Polio

1. MUMPS, MEASLES , RUBELLA ,
POLIO &CONGENITAL VIRAL INFECTIONS

2. MUMPS VIRUS MEASLES VIRUS RUBELLA
 s RNA s RNA s RNA
 Parotitis Measles German measles
 Children Children Children, adult
 Contact Inhalation , Contact Inhalation
 Enlargement of Koplik’s spots Generalized rash
parotid glands Rash on skin

3. Complications
MUMPS VIRUS MEASLES VIRUS RUBELLA
Meningitis Pneumonia, cataract,
Meningoencephalitis Post – measles encephalitis deafness
Orchitis, Oophoritis Otitis media cardiac defects
Polyarthritis Subacute sclerosing
Pancreatitis panencephalitis
Nephritis
 .

4. PROPHYLAXIS
MUMPS VIRUS MEASLES VIRUS RUBELLA
Live Attenuated Live Attenuated Live Attenuated
JERYL – LYNN Edmonston strain / RA 27/3 strain
strain Schwartz strain
MMR Vaccine MMR Vaccine MMR Vaccine
Age of immunisation Age of immunisation Age of immunisation
1-1.5yrs 1 -1.5yrs 1-1.5 yrs
Route-single –S.C Route-single –S.C Route-single –S.C
Protection at least for 10 yrs.

5. Lab. Diagnosis-
MUMPS & MEASLES VIRUS- Mainly clinical
Isolation  during febrile period
Serology  rising titre of Ig M Ab, HI, CF
IF – exfoliated resp. cells
RUBELLA VIRUS
1. Virus isolation
Specimen – congenital – all secretions, blood ,throat swabs.
2 . Inoculation- Prim. Cell cultures & continuous cell lines – rabbit
kidney vero cell line
3.Serology.- Demonstration of Ig M Ab; rising titre
• ELISA, HI, CF, IF, Nt. Tests
Fetus  demonstration of Ig M Ab

6. Poliovirus – morphology
Spherical particle,27 nm in diameter,
 single strand of positive sense RNA.

7. Antigenic properties
3 types
Type 1- (epidemics)
Type2 - (endemic)
Type 3 - (epidemics)

8. Pathogenesis
Mode of infection-
 Faeco-oral route through ingestion
 Inhalation
 through conjunctiva - droplets of respiratory secretions.

9. Virus multiplies in the epithelial cells of the alimentary canal &
lymphatic tissues (from tonsils to peyer’s patches).
regional lymph nodes
enter blood stream (Primary viraemia)
Spinal cord & brain
Multiplies selectively in neurons & destroy them - degeneration
of Nissl bodies.
anterior horns of spinal cord. Posterior horns
flaccid paralysis Encephalitis

10. Clinical features
I.P.- 4 days -4 weeks (Average 10 days).
 Abortive poliomyelitis
 Non paralytic poliomyelitis
 Paralytic poliomyelitis - Flaccid paralysis. Spinal, bulbar
or bulbospinal.

11. Laboratory diagnosis
1. Isolation of virus
Blood
Throat swab (early stage)
faeces
CSF
Postmortem from spinal cord & brain.

12. Laboratory diagnosis
2. Culture
Primary monkey kidney cell line
3. Serodiagnosis
Neutralization test or CFT

13. Prophylaxis
1. Passive immunisation - gammaglobulin
2. Active Immunisation
 Vaccine - Two types
 A- Sabin - Live attenuated vaccine (OPV)
Immunization Schedule - 0 day, 6th wk, 10 wk, 14 wk,
1.5yr, 5 yrs
B-Salk’s killed vaccine (IPV)
Three doses given 4-6 weeks apart,
booster after 6 months

14. Congenital Viral Infections
Infection transmitted during pregnancy  permanent defects or
teratogenic
 Rubella – deafness ,cataract & cardiac defects
 Cytomegalovirus (CMV) - conjunctivitis
 Parvovirus B19 - Fifth disease,slapped cheek rash.
(erythema infectiosum)
 Varicella-Zoster (VZV) – Chicken pox teratogenic in second
trimester, encephalitis
 Hiv & Hepatitis B