– acute spinal paralysis of varying severity. Him
the virus causes complex damage to the structure of the gray matter
the brain. As a result, motor function is impaired, and
degenerative disruptions in the limbs that hit the virus. With
the disappearance of innervation or its reduction of the muscles begin
Child polio is much more common than an adult.
Often the virus affects children under ten years old, so they lag behind in
development, and their limbs are subjected to severe form
Heine-Medina disease in most cases occurs in latent
form, without causing severe neurological disorders.
Clinical signs are characteristic of one percent of all.
infected. The disease is determined after 2−3 weeks from her
the beginning. The probability of death is quite low, and leads to
him paralysis of the respiratory center.
In 1840, the disease began to study, the first effective
The vaccine was developed in the 1950s. Due to several
outbreaks in the twentieth century, WHO launched a program for
vaccination of the population. Since then, the risk of infection has decreased by 99%.
And regions such as Europe, America and the western part of the Pacific
ocean, are considered eradicated from the virus zones.
Source of disease
Enterovirus — это сферической формы вирус, принадлежит
к семейству Picovrnaviridae. Him размеры варьируются от 27
up to 30 nm. Именно он является возбудителем diseases. Him
the structure is a chain of RNA molecules that carry
in itself data about the pathogen, enclosed in a protein shell. AT
the composition of the virus is no fat, which makes it resistant to acidic environments
and solvent effects.
The activity of the polio virus in the environment is
water for about 3 months, and in feces up to six months. Contagious
properties at low temperatures remain fairly
for a long time, and when boiling, under ultraviolet light and under action
disinfectant virus dies quickly.
The structure of the protein shell has differences based on this
three strains were isolated (I, II, III) of the virus. With вакцинации и заражении
the body develops immunity, it is a protection for life
от re-infection. But such an immune response cannot
protect against other strains of polio, therefore it is not
perfect. Often, infection with a first type of virus leads to
complications of a paralytic nature.
The bearer of the virus is only human, sometimes infected.
exposed and primates, but the source of infection they do not be
Poliovirus affects the gastrointestinal tract,
after implantation in the mucous tract he using structural cells
organism begins to multiply massively. When the virus will collect
the required number of viral particles, the causative agent will begin
spread, affecting intestinal lymphoid tissue.
ATиремия (попадание вируса в кровь) начинается через 3−4 дня
after infection. Usually during this period the body produces
antibodies that effectively destroy it, so the disease
begins to develop in asymptomatic form. But sometimes with massive
Viremia disease becomes more severe, in which
вирус проникает в ткани головного и спинного the brain. Still not
clarified the mechanism of infection of the central nervous system. According to medical scientists, the virus
blood flow is transferred from the muscle nerve endings to the brain.
Poliovirus in the brain tissue is present for several days. After
this time it is impossible to detect it, but despite this,
the process of inflammation does not stop and can last 2−3 months
while infecting more and more motor and autonomic neurons.
You can get infected not only from a sick person. Because of
that the virus is resistant to external factors, then penetrate into
the organism can also in other ways.
There is a notion of mechanism and methods
transmission of infection. Under the mechanism understand the way that
the pathogen from the beginning of its release into the environment moves to
susceptible human body. Virus poliomyelitis mechanism
fecal-oral transmission. This means that the pathogen is sick
man releases into the environment along with urine, vomit
And the path is a factor that ensures the interaction of the virus with
place of entry into the body of the infected.
ATыделяют три пути передачи полиомиелита:
- AT плане эпидемиологии самый важный — пищевой
путь. AT этом случае инфекция передаётся путём обсеменения
infected food particles when not in compliance
sanitary control and hygiene regulations.
- ATодный путь
ascertained rarely, it involves the use of contagious water.
But if there is a large discharge of sewage and sewage in
water sources such a path may well become a source
- Бытовой означает заражение путём контакта с
household items on which there are particles of the virus. This
The transmission path is not dangerous by itself. If you follow the rules of personal
hygiene, then the virus with the hands will not be able to get in suitable for him
Wednesday – on mouth mucous membranes.
Sometimes isolated aerosol transmission – infection
the particles that the patient coughs, talking, or
sneezing. But such a path can only harm the initial
stages of the disease and only with very close contact.
Susceptibility and risk factors
An organism’s susceptibility is its ability to manifest
reaction to any alien introduction. Natural susceptibility
polio is very high. Often a person is just
becomes a carrier of the virus without clinical and
pathological symptoms. Symptomatology manifests itself very rarely
and the paralytic picture is observed in 1−10 cases out of 1000.
