Poliomyelitis, also known as polio, is caused by a virus that attacks the nerve cells of the brain and spinal cord. It was first recorded in the late 1700s and caused epidemics in the late 1800s. While most infections result in no symptoms, it can cause paralysis in rare cases by destroying motor neurons. The poliovirus is transmitted through oral and fecal routes. Symptoms range from fever and vomiting to aseptic meningitis. Paralysis was feared during outbreaks in the early 20th century before vaccinations were developed. The polio vaccine introduced in 1955 eradicated the disease in most developed nations.

1. PoliomyelitisPoliomyelitis

2. What is Poliomyelitis?What is Poliomyelitis?
 polio= gray matterpolio= gray matter
 Myelitis= inflammation of the spinal cordMyelitis= inflammation of the spinal cord
 This disease result in the destruction ofThis disease result in the destruction of
motor neurons caused by the poliovirus.motor neurons caused by the poliovirus.
 Polio is causes by a virus that attacks thePolio is causes by a virus that attacks the
nerve cells of the brain & spinal cordnerve cells of the brain & spinal cord
although not all infections result in severalthough not all infections result in sever
injuries and paralysis.injuries and paralysis.

3. When was it reported?When was it reported?
 Poliomyelitis was recorded in the late 1700’sPoliomyelitis was recorded in the late 1700’s
with the first epidemic in the late 1800’s.with the first epidemic in the late 1800’s.
 The cases that were reported in 1979 whereThe cases that were reported in 1979 where
mild and self-limited and do not result inmild and self-limited and do not result in
paralysis.paralysis.
First described by Michael Underwood in 1789First described by Michael Underwood in 1789
First outbreak described in U.S. in 1843First outbreak described in U.S. in 1843

5. How is polio transmitted?How is polio transmitted?
 Poliovirus is transmitted through both oralPoliovirus is transmitted through both oral
and fecal routes with implantation andand fecal routes with implantation and
replication occurring in either thereplication occurring in either the
orapgaryngeal and or in the intestine oforapgaryngeal and or in the intestine of
mucosa. Polio cases are most infected formucosa. Polio cases are most infected for
7-10 days before and after clinical7-10 days before and after clinical
symptoms begin.symptoms begin.

6. Enterovirus (RNA)
Three serotypes: 1, 2, 3
Minimal heterotypic
immunity
between serotypes
Rapidly inactivated by heat,
formaldehyde, chlorine,
ultraviolet

7. What are the symptoms?What are the symptoms?
 Many include fever, pharyngitis,Many include fever, pharyngitis,
headache, anorexia, nausea, andheadache, anorexia, nausea, and
vomiting. Illness may progress to asepticvomiting. Illness may progress to aseptic
meningitis and menigoencephalitis in 1%meningitis and menigoencephalitis in 1%
to 4% of patients. These patients developto 4% of patients. These patients develop
a higher fever, myalia and severea higher fever, myalia and severe
headache with stiffness of the neck andheadache with stiffness of the neck and
back.back.

8. Paralytic disease occurs 0.1% to 1% ofParalytic disease occurs 0.1% to 1% of
those who become infected with the poliothose who become infected with the polio
virus.virus.
Paralysis of the respiratory muscles or fromParalysis of the respiratory muscles or from
cardiac arrest if the neurons in thecardiac arrest if the neurons in the
medulla oblongata are destroyedmedulla oblongata are destroyed
The most commonly affected muscles areThe most commonly affected muscles are
Quadriceps, glutei, tibialis anterior, medialQuadriceps, glutei, tibialis anterior, medial
hamstrings, and hip flexors.hamstrings, and hip flexors.

9. Polio in childrenPolio in children

10. Can it cause paralyzes?Can it cause paralyzes?
 Paralytic disease occurs 0.1% to 1% of thoseParalytic disease occurs 0.1% to 1% of those
who become infected with the polio virus.who become infected with the polio virus.
 Paralysis of the respiratory muscles or fromParalysis of the respiratory muscles or from
cardiac arrest if the neurons in the medullacardiac arrest if the neurons in the medulla
oblongata are destroyed.oblongata are destroyed.
 Patients have some or full recovery fromPatients have some or full recovery from
paralysis usually apparent with proximally 6paralysis usually apparent with proximally 6
monthsmonths
 Physical therapy is recommended for fullPhysical therapy is recommended for full
recovery.recovery.

11. TreatmentTreatment
 Bed rest with close monitoring ofBed rest with close monitoring of
respiratory and cardiovascular functioningrespiratory and cardiovascular functioning
is essential during the acute stage ofis essential during the acute stage of
poliomyelitis along with fever control andpoliomyelitis along with fever control and
pain relievers for muscle spasms.pain relievers for muscle spasms.
 Mechanical ventilation, respiratory therapyMechanical ventilation, respiratory therapy
may be needed depending of the severitymay be needed depending of the severity
of patients.of patients.

12. VaccineVaccine
 Polio vaccine first appeared to be licensed in thePolio vaccine first appeared to be licensed in the
United States in 1955.United States in 1955.
 Advantages:Advantages:
 Ease to administrationEase to administration
 Good local mucosal immunityGood local mucosal immunity
 Disadvantage:Disadvantage:
 Strict cold shipping & storage requirementsStrict cold shipping & storage requirements
 Multiple doses required to achieve high humeralMultiple doses required to achieve high humeral
conservation rates against all virus typesconservation rates against all virus types

13. Vaccine (continuation)Vaccine (continuation)
 Babies are given 4 doses through out theirBabies are given 4 doses through out their
infancy.infancy.
 Adolescents and adults should get vaccinatedAdolescents and adults should get vaccinated
as well. Adolescents younger than 18 shouldas well. Adolescents younger than 18 should
receive the routine four doses.receive the routine four doses.
 You should get it if you travel outside placesYou should get it if you travel outside places
where polio id still an epidemicwhere polio id still an epidemic

15. What is post polio syndrome?What is post polio syndrome?
 This can affect between 25 to 50% case of polio. theyThis can affect between 25 to 50% case of polio. they
show symptoms of muscle and joint pain general fatigueshow symptoms of muscle and joint pain general fatigue
and weakness.and weakness.
 Three indications of PPSThree indications of PPS
 Previous diagnoses of polio ( late affect of polio toPrevious diagnoses of polio ( late affect of polio to
people that got it like when they where 10 years old)people that got it like when they where 10 years old)
 Long interval following recovery( people usually live longLong interval following recovery( people usually live long
but effect can occur during 30 to 35 years after thebut effect can occur during 30 to 35 years after the
diagnoses)diagnoses)
 Gradual onset (weakness that tends to be perceptibleGradual onset (weakness that tends to be perceptible
until it interferes with daily activities)until it interferes with daily activities)

16. StatisticsStatistics
 Polio was one of the most dreaded childPolio was one of the most dreaded child
disease in the 20disease in the 20thth
century in the U.S.century in the U.S.
 An epidemic in 1916 killed 6,000 peopleAn epidemic in 1916 killed 6,000 people
and left 27,000 more paralyzed.and left 27,000 more paralyzed.
 In 1950 parents would not let their childrenIn 1950 parents would not let their children
go to local swimming pools or moviesgo to local swimming pools or movies
because of the polio virus.because of the polio virus.