1 / 28

Poliomyelitis

Poliomyelitis. ד"ר אלכס גורי מחלות זיהומיות בילדים, ב"ח קפלן. Introduction. “Polios” = “gray”, “myelos”= “spinal cord” First descriptions Medin (Sweden) 1890 First epidemics – Scandinavia, USA 189* 1950++ regular epidemics 25/100.000 1952 USA 58000 cases, 3145 fatalities, 21269 handicapped.

Download Presentation

Poliomyelitis

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Poliomyelitis ד"ר אלכס גורי מחלות זיהומיות בילדים, ב"ח קפלן

  2. Introduction • “Polios” = “gray”, “myelos”= “spinal cord” • First descriptions Medin (Sweden) 1890 • First epidemics – Scandinavia, USA 189* • 1950++ regular epidemics 25/100.000 • 1952 USA 58000 cases, 3145 fatalities, 21269 handicapped

  3. Virology • Enterovirus • 3 serotypes, lifelong specific immunity to each serotype • Humans are only natural host • Wild type, live-attenuated, VDPV (vaccine-derived)

  4. Pathogenesis

  5. Clinical • Incubation 9-12 (range 5-35) from contact to prodrome, 11-17 day to paralysis

  6. Clinical features • 60-1000/1 unapparent/clinically recognized (95% unapparent) • Abortive pm (4-8%) 2-3 dd fever, headache, sore throat, abd pain, vomiting • Nonparalytic pm = enteroviral meningitis • Spinal paralytic pn 0.1% of all infections Meningitis, muscle pain, involuntary spasm and then asymmetric flaccid paralysis, almost never sensory, 66% permanent • Bulbar pn Cranial nerves involvement 5-35% of paralytic cases

  7. Increased incidence in pregnant women • Girls and boys equal infection, boys>girls paralysed • Exercise during illness increases severity • IM injection provocation • Tonsillectomy increases risk of bulbar PM • Postpoliomyelitis syndrome (20-30%) 30yy after • Overall mortality 5-10% for paralytic disease

  8. DD • Entero 71 • West Nile virus • Guillain-Barre (symmetrical, ascending, lost of sensation, 1-2 weeks of progress, protein in CSF)

  9. Dx • Isolation (RT-PCR) in stool, rarely in CSF/brain biopsy, serology (no vaccine/wild differentiation)

  10. IPV • Jonas Salk 1955

  11. IPV • High titers of ab, no secretory ab

  12. OPV • Sabin OPV field trials 1955-59 • Monovalent originally • VAPP 1:2.6 million • 25%(VAPP) inimmune deficient (B-cell) Chumakov Mikhail

  13. Epidemiology

  14. VDPD outbreaks

  15. Advantages and Disadvantages

  16. ב01.09.2013 משרד הבריאות הפיץ המלצה לפיה יש להקפיד לחסן את הפגים לפי הגיל הכרונולוגי גם אם עודנו מאושפז כאשר גיל מינימום למתן IPV הוא 37 שבועות

More Related