Poliomyelitis, or infantile paralysis, is an infectious disease caused by the poliovirus, a member of the Picornaviridae family. Polio has three serotypes, each of which can cause asymptomatic and clinical forms of the disease, including mild forms, paralysis, and death. Paralytic poliomyelitis is characterized by an acute onset, with high fever, general symptoms, and then paralysis, which may be reversible or irreversible. The disease is transmitted by the feco-oral route and can lead to severe complications, such as muscle wasting and respiratory failure, and in some cases, death.
History of the disease and interesting historical facts
Poliomyelitis has been known to mankind since ancient times. One of the first historical references to the disease can be found in ancient Egyptian hieroglyphs, which describe people with paralyzed limbs. The disease became officially known in the 19th century, when outbreaks of poliomyelitis were recorded in Sweden, Norway, and the United States. In the 1950s, a landmark event in the fight against this disease occurred – the development of vaccines. The first live attenuated vaccine was created by Albert Sabin, and the inactivated vaccine – by Jonas Salk. These vaccines played a key role in controlling and reducing the incidence of the disease worldwide.
Epidemiology
According to the World Health Organization (WHO), polio has been almost completely eradicated in most countries since the beginning of the 21st century. In 1988, the incidence was about 350,000 cases per year. In 2020, less than 150 cases of polio were reported, exclusively in a few countries such as Afghanistan and Pakistan. Epidemiological studies show that although the main route of transmission of the virus is feco-oral, various factors such as low vaccination rates and living conditions create the risk of outbreaks in vulnerable populations. By 2021, the World Health Organization declared success in eradicating the disease, but there are still regions where vaccines have not yet achieved high levels of population coverage.
Genetic predisposition to this disease
The development of genetic studies has shown that predisposition to severe forms of poliomyelitis is associated with certain variants of genes responsible for the immune response, in particular, genes encoding interferons and their receptors. Among the genes involved are the following:
- IFNAR1 is a gene encoding interferon receptors, which play an important role in protecting the body from viral infections.
- APOBEC3 is a gene that is responsible for antibacterial activity and can affect viral replication.
- TLR3 is a gene involved in pathogen recognition and activation of the immune response.
Disruptions in these genes can provide the virus with the ability to evade the immune response, which increases the risk of developing paralytic forms in certain population groups and affects disease outcomes.
Risk factors for the development of this disease
There are various risk factors that increase the likelihood of contracting polio. These include:
- Low vaccination rates – Insufficient vaccination coverage leads to increased cases of the disease in communities.
- Poor sanitation and lack of clean water contribute to feco-oral transmission of the virus.
- Presence of associated infections - immunosuppression caused by HIV or other viruses increases the risk.
- Population migration – refugees and internally displaced persons may become infected in conditions of poor sanitation.
It is important to note that most cases of polio can be prevented through regular vaccination and improved sanitation.
Diagnosis of this disease
Diagnosis of poliomyelitis begins with a thorough history and physical examination of the patient. The main symptoms include:
- Fever, headache and general weakness;
- The occurrence of pain in the muscles and neck;
- Paralysis of the limbs (in severe cases);
Laboratory tests, such as detection of the virus in stool or cerebrospinal fluid, are essential to confirm the diagnosis. Radiological examinations, including MRI, can help identify changes in the spinal cord. Other diagnostics include serological tests for antibodies to the polio virus. The differential diagnosis includes other infectious and neurological diseases with similar symptoms.
Treatment
Treatment of poliomyelitis is largely supportive and symptomatic. General measures include:
- Providing rest and bed rest to reduce the load on the affected limbs;
- Pharmacological treatment includes analgesics and anti-inflammatory drugs to relieve pain;
- Physiotherapy to restore muscle function and strengthen weak limbs.
In severe cases, surgery may be required to correct the deformity or eliminate contractures. However, there is no specific antiviral treatment.
List of medications used to treat this disease
There are currently no specific antiviral drugs used to treat poliomyelitis. The main therapy includes:
- Ibuprofen – to relieve pain and inflammation;
- Paracetamol – to reduce temperature and relieve pain;
- Muscle relaxants – to relieve spasms;
- Physiotherapeutic drugs – for rehabilitation and restoration of muscle functions.
Disease monitoring
Monitoring of the patient's condition includes regular examinations to assess the progression of the disease and to mitigate potential complications. The prognosis depends on the speed of treatment initiation and the severity of the clinical picture. The leading complications may include:
- Long-term paralysis;
- Breathing problems;
- Joint contractures and deformities.
Optimal treatment and timely rehabilitation can significantly improve the quality of life of patients.
Age-related features of the disease
Polio can affect people of all ages, but the greatest threat is to young children. In children, the disease is usually more severe and can lead to paralysis. In adults, cases of poliomyelitis are less common, but more often lead to serious complications. In older people with weakened immune systems, the risk of developing severe forms of the disease is high, which requires careful consideration in clinical practice.
Questions and Answers
- What is polio and how is it transmitted? Polio is an infectious disease caused by a virus that is transmitted through the fecal-oral route.
- What are the main symptoms of polio? The main symptoms include fever, headache, muscle pain and possible paralysis of the limbs.
- How is polio diagnosed? Diagnosis includes tests for the presence of the virus in stool or cerebrospinal fluid, as well as a clinical examination and assessment of symptoms.
- How to treat polio? Treatment for poliomyelitis is supportive and includes analgesics, anti-inflammatory drugs and physiotherapy.
- What is the prevention of polio? Prevention includes vaccinating children and providing sanitation to reduce the incidence of the disease.
Polio thus remains an important public health problem requiring continued attention, monitoring and vaccination to prevent its spread and development of severe forms.