There are a number of factors that can aggravate the course.
diseases. Among them are the following:
- Floor. The risk of infection for both sexes is the same before sex.
ripening. With age, the risk of infection is more exposed to female
18-25 years old without immunity. And also PPS (myelitis) is observed more often
- Age. The disease is mainly
children and adolescents are susceptible because their organisms are the most
susceptible to infectious pathogens, and they are more in contact
with contaminated materials.
- Gestation period The body of a woman in such a period is very
susceptible to infection.
- A recent removal of the tonsils can cause damage.
- According to studies, the paralytic form of the disease
Often affects precisely the limb, which shortly before
infection received intramuscular injections.
Virus live attenuated
There are two types of vaccination. When first used live
weakened virus. The vaccine has advantages as opposed to
inactivated virus. But there are times that she becomes
the cause of the disease. That is why a number of countries do not
applies. It is worth considering the paralytic form of polio,
caused by vaccination is so small that the likelihood of developing
the disease is 1 case per 2.6 million vaccinated people.
A live virus is introduced into the body through the mouth. What makes him
passes the natural way and is able to cause synthesis not only
blood antibodies, but also secretory antibodies that protect against repeated
infection through the mucous membrane of the gastrointestinal tract.
After receiving the first dose of vaccine, the disease develops in
for 7−14 days. Poliomyelitis is often associated with
immunodeficiency of a person who has been vaccinated.
Possibility of infection
An infected person becomes dangerous to others.
a short time. The virus that is in the nasopharynx,
detected 36 hours after infection. Greatest risk
the patient presents in the first week of the disease, rarely excretion
virus lasts 1-2 months. In any case, its longer
Basically, the patient becomes not contagious after 14−21 days from
начала diseases. But due to the fact that many cases of illness
asymptomatic, as a carrier can be healthy, on
first look, baby. And this complicates the epidemiological control.
poliomyelitis. In identifying the disease a person is subject to
immediate hospitalization. To reduce the risk of infection
others, the patient must be isolated for a period of 40 days before
complete disappearance of acute signs of infection.
Symptoms of the disease
The period of incubation of the virus is from 9 to 12 days, in very
rare cases reaches 35 days. This time shows the duration
from the moment the virus enters the body until the first
symptoms. Poliomyelitis manifests itself in different ways and is different.
severity. Asymptomatic form occurs in almost 95%.
Identify it can only be using laboratory tests.
AT зависимости от симптомов различают такие формы
Abortive clinical picture
This form occurs more frequently than others, it is peculiar
non-specific symptoms that disappear in three to five days (sharp
fever and malaise). With this clinical picture
the diagnosis cannot be made because such symptoms are characteristic and
many other diseases.
- Temperature 38-38.5 C,
often preceded by chills. Feverish can
last a week. The mechanism of occurrence is associated with the influence of particles.
virus responsible for thermogenesis structures.
- A runny nose – breathing is slightly complicated and discharge is observed.
from the nose.
- A short cough without expectoration.
- Nausea and vomiting caused by eating.
- Diarrhea is characterized by frothy stools in which there are
impurities of mucus.
- Increased sweating in the area of the head and neck.
- Dull and aching pain in the abdomen.
Occurs when inflammation has struck the skin.
(protective structures) of the spinal cord and brain. Soft shell
take part in the synthesis and absorption of liquor – liquid
in the spinal cord. They are well innervated and supplied with blood.
Symptoms of meningeal form:
- Severe pain in the head that does not disappear even after taking
- Vomiting caused by irritation in the gut brain
- Symptom Kerning is detected during medical inspection and
characterized by impossibility and severe pain when bending the legs
at right angles.
- Upper, lower and middle symptom
Brudzinsky. With the upper symptom head tilt forward leads
involuntary bending of the leg at the knee and its pressing against the stomach. With
lower symptom bending of one limb leads to simultaneous
bending the second. If when pressing the pubic bone both lower
limbs pressed against the abdominal cavity, this is an average symptom.
- Stiff neck muscles. With сильном воспалении даже в
in a calm state, the head is thrown back.
Occur rarely, but have very dangerous consequences.
There are three options for paralytic osteopoliomyelitis:
spinal, bulbar and pontin.
With спинальном варианте периферический паралич слегка охватывает
different parts of the limbs. Symptoms such as atrophy and
muscle tremor, disappearance of tendon reflexes, muscle pain,
constipation and incontinence.
Bulbar – the most dangerous option. It affects parts of the brain,
responsible for the activity of the respiratory system and cardiovascular
system. Characterized by such manifestations as failures in the process
swallowing, nasal congestion with no signs of discharge, difficulty
breathing, impaired sound phonation, bradycardia and tachycardia,
increase or decrease in blood pressure, psychomotor agitation.
