Poliomyelitis, commonly known as polio, is an acute viral infectious disease that is spread through the fecal-oral route. There are three types of poliovirus that can cause the disease. While most infections cause mild symptoms, in rare cases the virus infects the central nervous system and causes paralysis. The disease was once widespread but vaccination programs have largely eradicated it in most countries. Immunization is the primary method of prevention and treatment focuses on relieving symptoms since there is no cure for the viral infection.

1. SEMINAR ON COMMUNICABLE
DISEASE
Topic: POLIOMYELITIS
Prepared by:
Himangshu Sharma
Dept. of Pharmaceutical
Sciences
Dibrugarh University

2. CONTENTS:
P
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 Introduction
 Different Types
 Causative Agent
 Mode of Transmission
 Clinical Features
 Diagnosis and Test
 Treatment
 Outlook
 Possible Complication
 Prevention
 Risk
 Reference

3. INTRODUCTION:
Poliomyelitis often called Polio or
infantile paralysis is an acute, viral, infectious
disease spread from person to person,
primarily via the fecal-oral route.
The term “Poliomyelitis” derives from
the ancient Greek word Polio’s means “grey”
and myelos meaning “marrow” referring to
the grey matter of the spinal cord. The suffix
itis denotes inflammation, i.e. inflammation of
the spinal cord’s grey matter.
A severe infection can extend into
the brain stream and even higher centre
resulting in Polio encephaletis and apnea.

4. DIFFERENT TYPES:
In about 1% of cases, the virus enters the
central nervous system, preferentially infecting
and destroying motor neurons leading to muscle
weakness and acute flaccid
paralysis.Depending on the nerves involved ,
Poliomyelitis can be classified as follows-
i.Spinal Polio: It is the most common form
characterised by asymmetric paralysis that most
often involves the legs.
ii. Bulbar Polio: This leads to weakness of
muscles innervated by cranial nerves.
iii.Bubospinal Polio: It is a combination of
bulbar and spinal paralysis.

5. CAUSATIVE AGENT:-
Poliomyelitis is a communicable
disease caused by a virus named
Poliovirus. Three Polio virus serotypes
(type 1,2,3) are the most important
enteroviruses.

6. MODE OF TRANSMISSION:
Poliovirus is transmitted by the fecal-oral
route through ingestion. Inhalation or entry through
conjunctiva of droplets of respiratory secretions may
also be possible modes of entry in close contacts of
patients in early stage of disease.
The virus multiplies initially in the
epithelial cells of the alimentary canal and the
lymphatic tissues. It then spreads to the lymph nodes
and enters the blood stream. After further
multiplication in the reticulo-endothelial system, the
virus enters the blood stream again and it is carried to
the spinal cord and brain.
Incubation Period: The time from being
infected with the virus to developing symptoms of
disease ranges from 5-35 days(average 7-14 days).

7. CLINICAL FEATURES:
Three basic patterns of Polio infections are as
follows:-
a. Subclinical infections
b. Paralytic infection
c. Non-paralytic infection
a. Subclinical infections:- It includes
symptoms like-
General discomfort or uneasiness(malaise), headache,
red throat, slight fever, sore throat, vomiting etc.
b. Paralytic infection & Non-paralytic
infection (clinical):-It includes development of flaccid
paralysis and affects the central nervous system.

8. Diagnosis and Tests:
The health care provider may find:-
Abnormal reflexes, Back
stiffness, Difficulty in lifting the head or
legs when lying flat or the back stiff neck,
trouble bending the neck.
Tests includes-
Cultures of throat
washing, stools or spinal fluid, spinal tap
and examination of the spinal fluid (CSF
exam.) using PCR. Test for levels of
antibodies to the Polio virus.

9. TREATMENT:
The goal of the treatment is to control symptoms
while the infection runs its course as there are no
specific treatment for this viral infection.
People with severe cases may need lifesaving
measures, especially breathing help. Symptoms are
treated based on their severity. Treatment may
include-
- Antibiotics for urinary tract infection
- moist heat to reduce pain and spasms.
- Pain killers to reduce headache, muscle
pain and spasms
- Physical therapy or orthopedic surgery
are also provided
to help in recovering muscle strength and function.

10. OUTLOOK:
The outlook depends on the form of
the disease and the body area affected.
Most of the time, complete recovery is
likely if the spinal cord and brain are not
involved.
Brain and spinal cord
involvement is a medical emergency that
may result in paralysis or death.
Disability is more common than
death. Infection that is located high in the
spinal cord or in the brain increases the
risk of breathing problems.

11. POSSIBLE COMPLICATION:
Various possible complications may
occur such as-
Aspiration Pneumenia, cor
pulmonale, lack of movement, lung problems,
myocarditis, paralytic ileus, permanent
muscle paralysis, disability, deformity,
pulmonary edema, shock, urinary tract
infections etc.
Post-polio syndrome is a
complication that develops
in some patients, usually 30 or more years
after they are first infected. Muscles that were
already weak may get weaker. Weakness
may also develop in muscles that were not
affected before.

12. PREVENTION:
Polio immunization(vaccine) effectively prevents
poliomyelitis in most people. There are mainly two types of
vaccines that are widely used to prevent poliomyelitis.
They are-
i. Inactivated Poliovirus Vaccine(IPV): It is given as an
injection in the leg or arm, depending on the patient age.
ii. Oral Polio Vaccine(OPV): It is also called as trivalent
oral polio vaccine.OPV consists of a mixture of live
attenuated poliovirus strains of all three poliovirus types.
It produces antibodies in the blood to all three
types of poliovirus. In the event of infection, these
antibodies protect against paralysis by preventing the
spread of poliovirus to the nervous system. Moreover, the
mucosal antibodies limit the replication of the poliovirus
inside the intestine. This intestinal immune response to
OPV is thought to be the main reason why mass
campaigns with OPV can rapidly stop person to person
transmission of poliovirus.…DOH BOONDH ZINDAGI KI…

13. Contd……
…..Advantages:
i. OPV is administered orally and it can be given
volunteers.
ii.OPV is save, effective and induces long lasting
immunity to all three types of poliovirus.
Disadvantages:
Although it is safe and effective, in extremly rare cases
the live attenuated vaccine virus in OPV can cause
paralysis.
Recommended dose:-
A single dose i.e. two drop is given at a time.
Immunization recommendation for polio vaccine:
IPV: 2,4 & 6-18 months, and 4-6 yrs of age.
OPV: Infants at 2 month with first DPT inj. 2nd and 3rd
dose are given at 2 months interval. 4th dose – at 18
month of age.

14. RISK:
Lack of immunisation against polio travel to
an area that has experienced a polio outbreak.
Outbreak still occur in the developed
world, usually in groups of people who have not
been vaccinated. Polio often occurs after
someone travels to a region where there has
been an outbreak of disease. As a result of a
massive, global vaccination campaign over the
past 20 years, polio exists only in a few
countries in Africa and Asia.

15. REFERENCE:
i. A Textbook of Microbiology by
R. Ananthanarayan, C K Jayaram
Paniker, seventh edition, 2005, Page
no: 491-494.
ii. A Textbook of Microbiology by P.
Chakraborty, 3rd edition, 2013, Page
No: 555-559.