Poliomyelitis (children's paralysis, heine-medina disease) - acute infectious disease caused by a virus with tropiness to the front horns spinal cord and the motor kernel of the brain, the destruction of which causes paralysis of the muscles and atrophy.

There are sporadic diseases bowl, but epidemics appeared in the past. The number of healthy carriers and persons with an abortive form, when recovery occurs before the development of paralysis, significantly exceeds the number of patients in the paralytic stage. It is healthy carriers and persons with an abortive form - the main distributors of the disease, although it is possible to become infected from the patient in the paralytic stage. The main ways of transmission of infection are personal contacts and fecal pollution. This explains seasonality with the maximum incidence of late summer and early autumn. At the age of 5 years, susceptibility decreases sharply. The incubation period is 7-14 days, but can last 5 weeks. In the last 20 years, there has been a sharp decrease in the incidence in countries where preventive vaccinations are carried out (at the beginning of a solka vaccine and a British vaccine and subsequently oral attenuated seabin vaccine).

What provokes / reasons of polio:

Three strains of the virus are highlighted: Types I, II and III. The virus can be isolated from the nasophack mucosa of patients in the acute stage, healthy virosters, recovering, as well as from the feces. In humans, the most common path of infection - through the digestive tract. The virus reaches the nervous system for vegetative fibers, spreading along axial cylinders in peripheral nerves and in the central nervous system.

Pathogenesis (what happens?) During polio:

It is believed that it is possible to propagate it through blood and a lymphatic system. The place of introducing the virus can be a throat, especially the tonsils after tonsillectomy. The virus is resistant to chemical agents, but is sensitive to heat and drying. It can be grown in the culture of kidney monkeys. Specific serological tests are used, including the complement fixation test and antibody neutralization test.

Patomorphology. The spinal cord is eaten, soft, its vessels are injected, in gray substance - small areas of hemorrhage. Histologically change is most pronounced in a gray substance of the spinal and oblong brain. In the ganglion cells of the front horns, a variety of changes are marked - from light chromatolysis to complete destruction with neuronophage. The essence of inflammatory changes consists in the formation of perivascular couplings, mainly from lymphocytes with fewer polynuclear, and diffuse infiltration of the gray substance by these cells and cells of neuroglial origin.

Recovery is characterized by returning to the norm of those ganglion cells that were not very rude damaged. Other cells disappear completely. In the front horns, a small amount of cells is found, the secondary degeneration of the front roots and peripheral nerves. In the affected muscles - neurogenic atrophy of varying degrees, an increase in connective and adipose tissues.

Symptoms of polio:

4 types of reaction to polio virus are observed:

1. development of immunity in the absence of symptoms of the disease (subclinical or implicit infection);
2. symptoms (in the stage of viremia), which bear the nature of a general moderate infection without engaging in the process of the nervous system (abortive forms);
3. the presence of many patients (up to 75% during the period of the epidemic) of fever, headaches, indisposition can be meningeal phenocytosis in the cerebrospinal fluid, but paralysis does not develop;
4. development of paralysis (in rare cases).

With subclinical form, there is no symptomatic. With an abortive form of manifestations are indistinguishable from any general infection. Serological tests are positive.

The virus can be highlighted. In the remaining variants of the course of the disease, it is possible to observe a preparalitic stage, which can sometimes go into step in paralysis.

Preparalithic stage. During this stage, two phases differ. In the first phase, fever is observed, ailments, headache, drowsiness or insomnia, sweating, hyperemia of pharynges, gastrointestinal disorders (anorexia, vomiting, diarrhea). This phase of small illness lasts 1-2 days. Sometimes, after it comes a temporary improvement with a decrease in temperature by 48 h or the disease passes into the "big disease phase", in which the headache is more pronounced and accompanied by pains in the back, limbs, increased fatigue muscles. In the absence of paralysis, the patient recovers. In the cerebrospinal fluid, the pressure is increased, there is plea) (50-250 in 1 μl). At first there are polymoretons, and lymphocytes, but after the 1st week - only lymphocytes. The level of protein (globulins) is moderately rising. Glucose content is normal. During the 2nd week, the protein level rises.

Paralytic stage. In the spinal form, the development of paralysis is preceded by the becuculation. Pains are noted in limbs, increased muscle sensitivity to pressure. Sometimes the preparalithic stage lasts up to 1-2 weeks. Paraliances can be common or localized. In severe cases, motion is impossible, with the exception of very weak (in the neck, body, limbs). In less severe cases, asymmetry, "spotty" paralysis, muscles can be strongly amazed on one side of the body and the other preserved. Usually, paralysis is maximally expressed during the first 24 hours, the disease is gradually progressing. With the "ascending" forms, paralysts are spread up (from the legs), the situation in connection with the respiratory disorder may occur. "Downward" forms of paralysis are possible. It is necessary to monitor the function of intercostal muscles and diaphragms. A test for identifying respiratory paresses is a loud account in one breath. If the patient cannot count to 12-15, then there is a pronounced respiratory failure, a forced respiratory amount should be measured to determine the need for auxiliary respiration.

