Poliomyelitis is an acute virus disease caused by the poliovirus, characterized by fever, motor paralysis, and atrophy of skeletal muscles. This often results in permanent disability and deformity, and inflammation of nerve cells in the ventral horns of the spinal cords. This disease is also known as infantile paralysis and polio. Polio is transmitted by direct person to person contact, contact with an infected mucus or phlegm, and contact with infected feces. The virus enters through the mouth and nose and multiplies in the throat and intestinal tract. It is then absorbed and spread through the blood and lymph system. From the time one is infected to the time symptoms appear is anywhere from 5-35 days with the average being just 7-14 days. During the time of the Polio epidemic -1840-1950’s- hand hygiene was very crucial. That was a time when hand hygiene and even facial mask were not such a priority as it is today. The first known case in the US was in 1894 in Vermont. Outbreaks usually occurred in July, August, and September. 1916 New York City experienced its first large epidemic of polio with over 9,000 cases and 2,343 deaths.
The nationwide toll for that year was 27,000 and 6,000. Epidemics worsened later on: in 1952-the worse ever- a record of 57,628 cases of polio were reported in the US alone. There are three basic patterns of polio infections: subclinical infection, nonparalytic, and paralytic. About 95% of the infections were subclinical infections, which may not have symptoms or last 72 hours or less. Some of the symptoms are: general uneasiness, head ache, red throat, slight fever, and vomiting. Clinical poliomyelitis affects the CNS. The symptoms for Nonparalytic Infection is: back pain, neck pain or stiffness, vomiting, leg pain/calf muscles, skin rash with pain, pain in the front of the neck, excessive fatigue, irritability, muscle tenderness/ spasm any part of the body. These symptoms usually last 1-2 weeks. The symptoms for Paralytic poliomyelitis are: a fever comes on for 5-7 days before other symptoms, abnormal sensations, bloated feeling in abdomen, trouble breathing, constipation, difficulty beginning to urinate, drooling, poor temper control, muscle spasms in calf, neck, back, muscle pain, sensitivity to touch-may be painful, difficulty swallowing.
A health care professional may test cultures of the throat, stool or cerebrospinal fluid (CSF). They may also test the antibodies for the polio virus. The goal of the treatment is to control symptoms while the infection runs its course. Those with severe cases may need life saving measures, such as breathing help. Treatments are given based on their severity. They can include, antibiotics for infections such as UTI’s, medications like bethanechol for urinary retention, pain killers for muscle pain as well as moist heat, but not to those with severe breathing problems, physical therapy, braces, etc; to help recover muscle weakness that was lost. As far as prognosis, disability is more common than death, atleast 90% of the time. An infection located high in the spinal cord or brain increases the risk of breathing problems.
Polio is still around today, although not as common as it once was. Because of vaccines and the advancement of medicines, there has not been a reported polio case in the US since 1979. Children receive 4 doses of the polio vaccine, usually combined with another vaccine (Dtap-Hepb) at 2 months of age, then again at 4 months, again at 6-18 months and again at 4-6 years. Vaccination is the only way to prevent this disease. Polio currently exists only in a few countries in Asia and Africa. In 2008, there were 1,659 cases of polio in 18 countries, according to the Global Polio Eradication Initiative. Many organizations have been working hard toward eradicating polio including, The United Nations Children’s Fund (UNICEF), the (CDC), and any other international and national groups. They have National Immunization Days, where even war zones have called temporary cease fires to allow children to be vaccinated.