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Poliomyelitis
Poliomyelitis
Poliovirus:
belongs to “Picorna” viruses which are
small RNA-containing viruses.
Faeco-oral infection:
Food-borne (ingestion) infection through the ingestion of
contaminated foods. Vehicles include milk, water, or any
others that may be contaminated by handling, flies,
dust….
Hand to mouth infection.
Enterovirus (RNA)
Three serotypes: 1, 2, 3
Minimal heterotypic immunity between serotypes
Rapidly inactivated by heat, formaldehyde, chlorine,
ultraviolet light
POLIOMYELITIS PATHOGENESIS
Polio infection
Paralytic Non-paralytic
polio polio
Spinal polio
Bulbar polio
Bulbospinal polio
INAPPARENT INFECTION
Manifestations:
Moderate fever
Upper respiratory manifestations: pharyngitis and sore
throat
Gastrointestinal manifestations: vomiting, abdominal
pain, and diarrhea.
II. Involvement of the CNS (major illness):
Fever
Fatigue,
Headache
Vomiting
Stiffness in the neck and pain in the limbs
DIAGNOSIS AND
LABORATORY TESTING
Laboratory studies, especially attempted poliovirus isolation,
are critical to rule out or confirm the diagnosis of paralytic
poliomyelitis.
Virus isolation
The likelihood of poliovirus isolation is highest from stool
specimens,
intermediate from pharyngeal swabs, and very low from
blood or spinal fluid.
Serologic testing
A four-fold titer rise between the acute and convalescent
specimens suggests poliovirus infection.
IPV(SALK) OPV(SABBIN)
IPV
Use standard IPV schedule if possible (0, 1-2 months, 6-12
months)
May separate doses by 4 weeks if accelerated schedule
needed
POLIO VACCINATION OF PREVIOUSLY
VACCINATED ADULTS