Improvement usually begins by the end of the 1st week from the moment of paralysis. As with other neuronal lesions, the loss or reducing tendon and skin reflexes is noted. Sphincter disorders are rare, sensitivity is not violated.

During trunk form (polyedencephalitis), facial paralysis, paralyst language, pharyns, larynx and less often paralysis of external eye muscles are observed. Dizziness, nystagm is possible. The risk of involvement in the process of vital centers is great. It is very important to distinguish respiratory disorders caused by the accumulation of saliva and mucus during paralysis of pharynses, from the true paralysis of the respiratory muscles.

Polio diagnosis:

Sporadic cases should be differentiated from other etiology from myelites.

In adults, poliomyelitis should be differentiated from acute transverse mixer and syndrome Guillana Barre. However, in the first case, the sluggish paralyst legs are combined with exclusive sole reflexes, sensitivity disorders, loss of control over the sphincters, in the second - paresis are localized proximally, is distributed asymmetrically, the protein content of the protein is raised in the cerebrospinal fluid. Bulbarina should be differentiated from other forms of encephalitis. The diagnosis of other forms of viral encephalitis usually depends on the results of serological tests and the selection of viruses.

Polyomelitis treatment:

Mortality during epidemics is quite high. The cause of death is usually respiratory disorders in bulbar forms or upstream paralymps, when intercostal muscles and aperture are involved in the process. Mortality became significantly lower when using IVL. With the termination of the progression of paralysis, recovery is possible. A favorable feature is the presence of arbitrary movement, reflexes and muscle cuts caused by nerve stimulation within 3 weeks after paralysis development. The advanced improvement can continue throughout the year. Sometimes more. However, the continuing manifestations of peripheral paralysis and paresses can lead to disability of patients.

In suspected polio, it is necessary to immediately create a patient with full peace, since the physical asset in the preparation stage increases the risk of heavy paralysis. Three categories of patients (without respiratory and bulbar paralysis can be distinguished; with respiratory paralysis, but without bulbar; with bulbar disorders) and, depending on this, carry out treatment. In the treatment of patients without respiratory disorders, intramuscular administration of ribonuclease, as well as serum reconvalued beans, is shown. In the acute stage, a sufficient amount of fluid is given. Lumbal puncture is necessary for diagnostic purposes, as well as it can reduce headache and back pain. Analgesics and sedatives (diazepams) are used to facilitate pain and reducing concern. The only permissible form of activity is light passive movements. Antibiotics are prescribed only for the prevention of pneumonia in patients with respiratory disorders.

Treatment after the development of paralysis is divided into steps:

1. in the acute stage with bits and increased sensitivity muscles (3-4 weeks);
2. in the recovery stage with the ongoing improvement in muscle strength (6 months - 2 years);
3. in the residual stage (motor disorders remain).

In the acute stage, the main goal is to prevent stretching of the affected muscles and contractures of antagonists, which may require long-term treatment. The patient must lie in a soft bed, the limbs must be in this position so that paralyzed muscles are relaxed (and not stretched) with pillows and sand bags. If recovery, exercises are very important, which the patient performs with extreme help, in a bath or in devices with support for straps and belts. In later stages, in the presence of contractures, there are tenotomy or other surgical interventions. Present prozerne, dibazole, vitamins, metabolic agents, physiotherapy.

With respiratory failure, sometimes during weeks and even months is needed by IVL.

With bulbar paralysis, the main danger is to enter the liquid and secrets into the larynx. Difficulties of feeding patients are aggravated by dysfagia. It is important to the correct position of the patient (on the side), and every few hours it should be rotated on the other side; The foot end of the bed is raised by 15 °. This posture can be changed for care or other purposes, but not long. The secret is removed by suction. After 24 hours of starvation, it is necessary to feed the patient through a nasogastric probe.

Poliomyelitis Prevention:

All discharge, urine, feces may contain a virus. Therefore, patients with recommended occasion isolate at least 6 weeks. In feces, the virus after 3 weeks is found in 50% of patients and after 5-6 weeks - in 25%. Children in a house where there is a sick one should be isolated from other children for 3 weeks after the patient isolate. Modern immunization is a more successful measure of limiting the spread of epidemics. Safety vaccine (1-2 drops on a piece of sugar) creates immunity for 3 years or more.

What doctors should contact if you have poliomyelitis:

Does something bothers you? Do you want to learn more detailed information about poliomyelitis, its causes, symptoms, methods of treatment and prevention, course of the course of the disease and the observance of the diet after it? Or do you need an inspection? You can make an appointment to the doctor - Clinic Euro.lab always at your service! Top doctors They will examine you, examine external signs and will help determine the disease in symptoms, they will advise you and provide the necessary assistance and make a diagnosis. you also can call a doctor. Clinic Euro.lab Opened for you around the clock.

How to contact the clinic:
Phone of our clinic in Kiev: (+38 044) 206-20-00 (multichannel). The secretary of the clinic will select you a convenient day and an hour of visiting to the doctor. Our coordinates and travel scheme are indicated. Look more detailed about all clinic services on it.

