Poliomyelitis: Treatment, symptoms, advice & help

About poliomyelitis:

Poliomyelitis is a viral disease in which in about 1% of cases the virus enters the central nervous system, destroying motor neurons, leading to muscle weakness and acute flaccid paralysis.

Poliomyelitis: Incidence, age and sex

It is much less common in developed countries following the widespread use of oral vaccines but is still a problem in the developing world, especially in parts of Africa.

Signs and symptoms of poliomyelitis: Diagnosis

The incubation period is 7-14 days. Many patients recover fully after the initial phase of a few days of mild fever and headache. In others, after a week of well-being there is recurrence of pyrexia, headache and meningism. Weakness may start later in one muscle group and can progress to widespread paresis. Respiratory failure may supervene if intercostals muscles are paralysed or the medullary motor nuclei are involved. The CSF shows a lymphocytic pleocytosis, a rise in protein and a normal sugar content. Poliomyelitis virus may be cultured from CSF stool.

Causes and prevention of poliomyelitis

The disease is caused by one of three polioviruses, which are a subgroup of the enteroviruses. Infection usually occurs through the nasopharynx. Prevention of poliomyelitis is by immunization with live (Sabin) vaccine. In developed countries where polio is now very rare, the live vaccine has been replaced by the killed vaccine in childhood immunization schedules.

Poliomyelitis: Complications

During the acute phase, death occurs from respiratory paralysis. Aspiration pneumonia, corn pulmonale, high blood pressure, kidney stones, lack of movement, lung problems, myocarditis, paralytic ileus (loss of intestinal function),permanent muscle paralysis, pulmonary edema, shock and urinary tract infections are the other complications. Muscle weakness is maximal at the end of the first week and gradual recovery may then take place for several months. Post-polio, residual paralysis may also occur causing disability and deformity.

Poliomyelitis: Treatment

There is no medication that can kill the polio virus. In the early stages, bed-rest is imperative because exercise appears to worsen the paralysis or to precipitate it. Supportive treatment with analgesics and fluids are given. At the onset of respiratory difficulties, tracheostomy and ventilation are required. Subsequent treatment of post-polio residual paralysis is by physiotherapy and orthopaedic measures.