Poliomyelitis, spinal children's paralysis, Heine Medina's disease is the names of a severe infectious disease. The causative agent of the disease is a filtering virus, the smallest of enterovirus, affecting the gray substance of the front horns spinal cord, Motor cores of the brain barrel and causing paralysis.

Polio virus

The pathogen landsteiner and popper is opened, the disease is described as early as the 80s of the nineteenth century Ya. Heine, A. Ya. Kozhevnikov and O. Medina. The virus is stable in an external environment, it is destroyed at a temperature of 56º in 30 minutes, with ultraviolet irradiation and in disinfectants - chlorine, chlorine lime, potassium permanganate, formalin. For a long time remains in milk and dairy products (up to 3 months), in water (up to 4 months), in the wheel masses (up to 6 months). Three types of virus were found: 1-virus of Brungilda, 2- virus Lansing, 3-Virus Leon.

In the middle of the 20th century, the increase in the incidence of poliomyelitis took the nature of the epidemic in Europe and North America. Currently, single, sporadic cases of polio disease are found, the incidence is reduced in countries where population vaccination is carried out. In 2010, only Afghanistan, India, Nigeria, Pakistan remained endemic in polio, in 1988 there were 125 countries. In 1988, the World Health Assembly adopted a resolution on the liquidation of poliomyelitis in the world. The Global Poliomyelitis Elimination Initiative has reduced the incidence of 99% over the years. And this is the merit of active immunization of children. The risk of import of the virus from the "disadvantaged" countries remains.

Now much argue about the feasibility and harm of the vaccinations to children. Before deciding, vaccinating your child or not - read - what is "poliomyelitis". Here are terrible photos of the poliomyelitis of children in countries where vaccination is not carried out:

A virus from the nasopharmaceous mucous membrane and the patient's feces in the acute period and in healthy viruses are distinguished. The source of the disease can be patient with erased, atypical, abortive forms, without a paralytic stage, when poliomyelitis proceeds as ordinary ORZ and is not diagnosed. The virus stands out with feces in the first 2 weeks of the disease, fecal carriage can last up to 3 - 5 months. From the nasopharynx, the virus is highlighted in the first 3 to 7 days.

The susceptibility is small - 0.2 - 1%. Mostly children under 7 years old.

The path of infection - through the gastrointestinal tract, unwashed hands, water, food. Across lymphatic system, blood, along the axial cylinders of vegetative fibers and peripheral nerves, the virus falls into the central nervous system, Causeing dystrophic and necrotic changes, which causes the development of motor disorders - paresis and paralysis.

There is a seasonality of the disease with a maximum in the summer-autumn period.

Symptoms of polio

Incubation period (The period before the emergence of clinical signs of the disease) - 7 - 14 days.
Paralytic poliomyelitis is distinguished - spinal, bulbar, pontane, encephalitic, mixed and non-paralytic - uncertain, visceral, meningeal.
The course varies from very light erased forms to heavy.

The initial stage of the disease is transparablyotic - characterized by acute start, increase in temperature, catarrhal phenomena and disorders of the gastrointestinal tract. From the side of the nervous system are possible - headache, vomiting, lethargy, low-passability, increased fatigue, drowsiness or insomnia, muscle twitching, trembling, convulsions, symptoms of irritation of roots and brain shells - Pain in the spine, limbs. It lasts such a state up to 5 days. At best (if vaccination was carried out) the disease does not switch to the next stage and the patient recovers.

The next stage is paralytic - the temperature drops, pain in muscles pass, paresis and paralysis appear. The lower limbs are more striking, the deltoid muscle, less often the muscles of the body, neck, abdominal press, respiratory muscles. With trunk form, the muscles of the face, language, pharynx, larynx are affected. Paraliances are asymmetrical, sluggish. The muscle tone is reduced, tendon reflexes are reduced, after 1 - 2 weeks, muscle atrophy develops, dislocations in the joints.

The rehabilitation stage - lasts 4 - 6 months, then the pace of recovery decreases - muscle atrophy remains, contractures.

Residual phenomena - the residual stage is the stage of persistent sluggish paralysis, atrophy, contractures, deformations and shortening limbs, spinal curvatures.

Mortality in the epidemics of polyomelitis is 5 - 25% mainly from respiratory disorders during the respiratory muscles paralysis.

The remaining deformations of the spine, limbs can cause disability for life.

Diagnosis of polio

Diagnostic significant symptoms - acute feverish principle, rapid development of sluggish paralysis, asymmetry of paralysis, with a great defeat of the proximal departments. Lumban puncture is made to confirm the diagnosis, laboratory diagnostics - serological and virological.

Paired blood serums collected with an interval of 3-4 weeks. The "color" sample is used - based on the ability of the indicator (phenol red) to change the color in the modified pH of the cell culture medium infected with the polio virus. Result for 48 hours.

The differential diagnosis is carried out with meningitis, myelitis, hyena bar, encephalitis, polio-like diseases.

Polyomelitis treatment

Specific antiviral treatment of poliomyelitis does not exist.

Treatment is carried out in a hospital - boxing hospital box. Isolation of the patient for 40 days. Use symptomatic therapy, gammaglobulin, vitamin C, B1, B6, B12, amino acids. With damage to the respiratory muscles - artificial ventilation of the lungs. Bed regime is required by 2 - 3 weeks.

Much attention should be paid to care for paralyzed limbs. All movements should be careful, slow, the feet should not hang, the position of the limbs and the spine must be correct. The patient lies on the bed on a hard mattress, legs are stacked in parallel, slightly bent in the knee and hip joints With rollers. The feet are placed at a right angle to the lower leg, under the sole, a dense pillow is put for stop. Hands are removed on the sides and bend in the elbow joints at right angles. To normalize nervously - muscle conduction Use prozerne, neuromidine, dibazole.