(+38 044) 206-20-00

If you have previously been performed any research, be sure to take their results for a consultation to the doctor. If the studies have not been fulfilled, we will do everything you need in our clinic or our colleagues in other clinics.

You? It is necessary to carefully approach your health as a whole. People are not paying enough attention. symptoms of disease And do not realize that these diseases may be vital. There are many diseases that at the beginning do not show themselves in our body, but in the end it turns out that, unfortunately, they are already treated too late. Each disease has its own specific signs, characteristic external manifestations - the so-called symptoms of Disease. The definition of symptoms is the first step in the diagnosis of diseases in general. For this you just need several times a year take a survey from a doctorSo as not only to prevent terrible disease, but also maintain a healthy mind in the body and the body as a whole.

If you want to ask a question to a doctor - use the online consultation section, you may find answers to your questions and read tips for care. If you are interested in reviews about clinics and doctors - try finding the information you need in the section. Also register with Medical Portal Euro.labTo be constantly aware of the latest news and information updates on the site that will be automatically sent to you by mail.

Other diseases from the nervous system disease group:

At the moment, single cases of poliomyelitis are found, whereas in the past, prior to mass vaccination, epidemics of this disease were noted. Even at the beginning of the twentieth century in Europe and Africa for an increase in the incidence of poliomyelitis wore the nature of the national disaster.

In the 50s of the last century, after the active introduction of a polio vaccine, the indicators of diagnosed outbreaks of infection decreased by 99%, but still the endemic regions of the disease in Nigeria and South Asia are noted.

Poliomyelitis is seasonal in nature, incidence growth occurs in the summer-autumn period. Children from a semi-annual age have been particularly susceptible to 5 years old, but also among adults is also recorded cases of infection.

Poliomyelitis - Polyovirus is from the group of intestinal enteroviruses of the Picornaviridae family (Picornaviridae). There are 3 types of this pathogen. In 85% of cases of paralysis, polyivirus of the first type is diagnosed.

The virus has high resistance in the external environment: it remains in the water for 100 days, and in feces six months. Impact of juice digestive tractFreezing and drying is not reflected on its livelihoods. The death of the polyovirus occurs with long boiling, under the influence of ultraviolet and low concentrations of disinfecting solutions (, chlorine lime, furacilin, hydrogen peroxide).

CAUSES

The source of infection is an infected person, both with signs of the disease and the carrier, in which pathology proceeds asymptomatic.

In the human body, the causative agent penetrates through the mucous membranes of the upper respiratory tract and intestines. Basically, there is a fecal and oral path of transmission of infection through polluted food, water, hands. Much less often the dissemination of the disease airborne. Also recorded cases of infection during bathing in a contaminated reservoir.

Development phases:

• Enteral. Primary replication of the virus in almonds with air-droplets or in the lymphoid intestinal follicles during fecal-oral infection.
• Lymphogenic. From localization sites, viral particles apply to lymphoid fabric, then in mesenteric and cervical lymphauzles, where the replication process continues.
• Virushemia The output of the polyovirus from lymphatic system In the bloodstream and its distribution throughout the body. The secondary replication of viral particles is already carried out from the internal organs.
• Neural. This phase of development is possible only in the absence of virus neutralization by mononuclear phagocytes. The pathogen from the blood migrates in the neurons of the front horns of the spinal cord and the motor nuclei of the brain. Damage and death of neurocytes provokes the development of inflammation, in this place the nervous tissue is replaced by the connective.

Special danger to others represent people with an erased symptomatic or light flow of polio. They continue to lead their usual life and distribute the virus among others, becoming the source of infection. In addition, another 3-4 days before the development of the first symptoms of poliomyelitis in the form of an increase in body temperature, the person is already inflamed.

Despite the severity of the disease, only 1% of people after the penetration of the polyovirus through the mucous membranes and virushemia develops a severe form of polio, which is accompanied by sluggish paralysis.

CLASSIFICATION

Poliomyelitis is classified by gravity of damage to the CNS, according to external manifestations, by nature of the flow.

Forms of the disease, depending on the symptoms:

• Poliomyelitis, which flows without damage to the nervous system cells is an inapparantant (Viro) and visceral (abortive) form.
• Poliomyelitis, leaking with damage to neurons, or typical - meningeal, paralytic and non-paralicic form.

By severity of damage to polyovirus of the nervous system:

• Spinal - Parabi muscles of the body, diaphragms, limbs and neck.
• Bulbarbage - suppression of the function of swallowing, breathing, changing speech and reduced cardiac activity.
• Pontine is accompanied by partial change of facial expressions with a distortion of the corner of the mouth on one side of the face and the incomplete closure of the eyelids.
• Encephalitic - signs of focal brain damage.
• Mixed

By the nature of the flow:

• smooth flow - without complications;
• non-country current - with the development of complications in the form of a secondary infection or with exacerbation of sluggish pathological processes).

Symptoms of poliomyelitis in adults

The latent period of poliomyelitis lasts from 2 to 35 days, but mainly it lasts 1-2 weeks. In 95-99% of adult patients, the disease occurs without paralysis.

