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INTRODUCTION Poliomyelitis often called Polio or infantile paralysis is an acute, viral, infectious disease spread from person to person, primarily via the fecal -oral route. The term “Poliomyelitis” derives from the ancient Greek word Polio’s means “grey” and myelos meaning “marrow” referring to the grey matter of the spinal cord.
DEFINITION Poliomyelitis which often called polio or infantile paralysis, is a highly infectious viral disease, which mainly affects young children under 5 years of age
INCIDENCE The estimated annual incidence of the disease is thus 18.6 per 100 000 of the general population, or approximately 1088 cases each year, with an estimated 163 deaths.
TYPES Apparent (5-10%) paralytic poliomyelitics Inapparent (90-95%%) Polioencephalitis
Abortive polio • 4-8% infections • Does not lead to paralysis • Minor illness Symptoms • Low grade fever • Sore throat • Vomiting • Abdominal pain • Loss of appetite • Malaise • Recovery:- complete, most recover in <1 week , noparalysis.
Non-paralytic aseptic meningitis Occurs in 1-2% of polio infections Symptoms : Headache
Paralytic poliomyelitis 0.5-1% of of those infected develop this type.
Polio encephalitis • Occurs in rare case • Causes inflammation of gray matter of brain • Autonomic dysfunction is common and it has a high mortality Signs & Symptoms Agitation, • Confusion • Stupor • coma • Irritability • Delirium
Life cycle of polio virus Enters through mouth Intestine if the virus finds a cell with the correct receptor in the intestine Infection begins The polio virus genoma (RNA) enters the intestinal cell
CONTI... The viral RNA takes over the cell Replicates (RNA) in intestinal cell New RNA+ new capsids (shells) = new polio virus Thousands of polio virus burst out of cell and enters the blood stream
PATHOPHYSIOLOGY Virus enters the body through feco-oral route Reaches digestive tract and attaches to specific receptors Replicates in the intestinal mucosa
Enters the blood stream Virus enters the nervous system through blood Spread along the axons of peripheral nerves to CNS Progress along the fibers of motor neuron of brain and spinal cord
Destroys anterior horn cells of spinal cord or nerves within bulbar region Nerve cell death results in failure of contraction of muscles Muscle dysfunction results in respiratory failure and paralysis of legs Virus is excreted through feces and contributes in further contamination & spread
CLINICAL MANIFESTATION Most patients infected with poliovirus develop in apparent infections and are frequently asymptomatic.
Nursing Assessment Nursing assessment in a client with polio include:
COMPLICATION • myocarditis • Pulmonary edema • Pneumonia • Urinary tract • infection. • Compression • neuropathy • Scoliosis • Osteoporosis • Bone Fracture • skeletal deformities
CONCLUSION As the disease polio cannot be cured if once attacked, it is better to follow preventive measures as it is contagious. The vaccination is definite in case of infants and children.