During the period of restoration, the priority role is assigned to therapeutic physical education, classes with orthopedics, massage, water procedures, physiotherapy - UHF, paraffin applications, electrostimulation. Sanatorial - resort treatment - Evpatoria, Odessa, Anapa, Saki. Sea baths, sulfur, mud baths are used.

In the residual period is carried out orthopedic treatment - conservative, operational for the purpose of correction of developing contractures and deformations.

The whole world united in the fight against the virus. In the world there should be not a single child infected with polio. Always kids in any country are risky. For Russia, the risk of import of wild virus in connection with migration from Tajikistan is relevant. In this regard, the surveillance surveillance of sanitary rules and the prevention of polio. It is planned at checkpoints through the state border of the Russian Federation arriving from Tajikistan once vaccinated and inform about the need for the second and third vaccination. Consider this by making the decision to vaccinate your child!

Poliomyelita Prevention

Polio prevention - vaccination of a lively weakened vaccine Sebin (Chumakov, Smorodins) in 3 months three times in a month - droplets in the mouth on lymphoid fabric, the surface of the sky almonds, revaccination at 18 months, 3 years, 6 years, 14 years.

Inactivated vaccine, containing killed wild polio viruses, is intramuscularly introduced.

Produced in the syringe - a dispenser of 0.5 militers. It is introduced to the kids subcutaneously into the subband area (less often in the shoulder), older children in the shoulder. Make 2-3 administrations at an interval of 1.5 - 2 months, in a year they carry out the first revaccination, in 5 years the second. In further revaccination is not required. Both vaccines contain all three types of poliomyelitis virus.

In the hearth of the disease, sanitizing - hygienic events - disinfection of dishes, clothes, all objects that could be infected. Contact children are on quarantine until 15-20 days.

Consultation of the doctor neurologist on polio:

Question: Can an adult, not a vaccinated person get sick?
Answer: Any adult man with a weakened immunity of vaccine-associated polio can get sick. Parents, Patients with AIDS, taking medicines that suppress the immune system can be infected with the child. To avoid it, you need to observe personal hygiene, wash your hands, not kiss a child in the lips.

Question: What is the difference in vaccines used?
Answer: Inactivated vaccine has a number of advantages in comparison with the vaccine that is injected through the mouth: the possibility of developing such a complication as a vaccine-general poliomyelitis, no intestinal disorders, gives 100% immunity. After a drop, the child highlights a lively vaccine virus for two months, which represents a danger to others.
Crushed painless. The droplets are salty-bitter, the baby can dump, snatch and the vaccination will disappear.

Question: Complications of grafting from polio?
Answer: Vaccinoassoic polio can develop in the case of the use of live vaccine (oral droplets) weakened child, allergic reactions - urticaria, swelling of quinque, intestinal dysfunction.

Doctor neurologist Kobzeva S.V.

Good day, dear readers!

In today's article, we will consider with you such an infectious-neurological disease, like polio, as well as its symptoms, causes, types, diagnosis, treatment, medication, folk remedies and prevention. So…

What is polio?

Polio - acute, viral nature, characterized by preemptive damage to the nervous system, head and spinal cord, gastrointestinal tract. One of the most popular result of polio disease is paralysis and muscle tissue atrophy. Disease polio in most cases is diagnosed in children, age up to 5 years.

Other names of polio - Heine Medina's disease, children's paralysis.

Polio causative agent - Poliovirus (Poliovirus Hominis), belonging to the group of enterovirus (lat. Enterovirus). The source of infection is the pathoger carriers.

The main symptoms of polio - general malaise, headaches, redness of the pharynx, increased sweating. In fact, poliovirus infection is accompanied by symptomatics, similar to the disease with sharp respiratory diseases (ORZ). Moreover, even the injection of the virus in the body is usually airborne.

The main measure of polyomelitis prevention is vaccinating the population.

Polio development

Path transmission of polio virus - air-drip and oral-fecal.

Entrance gates for poliovirus, where he settles and begins to actively multiply, are the nasophack and intestines, which depends on the path of infection of the body.

The incubation period of polio - from 5 to 14 days (rarely incubation period can last up to 35 days).

At the initial stage, the Viral infection begins to multiply in the lymphoid formations of the nasopharynx or intestines. Further, the polyovirus penetrates into the circulatory system, and together with blood current applies throughout the body. However, Poliovirus Hominis has one feature, he likes to "eat" the cells of the nervous system, therefore, the target organs with polio are preferably 2 parts - the head and spinal cord. Doctors have established if Polyovirus leads to the death of 25-33% of the spinal cord cells - a person develops paresis (partial loss of the motor function), but if the dead cells turn out to be about 75% - the full paralysis develops.

The dead nerve cells are replaced by another cloth, and due to the fact that the motor function is disturbed due to the innervation of certain tissues, the muscles lose tone and begin to atrophy. One of the main signs of muscle atrophy is their significant reduction in volume.

Nevertheless, the flow of polio and its nature depends on the state of human health, immunity reactivity, the presence of vaccinations from poliomyelitis.

In this regard, the flow of polio after the incubation period can occur in the following options:

1. Abortive form of polio - relatively light shape of the course of the disease with mainly catarrhal phenomena, total weakness, a slight increase in temperature, nausea, digestive disorders, as well as the absence of damage to the cells of the nervous system. In addition, this form of the disease is a source of infection.

2. non-paralitic form of polio - accompanied by symptoms characteristic of inflammatory infectious diseases - elevated body temperature, runny nose, nausea, diarrhea. It may also flow along the type of meningitis (inflammation of the brain shells) in a light form, with periodic pains in the back (radiculitis), symptoms of Kerniga, Nerry, Lasega.

