Poliomyelitis is caused by the poliovirus, which infects the gastrointestinal tract and sometimes spreads to the central nervous system. It primarily affects children under 5 years old and can cause a spectrum of symptoms from mild illness to paralysis. While polio was eradicated in many countries through vaccination programs, cases persisted in some developing nations until as recently as 2011 in India. The document discusses the history, epidemiology, clinical manifestations, diagnosis, treatment and prevention of poliomyelitis.
In this presentation you will find summary for poliomyelitis. what is polio ? what are the causes ? and what will be the prevention?
here you'll also find about the rehabilitation program for polio as well..
Brief and easily understandable description on measles along with images for undergraduate students. this presentation would help in picturising what measles is.
#Rubella #German measles
Rubella is also known as German measles because the disease was first described by German physicians, Friedrich Hoffmann, in the mid-eighteenth century.
hey friends, i have uploaded this topic of POLIOMYELITIS with its basic concept and treatment. I have added some animations. Hope this will help you to understand the topic in better way. Thank you.
japenese encephalitis is an important vector borne disease which carries a high mortality as well as high disability. it is a preventable disease and an effective vaccine is available for it.the vaccine is an important part of universal immunization program in india. Environmental modification and control of vector will go long way in the control of this disease.
In this presentation you will find summary for poliomyelitis. what is polio ? what are the causes ? and what will be the prevention?
here you'll also find about the rehabilitation program for polio as well..
Brief and easily understandable description on measles along with images for undergraduate students. this presentation would help in picturising what measles is.
#Rubella #German measles
Rubella is also known as German measles because the disease was first described by German physicians, Friedrich Hoffmann, in the mid-eighteenth century.
hey friends, i have uploaded this topic of POLIOMYELITIS with its basic concept and treatment. I have added some animations. Hope this will help you to understand the topic in better way. Thank you.
japenese encephalitis is an important vector borne disease which carries a high mortality as well as high disability. it is a preventable disease and an effective vaccine is available for it.the vaccine is an important part of universal immunization program in india. Environmental modification and control of vector will go long way in the control of this disease.
Polioviruses cause a highly infectious childhood disease - polio (or poliomyelitis) causing acute flaccid paralysis - involvement of nervous system.
Polio is in the verge of eradication globally.
Group: Group IV (ssRNA)
Family: Picornaviridae
Genus: Enterovirus
Species: Poliovirus
Simple in structure, very small (28–30 nm size) , non-enveloped
Spherical shaped and have icosahedral symmetry
Capsid is composed of 60 subunits, each consisting of four viral proteins (VP1-VP4), except parechoviruses (have three proteins).
Possess single stranded positive sense linear RNA
3 types
Type 1 (Brunhilde/Mahoney): mostly causes outbreaks
Type 2 (Lansing/MEF1): easiest to eradicate
Type 3 (Leon/Sankett): often last to be eradicated
Highly contagious (usually infects 100% of all susceptibles)
Occurs worldwide and is seasonal
Inapparent to apparent infection ratio = 200-1000:1
Polioviruses - classified into wild polioviruses - cause natural disease
Vaccine derived poliovirus (VDPV) - vaccine strains that have regained neurovirulence and are capable of producing disease in man
There are three wild poliovirus strains: Wild poliovirus type 1 (WPV1), wild poliovirus type 2 (WPV2) and wild poliovirus type 3 (WPV3).
All three strains are identical, produce similar manifestations and severity of illness.
They are genetically and immunologically distinct; differ from each other in VP1 region.
Antibody response is type-specific and not cross-protective.
Currently all the natural cases - caused by WPV1.
Both WPV2 and WPV3 - globally eradicated, in the years 1999 and 2019 respectively
Age – most vulnerable 6 months to 3 years
Sex – 3 males:1 female
Risk Factors – Fatigue, trauma, IM injections, tonsillectomy, alum containing DPT
Active
through immunization / natural infection
immunity believed to be lifelong
immunity to one type not protective against infection with other types
two types of immunity: intestinal and humoral
Passive
infants born to mothers with high antibody protected for first several weeks
Virus intermittently excreted for 6-8 weeks after infection
Most heavy excretion
just prior to paralysis onset
up to first two weeks
dramatically tapers off after 4 weeksShort incubation period
usually 7-14 days,
but may be a short as 4 days
(range 3-35 days)
Virus enters oral cavity
Local replication in tissues expressing receptor (tonsils, intestinal M cells, Peyer patches of ileum, and lymph nodes)
Viremia with hematologic spread to CNS
Retrograde spread along neurons to spinal cord
Motor neurons destroyed by viral replication
Paralysis extent depends on proportion of motor neurons lost
Transmission: Feco-oral route (most common), or rarely by respiratory droplets via inhalation or conjunctival contact.
