Polio Flashcards
acute viral disease primarily infecting the alimentary canal and occasionally targeting the CNS with or without paralysis
polio
first polio outbreak described in U.S.
1843
how many paralytic cases reported in the U. S. in 1952
21,000
symptom / clinical manifestation of polio
- acute onset of flaccid paralysis
- unapparent infection
- non-specific febrile illness
- aseptic meningitis
- paralytic disease
- death
ratio of cases of unapparent infection to paralytic disease
ranges from 100:1 to 1000:1
phases of acute poliomyelitis can be distinguished as
- non-specific febrile illness (minor illness)
- followed by in a small proportion aseptic meningitis and or paralytic disease (major illness)
three serotypes of poliovirus
leon berlinhide and lansing
countries with partial immunisation
- wild polio virus is largely replaced by vaccine virus in the environment
countries with almost total immunization coverage
- polio is becoming rare however sporadic cases do occur rarely
what percentage of polio cases are asymptomatic
90%
when and how many countries in the americas were certified polio free
1994 & 36 countries
when and how many countries in the western pacific were certified polio free
2000 & 37 countries and areas including china
when and how many countries in the europe were certified polio free
June 2002 51 countries
which virus group does the causative agent of polio belong too
picorna viruses which are small RNA-containing viruses
the commonest serotype in epidemics
type 1 : leon
the prevailing type in endemic areas
type II : berlinhide
endemic :infection is said to be endemic in a population when that infection is constantly maintained at a baseline level in a geographic area without external inputs
occasionally causes epidemics
type III : lansing
reservoir of polio infection
man is the only reservoir of infection
permanent carriers are
unknown / unheard of in polio
modes of transmission polio virus
vector borne includes house flies and cockroaches
incubation period for wild cases and vaccine-associated (recipient) cases
7 - 14 days
incubation period for vaccine-associated (recipient) cases
up to 35 days
incubation period for contact cases
up to 60 days
infectious period of poliomyelitis
7 to 10 days before & after the onset of symptoms
when do maternal antibodies disappear in an infant
during the 1st 6 months of life
paralytic polio includes
spinal polio
bulbs polio
bulbospinal polio
majority of clinical cases are
abortive polio
- mild systemic manifestation for one or two days only
- manifestations clear up giving immunity
- moderate fever
- URT manifestations pharyngitis and sore throat
- GIT manifestations: vomiting, abdominal pain, and diarrhea
abortive polio
- nausea vomiting and abdominal pain
- signs of meningeal irritation (meningism).
- aseptic meningitis with pain and stiffness in neck back and limbs
non-paralytic polio aka pre paralytic stage
- irritability
- destruction involves the motor nerve cells and not the sensory nerve cells
Paralytic poliomyelitis
when does paralysis start to show in paralytic poliomyelitis
within 4 days after the pre paralytic stage usually 7-10 days from onset of disease
spinal polio
- different spinal nerves are involved.
- due to injury of the anterior horn cells of the spinal cord, causes:
tenderness & weakness
flaccid paralysis of the corresponding striated
muscles - lower limbs are the most commonly affected.