Symptoms depending on the form of the disease:

• Inapparantant. In other words, meaning the carrier of the virus. There are no external manifestations of infection, it is possible to confirm the presence of the pathogen in the body only with the help of laboratory studies.
• Visceral (abortive). It occurs when diagnosing 80% of cases of polyovirus infection. Most often clinical manifestations There are in the form of fever, headaches, intoxication, the catarrhal phenomena, abdominal pain, nausea, vomiting and is not excluded. Sometimes muscle weakness and chromotype can be observed. Symptoms are nonspecific, the disease ends after 3-7 days with complete recovery.
• Meningheal. Two waves of fevers for 2-5 days are noted, then a headache, muscle weakness, nausea and vomiting appears after 1-3 days. The disease for their flow resembles serous. Recovery occurs after 3-4 days.
• Paralytic (spinal). This form of polio is characterized by the hardest course and an unpredictable outcome. At first, the patient has symptoms of meningeal and abortive form. When re-increasing the body temperature, pain in the spine and muscles, confusion of consciousness and convulsions are noted. The paralytic phase in adults manifests itself on 3-6 days after the appearance of the first symptoms. It is characterized by an unexpected development of the paralysis of the limbs (more often) without losing their sensitivity. Less frequently, the disease is aspic in nature, in which paresis of hands, face and body comes, often with a violation of the function of defecation and urination. Defeat cervical The spinal cord is accompanied by paralysis of the diaphragm and respiratory muscles, which can cause the death of the patient from acute respiratory failure. The severity of the paralysis is growing during the week, then half of the patients occur a gradual restoration of normal motor ability. The quarter of patients with a paralytic form of polio in the future becomes disabled.

DIAGNOSTICS

The identification of the causative agent of the disease is of great practical importance, as similar symptoms are able to cause other types of enteroviruses and herpes. Differential diagnosis It is carried out in order to exclude or confirm the tick-borne, Guienen-Barre syndrome, myelita, serous and other enterovirus infections.

The detection of polyomelitis in non-paralytic form or in the transparalistic stage flowing with the absence of damage to the nervous system is difficult. Often during this period, acute respiratory viral disease, intestinal infections or serous meningitis are mistakenly diagnosed. Therefore, the clinical picture at this stage does not have a determining value. The main role is assigned to laboratory diagnostics.

Diagnostic methods:

• The polymerase chain reaction (PCR) allows you to identify the virus in feces and the patient's spinal fluid.
• An immunoassimensional analysis (ELISA) helps to allocate RNA polyovirus.
• Seric analysis of blood plasma determines antibodies to polyovirus.
• Clinical analysis of the spinal fluid, electroencephalogram, CT, MRI - as additional methods Detect changes in the structure of the motor centers of the spinal and brain.

When taking the global puncture of the spinal fluid, its increased pressure is marked. The content in it leukocytes and protein exceeds the norm.

TREATMENT

Patients with suspicion of polio and detected cases of infection are undergoing treatment in the hospital of the infectious department. Therapy provides insulation, strict bed regime with a limitation of active movements and full nutrition.

Specific treatment of polio is absent, effective antiviral drugs At the moment there is no. All events are reduced to the conduct of symptomatic therapy.

For the treatment of illness, prescribe:

• analgesics;
• antipyretic;
• sedative;
• anti-inflammatory;
• antihistamines;
• intravenous infusion for detoxification.

In addition, it is possible to appoint diuretics, antibiotics, immunoglobulins, antihypoxants and preparations to improve neuromuscular conductivity.

It is important to monitor the correct position of the patient's body. With the development of paralysis, it is placed on a rigid bed without a pillow. Slightly bent in the knees and hip joints Feet are placed in parallel, the feet fixed in a normal physiological position. Hands are bred to the sides and bend them in the elbows at right angles.

Resuscitation activities are carried out in respiratory disorders. To do this, use the device forced ventilation of the lungs with simultaneous suction of mucus from the respiratory tract.

The recovery period begins in the hospital immediately after treatment and continues under ambulance conditions.

The recovery period includes:

• water procedures;
• medical physical education;
• physiotherapy (electrostimulation, UHF, hot compresses on affected muscles).

COMPLICATIONS

With polio, the development of the paralysis of the respiratory muscles, which provokes the attack of acute heart and respiratory failure. These severe conditions are able to cause a fatal outcome, so patients should be under the hospital surveillance.

Other complications of polio can be: interstitial myocarditis, and lung atelectasis. Bulbar forms of the disease sometimes lead to the development of heavy disorders of the gastrointestinal tract, which are accompanied by ulcers, bleeding and vessels.

One of the rather rare complications of vaccination of a living polyovaccine is the development of vaccine-general poliomyelitis.

Prevention

The only effective measure of polyomelitis prevention is vaccination. It provides an active lifelong immunity against the disease. Planned vaccination of children is usually carried out inactivated, and then live vaccine. Inactivated vaccine is introduced intramuscularly by injection, and the living is produced in the form of droplets for oral use. The graphs of the introduction of polyomelitis vaccine differ in different countries in terms of vaccination and revaccination.