Multiply locally- Intestinal epithelial cells, sub mucosal lymphoid tissues, of tonsils and Peyer's patches.
Receptor- Viral entry into the host cells - mediated by binding to CD155 receptors present on the host cell Hematogenous spread (most commo
Poliovirus is a picornaviridae. it has 3 wildtypes, Wildtype 2 has been eradicated from the world. All countries have been declared polio free except Pakistan, Afghanistan and Nigeria. Global Polio Eradication Initiative has been discussed.
Polio or poliomyelitis is first known to have occurred nearly 6,000 years ago, as evidenced by the withered and deformed limbs of certain Egyptian mummies.
Polio was epidemic in the United States and the world in the 20th century, especially in the 1940s and 1950s.
Poliomyelitis is a highly infectious viral disease, which mostly affects young children; the virus is transmitted by person-to-person spread mainly through the fecal-oral route, or, less frequently, by a common vehicle (e.g. contaminated food or water) and multiplies in the intestine, from where it can invade the nervous system and can cause paralysis.
Initial symptoms of polio include fever, fatigue, headache, vomiting, stiffness in the neck, and pain in the limbs.
Etiology
Polioviruses are enteroviruses within the Picornaviridae family.
Direct contact. Poliovirus can be transmitted through direct contact with someone infected with the virus.
Ingestion. Less commonly, it can be transmitted through contaminated food and water.
Clinical Manifestations
Most patients infected with poliovirus develop inapparent infections and are frequently asymptomatic.
Nonspecific symptoms. Fever, headache, nausea, vomiting, abdominal pain, and oropharyngeal hyperemia are observed in mild cases and usually resolve within a few days.
Nonparalytic poliomyelitis. Nonparalytic poliomyelitis is characterized by the symptoms described above in addition to the following: nuchal rigidity, more severe headache, back, and lower extremity pain, and meningitis with lymphocytic pleocytosis (usually).
Assessment and Diagnostic Findings
To confirm the diagnosis, a sample of throat secretions, stool or a colorless fluid that surrounds your brain and spinal cord (cerebrospinal fluid) is checked for poliovirus.
Viral cultures. Obtain specimens from the cerebrospinal fluid (CSF), stool, and throat for viral cultures in patients with suspected poliomyelitis infection.
Serum antibody. Obtain acute and convalescent serum for antibody concentrations against the 3 polioviruses.
IG titer. A 4-fold increase in the immunoglobulin G (IgG) antibody titers or a positive anti-immunoglobulin M (IgM) titer during the acute stage is diagnostic.
Medical Management
The treatment of poliomyelitis is mainly supportive.
Physical therapy. Physical therapy is indicated in cases of paralytic disease; in paralytic disease, it provide frequent mobilization to avoid the development of chronic decubitus ulcerations; active and passive motion exercises are indicated during the convalescent stage.
Total hip arthroplasty. Total hip arthroplasty is a surgical therapeutic option for patients with paralytic sequelae of poliomyelitis who develop hip dysplasia and degenerative disease.
Diet. Because patients with poliomyelitis are prone to develop constipation, a diet rich in fiber is usually indicated.
Pharmacologic Management
No antiviral agents are effective against poliovirus.
