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Transcript of Poliomyelitis
*She mostly uses a scooter, but can also use crutches, when necessary* Ermm...whadat? The actual definition of Polio is long and complicated.
"Poliomyelitis: An inflammatory process involving the gray matter of the cord. Acute anterior p., inflammation of the anterior cornua of the spinal cord; an acute infectious disease caused by the poliomyelitis virus and marked by fever, pains, and gastroenteric disturbances, followed by a flaccid paralysis of one or more muscular groups, and later by atrophy."
-Stedman’s Medical Dictionary, 1995 [Poliomyelitis] Polio Like...did it come from monkeys? My Story-Sun Joo Anderson My Aunt Sun Joo :) <3 Dude...how do I know its not the flu? But, it can be well described by one of the multiple names commonly used; "infantile paralysis"-a disease that infects infants and children (most often), and can cause paralysis. It is a viral disease caused by the virus "Poliovirus" which is a positive stranded RNA virus. PV is also a member of the Enterovirus subgroup, family Picornaviridae. Poliovirus resides only in humans. The symptoms of Polio (the cases that DO have symptoms) are actually very much like the flu. However, there is one large difference: You can wake up paralysed, or can become paralysed virtually any time. BUT...90-95% of all reported cases of Polio DO NOT have symptoms-and if they do, they are mild (see note about different types of polio & affects) FECAL-oral? I don't eat that stuff! It is a waterborne disease most often spread through the fecal-oral route. When people say something is spread by the fecal-oral route, they don't mean literally eating excrements of any sort. Most often, something passes through the fecal-oral route when someone drinks contaminated water. This is the reason polio used to be extremely common in developing and poorer countries. Lakes, rivers, ponds, any available source was-and still often is-used as a toilet, bathtub, and drinking water. Thus the fecal-oral route. In the 1950s when there was one of the largest polio outbreaks, doctors still didn't know where people were getting polio, so in an effort, posters were used to advise people of what to do. Posters like this: An image of kids playing in and around open sewers. Two street children playing in the Buriganga River in Dhaka, Bangladesh. Subclinical/Innapparent Polio Non-paralytic Polio Paralytic Polio Symptoms Malaise (general discomfort or uneasiness)
Or no symptoms at all
*mild symptoms may last 72 hours or less* Muscle fatigue & pain
Sudden high fever
Headache Asymmetric paralysis
Sudden high fever (usually 2-3 days)
And possibly death The majority of Polio infections are Asymptomatic (90-95%).
Polio symptoms are more likely to be severe in older children and adults
Young children with infections most often show no signs, but are carriers of Polio More Symptom Stats The incubation period for Polio is (most commonly) 6-20 days but could be anywhere from 3 to 35 days. "I woke up and tried to get out of bed but fell to the floor because my legs would no longer move me, and I was rather limp. I was then taken to the University Hospital in Indianapolis where I was diagnosed with Polio."
-Richard O., 1940 This was often the most common indicator of Polio. Lots of people had fevers, but when you collapsed, that was when people took notice. Polio can also be spread (less commonly) by:
Direct person to person contact
Contact with mucus or phlegm
Once virus enters body, it multiplies in throat & intestinal tract, then is absorbed and spread through blood and lymphatic system as depicted here: http://amhistory.si.edu/polio/activities/lifecycle/index.htm Will I go cross-eyed? Poliomeylitis comes from two Greek words:
Poliós: meaning grey
Myelós: meaning marrow
Contrary to common sense, marrow in this case, doesn't talk about bone marrow. The Greek words refer to how polio affects the grey matter of the spinal cord As stated before, once the virus enters body, it multiplies in throat & intestinal tract.....enters blood and lymphatic systems. From there, in some cases, PV hijacks the central nervous system and weakens or destroys motor neurons. Eventually, it causes muscular atrophy-the gradual decrease in the size of muscles. When PV attacks motor neurons, the messages from the brain don't get to affected muscles and they become paralysed. However, it is NOT the other way around, the muscles DO NOT lose feeling.
(Although patients may not be able to move, they still have feeling in paralysed muscles) Why would I want to know about a bunch of old guys? Paralytic polio occurance in the US peaked in 1952 with 21 000 reported (paralytic ONLY, remember) cases and numerous deaths
Before vaccines, 13 000 to 20 000 were paralyzed by it and 1000 died each year in the United States ALONE
If only less than 2% of cases cause parlytic polio, imagine how common it was! Possible Complications Lack of movement
Permanent muscle disability, paralysis, deformity...etc
And Lung problems such as
Also, Post-polio syndrome can occur Post-polio syndrome Post-polio syndrome is a condition that affects polio survivors years after recovering from an infection of Poliomyelitis. Most often, survivors start to have gradual NEW weakening in muscles that were affected by polio previously.
Slow progressive muscle weakness,
and muscular atrophy
Pain from joint degeneration is also common It is rarely life-threatening, but symptoms can seriously interfere with an individual's ability to live independently.
For example, weakness of respiratory muscles can lead to trouble breathing.