3. Paralytic form of polio - accompanied by damage to the cells of the spine and brain in combination with symptoms characteristic of inflammatory infectious diseases.

The initial manifestations of paralysis are considered precursors of the transition of the disease from non-paralytic form to paralytic. The development of paralytic form takes place in 4 stages:

Poliomyelitis 1 Stage (Preparalic Stage) - It is characterized by an acute beginning of a duration of 3-5 days, elevated body temperature, headaches, runny nose, pharyngitis and digestive disorders. After 2-4 days, a secondary fever wave appears with an increase in temperature to 40 ° C and a strengthening of symptoms. The patient begins to disturb pain in the back and limbs, sometimes there is a confusion of consciousness, there is a periodic weakness of muscles, muscle cramps and some limitations. motor functions.

Poliomyelitis 2 Stages (paralytic stage) - It is characterized by the weakening of tendon reflexes, a decrease in muscle tone, restricting motor functions and a sharp development of paralysis. Most often, these phenomena are present in the upper part of the body - hand, neck, torso. Danger for life is a bulbar form of paralytic polio, which is accompanied by paralymps of respiratory organs and impairment in the work of the heart, which ultimately leads to suffocation of the patient. The duration of the paralytic stage is from several days to two weeks.

Poliomyelitis 3 Stages (rehabilitation stage) - It is characterized by the gradual restoration of the functioning of paralyzed muscles for a long period - from several months to 3 years, and, at the beginning, this process is quite fast, and after slowing down.

Poliomyelitis 4 stages (residual, or stage of residual phenomena) - characterized by atrophy of some muscles, sluggish paralysis, the presence of contractures and deformities in the limbs and torso.

The functions of deeply affected muscles are usually completely restored, therefore, children often remain different deformations.

Pathogenesis of polio

Under the damage to Polyovirus and the development of the disease, the spinal cord is inflamed, becomes soft and edema, and hemorrhagic sectors are present in the gray substance. With the help of histology, the most pronounced changes are noted in the gray substance of the oblong and spinal cord. Diagnostics shows a variety of changes in the ganglion cells of the front horns - from a light degree of chromatolysis to their complete destruction, accompanied by neuronophage. The main essence of the pathogenesis is expressed in the formation of perivascular couplings consisting mainly of lymphocytes, as well as diffuse infiltration lymphocytes and neuroglial cells of the gray matter. Not affected by deep ganglion cells, in the recovery stage, gradually return to normal state.

Polio statistics

Poliomyelitis in children from 6 months to 5 years has been registered most often. The peak of morbidity usually falls for summer-autumn. At an earlier age, the disease is practically not diagnosed, which is associated with the presence of maternal immunity in newborns, transplantary transmitted by the mother to the child.

Poliomyelitis, like Rishta, is included in the global liquidation program, which is conducted under the guidance of WHO, UNICEF and Rotary International (Rotary International).

In general, the spread of polio with the help of mass vaccination of people managed to suspend. For example, in 1988, there were about 350,000 record cases of the disease, and in 2001, only 483 cases of illness were recorded. After 2001, it is recorded annually, an average of about 1000 patients, a significant part of which lives in the territories of South Asia (Afghanistan, Pakistan and their surrounding countries) and in Nigeria.

The most often rates of morbidity were registered in the summer and autumn.

Poliomyelitis - ICD

ICD-10: A80, B91;
ICD-9: 045, 138.

Poliomyelitis - symptoms

Symptoms and its severity depend on the age and health of the patient, as well as type inflammatory process. In some cases, the disease can flow in asymptomatic form or with minimal manifestations.

The first signs of polio:

• Sometimes digestion disorders may be present in the form or.
• Increased body temperature.

The main symptoms of poliomyelitis are manifested in 2-4 days after the first signs of the disease, while the patient's condition deteriorates sharply.

The main symptoms of polio

• , soreness;
• Headaches;
• (up to 40 ° C);
• Increased sweating;
• Redness () and sore throat;
• Increased drowsiness or;
• Gastrointestinal disorders - nausea, diarrhea, constipation, rapid weight loss;
• There is a decrease or loss of tendon and skin reflexes;
• Tension in the cervical muscles;
• Pares, muscle atrophy, paralysis (in rare cases);
• It is also possible to appear, nystagm, incontinence or urine delay and feces.

Complications of polio

• Paralysis;
• Respiratory failure;
• Violation of the cardiovascular system;
• Interstitial ,;
• Acute expansion of the stomach;
• Formation in the organs of the zhazv gastrointestinal, carriers and internal bleeding;
• Lung Atelectasis;
• Fatal outcome.

Polio causative agent - Poliovirus (Poliovirus Hominis, polio virus), belonging to Enterovirus (Enterovirus), Picornaviridae family.

In total, there are three strains of polyovirus - Types I, II, III, and Most people are diagnosed with polyovirus I type.

Source infection - a sick person who at the initial stage the virus is excreted with saliva and is transmitted by air-droplet, but as the disease develops, Polyovirus will settle in the intestine and stands out to the external environment through feces, which is why people are infected through non-compliance, as well as Eating infected food. Flys can also be transferred, which first climbed on infected feces, and after food.

Poliovirus is sufficiently resistant in the external environment - it can maintain its activity in feces up to 6 months, in the open air to 3-4 months, tolerates freezing, does not destroy when exposed to digestive juices. You can inactivate the virus using drying, ultraviolet rays, boiling, chlorine processing, heating to 50 ° C.

