Acute poliomyelitis

Acute poliomyelitis /epidemic infantile paralysis, Heine-Medin disease/ is an acute infectious disease with localization of the pathological process in the anterior horns of the spinal cord.

The incidence is highest among children under 5 years of age. Cases of poliomyelitis disease in adults have also been described.

The disease has been known since ancient times, the 4th century BC, however its origin has long remained unknown.

In the 1840s, the German orthopedic doctor Jakob Heine described the clinical picture of poliomyelitis, and in 1887 the Swedish physician Medin established the mode of transmission of this infection and started the epidemiological study of the disease.

In 1908, scientists succeeded in experimentally reproducing poliomyelitis by injecting into the body of a monkey an emulsion from the spinal cord of a child who had died of this viral infection.

The negative results of the bacteriological tests gave reason to attribute the causative agent of this disease to filterable viruses.

The turning point in the study of poliomyelitis was in 1949-51, when the virus that causes it was grown inside the body in monkey kidney and testicular tissue, in human embryo fibroblasts, and in the placenta.

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This discovery made it possible to create a vaccine against poliomyelitis, created prerequisites for laboratory diagnosis of this disease and for the development of methods for its active prevention.

What are the causes?

To date, 3 immunologically distinct types of acute poliovirus have been studied:

• 1st type – Brunhild’s virus – from the name of the monkey from which the virus was isolated.
• 2nd type Lansing – from the name of the city in the USA where this virus was discovered;
• 3rd type Leon – on behalf of the child who died of polio, from whom the virus was identified.

Polio virus is one of the smallest viruses of the enterovirus group with an average diameter of 17-27 microns.

The infectious organism is very resistant to external influences and retains its pathogenic properties for a long time – in milk and milk products for up to 3 months, in water for 114 days, in feces for 180 days.

Tolerates several months of low temperatures, freezing and drying, but is sensitive to the effect of high temperature. A temperature of 55 degrees Celsius inactivates the virus after 6-8 minutes, 75 degrees for 50 seconds.

The virus is completely destroyed by chloramine, bleach, formalin, potassium permanganate, hydrogen peroxide and other disinfectants.

The source of the infection is the sick person or the virus carrier, releasing viruses from their gastrointestinal intestinal contents or from secretions from the nasopharynx and respiratory tract.

Transmission of the infection takes place by air-droplet and fecal-oral route. The autumn-summer seasonality of poliomyelitis indirectly confirms the importance of flies in the spread of the disease.

Until the implementation of mass vaccination, the disease was widespread and observed in all countries of the world, especially in the United States, where the study of this disease was given special attention.

What are the symptoms?

There are 4 forms of poliomyelitis – asymptomatic, abortive, non-paralytic and paralytic.

The asymptomatic form of the disease does not manifest itself at all, being characterized by a temporary shedding of the virus.

The abortive form takes the form of a short-term infectious disease with signs of mild involvement of the upper respiratory tract or esophagus without signs of involvement of the nervous system.

The non-paralytic or meningeal form is characterized by the involvement of the meninges or spinal roots. Clinically, it proceeds as serous meningitis or meningoradiculitis.

The paralytic form occurs only in 2-3% of cases, but it is precisely this one that is associated with severe consequences in the form of severe movement disorders, and that is why the disease has become an extremely serious social and topical problem.

Treatment of acute poliomyelitis

It must be complex, taking into account the stage and form of the disease.

Bed rest is prescribed, which is extremely important for the prevention of the paralytic form.