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1. Poliomyelitis
POLIO
Poliomyelitis popularly known as polio was first described by Michael Underwood in 1789. It is a highly infectious viral disease which mostly
affects children. The virus is transmitted from person to person via fecal–oral route and less frequent by common vehicle route like contaminated
water or food. Polio is a member of the enteroviruses which are transient inhabitants of the gastrointestinal tracts and stable at acid pH. The
incubation period for poliomyelitis is 6 to 20 days with a range of 3 to 35 days. The preclinical phase of poliomyelitis varies from asymptomatic to
presentation of mild systemic symptoms ranging from pharyngitis or gastroenteritis thus it can mistake at the initial stage as a minor infection.
About 95%...show more content...
Therefore, the suspicion of polio as a differential diagnosis is mostly days after the onset of symptoms. Isolation of the polio virus is
principal to the diagnosis of the disease. The likelihood of polio virus isolation is highest from stool specimen, intermediate from pharyngeal
swabs and low for blood and spinal fluids. Polio virus shedding can be intermediate and does increase the probability of polio virus isolation.
At least two stool specimens and two throat swab should be obtained 24 hours apart from patients as early as it considered as a differential
diagnosis. This is ideally within the first 14 days after the onset of the onset of the disease. It is important to determine whether the polio virus
isolated is wild or vaccine related. Serologic test may be helpful in assisting the diagnosis of paralytic poliomyelitis and acute serum specimen
should be obtained as early in the course of disease as possible, and a convalescent specimen should be obtained at least three weeks later.
Cerebral spinal fluid usually contains increased number of leucocytes and mildly elevated protein. These findings are non–specific and may result
in a variety of infections and non–infectious conditions. Therefore, the best diagnostic test is a isolation of the polio virus from stool specimen
(Wallace and Oberste,
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