- is an acute infectious disease caused by any of the three types of Poliomyelitis virus which affects chiefly the anterior horn cells of the Spinal cord and the medulla, cerebellum and midbrain.
- Characterized by two febrile episodes, a minor and major illness separated by a remission of one or two days followed by varying degrees of muscle weakness or occasionally a progressive Paralysis that ends fatally.
- Other names: Acute Anterior Poliomyelitis; Heine-Medin Disease: Infantile Paralysis.
Etiology and Epidemiology
- the causative virus is poliovirus (Legio Debilitants)
- there are 3 distinct serelogic types of poliovirus (with no cross Immunity)
- Type I – is the most paralytogenic or the most frequent cause of Paralytic poliomyelitis, both epidemic and endemic.
- Type II – the next most frequent.
- Type III – the least frequently associated with paralytic disease.
Types of Poliomyelitis
- Cranial nerves
- Circular System
- Respiratory System
PERIOD OF COMMUNICABILITY:
- Most contagious a few days before and after the onset of symptom when the virus is found in the oropharynx for about a week, and in large quantities in the small bowel, and continues to be in feces up to about 3 months.
Mode of Transmission:
- Fecal-oral route
- Oral route through pharyngeal secretion
- Contact with infected persons
- – Usually 7-14 days, with a range of 5-35 days, for paralytic and non-paralytic forms; 3-5 days for the minor illness.
Signs and symptoms
- General discomfort or uneasiness (malaise)
- Red throat
- Slight fever
- Sore throat
- Back pain or backache
- Excessive tiredness, fatigue
- Leg pain (calf muscles)
- Moderate fever
- Muscle stiffness
- Muscle tenderness and spasm in any area of the body
- Neck pain and stiffness
- Pain in front part of neck
- Pain or stiffness of the back, arms, legs, abdomen
- Skin rash or lesion with pain
- Fever 5 – 7 days before other symptoms
- Abnormal sensations (but not loss of sensation) in an area
- Bloated feeling in abdomen
- Breathing difficulty
- Difficulty beginning to urinate
- Irritability or poor temper control
- Muscle contractions or muscle spasms in the calf, neck, or back
- Muscle pain
- Muscle weakness that is only on one side or worse on one side
- Comes on quickly
- Location depends on where the spinal cord is affected
- Worsens into paralysis
- Sensitivity to touch; mild touch may be painful
- Stiff neck and back
- Swallowing difficulty
- medication and treatment
- Analgesic- for relieving pain
- Antipyretic- to relieve fever
- Polio Vaccine
- Salk Vaccine
- Sabin Vaccine-
- Muscle and tendon transplantation
- Operation of Tendons
- Arthrodesis- fusion of bones across a joint space by surgical means, which eliminates movement, usually performed to eliminate pain over a joint.
- Osteotomy- cutting of bone into 2 parts followed by realignment of ends to allow healing
- Operation to equalized the leg length discrepancy After poliomyelitis, growth affected leg is slowed down as much 6 to 7 cm by disuse, atrophy and diminished blood flow to the limb. The degree of shortening depends of the severity of the paralysis and the age at which paralysis begins.
- Maintain a patent airway, and keep a tracheotomy tray at the patient’s bed side.
- Encourage a return to mild activity as soon as possible.
- Prevent fecal impaction by giving enough fluids to ensure an adequate daily urine output of low specific gravity.
- Provide tube feedings when 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 splints as ordered.
- Wash hands thoroughly after contact with the patient or any of his secretions and excretions.
- Frequently check blood pressure, especially if the patient has bulbar poliomyelitis.
- Assess bladder retention that cause muscle paralysis.
- Have the patient wear high-top sneakers or use a footboard to prevent foot drop.
- Provide emotional support to the patient and his family.
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