Another measure of the prevention of the dissemination of the disease is the insulation of patients into specialized hospitals to complete recovery and compliance with the norms of hygiene.

Forecast for recovery

With non-paralytic species, the prognosis is favorable, often the disease is not accompanied by the emergence of any complications.

With paralytic development with a large share of probability, defects of different severity arise (contracture, paresis, muscle atrophy) and the likelihood of death is increasing.

In case of obtaining disability, prolonged proper treatment and rehabilitation period leads to a significant recovery of lost functions. After defeating the respiratory center, the forecast is significantly aggravated.

According to statistics, in the structure of identified cases of poliomyelitis, light forms of the disease are significantly dominated. As a rule, severe lesions are observed in non-vaccinated patients.

Found a mistake? Highlight it and press Ctrl + Enter

Polio (From Greek Polios Gray, Myelos Brain), or Heine-Medina's disease - an infectious viral disease, characterized by the defeat of predominantly gray spinal cord substance with the development of a sharp muscular weakness. Although today, due to mass vaccination, this disease is rare in Russia, there is still a certain risk. In Afghanistan, Nigeria, Pakistan, and to the present, outbreaks are observed, and this means that the causative agent can be brought to any country of the world. Transferred poliomyelitis leaves after heavier motor disorders, the deformation of the limbs, which is caused by disabilities.

In this article, let's talk about the symptoms of this ailment, about treatment, as well as tell about the importance of high-quality prevention in order to avoid infection.

Historical facts

The disease amazes people since the times of Ancient Egypt. In addition to people, monkeys are sensitive to the causative agent. Poliomyelitis was the cause of epidemics in the twentieth century, carried thousands of lives. Since the 50s of the last century, thanks to the vaccine created, the world got the opportunity to successfully deal with the ailment. Grafting from polio - and today the only effective preventive measure. The beginning of the mass application of vaccination has caused a sharp reduction in the incidence of poliomyelitis, made it possible to almost defeat the disease.

Causes

The causative agent of the disease is polio virus (polyovirus).
It belongs to the family of intestinal viruses. Three types of virus (1,2,3) are known, the 1st of which meets most often. It is multiplied only inside the body, but very stable in the external environment. At temperatures below zero, many years are preserved, at 4-5 ° C - several months, at room - a few days, it does not inactivate gastric juiceThe dairy products are preserved up to three months. Effective in the fight against the virus are boiling, ultraviolet radiation, treatment with chlorine lime, chloramin, hydrogen peroxide, formaldehyde.

The source of infection is always an infected person. It is infected, and not only a patient, since there are cases of carrier of virus without clinical symptoms. A person begins to allocate the virus in 2-4 days from the moment of infection. You can "catch" the infection in two ways:

• fecal-oral: through dirty hands, food, shared things, dishes, towels, water. Insects (flies) can become a carrier of the disease. This path of transmission of infection is possible due to the release of the virus with the feces. In case of non-compliance with the rules of personal hygiene, the pathogen is distributed in the environment. It is believed that the virus is distinguished with feces up to 7 weeks;
• air-drip: with sneezing and cough. The virus enters exhaled air from the nasopharynx of the person in which it is multiplied in lymphoid fabric. The selection of the virus in this way is about a week.

The spread of infection is facilitated by staying in a small room with a significant number of people, impairment of sanitary and hygienic regime, decrease in immunity. Children's teams are in the zone of the greatest risk.

The peak of morbidity falls on the summer-autumn period. The disease is more susceptible to children from year to 7 years.

After entering the virus to the gastrointestinal tract or in the nasopharynx in the lymphatic structures of these parts of the body, the virus is reproduced. After that, it penetrates blood. The blood current is distributed throughout the body, continues its reproduction in other lymphatic structures (liver, spleen, lymph nodes). In most cases, at this stage, the spread of the virus in the body ends. In this case, the patient transfers the disease in easy form (signs of intestinal infection or Qatar of the upper respiratory tract without the development of muscle manifestations) or generally develops the carrier of polio virus. How efficient the body will withstand the further spread of the pathogen depends on the immune state of the body, the number of the virus that has fallen into the body.

In some cases, the virus from the bloodstream falls into the head and spinal cord. Here it selectively affects the motor neurons of the gray matter. The death of neurons is clinically accompanied by the development of muscle weakness in different groups Muscles are developing paralysis.

Symptoms

From the moment of the virus hitting the body to the development of the disease, it can pass from 2 to 35 days (this is called the incubation period). After that, it is possible to further develop the situation in the form:

• vironessions (inapparanty form) - clinical symptoms are completely absent. You can identify the virus only with a laboratory or detect blood antibodies. At the same time, the person is infliced, allocates the virus into the environment and can become a source of the disease for other people;
• small (abortive, visceral) form of the disease;
• defeat nervous system.

