Introduction
Polio is a viral infectious disease that affects nerves in the spinal cord or brain stem. In severe form, polio leaves a specific limb incapable of movement, known as paralysis. It can also cause breathing difficulties and sometimes death. This disease is also called polio. The virus is primarily transmitted from person to person via the fecal-oral route, but less commonly, it is transmitted via carriers such as contaminated food or water and further multiplies in the intestine. The first symptoms are fever, malaise, headache, vomiting, stiff neck, and body aches. One in 200 infections causes irreversible paralysis, usually in the legs. 5 to 10 percent of paralyzed people die when their respiratory muscles stop working.
What Is Paralytic Poliomyelitis?
Paralytic poliomyelitis is a severe and rare form of poliovirus disease. The disease begins much like nonparalytic polio. But it progresses to more severe signs and symptoms, including:
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Intense pain.
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Extreme sensitivity to touch.
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Tingling or pricking sensations.
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Muscle spasms or twitching.
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Muscle weakness progresses to limb paralysis.
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Any combination of limbs may experience paralysis.
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Paralysis of muscles involved in breathing.
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Difficulty swallowing.
What Are the Causes of Paralytic Poliomyelitis?
Polio is caused by poliovirus. It mainly targets nerve cells present in the spinal cord and brain stem that control muscle movement. Neurons that control sensation are usually unaffected. The naturally occurring poliovirus, called wild poliovirus, has been eliminated in most countries, leaving very few cases of polio. Another version of the virus, called vaccine-derived poliovirus (VDPV), is more widespread and currently causes the most infections worldwide. VDPV is primarily present in several countries using oral attenuated poliovirus vaccines.
The attenuated virus contained in the oral vaccine itself does not cause polio, and vaccinated individuals rarely develop VDPV. Instead, VDPV is a recent version of the virus that occurs in communities or areas with large numbers of unvaccinated people. Attenuated viruses in oral vaccines can spread even if they do not cause disease. When most people in the community are vaccinated, the spread of the weakened virus is suppressed. A weakened virus can roam within a community for long periods if many people are not vaccinated.
What Are the Risk Factors for Paralytic Poliomyelitis?
Poliovirus carriers can transmit the virus through feces, sneezing, and coughing droplets, even if they are not sick. The virus invades others through the mouth. Viruses can spread easily. For example, not washing hands after coughing, going to the bathroom, or eating can spread the virus. The virus is also found in water contaminated with feces that carry the poliovirus. Polio primarily affects children. However, unvaccinated people are at risk of contracting the disease.
What Are the Symptoms of Paralytic Poliomyelitis?
Some people have a more severe kind of polio, which is called paralytic polio. If a person has a paralytic form of polio, they will start to exhibit the following symptoms:
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Loss of reflexes.
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Severe muscle pain or weakness.
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Floppy limbs.
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Tingling sensation in legs.
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Paralyzed arms and legs.
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Meningitis (infection of the brain or spinal cord).
How Is Paralytic Poliomyelitis Diagnosed?
Poliovirus was obtained from the throat, feces, and in some cases, cerebrospinal fluid (CSF) by isolating the virus in cell culture or using the polymerase chain reaction (PCR) to detect the virus. It can be detected in samples. The laboratory conducts tests for poliovirus, including:
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Culture - The isolation of viruses by culture is the most sensitive method for the diagnosis of poliovirus infection. Poliovirus is usually isolated from stool samples. It can also be separated from the throat swab. Separation from blood or CSF is less likely.
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Intratypic Differentiation - Real-time reverse-transcription PCR is used to distinguish between potential wild and vaccine-like strains using culture-isolated viruses as starting material.
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Genome Sequencing - It is used to confirm the poliovirus genotype and determine its most likely geographic origin.
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Serology - Serology can help diagnose paralytic poliomyelitis, especially when it is known or suspected that the patient has not been vaccinated. Acute-phase serum samples should be taken as early as possible in the course of the disease, and convalescent-phase samples should be taken within three weeks.
What Is the Treatment of Paralytic Poliomyelitis?
If having polio, the doctor will focus on ensuring the patient is comfortable and try to prevent any other health issues. Some treatments and tools for support include:
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Pain relievers (such as Ibuprofen).
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A ventilator (a device that helps the patient breathe).
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Physical therapy can help the muscles to keep working.
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Bed rest and plenty of fluids.
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Antispasmodic medications relax the muscles.
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Antibiotics to treat any urinary tract infections.
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A heating pad to treat muscle aches and spasms.
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Corrective braces.
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Pulmonary rehabilitation to treat any lung complications.
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Walking cane, wheelchair, or electric scooter as a mobility aid.
What Are the Complications of Paralytic Poliomyelitis?
Serious illnesses that affect the breathing and swallowing capacity of a person can be fatal. Long-term complications in recovered people include:
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Permanent paralysis.
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Shortening of muscles causes deformed bones and joints.
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Chronic pain.
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Post-polio syndrome.
How to Prevent Paralytic Poliomyelitis?
Two types of vaccines prevent polio, oral polio vaccine (OPV) and inactivated polio vaccine (IPV). IPV is given in the form of an injection into the leg or arm, depending on the patient's age, while OPV is given orally. The polio vaccine can be given at the same time as other vaccines. Most people should be vaccinated against polio during childhood. A person who receives an initial course of three or more doses of inactivated poliovirus vaccine (IPV), live oral poliovirus vaccine (OPV), or four doses of any combination of IPV and OPV is considered to be fully vaccinated.
Is It Safe to Get a Polio Vaccine?
Yes, polio vaccines are very safe and effective in preventing polio. Vaccines, like other drugs, can have side effects. Most children who receive the polio vaccine have no side effects. OPV and IPV have been administered billions of times worldwide and have few side effects. If side effects do occur, they are usually mild, such as temporary redness or pain at the injection site. OPV can, in very rare cases, cause vaccine-associated polio in vaccine contacts or recipients.
Conclusion
Paralytic poliomyelitis occurs when the poliovirus attacks the brain and the spinal cord. Muscles that enable breathing, speaking, swallowing, and limb movement may be paralyzed. It is called spinal polio or bulbar polio, depending on which part of the body is affected. Polio is a highly contagious condition that spreads easily from one person to another. Timely vaccination in children helps eradicate this condition.
