the spinal
column responsible for movement of
the muscles, including those of the
trunk, limbs and the intercostal
muscles. !irus invasion causes
inflammation of the nerve cells, leading
to damage or destruction of motor
neuron ganglia.
Making up about #4 of cases of
paralytic polio, bulbar polio occurs
.hen poliovirus invades and destroys
nerves .ithin the bulbar region of the
brain stem. The bulbar region is a
.hite matter path.ay that connects
the cerebral corte) to the brain stem.
The destruction of these nerves
.eakens the muscles supplied by the
cranial nerves, producing symptoms
of encephalitis.
Nonparalytic polio
*ome people .ho develop symptoms
from the poliovirus contract
nonparalytic polio 5 a type of polio
that doesn6t lead to paralysis 1abortive
poliomyelitis2. This usually causes the
same mild, flu&like signs and
symptoms typical of other viral
illnesses.
*igns and symptoms, .hich
generally last t.o to "7 days, include
- Fever - Back pain or stiffness
- Sore throat - Headache
- Vomiting - Fatigue
- Neck pain or stiffness
- Pain or stiffness in the arms
or legs
- Muscle spasms or tenderness
- Meningitis
Paralytic Poliomyelitis
8e.er than " percent of people
infected .ith poliovirus develop
paralytic polio, the most serious
form of the disease. %nitial signs and
symptoms of paralytic polio, such as
fever and headache, often mimic
those of nonparalytic polio.
-et.een one and "7 days later
ho.ever, signs and symptoms
specific to paralytic polio appear,
including
Loss of reflees
Severe muscle aches or
spasms
Loose and floppy lim!s "acute
flaccid paralysis#$ often %orse
on one side of the !ody
Viral isolation from
Throat swabs, Rectal
swabs, Stool specimens, and
+*8.
%f poliovirus is isolated from
a patient e)periencing acute
flaccid paralysis, it is further
tested through
oligonucleotide mapping
"genetic fingerprinting#,
or more recently by P+9
amplification, to determine
.hether it is :.ild type;
1that is, the virus
encountered in nature2 or
;vaccine type; 1derived from
a strain of poliovirus used to
produce polio vaccine2.
%t is important to determine
the source of the virus
because for each reported
case of paralytic polio caused
by .ild poliovirus, an
estimated another #77 to
$,777 contagious
asymptomatic carriers e)ist.
&stimation of 'nti!odies
(gM
There is no cure for polio. The
focus of modern treatment has
been on providing relief of
symptoms, speeding recovery
and preventing complications.
*upportive measures include
antibiotics to prevent infections
in .eakened muscles, analgesics
for pain, moderate e)ercise and a
nutritious diet. Treatment of
polio often re<uires long&term
rehabilitation, including physical
therapy, braces, corrective shoes
and, in some cases, orthopedic
surgery
)iet* -ecause patients .ith
poliomyelitis are prone to
develop constipation, a diet rich
in fiber is usually indicated.
(rthotic treatment 1A8(=>A8(2
*urgical +are +otal hip
arthroplasty is a surgical
therapeutic options for patients
.ith paralytic se<uelae of
poliomyelitis .ho develop of hip
dysplasia and degenerative
disease.
-ladder involvement may
re<uire catheteri,ation
respiratory muscle involvement
may re-uire mechanical
ventilation
Postural drainage & suction
may be sufficient to manage
pooling of secretions in patients
.ith nonparalytic polio.
Paralytic polio can lead to
temporary or permanent
muscle paralysis, disability,
and deformities of the hips,
ankles and feet. Although
many deformities can be
corrected .ith surgery and
physical therapy, these
treatments may not be
options in developing
nations .here polio is still
endemic. As a result,
children .ho survive polio
may spend their lives .ith
severe disabilities.
?ou6re at greatest risk of
polio if you haven6t been
immuni@ed against the
disease. %n areas .ith poor
sanitation and sporadic or
none)istent immuni@ation
programs, the most
vulnerable members of the
population 5 pregnant
.omen, the very young and
those .ith .eakened
immune systems 5 are
especially susceptible to
poliovirus.
These factors also increase
your risk if you haven6t been
vaccinated
Travel to an area .here polio
is common or that has
recently e)perienced an
outbreak
0iving .ith or caring for
someone .ho may be
shedding poliovirus
Aandling laboratory
specimens that contain live
poliovirus
A compromised immune
system, such as occurs .ith
A%! infection
Aaving had your tonsils
removed 1tonsillectomy2
')treme stress or strenuous
physical activity after being
e)posed to poliovirus, both
of .hich can depress your
immune system
Paralytic polio can lead to
temporary or permanent
muscle paralysis, disability,
and deformities of the hips,
ankles and feet. Although
many deformities can be
corrected .ith surgery and
physical therapy, these
treatments may not be
options in developing
nations .here polio is still
endemic. As a result,
children .ho survive polio
may spend their lives .ith
severe disabilities.