Abortive form of polio

According to statistics, this form of illness develops in almost 80% of all cases of polio. Guess by clinical signsThat this is precisely polio, almost impossible. The disease begins acutely with an increase in temperature to 38-39 ° C, headaches, general ailment, sweating. Against the background of weakness and lethargy, there may be a catarrhal phenomena: a small runny nose, redness of the eyes, redness of the mucous membrane of the pharynx, easy sensations In the throat, shaking. This situation is in most cases perceived as an acute respiratory viral disease.

Instead of catarrhal phenomena on the side of the upper respiratory tract, may appear intestinal symptoms: nausea, vomiting, stomach pain, challenge chairs. These symptoms resemble a banal intestinal infection Or are regarded as food poisoning.

After 5-7 days, the body copes with the disease and recovering. Confirm the diagnosis of poliomyelitis in this case is also possible only with the help of additional research methods (search for the pathogen in the nasopharynk, feces or the definition of blood antibodies).

Poliomyelitis, which is also known as children's spinal paralysis or heine-medina disease is an extremely severe infectious disease. Its causative agent is a filtered virus acting on the damage of the gray matter in a certain area of \u200b\u200bthe spinal cord, as well as the defeat of the motor nuclei of the brain. As a result, poliomyelitis, the symptoms of which arise after a while after entering the virus to the body, leads to paralysis.

Poliomyelitis: general information about the disease

Infection of a virus of this disease occurs mainly by means of fecal-oral contact, which occurs through the hands of the mouth. Then, for one to three subsequent weeks, which belong to the incubation period, the virus gradually multiplies in the medium of the mucous membrane of the chipboard and the gastrointestinal tract. In addition, the virus can also be in feces and saliva, which is why the overwhelming majority of cases are marked by the transmission of the virus throughout the specified period.

The completion of the initial phase in which the virus involvement occurs in the digestive system, accompanies its ingress into mesenteric and cervical lymph nodes, after which it turns out to be in the blood. It should be noted that only about 5% of the total number of transfers infected during the passage of the listed periods of the virus are faced with selective damage to the nervous system.

The virus falls into the nervous system due to the intersection of the hematorecephalic barrier, it can also occur through axons of peripheral nerves. Such a development of events can cause infectious damage for the nervous system, in which a presenter clever, hypothalamus and thalamus, surrounding the reticular formation and motor kernels in the brain barrel, cerebellar and vestibular nuclei, as well as neurons of the intermediate and front columns of the spinal cord, are involved.

Poliomyelitis in children whose symptoms are determined depending on the specific form of the disease, the most vulnerable to it determines the category under the age of 4, several years decreases in children under 7 years old, an even less degree of susceptibility, respectively, in older children.

It is noteworthy that by conducting successful developments concerning the creation of an anti-element vaccine, this, once one of the most dangerous diseases of the infectious type, today is almost completely prevented by relevant immunization.

Symptoms of polio

Most patients who subsequently notice infection with the virus of this disease are submitted asymptomatic (about 95%), possibly with small manifestations of a systemic nature expressed in gastroenterite or in. These cases are defined as a small disease, failed poliomyelitis or poliomyelitis abortion. The presence of light symptoms is associated directly with the immune response and the evidence of the virus into the bloodstream with the possibility of its propagation through the body. As for the remaining 5%, the manifestations from the nervous system are possible here, which can be expressed in non-paralytic polio or paralytic (heavier form) polio.

Poliomyelitis: Symptoms of nonparalithic

The initial form of the disease is the form of preparative (non-paralytic poliomyelitis). It is characterized by the following symptoms:

• Ailment of a general nature;
• Increased temperature in the range of up to 40 ° C;
• Decline in appetite;
• Nausea;
• Vomiting;
• Muscle pain;
• Sore throat;
• Headaches.

The listed symptoms within one to two weeks gradually disappear, but in some cases there may be a longer period. As a result of headaches and fever, symptoms appear indicating the defeat of the nervous system. In this case, the patient becomes more irritable and restless, there is an emotional lability (mood instability, permanent change). Also arises muscle rigidity (that is, their numbness) in the field of back and neck, indicating the actively developing meningitis signs of Kernig-Brudzinsky. In the future, the listed symptoms of the preparative form can grow into a form of paralytic.

Poliomyelitis: Abspective Symptoms

The abortive form of the disease does not provoke damage to the nervous system. At the same time, the symptoms characteristic of it are expressed in the following manifestations:

• Increase in order temperature up to 38 ° C;
• Weakness;
• General malaise;
• Nest headaches;
• Lethargy;
• Stomach ache;
• Runny nose;
• Cough;
• Vomiting.

In addition, there is a redness of the throat, enterocolitis, gastroenteritis or catarrhal agrint as associated diagnoses. The duration of the manifestation of these symptoms is about 3-7 days. Poliomyelitis in this form is characterized by pronounced intestinal toxicosis, in general there is a significant similarity in manifestations with, the course of the disease can also be cholera-like.

Poliomyelitis: Meningkeal Symptoms

This form is characterized by its own sharpness, and the symptoms are noted similar to the previous form:

• Temperature;
• General weakness;
• Malaise;
• Stomach ache;
• Headaches of varying degrees of intensity;
• Runny nose and cough;
• Decline in appetite;
• Vomiting.