THESE SLIDES ARE PREPAREED TO UNDERSTAND about communicable diseases IN EASY WAY Important links- NOTES- https://mynursingstudents.blogspot.com/ youtube channel https://www.youtube.com/c/MYSTUDENTSU... CHANEL PLAYLIST- ANATOMY AND PHYSIOLOGY-https://www.youtube.com/playlist?list=PL93S13oM2gAPM3VTGVUXIeswKJ3XGaD2p COMMUNITY HEALTH NURSING- https://www.youtube.com/playlist?list=PL93S13oM2gAPyslPNdIJoVjiXEDTVEDzs CHILD HEALTH NURSING- https://www.youtube.com/playlist?list=PL93S13oM2gANcslmv0DXg6BWmWN359Gvg FIRST AID- https://www.youtube.com/playlist?list=PL93S13oM2gAMvGqeqH2ZTklzFAZhOrvgP HCM- https://www.youtube.com/playlist?list=PL93S13oM2gAM7mZ1vZhQBHWbdLnLb-cH9 FUNDAMENTALS OF NURSING- https://www.youtube.com/playlist?list=PL93S13oM2gAPFxu78NDLpGPaxEmK1fTao COMMUNICABLE DISEASES- https://www.youtube.com/playlist?list=PL93S13oM2gAOWo4IwNjLU_LCuhRN0ZLeb ENVIRONMENTAL HEALTH- https://www.youtube.com/playlist?list=PL93S13oM2gAPkI6LvfS8Zu1nm6mZi9FK6 MSN- https://www.youtube.com/playlist?list=PL93S13oM2gAOdyoHnDLAoR_o8M6ccqYBm HINDI ONLY- https://www.youtube.com/playlist?list=PL93S13oM2gAN4L-FJ3s_IEXgZCijGUA1A ENGLISH ONLY- https://www.youtube.com/playlist?list=PL93S13oM2gAMYv2a1hFcq4W1nBjTnRkHP facebook profile- https://www.facebook.com/suresh.kr.lrhs/ FACEBOOK PAGE- https://www.facebook.com/My-Student-S... facebook group NURSING NOTES- https://www.facebook.com/groups/24139... FOR MAKING EASY NOTES YOU CAN ALSO VISIT MY BLOG – BLOGGER- https://mynursingstudents.blogspot.com/ Instagram- https://www.instagram.com/mystudentsu... Twitter- https://twitter.com/student_system?s=08 #PEM, #polio,#communicablediseases,#ASSESSMENT, #APPEARENCE,#PULSE,#GRIMACE,#REFLEX,#RESPIRATION,#RESUSCITATION,#NEWBORN,#BABY,#VIRGINIA, #CHILD, #OXYGEN,#CYANOSIS,#OPTICNERVE, #SARACHNA,#MYSTUDENTSUPPORTSYSTEM, #rashes,#nursingclasses, #communityhealthnursing,#ANM, #GNM, #BSCNURING,#NURSINGSTUDENTS, #WHO,#NURSINGINSTITUTION,#COLLEGEOFNURSING,#nursingofficer,#COMMUNITYHEALTHOFFICE,#HEALTHPROBLEMS
“Patient Education is an individualized, systematic, structured process to assess and impart knowledge or develop a skill in order to effect a change in behavior. The goal is to increase comprehension and participation in the self-management of health care needs.”
“A restraint is any manual method, physical or mechanical device, material or equipment that immobilizes or reduces the ability of a patient to move his/her arms, legs, body or head freely” (e.g. -Safe keeper bed, Posey bed, safety mitt, soft limb restraint), or a restraint is a drug or medication when it is used as a restriction to manage the patient's behavior or restrict the patient's freedom of movement and is not standard treatment or dosage for the patient's condition A restraint does not include devices, such as orthopedically prescribed devices, surgical dressings or bandages, protective helmets, or other methods that involve the physical holding of a patient for the purpose of conducting routine physical examinations or tests, or to protect the patient from falling out of bed, or to permit the patient to participate in activities without the risk of physical harm., side rails, airways, trapeze etc.
Unit 10 Promoting Safety in Health Care Enevronment (FON).pdfKULDEEP VYAS
Healthcare environments need to provide a balance between the need for practical and clinical activities or procedures to take place within them, while creating an environment that can contribute to a good experience.
International Nurses Day
IND is celebrated around the world every May 12, the anniversary of Florence Nightingale's birth. ICN commemorates this important day each year with the production and distribution of the International Nurses' Day (IND) resources and evidence.
Fluorosis is a cosmetic condition that affects the teeth. It's caused by overexposure to fluoride during the first eight years of life. This is the time when most permanent teeth are being formed. After the teeth come in, the teeth of those affected by fluorosis may appear mildly discolored.
Evaluation is a process used to determine what has happened during a given activity or in an institution.Evaluation requires many skills that are as important as other elements of the instructional process.
Human resource management in hospital and community servicesKULDEEP VYAS
HRM is the function within an organization that focuses on recruitment ,managing and providing direction for the people working in that organization.
*It is the organizational function dealing with issues related to people such as hiring, compensation, performance management ,safety, organization development, wellness, benefits, employee motivation, communication, administration and training.