Pontinny – the most favorable, leads to one-sided
paralysis of the facial muscles responsible for facial expressions. A separate group
makes up chronic or subacute polyamide. Such a clinic
quite difficult to characterize, since the localization of paralysis
very diverse and can take place both in one and in all
Diagnosis and treatment
Diagnostics based on
research in the laboratory. In the first seven days of the virus
can be distinguished from discharge in the nose, starting from the second week – from
kala. The pathogen is very rarely isolated from the fluid in the spinal cord.
brain, in contrast to other enteroviral infections.
Since virus isolation is impossible, it is studied by
serological analysis. The method is based on the isolation of antibodies and
is very receptive, but it has its drawback – with its
using can not distinguish between natural and post-vaccination infection.
Still an effective antiviral drug for polio
does not exist. However, the use of symptomatic drugs
together with physiotherapy significantly speeds up recovery and
reduces the risk of possible complications.
In the treatment of polio are used drugs
which do not affect the pathogen, but improve the overall condition
infected and relieve negative symptoms.
Drug treatment involves the use of such
- Pain reliever and antipyretic –
- Non-steroidal anti-inflammatory drugs – Meloxicam,
Acetylsalicylic acid, Ibuprofen, Diclofenac.
- With запорах в качестве слабительного — семена льна, лактулоза,
sodium sulfate and castor oil.
- To restore lost fluid during vomiting –
Hydrovit, solution of Regidron and Ringer.
functionality of the affected limbs apply physical
impact. In the acute phase to give their limbs
natural position apply special pillows. Sometimes for
to prevent deformation, a tire is used;
In the process of restoring the body, splinting and
physiotherapy methods. The latter activates regenerative resources
organism, so you can eliminate a lot of negative
manifestations and slow the deformity and atrophy of the affected
Among the methods of physiotherapy stand out
- Magnetic field treatment.
- Physical exercise.
- Tissue treatment with current pulses.
Withнцип питания при полиомиелите зависит от конкретных
проявлений diseases. Diet in abortive form, when
place an upset stomach, should rule out such violations in
the body. To do this, it is recommended to use only the lungs.
products that do not provoke the strengthening of the digestive tract.
With диарее рацион должен состоять из рисового отвара, каш со
butter (semolina, oatmeal), mashed meat, cottage cheese, steam
cutlets and boiled fish. With рвоте нужно выпивать очень много
liquids, preferably rehydrants, they quickly fill up reserves
электролитов и воды в the body.
The paralytic form is characterized by the appearance of constipation. To
normalize the bowels, the diet should be included
fermented milk products, more fruits and vegetables (raw and baked
form), wholemeal bread, corned beef, butter (butter,
sunflower, olive), kvass and herring.
To улучшить общее состояние, уменьшить интоксикацию и
manifestations of fever, the diet should also include a protein-rich and
The disease is extremely dangerous and can cause many severe
complications that will appear after a certain period. The most
dangerous consequence of polio – respiratory failure,
which appears due to the defeat and blockage of muscles
respiratory tract. Sometimes marked myocarditis, in which
there are failures in the pumping function of the heart.
Gastrointestinal lesions, such as bleeding, acute gastric
expansion and obstruction of the intestine complicate the paralytic
form of ailment. Post-polio syndrome manifests itself later
many years after infection. Why it arises is not known for sure.
It is characterized by the following symptoms:
- Muscle weakness
- Rapid and difficult breathing.
- Muscle pain.
- Fast fatiguability.
- Dysfunction of swallowing and gait.
These symptoms progress over time and lead to
To prevent polio
IPV and OPV are used. IPV is an inactivated vaccine in the form of
injections, and OPV is a weakened vaccine in the form of droplets that drip
in your mouth. IPV is obtained by exposure to formalin solution to the virus on
over 12–14 days, causing him to die. After
vaccine injections into humans immune cells capture particles
virus and provide protection against re-infection.
Vaccine is prescribed three times with breaks of one month. there is
areas that need re-vaccination. IWP not
promotes the development of secretory antibodies, so after vaccination
there remains the risk of polio infection.
The immune potential of OPV is much higher. However, its use entails
риск появления постпрививочного poliomyelitis. Live weakened
the vaccine is obtained by repeatedly growing the virus on cells
monkey. In such an environment, the virus loses its pathogenic properties.
such a vaccine in the cells of the gastrointestinal tract – the process of producing immunoglobulins,
which protect the mucosa from the virus. Three doses of OPV
provide reliable protection to the vaccinated person.
You need to understand that you can protect against reinfection
only if a well-functioning immunity. If in
the immune system is malfunctioning, then hypothetically there is a risk