Types of Poliomyelitis (Polio), Symtoms, Prevention and Treatments

Types of Poliomyelitis (Polio), Symtoms, Prevention and Treatments

Poliomyelitis was a common acute viral infection; it occurs naturally only in human beings. Infection with the polio virus produces a wide variety of clinical manifestations. Its most severe form attacks part of the central nervous system. After an incubation period of 3 to 35 days, the poliovirus infection may assume one of four forms:
1) Inapparent infection.
2) Minor illness, such as a transient respiratory or gastrointestinal disturbance.
3) Nonparalytic Poliomyelitis, which usually produces temporary stiffness of the neck and other symptoms of spinal meningitis.
4) Paralytic poliomyelitis.

In the latter, most serious form, the virus attacks specialized cells in the spinal cord and brain stem, producing paralysis in the face or extremities. This varies from mild affliction to respiratory paralysis. Some of the most heroic medical treatments have been developed to save the lives of these respiratory polio cases, often maintaining the patient for years in an “iron lung.” Some of the most dramatic uses of hydrotherapy have also been effective in the treatment of advanced polio cases, especially the Kenny packs, used for severe muscle spasm. Rehabilitation in a specialized setting offers maximal potential for complete recovery. Prevention, however, is the best approach. With several vaccines available for each type of polio, childhood immunization offers an inexpensive and relatively safe medical practice to avoid this dreaded disease.

Symptoms

Most infected people (90%) have no symptoms or very mild symptoms and usually go unrecognized. In others, initial symptoms include fever, fatigue, headache, vomiting, stiffness in the neck and pain in the limbs.

Acute flaccid paralysis (AFP)

One in 200 infections leads to irreversible paralysis, usually in the legs. This is caused by the virus entering the blood stream and invading the central nervous system. As it multiplies, the virus destroys the nerve cells that activate muscles. The affected muscles are no longer functional and the limb becomes floppy and lifeless – a condition known as acute flaccid paralysis (AFP).

All cases of acute flaccid paralysis (AFP) among children under fifteen years of age are reported and tested for poliovirus within 48 hours of onset.

Bulbar polio

More extensive paralysis, involving the trunk and muscles of the thorax and abdomen, can result in quadriplegia. In the most severe cases (bulbar polio), poliovirus attacks the nerve cells of the brain stem, reducing breathing capacity and causing difficulty in swallowing and speaking. Among those paralysed, 5% to 10% die when their breathing muscles become immobilized.

Post-polio syndrome

Around 40% of people who survive paralytic polio may develop additional symptoms 15–40 years after the original illness. These symptoms – called post-polio syndrome – include new progressive muscle weakness, severe fatigue and pain in the muscles and joints.

Risk factors for paralysis

No one knows why only a small percentage of infections lead to paralysis. Several key risk factors have been identified as increasing the likelihood of paralysis in a person infected with polio. These include:

•     immune deficiency
•     pregnancy
•     removal of the tonsils (tonsillectomy)
•     intramuscular injections, e.g. medications
•     strenuous exercise
•     injury.

Treatment and prevention

There is no cure for polio, only treatment to alleviate the symptoms.  Heat and physical therapy is used to stimulate the muscles and antispasmodic drugs are given to relax the muscles. While this can improve mobility, it cannot reverse permanent polio paralysis.

Polio can be prevented through immunization. Polio vaccine, given multiple times, almost always protects a child for life.



References:
- Richard A Hansen. 1999. Get Well at Home: Complete Home Health Care for the Family. Rapidan: Hartland Publications
- Polio and prevention. http://www.polioeradication.org/Polioandprevention.aspx
- Image source: http://www.healthgiants.com/2009/12/21/basic-symptoms-and-causes-of-poliomyelitis/

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