Finding into the body, polyovirus spreads through the body using the lymphatic and blood system, reaching and affecting the ultimate nervous system. Especially infection likes to hit the motor cells of the front horns of the spinal cord, as well as the core of the cranial nerves.

Types of polio

The classification of polio is made as follows:

Type:

Typical forms - With the defeat of the central nervous system. The disease can develop in the following options:

- non-paralytic - is accompanied mainly by symptomatics characteristic of acute respiratory diseases (ORZ) and the development of serous meningitis or meningoradiculite, in which the presence of radiculitis is often noted.

- paralytic - accompanied by the appearance of patients in patients, muscle atrophy and paralysis. Depending on the localization of the inflammatory process, distinguishes:

• Spinal poliomyelitis - accompanied by damage to the spinal cord mainly in the region of lumbar thickening and is characterized by a violation of the motor function (bending, extension) different groups Muscles on the legs and arms. Paraliances are usually asymmetrical. The most dangerous is paralysis of chest and cervical departments The spinal cord, since this often leads to the appearance of the muscles of the muscles of the respiratory organs and, accordingly, disruption of the respiratory function.
• Bulbaric poliomyelitis - accompanied by the lesion of bulbar brain nerves and is characterized by disorders of swallowing, violation of the activity of respiratory and cardiovascular systems. Special attention is paid to the performance of breathing, since the paralysis of the diaphragm with further fading sometimes leads to a fatal outcome. The defeat of the respiratory organs can be divided into two main forms - "dry" ( airways Free) and "wet" (the respiratory tract is clogged with saliva, mucus, and sometimes with vomit masses).
• Pontane polio - accompanied by the defeat of the Barolic Bridge and is characterized by the lesion of the facial nerve (paresa and other manifestations), which can be the main, and sometimes a single sign of the disease;
• Mixed form is accompanied by simultaneous damage to several areas of the spinal and brain.

Atypical forms - It is characterized by the lack of damage to the CNS. Maybe under the following types:

- the inapparanty form - the symptomatics is absent, however, the patient is a peddler of infection (Vironessiance);

- Abortive form - there are minimal manifestations of the disease in the form of catarrhal phenomena, total weakness, nausea, elevated body temperature, while there are no signs of damage to the nervous system. Nevertheless, despite the ease of the course of the disease, such a patient is an active virus monitoring and source of infection.

With the flow:

- smooth;

- Non-smooth, which can be:

• With complications;
• With the advent of secondary infections;
• With the appearance of exacerbations chronic diseases.

By severity:

• Light shape;
• Middle shape;
• Heavy shape.

Diagnosis of polio

Polio diagnosis includes:

• General inspection, history;
• Study for the presence of a virus of nasopharynx and cartoons;
• Research using IFA methods (IGM discovery) and RSK;
• Polymerase chain reaction (PCR diagnostics);
• Electromyography;
• Carrying out lumbar puncture and further study of the cerebrospinal fluid.

Poliomyelitis in adults should be differentiated from Guienen Barre syndrome, myelita, botulism, and serous meningitis.

Poliomyelitis - Treatment

How to treat polio? Polyomelitis treatment is carried out after careful diagnosis and includes the following items:

1. Hospitalization and bed regime;
2. Medical treatment;
3. Physiotherapeutic procedures.

1. Hospitalization and bed

The patient with a suspicion of polio is delivered to the medical institution under the hospital. Moreover, the patient in the case of the identification of polyovirus is placed in the infectious compartment, in a special boxing for 40 days.

Bed regime is aimed at preventing the development of complications in the form of contractures and deformations of the limbs, so the patient needs to limit movement in the first 2-3 weeks. If necessary, damaged areas are immobilized with special devices - Longlets, etc.

The affected parts of the body must be wrapped in a warm handkerchief, plaid. The patient must lie on the hard mattress.

In addition, the patient's isolation is important in epidemiological purposes - to prevent the dissemination of infection on the surrounding people.

2. Medical treatment

2.1. Anti-infectious therapy

Special serums to relieve a polio virus in the body of the patient as of the beginning of 2018, not yet invented, at least official information about this was not revealed.

In this regard, anti-infectious therapy is aimed at strengthening immunity so that the body can overcome polyovirus.

For this, the patient is introduced intramuscularly gamma globulin, with a dosage of 0.5-1 ml per 1 kg of body weight, but in the amount of not more than 20 ml. A total of 3 to 5 such injections is made. Interferon preparations are also introduced.

Gemotherapy (according to MA Khazanova method) is also carried out by a child intramuscularly introduced 10-20 injections of 5-30 ml of blood, taken from the Vienna of the Father or Mother. Serum for injection is taken from parents recovered from polio or adults, which in contact with patients with children (serum reconversion).

Antibiotics in polio are prescribed only if there is a threat to the addition of a secondary infection of bacterial origin in order to prevent the development of pneumonia and other diseases of the bacterial nature. Antibiotics counter viral infection Not effective.

2.2. Anti-inflammatory therapy

Dehydration therapy is used to remove the inflammatory process with the shells of the head and spinal cord, using saluretics - "Furosemid", "Indapamide", "Hydrochlorostiazide".

To dilute the sputum and removal of the inflammatory process, in the absence of respiratory disorders, ribonuclease is used.

Also, to remove the inflammatory process can be designated - "", "", "Afida".

2.3. Symptomatic treatment

To normalize the state of the patient and maintain the general condition of the body, from the first days it is necessary to introduce vitamins, amino acids.

With respiratory disorders, artificial ventilation of the lungs (IVL) is used.

After the end of new paralysis, with the aim of normalizing the work of the nervous system, anticholinesterase preparations are used, which stimulate the myonevel and interneurone conductivity - Nivalin, Poszerne, Dibazol.