Moulding or training of the mind and character to bring about desired behaviour is known as discipline.it helps a person to have some control over another person.
Patient ASSIGNMENT does not only mean that dividing the patient among available staff nurses but it is assigning an individual patient or group of patients to nurses according to the required nursing care needs and nurses capability to provide the quality care
Directing leading in hospital and community servicesKULDEEP VYAS
Directing is the fourth phase of the management process, it can also be called as coordinating or activating
*Here the leadership and the management skills are both required in order to accomplish the goal of the organization.
*It consists of 2 major components like guidance and supervision which is to be done during job process which help the nurses to utilize their total skills and knowledge in providing the quality care.
Commonly used Insecticides and Pesticides KULDEEP VYAS
Pesticides include insecticides, herbicides and fungicides. There are several thousand different types in use and almost all of them are possible causes of water pollution. For example, DDT, malathion, parathion, delthametrine and others have been sprayed in the environment for long periods of time for the control of disease vectors such as mosquitoes, and to control the growth of weeds and other pests.
Material management in hospital and community servicesKULDEEP VYAS
Material management is a methodical technique that includes planning strategies, systemizing and regulating the flow of material from procurement till the point of disembarkation.
It is the process of coordination and controlling the activities in an organization. It includes the responsibility of purchasing the materials, their scheduling from supply or from other internal sources, their handling, storage and movement through the organization, and their delivery.
-It is a statement of anticipated results during a designated
time period expressed financial and nonfinancial terms.
-Three essential steps in the control process are establishing standards, comparing results with standards and taking corrective action.
-Budgeting process starts when top-level management establishes the strategies and goals for the organization.
The client classification system or patient classification system is the cluster of clients that has been categorized on the specific characteristics, needs ,requirements and their severity of the disease conditions based on which patient assignment is made to provide nursing care.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
New Drug Discovery and Development .....NEHA GUPTA
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
2. Introduction
Greek poliós= "grey", myelós= marrow, and the suffix -
itis= inflammation
First described by British physician Micheal Underwood in 1799
referring to it as "debility of the lower extremities.“
A viral infection most often recognized by acute onset of flaccid
paralysis.
Primarily an infection of human alimentary tract, but may infect
CNS in very small no. (i.e <1%)
Infection results in a spectrum of clinical manifestations……
2Kuldeep Vyas M.Sc. N. CHN
4. Problem statement
World
A worldwide problem in pre vaccination era
With the wide use of polio vaccine from 1954 disease
being eliminated from most of the developed countries
In 1988 WHA resolved to eradicate the disease globally
Since than no. of endemic countries reduced from 125 in
1988 to 3 in 2012.
Reported cases worldwide decreased by 51% (1352 in
2010 to 650 in 2011)
4Kuldeep Vyas M.Sc. N. CHN
5. Cont…
India
No reported cases since January 2011 (last
case reported in 13th Jan 2011, Howrah,
West Bengal)
Considered polio-free since February 2012
Attained the status of eradication in 13th
January 2014
5Kuldeep Vyas M.Sc. N. CHN
7. Agent factors
Agent
Poliovirus: belongs to “Picorna” viruses which are
small RNA-containing viruses.
Three serotypes- 1, 2 & 3 giving no cross
immunity
Long survival in environment….lives upto 4hours
in water and 6 hours in faeces in cold
enviornment.
Readily destroyed by heat (e.g. pasteurization of
milk, and chlorination of water). 7Kuldeep Vyas M.Sc. N. CHN
8. Reservoir of infection
Man is the only reservoir of infection of poliomyelitis.
Man: cases and carriers
Cases: all clinical forms of disease
Most of the infections are subclinical- dominant role in spread of
infection
Estimated subclinical infection ranges from 75 to 1000 per clinical case
No chronic cases or animal sources documented
Foci of infection
Pharynx: the virus is found in the oropharyngeal secretions.
Small intestine: the virus finds exit in stools.
8Kuldeep Vyas M.Sc. N. CHN
9. Modes of transmission
Since foci of infection are the throat and small intestines,
poliomyelitis spreads by two routes:
Oral-oral infection: direct droplet infection
Faeco-oral infection:
– Through contaminated foods. Vehicles include milk, water, or any
others that may be contaminated by handling, flies, dust….
– Hand to mouth infection.
