Poliomyelitis Prophylaxis

Poliomyelitis General Information

Poliomyelitis is the generic medical term used to define an acute infectious disease of viral nature. This affection is also commonly known as polio or infantile paralysis. The disease is primarily spread from one person to another through the fecal-oral route. The name of the affection is a derivative from Greek terms: polio (which means “grey”), and myelon (a reference to the spinal cord). In up to 90% of the cases, this infection is asymptomatic, while the remaining 10% may exhibit a range of signs and symptoms. In less than 1% of the cases however the virus permeates into the individual’s central nervous system where it infects and destroys the motor neurons, causing the patient to experience muscle weakness and eventually acute flaccid paralysis. Depending on the damaged nerves, there are several types of paralysis which may occur.

There are three types of the disease. Spinal polio is the most common form of the disease, which leads to asymmetric paralysis typically involving the patient’s legs. Another type of Poliomyelitis is the bulbar type, which causes weakness in the muscles that are innervated by the cranial nerves. The third type of the affection is the bulbospinal one, which is a combination between spinal and bulbar polio.

Poliomyelitis Prophylaxis

Poliomyelitis Prophylaxis mainly relies on vaccination to prevent the disease. There are currently two available types of vaccines, and they are employed all around the world in the prevention of the disease. They effectively block the transmission of the virus from one person to another, achieving immunization shortly after the preventive vaccination.

The first vaccine has been developed in 1952 and is generally known as IPV or inactivated poliovirus vaccine. This vaccine is administered to the patients in two to three injectable doses. This commonly results in the developing of protective antibodies in over 99% of the cases; this leads to full immunization against all three subtypes of the virus. The second vaccine, OPV or oral polio vaccine, has been developed a decade later and is known to yield immunity to all serotypes in up to 50% of the cases following a single dose. After three doses of the vaccine, full immunization is attained in over 95% of the vaccinated individuals.

OPV is based on a weakened version of the virus which effectively replicates in the intestine, which is the primary site of infection with the wild form of the virus; however this form is not able to attack and damage the nervous system. The low costs of OPV and its easy administration make it the first choice in Poliomyelitis Prophylaxis in many countries around the globe. However, in very rare cases (studies have estimated the incidence rate for this to be as low as 1 in 750,000) the virus contained in the OPV may revert to a form that may cause paralysis in the vaccinated individual. In order to prevent this, in most developed countries IPV has become the vaccine of choice (as it cannot revert) as part of Poliomyelitis Prophylaxis, either as a stand-alone vaccine or in combination with OPV.

Apart from vaccination, Poliomyelitis Prophylaxis also involves proper surveillance of any possible epidemic outbreaks. If an isolated case occurs, the patient as well as the individuals that may come in close contact with him or her should be immediately vaccinated in order to prevent the spreading of the disease. This includes the medical personnel attending to the patient, although the medical personnel in specialized facilities should be routinely immunized against such infectious diseases.

Maintaining proper hygiene may help prevent the infection. In most cases, thorough washing of the hands with water and soap (or with an alcohol-based solution), particularly before meals, effectively reduces the chances of infection not only with the poliovirus but also with a large number of other types of pathogenic agents.

Poliomyelitis Treatment

Unfortunately, at this time, there is no effective cure for Poliomyelitis. Currently, the treatment mostly focuses on the relief of symptoms and on hasting the patient’s recovery. Prophylactic therapy is also employed, and it aims at preventing any complications from developing. Medication under the form of antibiotics may be administered in order to prevent infections in the muscles. Such medicines are also prescribed to those most affected by the disease. Pain is suppressed through the administration of analgesics, and the patient needs to follow a nutritious diet accompanied by moderate exercise. In many cases, rehabilitation therapy is needed. Physical therapy, corrective shoes and braces are used, and in some cases the patient may need orthopedic surgery.

In some cases, the individual may require assistance in breathing, situations in which the use of portable ventilators is employed. Currently, jacket-type ventilators using negative pressure are employed. These have replaced the so called “iron lungs” that were used in the past to assist the patient’s breathing until he or she was able to breathe again independently. Other Poliomyelitis treatment types were used in the past as well, such as electrotherapy, hydrotherapy, passive motion exercises and massage. Surgery was also employed through procedures such as nerve grafting and tendon lengthening. In some cases, body casts and rigid bracers were used, however their use tended to induce muscular atrophy due to the limiting of the user’s movements.