Inspection reveals the redness of the throat, the possible presence of plaque in the area of \u200b\u200bthe almonds and the sky meck. The duration of this state is 2 days, after which the temperature normalization is observed, the reduction of catarrhal phenomena. The patient looks outwardly looks healthy, which lasts up to 3 days, then the second period comes with an increase in body temperature and greater durability in the symptoms:

• Sudden deterioration in the overall state of the patient;
• Strong headaches;
• Back pain, limbs (mainly in the legs);
• Vomiting.

In an objective examination, symptoms characteristic of meningism (positive symptom of Kernig and Brudzinsky, rigidity in the field of the back and towing muscle). Improving the state is achieved by the second week.

Poliomyelitis: Paralytic Symptoms

As we have already noted, this form is the most severe in the disease and it schemes directly from the symptoms of the form of the previous one. The incubation period lasts from the moment of contacting the virus until the manifestations of a neurological nature, which is usually from 4 to 10 days. In some cases, it is possible to increase this period to 5 weeks.

Initially, there is an appearance of convulsive cuts in muscles with characteristic pains, after which muscle weakness occurs, reaching the peak in the maximum manifestations in the next 48 hours. Further progression can last up to the week. Then, when the temperature drops to the achievement of normal indicators, which also occurs throughout these 48 hours, the progression of weakness in the muscles is stopped. This weakness is asymmetrical, the lower limbs are subjected to a greater degree of suffering.

In the future, there is a lethargy of a muscle tone, an increase in reflexes at the very beginning with their subsequent exception. Often, patients with this form of polyomelitis are faced with overgoing or, in some cases, expressed and permanent beziculation (that is, with externally notable or tangible with palpation with rapid involuntary abbreviations arising in muscle bunches without subsequent movements). Also, patients complain about the occurrence of paresthesia (disorders of sensitivity with feelings of tingling, numbness and "goosebumps"), and sensitivity is not lost in relation to the impact of real irritants.

Passed paralysis for several days or weeks, after which the transition to the gradual recovery period is observed, which, in turn, can last from several months to several years. For residual phenomena, it is characteristic of the presence of sluggish resistant paralysis, contractures, atrophy, deformations, spinal curvatures and limb shortitions. Any such manifestations can cause a relevant disability group depending on the characteristics.

It remains not quite clear such a moment as specific factors contributing to the development of this form of paralytic disease. Meanwhile, there are also experimental evidence indicating that intramuscular infections along with physical activity act in many cases as a serious aggravating factor.

Poliomyelitis: Symptoms of the spinal shape

It is characterized by sharpness of manifestations, the high temperature is constant, sticking to the mark in the range of 40 ° C. Other symptoms:

• Weakness;
• Lethargy;
• Drowsiness;
• Adamina (severely pronounced muscular weakness);
• Often there is an increased excitability;
• Headaches;
• Spontaneously emerging pain in the field of lower extremities;
• Spasms and muscle pain navel, back.

An objective inspection when making a diagnosis of poliomyelitis, the first symptoms of which for two days are expressed in, or pharyngitis, also determines the availability of communal symptoms. Already on their background, manifestations of meningism, including increasing sensitivity regarding the impact of stimuli, are diagnosed. When pressed for the spine or in the area of \u200b\u200bprojection of the focus of the nervous barrel appears pain syndrome. The appearance of paralysis in this case is observed for 2-4 days with signs of asymmetry (left leg, right hand), mosaic (with the damage to the sample muscles of the limbs), the reduction of muscle tone (atony,), lower, or the absence of tendon reflexes. After polio recovery in the primary state motor functions It is characterized by unevenness and the duration of the process, which originates from the second week of this disease.

Poliomyelitis: Dining Symptoms

This form of the disease occurs when the cereal nerve nuclei is damaged, which provokes paralysis of mimic muscles, as well as chewing muscles. The following symptoms are distinguished here:

• Characteristic asymmetry in the field of facial muscles;
• Talking the corner of the mouth to the healthy side of the face;
• Smoothing nasolabial folds;
• Partial time closure;
• The corresponding extension forming in the eye slit;
• Lack of horizontal wrinkles on the forehead.

The listed symptoms acquire significant distinctness when smile, attempts to inflate cheeks and closing eyes.

Poliomyelitis: Bulbarm shape symptoms

This form sometimes occurs in children and is in some kind of "clean". She proceeds without the characteristic paralysis of the limbs and in particular it is subject to children who have passed through the procedure for removing adenoids and almonds. Meanwhile, most often all the same appearance of this form of polio is observed for adults, which is simultaneously combined with characteristic spinal phenomena, as well as when engaging brain. Characteristic symptoms:

• Dysphagia (difficulty in swallowing);
• Dispony (hoarseness, weakness and vibration in a voice when it is conserved caused by a specific voicing disorder);
• Vasomotor violations
• Respiratory failure (slowness and breathing slowness);
• Ikota;
• Cyanosis (skin sinusiness, as well as mucous membranes, resulting in view high content reduced hemoglobin in the blood);
• Frequent alarming and restless states.