Polio virus has the ability to survive in cold environments.
Overcrowding and poor sanitation provide opportunities for
exposure to infection
9Kuldeep Vyas M.Sc. N. CHN
10. Period of communicability
Estimated to about 2 weeks
Cases: 7 to 10 days before and after the onset of symptoms.
Virus is excreted commonly for 2 to 3 weeks, sometimes as
long as 3 to 4 months in faeces.
In polio cases, infectivity in the pharyngeal foci is around one
week, and in the intestinal foci 6-8 weeks.
Incubation Period: 7-14 days
10Kuldeep Vyas M.Sc. N. CHN
11. Host factors
Age:
All age groups; children(6 MONTHS TO 3 YEARS most susceptible)
more than 95% reported in infancy and childhood with over 50% of them
in infancy.
Sex:
no sex ratio differences, but in some countries, males are infected more
frequently than females in a ratio 3:1.
Risk factors:
Fatigue, trauma,im injections, tonsillectomy, immunizing agents like alum
containing DPT vaccine and excessive muscular exercise…
Immunity:
Immunity by maternal antibodies till the age of 6months
Immunity conferred by natural infection fairly solid but doesn’t protects
against the reinfection by other strains
11Kuldeep Vyas M.Sc. N. CHN
12. Environmental factors
Rainy season (june to september)
Environmental sources- food, flies and water
Overcrowding and poor sanitation-
oppourtinities
12Kuldeep Vyas M.Sc. N. CHN
14. Inapparent infection
Occurs approximately in 91-96% of poliovirus infection.
Incidence is more than 75 to 1000 times the clinical
cases.
No clinical manifestations, but infection is associated
with acquired immunity.
Recognition only by virus isolation or rising antibody titre.
14Kuldeep Vyas M.Sc. N. CHN
15. Clinical poliomyelitis
Abortive polio (minor illness):
Occurs approximately in 4-8% of the infection.
Causes only a mild or self limiting illness due to
viraemia.
Mild systemic manifestations for 1-2 days
Some abortive cases so mild to pass unnoticed.
Patient recovers quickly.
Manifestations:
Moderate fever
Upper respiratory manifestations: pharyngitis and sore throat
Gastrointestinal manifestations: vomiting, abdominal pain,
and diarrhea.
15Kuldeep Vyas M.Sc. N. CHN
16. Cont…..
Involvement of the CNS (major illness):
Affects a small proportion of the clinical cases
Takes two forms: Non-paralytic and Paralytic polio.
Non paralytic polio:
Occurs approximately in one per cent of all infections.
Presenting features are stiffness and pain in neck and back.
Disease lasts for 2-10 days.
Recovery is rapid.
16Kuldeep Vyas M.Sc. N. CHN
17. Cont…
Paralytic polio:
Occurs in less then one per cent of infections.
The virus enters the CNS and causes varying degree of disability
with destruction of the motor nerve cells, but not the sensory
nerve cells.
Forms: spinal, bulbar, and bulbospinal.
Paralysis usually appears within 4 days (around 7-10 days from
onset of disease).
History of fever at the time of paralysis- suggestive of polio.
Progression of paralysis reaches maximum by 4th day (4-7 days)
17Kuldeep Vyas M.Sc. N. CHN
18. Cont….
Other symptoms- malaise, anorexia, vommiting, headache, sore
throat, constipation and headache.
Signs of meningeal irritation
Tripod sign may be present
Assymetrical, patchy flaccid paralysis, of descending type
affecting the proximal group of muscle the most
Deep tendon reflexes (DTR) deminished before the the onset of
paralysis.
Cranial nerve involvement seen in bulbar and bulbospinal
paralytic poliomyelitis
Facial assymetry, difficulty in swallowing weakness of voice;
respiratory insuffiency may lead to death
18Kuldeep Vyas M.Sc. N. CHN
20. Spinal polio
Different spinal nerves are involved
Injury of the anterior horn cells of the spinal cord
causing tenderness, weakness, and flaccid
paralysis of the corresponding striated muscles.
The lower limbs are the most commonly affected.
20Kuldeep Vyas M.Sc. N. CHN
21. Bulbar polio
Nuclei of the cranial nerves are involved, causing
weakness of the supplied muscles, and maybe
encephalitis.
Bulbar manifestations include dysphagia, nasal voice,
fluid regurgitation from the nose, difficult chewing, facial
weakness and diplopia
Paralysis of the muscles of respiration is the most
serious life-threatening manifestation.