Analgesics are used to relieve pain syndrome in muscles.

To calm and relax the patient, sedatives are used - "Diazepams," Taoten "," Persen "," Valeriana ".

With violation of the swallowing function, feeding is carried out using a nasogastric probe.

2.4. Restoration

In the initial recovery period (approximately from 14 to 20 days) assign:

• - , AT 6;
• anticholinesterase preparations - Nivalin, Poszerne;
• nootropic drugs - "glycine", "piracetam", "Cavinton", "Bifren";
• anabolic hormones.

3. Physiotherapeutic treatment

Physiotherapeutic procedures are aimed at restoring motor activity and muscle restoration, internal organs and systems, restoration of nerve cells.

So, for the treatment of poliomyelitis and rehabilitation after it, the following procedures apply:

• Electromability;
• Refinotherapy;
• UHF therapy;
• Medical baths;
• Orthopedic massage and medicinal physical culture (LFC) - aimed at restoring muscle tone and motor activity damaged plots On the body of the patient.

Very beneficial on the body affects the rehabilitation in sanatorium-resort conditions.

Sanatorium-resort treatment is carried out in the interval from 6 months to 3-5 years, not earlier and no later.

Important! Before applying folk remedies against polio, be sure to advise with the attending physician!

The following folk remedies are used mainly in the recovery period of the disease.

Rosehip. Push up half the glass of fruits into the thermos, fill their 1 liters of boiling water and put on the night to insist. Take the infusion of rosehip is in warm form, half a glass 3 times a day. Rosehip in its composition has a large number ascorbic acid (Vitamin C), which is a natural work stimulator immune system. Due to this, the rosehip helps in the fight against many infectious diseases.

Celandine. Fill 1 tbsp. A spoonful of dry grass 300 ml of boiling water, cover the capacitance with a lid and leave a means for 1 hour to insist. After, strain the infusion, and take it in a warm form for 2 hours. Spoons 3 times a day.

Aloe. In pharmaceutical kiosks, you can purchase an extract for injection, which is introduced subcutaneously to 1 ml within 30 days, 1 time per day. After injection, 20 minutes of peace is needed.

Poliomyelita Prevention

Poliomyelitis prevention includes:

• Isolating the patient at the time of treatment in the infectious department of the medical institution;
• Carrying out disinfection in the field of detection of the source of infection;
• Compliance with personal hygiene rules;
• Processing of food before their use;
• Vaccination.

Vaccination against polio

Graft from poliomyelitis today is considered the main preventive event against this disease. The vaccination contributes to the development of immunity to the poliovirus, after which, if a person is ill (which occurs extremely rarely), the course of the disease passes in an easy degree with the lack of complications.

As of 2018, there are 3 main types of polyomelitis vaccine:

Sea vaccine (Live vaccine Sein, OPV, OPV) - oral vaccine against poliomyelitis, which is given to a child of 1-2 drops on a piece of sugar. Immunity against poliovirus is created for 3 or more years. Replicates in the gastrointestinal tract without spreading to nervous fibers. To achieve the desired result, the OPV vaccine must be administered 2-3 times. Effective against all 3 types of polyovirus - PV1, PV2 and PV3. There are also rare cases when a weakened virus returns to its normal form and causes paralytic poliomyelitis, which is why many countries have moved to the immunization of the population using a solka vaccine (IPV).

Infectious

Video about polio

Poliomyelitis - acute infectionIn which the Poliovirus Hominis virus affects the spinal cord and causes the body muscle paralysis. The disease most often amazes children from 1 to 5 years.

How can I get infected with polio

Poliomyelitis causative agent is Poliovirus Hominis Enterovirus. The virus is well adapted to survival in an aggressive environment. It lives up to 30 days with sunlight, not afraid of cold, household chemicals. At room temperature, the death of the virus occurs only in 90 days. All this explains his ability to mass infection and ease of transmission from the patient to a healthy person.

Poliomyelitis is transmitted mainly in two ways:

1. through direct contact (through touch, public items, food);
2. by air from the sick people and carriers.

Cases are recorded when the disease was transferred through flies and other insects.

Epidemics are more often starting in summer and autumn. The most popular is the air-drip method of infection. The virus with a jet of air falls into the throat, settles on the lymph nodes and begins to be self-reproduced. Next, the pathogen goes to other the lymph nodes On the body, penetrates the intestines, then into the blood. Next, it is possible to defeat the central nervous system - the spinal and brain.

The injection of the virus into the body does not always cause a disease in its full form. Often the disease proceeds asymptomatic or in a light form. Most of the diseases are children from year to 5 years.

What are the forms of polio

Depending on the immunity of the child, polio can flow in different ways. There are several forms of the disease.

• Atypical inapparanty form- The absence of any symptoms of the virus. The body is able to defeat the virus before he began to have a significant impact on it. Polyomyelitis in an inapparanting form often do not recognize that the disease was. Confirm the fact of the disease can only analyzing blood on antibodies.
• Atypical abortive form - Lack of specific polyomyelitis syndromes, but the manifestation of common symptoms of infection. Headache, runny nose, weakness, small raising Temperatures resemble the usual cold. There is no lesion of the central nervous system. Symptoms disappear in a week without special treatment. This is the most common form of polio.
• Typical non-paralytic form- manifestation of symptoms of polio with the defeat of the central nervous system, but in the absence of paralysis. Diagnose serous meningitis.
• Typical paralytic form- Manifestation of symptoms of a polio virus with the defeat of the central nervous system and paralyc. The virus can cause paralysis of various muscle groups: leg muscles, hands, torso, diaphragms, faces.

