Polio -cause, clinical features, treatment and prevention
Polio or poliomyelitis is an infectious disease caused by a virus. The disease has become uncommon due to immunization but is still prevalent in countries where immunization is incomplete. The virus attacks the central nervous system and can cause death or disability due to paralysis. The infection can be subclinical (no symptoms or signs) in majority of children especially in endemic areas where most children have developed immunity.
Rarely the disease can result from administration of oral vaccine which contains live weakened virus if the recipient has some deficiency in the immune system. Hence some countries have switched over to inactivated polio vaccine (IPV which is given as injection) from oral vaccine (OPV). Symptoms and signs: The disease starts with non specific symptoms like fever, pain in muscles, headache and sore throat. Many children recover completely from this stage and do not progress to paralysis. Some children develop features of aseptic meningitis like increasing headache, vomiting and stiffness of neck muscles.
Only a few children develop flaccid paralysis which is usually asymmetrical and affects lower limbs more often than upper limbs. Flaccid paralysis means weakness of limbs associated with decreased muscles tone. Of those children suffering from paralysis some may completely regain the strength of muscles. However many children will suffer from varying degrees of weakness. If any weakness persists for six months it is likely to be permanent. Laboratory findings: The virus can be cultured from throat and stool for quite some time after infection. Rise in antibodies is diagnostic.
Complications: Respiratory failure can occur if the virus affects the brain stem which contains vital centers regulating breathing. Difficulty in swallowing can occur due to paralysis of pharyngeal muscles. Retention of urine and constipation are other complications. Injury to affected limb (for example intramuscular injection) can aggravate paralysis. This is called provocative paralysis. Affected muscles shrink in size over a period of time (post-polio muscular atrophy). Treatment: There is no specific treatment. Supportive treatment is given for fever and pain. Heat therapy may help in reducing pain. Intramuscular injection should not be given. Repeated suction may be needed to remove secretions if there is paralysis of muscles responsible for swallowing.
Prevention: The disease is preventable. For more information on prevention please visit childhood vaccination.
Page last reviewed on 12th June 2010
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