Bulbospinal polio
Combination of both spinal and bulbar forms
21Kuldeep Vyas M.Sc. N. CHN
23. Complications and case fatality
Respiratory complications: pneumonia, pulmonary edema
Cardiovascular complications: myocarditis, cor pulmonale.
Late complications: soft tissue and bone deformities,
osteoporosis, and chronic distension of the colon.
Case fatality: varies from 1% to 10% according to the form
of disease (higher in bulbar), complications and age (
fatality increases with age).
23Kuldeep Vyas M.Sc. N. CHN
24. Polio is caused by a virus called polio virus
24Kuldeep Vyas M.Sc. N. CHN
25. Virus gets
into the body
by mouth
Then moves to
GI Track
towards
intestine
Multiplies
Passes into
the blood
Reaches the
spinal cord
Attacks the
nerves
Destruction of
motor neurons
of brain stem
Result in
polio
paralysis
25Kuldeep Vyas M.Sc. N. CHN
26. Diagnosis and laboratory testing
Laboratory studies critical to rule out or confirm the
diagnosis of paralytic poliomyelitis.
Virus isolation
The likelihood of poliovirus isolation is highest from stool
specimens,
Intermediate from pharyngeal swabs, and very low from blood
or spinal fluid.
Serologic testing
A four-fold titer rise between the acute and convalescent
specimens suggests poliovirus infection.
26Kuldeep Vyas M.Sc. N. CHN
28. Cont….
Seroprophylaxis by immunoglobulins:
Not a practical way of giving protection
because it must be given either or before or
very shortly after exposure to infection.
Dose-(0.25-0.3 ml/kg of body weight).
Immunized status after a few weeks
28Kuldeep Vyas M.Sc. N. CHN
29. Active immunization
Inactivated (Salk) vaccine (FIPV)
Contains 3 serotypes of vaccine virus
Route of administration- Intra-dermal: Right upper arm .
Schedule
First dose given at the age of 6 weeks
Second dose given at the 14 weeks of age
Intra dermal two fractional dose of : 0.1 ml
Highly effective in producing immunity to poliovirus
>90% immune after 1 doses
>99% immune after 2 doses
Duration of immunity not known with certainty
29Kuldeep Vyas M.Sc. N. CHN
30. Cont…
Oral (Sabin) Polio Vaccine
Contains 3 serotypes of vaccine virus
Route of administration- Oral.
Schedule
Zero dose vaccination recommended in hospital delivery
First dose given at the age of 6 weeks
Next 2 doses 10 weeks
3rd dose at 14 weeks
2 drops
Highly effective in producing immunity to poliovirus
50% immune after 1 dose
>95% immune after 3 doses
Immunity probably lifelong
Shed in stool for up to 6 weeks following vaccination
30Kuldeep Vyas M.Sc. N. CHN
33. ORAL POLIO VACCINE
OPV
INACTIVATED POLIO
VACCINE IPV
Albert sabin develop
sabin vaccine
Jonas salk developed salk
vaccine
Live, attenuated
(weakened) virus
Killed virus
Administered by drops Administered by injection
Highly successful in
reducing transmission in
developing countries as
part of eradication
strategy
Highly effective and safe;
Used in developed countries
Inexpensive Expensive
33Kuldeep Vyas M.Sc. N. CHN
34. Easy to administer Requires trained health care
worker
Provides humoral, mucosal
and gut immunity
Provides humoral immunity
Prevents paralysis and
prevents re-infection
Prevents paralysis but does
not prevent re-infection
Dose = 2 drops Dose = 0.5 ml
Recommended storage
temperature= -15֯C to -
25֯C
Storage temperature= +2֯C
to +8֯C
34Kuldeep Vyas M.Sc. N. CHN
35. Epidemiological Investigations
Epidemic
Occurrence of 2 or more local cases caused by the same virus in any
4-weeks period
Sample of faeces to be collected from all the cases and suspected
cases and subjected to lab testing
If possible, paired sera to be tested
– First specimen at the clinical suspicion
– Second at the period of convalescence
An increase in antibody titre provides confirmatory evidence
OPV should be provided to all persons over 6 weeks age who are not
completely immunize de or immune status unknown in the epidemic
area
35Kuldeep Vyas M.Sc. N. CHN