bulbar polio
- nuclei of cranial nerves are involved, causing weakness of the supplied muscles, and may be encephalitis
- dysphagia
- nasal voice
- fluid regurgitation from the nose
- difficult chewing
- facial weakness and diplopia
bulbar polio
- nuclei of cranial nerves are involved, causing weakness of the supplied muscles, and may be encephalitis
- dysphagia
- nasal voice
- fluid regurgitation from the nose
- difficult chewing
- facial weakness and diplopia
- paralysis of the muscles of respiration is the most
which nerves are affected in bulbar polio
- weakness in muscles innervated by the
- trigeminal (V),
- glosso-pharyngeal (IX)
- accessory nerves (XI). These nerves control the muscles in the neck and tongue and the muscles used for swallowing
active immunisation of polio includes
salk vaccine & sabin vaccine
intramuscular polio trivalent killed vaccine
salk vaccine
oral polio trivalent live attenuated vaccine
sabin vaccine
inactive polio vaccine contains how many serotypes
3
inactive polio vaccine cells are grown on
monkey kidney (vero) cells
inactive polio vaccine is inactivated with
formaldehyde
contains 2-phenoxyethanol neomycin streptomycin polmyxin B
inactive polio vaccine
killed formalised virus (inactivated (killed) poliovirus strains of all three poliovirus type)
IPV Inactivated Polio Vaccine (Salk)
given subcutaneous or intramuscularly
IPV Inactivated Polio Vaccine (Salk)
induces circulating antibodies, but not local (intestinal immunity)
IPV Inactivated Polio Vaccine (Salk)
prevents paralysis but does not prevent reinfection
IPV Inactivated Polio Vaccine (Salk)
not useful in controlling epidemics
IPV Inactivated Polio Vaccine (Salk)
more difficult to manufacture and is expensive
IPV Inactivated Polio Vaccine (Salk)
does not require stringent conditions during storage and transportation
IPV Inactivated Polio Vaccine (Salk)
has a long shelf life
IPV Inactivated Polio Vaccine (Salk)
live attenuated virus
OPV Oral Polio Vaccine (Sabin)
given orally
OPV Oral Polio Vaccine (Sabin)
immunity is both humoral and intestinal induces antibody
quickly
OPV Oral Polio Vaccine (Sabin)
prevents paralysis and prevents reinfection
OPV Oral Polio Vaccine (Sabin)
can be effectively used in controlling epidemics
OPV Oral Polio Vaccine (Sabin)
easy to manufacture and is cheap
OPV Oral Polio Vaccine (Sabin)
requires to be stored and transported at subzero temperatures, and is damaged easily
OPV Oral Polio Vaccine (Sabin)
vaccine adverse reaction of IPV
- no serious reactions have been documented
- rare local reactions
vaccine adverse reaction of OPV
- diarrhoea anorexia vomiting
- sensitivity to the component ( neo, strepto )
- vaccine associated paralytic poliomyelitis ( rare )
- A gammaglobulinaemia
class 1 disease under surveillance by WHO
polio with paralytic case
last case of polio in the U.S.
in 1979
western hemisphere certified polio free
in 1994
in 1789 british physician that provided the first clinical description of polio referring to it as “debility of the lower extremities.”
Michael Underwood
in 1840 german physician that published a 78-page monograph in 1840 which not only describes the clinical features of the disease, but also notes that its symptoms suggest the involvement of the spinal cord.
Jacob von Heine
in 1908 austrian physicians that made the first hypothesis that polio may be caused by a virus
Karl Landsteiner and Erwin Popper
In 1908 discovered a filterable agent as the cause of poliomyelitis
Karl Landsteiner & Erwin Popper
manage to pass the disease monkey to monkey to find antibodies.
Simon Flexner & Paul Lewis
found antibodies in human convalescents in 1908
Arnold Netter & Constantin Levaditti
demonstrated neutralizing antibodies in monkey serum against active virus
Levaditti & Landsteiner
in 1931 demonstrated polio serotypes
Frank Mcfarland Burnet & Jean MacNamara
In 1936 cultured poliovirus in embryonic nervous cells.
Albert Sabin & Peter Olitsky
In 1949 grew the virus in muscle cells (fibroblasts) human embryonic skin cells, connective tissue cells, intestine and nervous cells, winning the Nobel Prize in 1954.
John Enders Thomas Weller & Frederick C. Robbins
polio virus for production grows in
non nervous cells.
from 1906-93 pioneering researcher on viruses and viral diseases who developed the oral live-virus vaccine against polio.
Sabin, Albert
contains harmless attenuated polio virus.
Sabin
which vaccine is preferred
Sabin
albert sabin
polish