What are the symptoms of polio

The symptoms of poliomyelitis are different in different forms of the disease. The incubation period lasts from 6 to 12 days.

In atypical form, the main symptoms is:

• weakness;
• headache;
• temperature increase;
• sweating;
• runny nose;
• abdominal pain;
• vomiting;
• diarrhea;
• rash.

In typical form, the following symptoms are manifested:

• muscle pain;
• backache;
• reduced muscle tone;
• labored breathing;
• difficult swallowing;
• violation of speech;
• confusion of consciousness;
• paralysis;
• paralytic edema;
• meningeal syndrome;
• uncontrolled urination;
• cooling hands and legs;
• pressure instability;
• disruption of reflexes.

How polio flows

In atypical forms without paralysis, poliomyelitis proceeds without consequences for the body, the symptoms disappear after a week, the patient completely recovers and acquires immunity to poliomyelitis.

In typical forms, the course of the disease is more severe. The paralytic form is especially dangerous. The spinal cord cells gradually die, causing muscle paralysis. Without movement, the muscles die and no longer restore. When the cells of the oblong brain are dying, the patient is dying. Female cases occur as a result of diaphragm paralysis: the patient dies from suffocation. The probability of the patient's death increases if a bacterial is attached to a viral infection.

Mortality among adult patients is higher than among children. Although polio is considered predominantly childhood, it is dangerous for adults. Adults should not neglect the prevention of polio.

What are the complications after polio

Poliomyelitis in lung forms does not cause complications.

In severe forms of the disease, complications are possible. Among them:

• paralysis legs, hands, torso, neck and face;
• breathing disorder, speech, swallowing;
• brain damage;
• lag of developing bones of affected limbs;
• bone tissue atrophy;
• deformation of the brushes and stop;
• rachiocampsis.

The degree and seriousness of complications affects the condition of immunity, quality of treatment and rehabilitation. Thus, the deformations of the joints and bones can be avoided, if you immediately provide a patient with bedding with fixation of the body and limbs. Timely diagnosis and treatment reduces the risk of irreversible paralysis and nerve disorders.

How to identify poliomyelitis

For successful treatment of polio, accurate diagnosis is necessary. The disease often has blurred symptoms that resemble a normal cold or ORVI, which makes it difficult to timely detect the pathogen.

Polio diagnosis in children are engaged in a pediatrician and an infectiousist. Analysis of blood, urine, feces, mucus from the nose, if necessary - the spinal fluid.

If the polio is suspected, the patient is immediately sent to the infectious hospital. It is important to watch the patient carefully to distinguish poliomyelitis from other ailments and ensure adequate treatment.

How to treat poliomyelitis

Effective drug from poliomyelitis has not yet been found. All sick hospitalizes. This is necessary to protect the surrounding people and prevent complications in a patient in a sharp period. The hospitalization period lasts from 40 days.

Treatment is the rapid removal acute symptoms. With severe pain, pain relief is carried out. High temperatures are removed by antipyretic drugs. Additionally, the patient gets vitamins. In the acute period, which lasts up to 6 weeks, recommended strict bed regime. Medical staff with pillows and rollers ensures the correct position of the body and limbs, it reduces the risk of deformation of the bone shape. Prevention is underway. With damage to the diaphragm and interrochemical muscles and insufficient breathing, resuscitation is necessary. With violation of swallowing functions, liquid nutrition is supplied through a probe.

After the sharp period ends, the patient's rehabilitation begins. It is from the quality of rehabilitation that the state of the muscles and the central nervous system after illness depends. Muscles, not fully lost activity, restore gymnastics, massage, acupuncture, swimming. With full paralysis, the muscle electrostimulation, massage, bath, acupuncture, paraffin therapy and other thermal procedures are prescribed. Sanatorium-resort treatment is recommended in specialized agencies.

Medicines also turn out to be useful during rehabilitation. Preparations are prescribed to improve the blood supply of the brain, stimulating the nerve impulses, hormonal drugs.

For the prevention of contractures shows the wearing of orthopedic shoes, tires, dressings. They protect weakened legs from deformation, adjust the shapes and position of the stop and joints.

Adjust complications after transferred polio can be surgically in a surgical way. Surgeons conduct plastic muscles and tendons, resection and osteotomy bone, resection and prosthetics of joints.

The treatment of poliomyelitis is engaged in a wide range of specialists - pediatricians, therapeutors, neurologists, surgeons, infectiousists, immunologists, orthopedists, rehabilitation specialists.

How to prevent poliomyelitis

The main method of the prevention of polio is vaccination, due to which it was possible to significantly reduce the incidence of polio. Treat polio is difficult, after heavy forms a risk of disability is great, so it is better to vaccinate and protect yourself and their children from this terrible disease.

There are 2 types of vaccine: inactivated vaccine for injection and a living vaccine for receiving inward in the form of dragee or solutions. In the first case, the killed virus falls into the body, in the second - alive, but weakened.

By the number of diseases with which vaccines are struggling, monovaccines and polyvaccines differ. Monovaccines warn only polio, polyvaccines combine the prevention of polio and cough, tetanus, diphtheria, hemophilic sticks and hepatitis B in different combinations.

In Russia, vaccination against polio is mandatory, it is carried out for free, starting with infant age and ending at 14 years. Use predominantly live vaccine.

Vaccination Vaccination Schedule Next:

1. 3 months;
2. 4 months;
3. 5 months;
4. 18 months;
5. 3 years
6. 6 years;
7. 14 years.

After the introduction of the vaccine, a sparing mode is needed: a full-fledged vacation and sleep, light-rich in vitamins food. It is necessary to protect the child from supercooling and communicating with possible carriers of bacteria and viruses, since the fight against the virus temporarily reduces immunity, and the infection can capture the weak body of the kid.