In situations with the occurrence of paralysis of intercostal muscles and diaphragms, it is urgent to take care of the conduct of intensive therapy for the patient, as well as ensure artificial ventilation, because the risk of respiratory failure is becoming extremely relevant, which makes it life-threatening. Thus, the process of brainwear is involved in the process, due to which the impassability of the respiratory tract and the oppression of the respiratory center, which contributes to the blockage of their mucus or falling out the pharynx. All this, in turn, leads to a straight obstruction, that is, to obstruction in the field of respiratory tract. Due to the vascular insufficiency, which is characterized by high mortality.

Poliomyelitis: Encephalitic Symptoms

Despite the rarity cases of this form of polio, it should not be noted, as, in fact, and its symptoms. In particular, they have a pronounced nature and include the following manifestations:

• Rapid increase in confidence of consciousness;
• Weakening in arbitrary movements;
• Convulsive syndrome;
• Atfa (speech disorders in the loss of the ability to use phrases and words due to the defeat of the brain zones);
• Hypercines (sudden involuntary pathological movements in a particular muscle group);
• Stupor;
• Coma;
• There are often cases of vegetative dysfunction (manifestations, peculiar to vegetative dystonia, characterized by disorders in certain vegetative functions due to the disorders of their nervous regulation).

Polyomelitis treatment

Antiviral specific treatment of this disease does not exist. The main treatment is carried out at a hospital during isolation for a period of 40 days. Important attention is paid to the care that is required by paralyzed limbs. The recovery period determines the special importance for therapeutic physical culture and classes conducted by orthopedic. Water treatments and massages, physiotherapy in various forms of it play an important role. The period of recovery provides for the need for an orthopedic treatment oriented to the correction of arising deformations and contractures.

To identify poliomyelitis, as well as to determine the appropriate measures to combat its manifestations, contact a neurologist.

Is everything correctly in the article from a medical point of view?

Answer only if you have confirmed medical knowledge

(The disease is also called children's paralysis , heine Medina's disease ) - this is acute disease infectious nature that provokes virus , having tropiness to motor neurons in the front horns of the spinal cord, as well as to the motor neuron of the brain. Due to the destruction of these neurons occurs paralysis muscles and subsequent them atrophy .

Epidemics of the disease occurred in the world until the middle of the last century. But today, due to the mass immunization of children specially developed From polyomelitis, exceptionally sporadic cases of the disease are observed. Graft from poliomyelitis made it possible to stop the spread of polio. However, the number of healthy carriers of poliomyelitis, as well as the number of abortion cases (person recovers before developing ) significantly exceeds the number of people in the paralytic stage. It is they who are the main distributors of polio, although it happens that the infection occurs from the patient in the paralysis stage.

The infection is transmitted mainly through personal contacts, as well as by fecal food pollution. It is the last circumstance that explains why the disease is often developing seasonally: the peak of the dissemination of the disease falls at the end of summer and the beginning of autumn. When poliomyelitis lasts from one to two weeks. Dish polio, as a rule, children aged six months to five years. To date, the disease is found in all countries of the world.

Polio causative agent

If the patient is diagnosed with bulbar paralysis, then there is a risk of fluid in the larynx. In this case, the patient must lie on the side, and once a few hours it must be turned on the other side. The secret is removed using a suction. Food the patient gets through a nasogastric probe.

Previously, during the epidemics of polio, the mortality rate of the fallen was from 5% to 25%. Death during polio occurs due to respiratory disorders when bulbarm or ascending paralycles . Today, mortality decreased significantly. If in time to stop the progress of paralysis, the patient recovers. A good sign in the patient is random movements, deep reflexes and muscle contractions, which are manifested after paralysis due to nerve stimulation. The process of recovery is sometimes lasting a year and more.

The doctors

Medicine

Poliomyelita Prevention

To prevent the dissemination of the disease, mass timely immunization will be applied. Polyomyelitis vaccination using an attenuated poliomyelitis vaccine provides a person with immunity for three years. To date, precisely the vaccination from polio is considered the most effective measure of preventing the dissemination of the disease.

As common measures for the prevention of the disease, a variety of actions are used, among which it is necessary to allocate work on the identification of all cases of the occurrence of the disease, monitoring the circulation of polio viruses in an external environment, a complete vaccination conducted in exactly the deadlines, control over the quality of a vaccine from polio, as well as process Vaccination.

List of sources

• Nisevich, N.I. Infectious diseases in children / Nisevich N.I., Pirikhkin V.F. - M., 1990.
• Laddlenikova I.V. Infectious Disease Handbook in Children / Prot. I.V. Laddlenikova, A.V. Kubashka-on, M.V. Lobody. - K.: Simferopol, 2008.
• Tastenko V.K. Sharp respiratory diseases in children. - M.: Pharmus Print Media, 2008.
• Medical virology: Guide / Ed. D.K. Lviv - M.: Mia, 2008.