T.o types of vaccine are
used throughout the .orld
to combat polio. -oth types
induce immunity to polio,
efficiently blocking person&
to&person transmission of
.ild poliovirus, thereby
protecting both individual
vaccine recipients and the
.ider community 1so&called
herd immunity2.
'l!ert Sa!in 1Virologist2
T.o types of vaccines
used in the prevention of
poliomyelitis
inactivated poliovirus
vaccine :%P!B
administered through
%M 1Salk
Vaccine given by
in!ection2
oral attenuated
poliovirus vaccine
:(P!B. "Sabin Vaccine#
%P! .as the first polio
vaccine available on the
market, and its
.idespread
administration began in
the "CD7s.
An enhanced inactivated
poliovirus vaccine 1e%P!2
formulation is no.
available.
,onenhanced early
formulations had the
disadvantages of not
being as immunogenic as
(P!, not being able to
induce mucosal
immunity, and having to
be administered
parenterally, .hich
increased costs and
decreased compliance.
(ne of the major
advantages of %P! is that
it contains an inactivated
virus3
for that reason, %P! is not
associated .ith the
development of vaccine&
associated poliomyelitis
and can be given to
immunocompromised
patients.
This vaccine is
administered .hen
individuals are aged #
months, E months, and
F&"# months and before
school entry, .hich is
usually at age E years.
Trivalent (P! has been
used since the early
"CF7s.
%mmuni@ation .ith this
formulation .as
responsible for the
significant decrease in
the prevalence of disease
throughout the .orld.
This formulation has the
advantages of inducing
mucosal immunity,
providing appropriate
herd immunity, and
increasing vaccine uptake
because of oral
administration.
Additionally, it is cost&
effective, especially in
countries in the
developing .orld.
The major disadvantage
of trivalent (P! is its
association .ith
vaccine&associated
paralytic poliomyelitis
1!APP2. Although the
virus contained in this
formulation is
attenuated, it may
occasionally become
neurotropic and be able
to produce disease
similar to .ild&type virus.
Trivalent (P! is being
administered in
developing countries
.hen individuals are
aged # months, E
months, and F
months and .ith a
booster at age E years.
!APP occurs most
fre<uently after the first
dose of (P! but may also
occur after
administration of the
second or third doses.
Administration of (P! is
contraindicated in
children .ho are
immunocompromised
and in children .hose
caretakers are
immunocompromised.
A risk for development of
poliomyelitis is present in
those individuals .ho
receive this vaccine and
are
immunocompromised
.hildren
+hildren are
recommended a primary
course of $ doses of an
%P!&containing vaccine at
#, E and F months of age
and a booster dose at E
years of age.
The recommended
interval bet.een # doses
is # months, but, for
catch&up, the minimum
interval can be " month
'dults
The schedule for
unvaccinated adults is $
doses administered at
intervals of "G# months.
Booster doses
A booster dose is not
re<uired for fully
vaccinated children or
adults unless they are at
increased risk of
infection,
such as
Travelling to areas or
countries .here
poliomyelitis is
epidemic or endemic.
Aealthcare .orkers,
including laboratory
.orkers, in possible
contact .ith
poliomyelitis cases.
8or those e)posed to a
continuing risk of
infection, booster doses
are desirable every $%
years.
%nactivated poliomyelitis
vaccines can be safely
administered to either
persons .ith impaired
immunity or to persons
living .ith someone .ith
impaired immunity.
%P! vaccines may cause
erythema, pain, and
induration at the in!ection
site. (ther symptoms
reported follo.ing
administration of %P!
vaccines in young babies
include fever, crying and
decreased appetite.
(m!alanced Nutrition*
Less +han Body
/e-uirements r=t
anore)ia, nausea and
vomiting
(neffective
+hermoregulation r=t the
infection process
(neffective 'ir%ay
.learance r=t muscle
paralysis
(neffective Breathing
Pattern r=t muscle
paralysis
'cute Pain r=t the infection
that attacks the nerve
(mpaired Physical
Mo!ility r=t paralysis
'niety* in children and
families related to disease
conditions
Maintain a patent air.ay,
and keep a tracheotomy tray
at the patientHs bed side.
'ncourage a return to mild
activity as soon as possible.
Prevent fecal impaction by
giving enough fluids to
ensure an ade<uate daily
urine output of lo. specific
gravity.
Provide tube feedings .hen
needed.
Provide good skin care,
reposition the patient often,
and keep bed linens dry.
To alleviate discomforts, use
foam rubber pads and
sandbags or light splint as
ordered.
Iash hands thoroughly
after contact .ith patient or
any of his secretions and
e)cretions
8re<uently check blood
pressure, especially if the
patient has bulbar
poliomyelitis
Assess bladder retention
that cause muscle paralysis.
Aave the patient .ear high&
top sneakers or use of
footboard to prevent foot
drop
Provide emotional support
to the patient and his family.
Thank you for
listening!!!
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