Adults are vaccinated in two cases: if there was no planned vaccination in childhood or when traveling to high-risk zones by poliomyelitis. This is predominantly Asia and Africa. Healthcare organizations track epidemic situations in the world and recommend vaccination from certain diseases. Repeated vaccinations of adults from poliomyelitis are held every 5-10 years while maintaining the risk of infection.

Usually the vaccine is moved well. Perhaps a small increase in temperature, disorder of digestion, ethnicity and weakness. In rare cases, urticaria, shortness of breath, cramps, extensive edema are possible. If this happened, you need to refer to the doctor without delay.

Some people vaccinate from poliomyelitis are contraindicated. Absolute contraindications Is immunodeficiency, allergic to vaccine components. Temporary contraindications are bacterial or viral diseases, pregnancy, breastfeeding, acclimatization after a trip to another climatic zone.

(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. Acute respiratory diseases in children. - M.: Pharmus Print Media, 2008.
• Medical virology: Guide / Ed. D.K. Lviv - M.: Mia, 2008.

Poliomyelitis is sharp viral disease, striking the central nervous system, primarily the spinal cord, and sometimes causing paralysis. The main way of distribution is considered direct or indirect contact with the patient (through hands, nasal shawls, clothes, etc.). Also applies through products, water, with air.

What it is? Poliomyelitis is the poliovirus (poliovirus hominis) of the Picornaviridae family of Enterovirus. Three virus serotypes are isolated (I type prevails): I - Brungilda (isolated from a sick monkey with the same nickname), II-abandoning (highlighted in the town of Lansing) and III-eleon (highlighted from the patient boy Macclon).

In some cases, the disease occurs in an erased or asymptomatic form. A person can be a carrier of a virus, highlighting it into an external environment with the feces and discharge from the nose, and at the same time feel absolutely healthy. Meanwhile, the susceptibility to polio is quite high, which is fraught with the rapid spread of the disease among the children's population.

How polio is transmitted, and what is it?

Poliomyelitis (from Dr. Greek. Πολιός - gray and μυελός - spinal cord) - children's cereal paralysis, acute, high-contagious infectious disease due to the damage of gray spinal cord substance by polyovirus and characterized mainly by the pathology of the nervous system.

Basically proceeds in asymptomatic or erased form. Sometimes it happens that polyiovirus penetrates into the CNS, multiplies in motnelones, which leads to their death, irreversible terrains or paralymps of the muscles innervoable.

Infection occurs in several ways:

1. Air-drip - It is realized when inhalation of air with viruses weighted in it.
2. Alimentary path transmission - Infection occurs when eating contaminated food.
3. Domestic contact - It is possible when using one dishes for meals with different people.
4. Waterway - the virus enters the body with water.

Particularly dangerous in infectious plane are persons carrying diseases asymptomatic (in the actual form) or with non-specific manifestations (a small fever, total weakness, increased fatigue, headache, nausea, vomiting) without signs of damage to the CNS. Such people can infect a large number of contacting them, because The diagnosis of sickness to deliver is very difficult, and, consequently, these individuals are practically not exposed to the insulation.

Graft from polio

Specific prophylaxis is a vaccination against poliomyelitis. There are 2 types of polyomelitis vaccines:

• living vaccine Sein. (OPV - contains lively weakened viruses)
• inactivated (IPV - contains polyoviruses of all three serotypes killed by formalin).

Currently, the only manufacturer of polio vaccine on the territory of Russia FSUE "Enterprise for the production of bacterium and viral preparations of the Institute of Poliomyelitis and viral encephalitis them. MP Chumakov "produces only alive vaccines against poliomyelitis.

Other vaccination preparations are traditionally purchased abroad. However, in February 2015, the enterprise presented the first samples of the inactivated vaccine of their own development. The beginning of its use is scheduled for 2017.

Symptoms of polio

According to WHO, polio is striking, mainly children under the age of 5 years. The incubation period lasts from 5 to 35 days, the symptoms depend on the form of polio. According to statistics, the disease is most often occurring without disrupting motor functions - one paralytic case accounts for ten non-paralytic. The initial form of the disease is the form of preparative (non-paralytic poliomyelitis). It is characterized by the following symptoms:

1. Ailment of a general nature;
2. Increased temperature in the range of up to 40 ° C;
3. Decline in appetite;
4. Nausea;
5. Vomiting;
6. Muscle pain;
7. Sore throat;
8. 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.

Abortive form of polio

With an abortive form of polio, sick children complain of an increase in body temperature up to 38 ° C. Against the background of temperature, observe:

• malaise;
• weakness;
• lethargy;
• non-beadache;
• cough;
• runny nose;
• abdominal pain;
• 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 dysentery, the course of the disease can also be cholera-like.

Meningial form of polio

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.

In case of inspection, the throat is red, there may be a raid on the breadless arms and almonds. This condition lasts 2 days. Then the body temperature is normalized, the catarrhal phenomena decreases, the child looks healthy for 2-3 days. After that, the second period of increasing body temperature begins. Complaints become more distinct:

• sharp deterioration of the state;
• strong headache;
• vomiting;
• pain in the back and limbs, as a rule, legs.

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.

