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Poliomyelitis
Poliomyelitis
Causative organism:
Poliovirus, belonging to picorna viruses (small RNA-containing viruses). It has
three antigenically distinct types, giving no cross immunity : type I, the
commonest in epidemics, type II, the prevailing type in endemic areas, and type
III. Polioviruses can survive for long time under suitable conditions but are readily
destroyed by heat and disinfectants as chlorine. Poliovirus is a neurotropic virus.
Reservoir of infection:
Cases: All clinical forms of the disease.
Carriers: All types of carriers (healthy carriers are the most frequent due to
polluted environment). There is no chronic carriers
Pattern of spread:
It was endemic in Egypt, but now, it is about to be eradicated (due to effective
eradication strategies) . Cases may occur sporadic or in epidemics. Age of
incidence (< 5 years).
Period of Infectivity:
6 – 8 weeks, through the incubation period to convalescence. The
organism appear in the throat 1 ½ day after exposure and in the stool 3 days
after exposure.
Modes of transmission:
1- Oral-Oral infection: Direct droplet infection.
2- Faecal-oral infection :
Food-borne infection (ingestion of contaminated food, water or milk)
Hand-to-mouth infection.
Incubation period: 7 – 14 days.
Complications:
Respiratory, myocarditis, urinary infection, soft tissue and bone deformities, and
others.
Fatality: (2-10%) due to respiratory muscles paralysis.
Predisposing factors: (for invasion of the CNS)
Mouth and throat surgery.
Diagnosis:
Poliomyelitis is suspected only when CNS involvement occur.
Laboratory Diagnosis : Suspected cases can be confirmed by isolation of the
virus from throat washing or stools, or serologic testing for neutralizing
antibodies (rising titer is diagnostic).
Prevention:
1. General preventive measures.
2. Specific prevention :
a- Active immunization: (see practical book)
i- Sabin poliovaccine .
ii- Salk poliovaccine :
Application of Salk vaccination : In some countries
Mass immunization of infants and children.
Control:
1. Case-finding: Cases are suspected in the non paralytic or paralytic
stage.
2. Control of Cases: Notification, isolation at home (of little value) or
hospital (with enteric precautions). Concurrent disinfection and terminal
cleaning. Medical care and rehabilitation of paralytic cases.
3. Control of Contacts: Examined for case-finding, seroprophylaxis and
immunization, if necessary.
4. Epidemic Measures: When poliomyelitis outbreak threatens a
community.