It is defined as “An acute viral disease that cause destruction of anterior cells in spinal cord and cranial nerve, causing paralysis.
CAUSATIVE AGENT: polio virus
MODE OF TRANSMISSION: oropharyngeal route and fecal oral route
INCUBATION PERIOD: For 7-10 days.
PERIOD OF COMMUNICABILITY: unknown. It’s infectious for upto several weeks before symptoms develop..
Poliovirus is excreted in stool of patient, 2 weeks before and 6-8 weeks after onset of illness.
The virus may also be water borne, resulting from contamination of water with sewage
Most infections are asymptomatic.
2.ABORTIVE: In this condition the virus invaded the blood stream, causing a sort of viremia, manifested with body pain, fever , sore throat,s anorexia, etc.
SYMPTOMS ARE MODERATE INCLUDING:
- loss of appetite
- vague abdominal pain
- neurological manifestations are absent.
NON PARALYTIC POLIO
The poliovirus enters the nervous system without destroying the cells. The febrile illness is then followed by meningeal irritation in the form of neck stiffness, headache, pain in neck, back muscles, vomiting etc.
No paralysis occurs in this condition.
Kiss the knee sign: consists in directing the child to sit up and kiss his/her knees. The test is positive if he fails to do so without bending the knee. This is owing to nuchal rigidity.
Tripod sign is elicited by asking the child to sit up. The test is positive if he assumes a tripod position while doing so.
1.SPINAL FORM: It involves extremities, neck, abdomen, diaphragm and intercoastals. Its major manifestations are:
a.fever and other constitutional symptoms
b.muscle pain and tenderness
large muscles are more often involved than small muscles.
Maximum paralysis occurs on second to third day, with no sensory loss.
bladder and bowel involvements are common.
It’s very rare, but is most severe because of the involvement of vital medullary centres.
It is characterized by paralysis of muscles supplied by cranial nerves(dysphagia, nasal speech and dyspnea due to involvement of soft palate and pharynx and facial paralysis).
Mild hypertension may accompany.
3.BULBOSPINAL FORM: it is the combination of both spinal and bulbar forms.
4.ENCEPHALY FORM it is relatively uncommon.. It may occur as an isolated entity.
GASTROINTESTINAL : bleeding, perforation, dialatation
CVS: hypertension, tachycardia, congestive cardiac failure, myocarditis and cardiac arrest etc..
Pulmonary: respiratory distress, pneumonia, collapse, pulmonary edemaetc.
Urinary tract: paralysis of bladder, calculi,infection.
- History collection
- Physical examination
- Lumbar puncture
- Stool and throat swab.
- Minimum handling of affected part.
- Analgesics and mild sedatives for pain relief
- Attention to solving problem like retention of urine and constipation
- Maintenance of adequate fluid and dietary intake.
- Suction to remove secretions
- Watch for respiratory distress.
- report about the case to the health authorities
- bed rest upto 3 to 4 weeks
- vital signs
- hot packs may be used to relieve muscle shortening, pain and tenderness.