Paralytic poliomyelitis

It rarely develops, but, as a rule, leads to a violation of many functions of the organism and, accordingly, to disability:

• Bulbar. Special severity is the development of bulbar paralysis. The whole group of caudal nerves is affected. The selective lesion of one, two nerves for poliomyelitis is atypically. With the damage to the reticular formation, respiratory and vascular centers, consciousness, respiratory disorders of the central genesis may be disturbed.
• Pontina. For this type of poliomyelitis, the development of paresis and paralysis of the facial nerve, in which the partial or complete loss of mimic movements occurs.
• Encephalitical. The brain substance and subcortical nuclei are affected (very rarely). Central paresis develops, convulsive syndrome, aphasia, hypercines.
• Spinal. Weakness and pain in the muscles are gradually replaced by paralysis, both shared and partial. The damage to the muscles in this form of polio can be symmetrical, but paralysis of individual muscle groups are found throughout the body.

During the disease, 4 periods are distinguished:

• preparative;
• paralytic;
• recovery;
• residual.

Preparalithic stage

It has a rather acute beginning, high-digits of body temperature, common malaise, headache, gastrointestinal disorders, rhinitis, pharyngitis. Such a clinical picture remains 3 days, the state is normalized by 2-4 days. After the sharp deterioration of the state with the same symptoms, but more pronounced intensity occurs. Signs are joined:

• pain in legs, hands, back;
• reducing reflexes;
• increased sensitivity;
• lowering muscle strength;
• convulsions;
• confusion of consciousness;
• excessive sweating;
• spots on the skin;
• "goose pimples".

Paralytic stage

This is a stage when a suddenly patient breaks paralysis (in a couple of hours). Lost this stage from 2-3 to 10-14 days. Patients for this period often die from severe respiratory disorder and blood circulation. It has such symptoms:

• sluggish paralysis;
• disorders of the act of defecation;
• reduced muscle tone;
• restriction or complete absence of active movements in limbs, body;
• the defeat is predominantly the muscles of the hands and legs, but may suffer the muscles of the neck, torso;
• spontaneous pain muscular syndrome;
• damage to the oblong brain;
• urination disorders;
• defeat and paralysis of the diaphragm and respiratory muscles.

In the recovered period of polio, which lasts up to 1 year, there is a gradual activation of tendon reflexes, movements are restored in separate muscle groups. The mosaic of lesion and uneven recovery causes the development of atrophy and muscular contractures, the lag of the affected limb in the growth, the formation of osteoporosis and bone atrophy.

The residual period, or the period of residual phenomena, is characterized by the presence of persistent paresses and paralysis, accompanied by muscle atrophy and trophic disorders, the development of contractures and deformation in the affected limbs and body sections.

POSTOLIOSITING SYNDROME

After transferred poliomyelitis in some patients for many years (on average, 35 years) persists limited opportunities and a number of manifestations, most frequent of which:

• progressive muscular weakness and pain;
• general breakdown and fatigue after minimum loads;
• amyotrophy;
• breathing and swallowing disorders;
• breathing disorders in a dream, especially the night apnea;
• poor tolerance of low temperatures;
• cognitive disorders - such as a decrease in the concentration of attention and memorization difficulties;
• depression or mood swings.

Diagnostics

In the case of polio, the diagnosis is based on laboratory studies. In the first week of the disease, the polio virus can be isolated from the secret of nasopharynx, and starting with the second - from the carte masses. Unlike other enteroviruses, polyomelitis causative agent is extremely rarely able to isolate from the spinal fluid.

If the insulation is impossible and the study of the virus, serological analysis is performed, which is based on the release of specific antibodies. This method It is quite sensitive, but it does not allow to distinguish the post-preparing and natural infection.

Treatment

Events against poliomyelitis require mandatory hospitalization. Bed regime is prescribed, taking painkillers and sedatives, as well as thermal procedures.

In paralyams, a complex reducing treatment is carried out, and then supporting treatment in sanatorium-resort areas. Such complications of poliomyelitis as respiratory disorders require urgent measures to restore respiration and resuscitation of the patient. The hearth disease is subject to disinfection.

Forecast for life

Light forms of polio (flowing without damage to CNS and meningeal) pass without a trace. Heavy paralytic molds can lead to a disknal disability and fatal outcome.

Due to the long-term targeted vaccine polyomyelitis vaccination in the structure of the disease, light inapparantant and abortive forms of infection prevail; Paralytic forms arise only from unvaccinated persons.

Prevention

Nonspecific aims to generally strengthen the body, an increase in its resistance to various infectious agents (hardening, proper nutrition, timely rehabilitation of chronic foci of infection, regular physical exercise, Optimization of the sleep-awake cycle, etc.), the fight against insects, which are peddles of pathogenic microorganisms (various types of disinsection), compliance with personal hygiene rules (first of all it was washing hands after the street and after visiting the toilet), thorough treatment of vegetables, fruits And other products before using them in food.

To prevent the development of poliomyelitis, vaccination is used, which is carried out with the help of lively weakened viruses - they cannot cause the disease, but cause a specific immune response of the body with the formation of long-term sustainable immunity. To this end, in most countries of the world, anti-poliotic vaccination is included in the calendar of mandatory vaccinations. Modern vaccines are polyvalent - contain all 3 serological groups of poliomyelitis virus.

Poliomyelitis today is a very rare infection due to the use of vaccination. Despite this, certain cases of the disease are still registered on the planet. Therefore, the knowledge of the main symptoms and methods of prevention is simply necessary. Forewarned is forearmed!

Global number of cases of the disease

Since 1988, the number of cases of polyomelitis decreased by more than 99%. It is estimated that with 350,000 cases in more than 125 endemic countries up to 359 cases registered in 2014. Today, only certain territories of the two countries of the world remain endemic for this disease with the minimum in the entire history of the area.

Of the 3 strains of the wild poliovirus (type 1, type 2 and type 3), the Wild Polyovir 2th type was liquidated in 1999, and the number of victims of the wild polyovirus of the third type was reduced to the lowest in the history of the level - from November 2012 in Nigeria There were new cases of the disease.