Or weakness in swallowing muscles can result in the aispiration of food or drink, causing pneumonia. PPS-Con't Someone more severely affected by Polio in the first place, could have more extreme PPS PPS affects 25-40% of polio survivors some say, while other sources cite that that percent is only of paralytic polio survivors Can someone wave around a magic wand and cure me? There is no cure for polio, it can only be prevented. There are 2 types of vaccines:
"Salk Vaccine" also called IPV-inactivated polio vaccine was the 1st sucessful vaccine. Developed by Jonas Salk, and tested in 1952. It used killed viruses, and the vaccine was available by injection. Safety was a big advantage, but the formaldehyde used caused the immune system to recognize it was a dead not live virus, possibly risking shortened immunity period. He called it the "Pittsburgh vaccine" but reporters called it Salk.
"Sabin Vaccine" also called OPV-oral polio vaccine was developed by Albert Sabin. While Salk vaccine was being used for mass protection, he kept working on his live-virus and believed one could only be immune with a live, weakened virus. Has replaced the IPV all over the world, but since it has ability to cause the actual virus, in the US and Europe, IPV is more common.
Neither Sabin nor Salk patented their vaccines; they donated the rights as gifts to humanity. Albert Sabin (left), and Jonas Salk (center) meeting with Basil O’Connor President of the March of Dimes in 1961. Today the number of Polio cases have gone down over 99% and it has been eradicated in countries all over the world with help from WHO (World Health Organization), Rotary International, and numerous other groups. As of 2012, there are only three countries still in endemic status: Nigeria, Afganistan, and Pakistan (India hasn't had a case of natural-occuring polio in 2 years, one more to go until officially "eradicated"). This is all part of the Global Polio Eradication Initiative (GPEI), which started in 1988 and has come a long way since then. Polio Today Tough Stuff Scientists who raced to an effective polio vaccine tested work on prisoners, institutionalized children, and over 100 000 monkeys were killed in course of developing polio vaccines BUT...for every rhesus monkey killed, 65 doses of vaccines were made Dr Michael Underwood described it as this in 1789 -Jakob von Heine, 1843 The actual origins of the disease are unknown, but polio may go as far back as the 18th Dynasty-as this Egyptian stele is thought to represent (1403 - 1365 BC) Throughout history, it has also been called many names. Names such as: "debility of the lower extremities," "spinal infantile paralysis," "poliomyelitis anterior acuta," and "Heine-Medin." -Adolph Kussmaul in 1872 Dr. Ivar Wickman, 1907 Sources Books Internet http://www.who.int/topics/poliomyelitis/en/
http://en.wikipedia.org/wiki/History_of_poliomyelitis Peters, Stephanie True. Epidemic!: The Battle Against Polio. New York: Marshall Cavendish, 2005
Facklam, Howard and Margery. Viruses. New York: Henry Holt and Co, 1994
Halstead, Lauro S. MD & Grimby, Gunnar MD PhD. Post-polio Syndrome. Philadelphia: Hanley & Belfus, 1995
Mason, Martha. Breath. New York: Bloomsbury USA, 2003 (memoir)
Black, Kathryn. In the Shadow of Polio. New York: Addison-Wesley Publishing Company, 1996 Other "In Search of the Polio Vaccine" (History Channel DVD) Early Attempts In 1935 First known drawing of man with similarities to polio. Egypt, around 1403-1365 BC Speculation that Tiberius Claudius Caesar Augustus Germanicus (Claudius, a Roman emperor) may have had Polio.
5BC-54AD (roughly) First recorded case of Poliomyelitis: Sir Walter Scott.
"In 1773 Scott was said to have developed 'a severe teething fever which deprived him of the power of his right leg.' At the time, polio was not known to medicine. A retrospective diagnosis of polio is considered to be strong due to the detailed account Scott made."
-Wikipedia First clinical discription of Polio by Dr. Michael Underwood, England 1789 1773 1840 First medical report on Polio published by Jakob Heine 1890 First person to study a Polio epidemic, Karl Oskar Medin. Early 1900s Some epidemics throughout Europe and the United States. Families with it were quarantined. Elsewhere, fine. Notices such as this were placed in windows and doors of households with polio. 1927 First Iron Lung (respirator) developed by Philip Drinker (and Louis Agassiz Shaw) and installed in a New York hospital. (used for polio patients with bulbar polio) 1940s-50s Major outbreaks spread from coast to coast of the US (and smaller in Europe) Children under 16 banned from certain towns. Cause still unknown. 1955 Jonas Salk invents first vaccine. Sabin continues to develop his. Government emphasizes vaccine urgency. 1938 March of dimes founded by Franklin Delano Roosevelt. 1962 Sabin's OPV vaccine liscensed. Salk vaccine still used in US & Europe, otherwise Sabin vaccine more common 1977-79 Last natural-occuring cases of Poliomyelitis in Canada ('77) and US ('79) 1988 Global Polio Eradication Initiative started by WHO (World Health Organization) Today Only 3 countries in the world still considered endemic: Nigeria, Afganistan, and Pakistan. (India in 2nd out of 3rd year without a natural-occurring case) A child getting vaccinated with the OPV vaccine (Sabin) Albert Sabin's vaccine (OPV) is currently used more often, but Salk vaccine still around Here is another lady's story: