Polio

January 21, 2012

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Polio   (also referred to as a disease infantile paralysis . Medin's disease ) - An acute infectious disease of the character that provokes virus Having affinity for motor neurons in the anterior horn of the spinal cord, as well as motor neurons of the brain stem. Due to the destruction of these neurons occurs paralysis   muscles and their subsequent atrophy .

Epidemics of the disease have occurred in the world until the middle of last century. But to date, as a result of mass immunization of children specially developed vaccine   polio observed only sporadic cases. Vaccination against polio allowed to stop the spread of polio. However, the number of healthy carriers of polio, and the number of abortive cases (people recover before developing paralysis ) Substantially exceeds the number of people in the paralytic stage. It is they who are the main distributors of polio, although it happens that infection occurs and the patient in a stage of paralysis.

The infection is transmitted mainly through personal contacts and through fecal contamination of food. The latter circumstance explains why the disease often develops seasonally: a peak spread of the disease occurs at the end of summer and beginning of autumn. Incubation period   when polio last from one to two weeks. Sick with polio as a rule, children aged six months to five years. To date, the disease occurs throughout the world.

Polio

There are three strains of the virus that causes polio: I, II and III type. In the process of diagnosis of the disease virus is released from the nasal mucosa in patients with acute stage of the disease, from convalescent patients and virus carriers. Most often the person infected with the virus through the digestive tract. The virus enters the nervous system of vegetative fibers and perineural. Today, it is believed that the virus can spread through the lymphatic and circulatory systems. It is introduced into the body through the throat. Features of the virus are: it is very sensitive to heat and dryness, but steadily perceives chemical agengeny.

Symptoms of polio

There are four different types of reactions to polio virus:

• immunity can develop when no symptoms (so-called subclinical   or Implicit infection );
• symptoms in the stage of viremia. They are similar to the symptoms of infection in general, wherein the nervous system disease process does not involve the nervous system (the so-called abortive cases );
• in many cases there is a feeling of malaise, fever , headache; it is also possible manifestation of meningeal phenomena of paralysis does not occur;
• the patient develops paralysis (rare cases).

So, if the patient is a subclinical form of the disease, the symptoms are absent. If there is a form of abortive polio, the symptoms are identical to the grounds of a common infection. This serological tests are positive, the patient is released the virus. On preparaliticheskoy stage into two distinct phases of the disease. In the first phase of a person there are a number of symptoms: fatigue, malaise, gastrointestinal disturbances, headache , Sweating, etc.. This stage may last one or two days. In some instances, followed by improvement for some time, there comes a second phase of the disease. As the symptoms in this case, there is a severe headache, a feeling of pain in the back, legs, arms, a high level of fatigue. All the symptoms are very similar to other forms of expression of the viral meningitis . If the patient is no paralysis, he is recovering. The patient is observed increase in protein and globulin in the second week of the disease increases in protein levels CSF . Duration preparaliticheskoy stage - from one to two weeks.

Patients allocated to the paralytic stage spinal form of the disease, in which paralysis does not develop as a result of having expressed fasciculations. The patient complains of sore limbs and muscles high sensitivity to pressure. There are widespread or localized paralysis. If the disease runs hard, then the patient may not even move. The opportunity to develop that very little traffic - in the torso, neck and limbs. If the disease less severe, the paralysis may occur asymmetrically. Perhaps the defeat of the muscles on one side of the body and the lack of it on the other side. Usually paralysis manifested during the first days of development of the disease. It is also possible "bottom-up" version of paralysis when it spreads upward, threatening to human life due to respiratory distress manifested in parallel. Possible variant displays a downward stroke.

Generally, improvement in the patient's polio occurs around the end of the first week of the time development of paralysis. When paralysis and decrease skin deep reflections . The sensitivity is also not disturbed.

When paralytic stage of the disease and can stem form ( polioentsefalit ). In this case the patient paralysis tongue, larynx, pharynx, facial muscles. In more rare cases, possible paralysis of the eye muscles. The patient is sometimes seen dizziness . Also, the process may involve the vital centers.

Polio

When sporadic cases of polio is very important to differentiate the disease from other etiology myelitis. In the diagnosis of disease in adult patients with differentiated polio Guillain-Barre-Shtrolya   and acute transverse myelitis. By virus isolation and serological tests of differentiated bulbar form   polio.

In the process of diagnosis of acute polio doctor conducts a survey and examination of the patient. When the diagnosis is taken into account the characteristic of its beginning, which is accompanied by fever, obscheinfektsionnymi symptoms, manifestations and intensive growth sluggish paresis   and paralysis . It confirms the diagnosis by virological testing. Also paired blood serum titers of specific antibodies . Analysis of taking an interval, which should be about 10 to 14 days.

Treatment of polio

Methods of treatment of polio is directly dependent on how severe stage of the disease occurs in the patient, and what form of polio was diagnosed. If there is a suspicion of the existence of human polio should immediately establish his state of complete rest. When physical activity preparaliticheskoy stage polio significantly increases the possibility of manifestation of severe paralysis. If there is paralysis, the doctor determines the tactics of therapy individually, guided by the prevalence of respiratory paralysis and muscle tabloids. If the patient is not observed respiratory disorders, the intramuscular injections ribonuclease   and convalescent sera . In the acute stage of the disease the patient must drink a lot of fluids. To clarify the diagnosis, as well as reduce pain in the back and headaches, held lumbar puncture . In order to reduce patient anxiety and pain relief are assigned sedatives   and analgesics .

A person who is undergoing treatment polio can only produce very lightweight passive movements. Treatment with antibiotics is performed only if the patient has a respiratory disorder, and, consequently, requires prevention of pneumonia.

After the development of patient treatment of disease of polio paralysis taken hold in three stages. In the acute stage of the disease when a person feels a sharp pain, and his muscles have a high sensitivity, it is important to protect the affected muscles from stretching. For this, the patient must lie on a soft mattress, wherein the position should be such that the muscles that have been paralyzed, were in a relaxed state. To improve comfort, you can use special sand bags or pillows.

In the process of recovery is very important regular exercise specifically designed to increase muscle strength of the patient. Such exercises can be done through other people on special devices in the bath.

If there is a residual stage of the disease, the possibility of tenotomy or other surgeries. In the treatment of used t neostigmine methylsulfate . Dibazolum . metabolic means . vitamins . Also effective in the present case physiotherapy   - Conducting UHF iontophoresis novocaine .

If the patient is diagnosed with bulbar palsy, there is a danger of liquid getting into the larynx. In such case the patient must lie on his side, and every several hours, it must be turned to another side. The secret is removed by suction. The patient receives food through a nasogastric tube.

Earlier, during epidemics of polio cases mortality ranged from 5% to 25%. Death occurs as a result of polio in the respiratory disorders in bulbar forms   or ascending hemiplegia . Today, the death rate has decreased significantly. If the time to stop the progress of paralysis, the patient recovers. A good sign of a patient considered voluntary movements, deep reflexes and muscle contractions that occur after paralysis due to nerve stimulation. The healing process sometimes last a year or more.

Prevention of polio

Because the content of the causative virus of poliomyelitis in feces, saliva, urine of the patient, it must be isolated at least six weeks. The children who had contact with the sick with polio, isolated for three weeks by the other children.

To prevent the spread of disease applied mass timely immunization. Vaccination against poliomyelitis with attenuated polio vaccine provides immunity for a man for three years. Today it is a vaccination against polio is considered to be the most effective measure to prevent the spread of the disease.

As a general prevention of disease used a variety of activities, among which we should highlight the work on identifying all cases of the disease, monitor the circulation of poliovirus in the environment, fully vaccinated, carried out in exactly on time, control over the quality of polio vaccine, as well as the process vaccination.