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Poliovirus
Author: Ali Sharifi
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Page tort
IMMUNIZATION RECORD
Comprobane de immunizacion
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Major campaign by WHO in 1988
350,000 cases in 1988 to less than
2,000 cases in 2016
Americas in 1944
last case in Peru, 1991
western pacific region in 2000
Europe in 2002
No case of WPV 2 since 1994 in USA
Eradication of WPV 3 in 1998 globally
India in march 2014
Only three countries ; Afghanistan, Pakistan, Nigeria
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Disease outbreak news
24 May 2019
On 9 May 2019, the Global Polio Laboratory
Network (GPLN) notified WHO of the
detection of wild poliovirus type 1 (WPV1)
from an environmental sewage sample
collected on 20 April 2019 in Konarak district,
Sistan-Baluchistan province, Islamic Republic
of Iran. The virus was detected in an
environmental sample only, and to date, no
associated cases of paralysis have been
detected.
The subsequent scheduled sewage sample
collected from the same site on 4 May 2019
(2 weeks after the positive sample) tested
negative for poliovirus.
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Introduction
3 types => WPV 1, WPV 2, WPV 3
Paralysis associated with WPV 1
Host range = Homo Sapian and some primates
Incubation period = 7-14 days, rarely to 35
Transition = chiefly oral-focal
Primary multiplication = intestine & oropharynx
Antibody appears before paralysis
Seldom found in blood
Treatment is supportive (hot packs, hospitalization,
sedatives)
No antiviral drug
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Neural lesion
1- Spinal cord (anterior horn cells)
2- Cerebellum
3- midbrain
4- thalamus & Hypothalamus
5- medulla (vestibular nuclei)
6- Pallidum
Cranial nerve blockage = 9t, 10,
12th
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Courses of disease
1) Inapperent
2) Abortive
3) Non-paralytic
4) Paralytic
5) Polio syndrome
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Abortive
Febrile illness
malaise, vomiting, sore throat,
constipation
coryza, pharyngeal exudate is rare
Temperature sometimes exceeds
39.5
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Non-paralytic
* Previous symptoms + stiffness of
posterior muscles (lower limb, back)
* Fleeting paralysis bladder (overflow)
* Bethanechol 10mg (oral) / 5mg
(subcutaneous)
* Examinations for diagnosis;
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Kernig's sign
0 Brudzinski’s neck sign
ADAM.
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Paralytic & polio syndrome
Previous symptoms + weakness of back or
cranial muscles
Flaccid paralysis / respiratory & cardiac
arrhythmia
Bowel atony
Distribution of paralysis is spotty
Caution!!! Guillain-Barre syndrome
Polio syndrome; recrudescence of muscle
paralysis decades after infection
Physiologic and aging changes
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Patterns
Pure spinal ; increased RR
frequent-pause speaking
paradoxical abdominal movement
Pure bulbar; inability to swallow
nasal regurgitation of saliva
“rope sign”
deviation of tongue and uvula
paralysis of vocal cord
Bulbo-spinal ; both symptoms
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vaccines
IPV (Salk) derived from monkey kidney (IGG and IG
OPV (Sabin) => IGG, IGM, IGA (in intestine)
Types of 2 & 3 mutate
No effect with other type of Enterovirus in alimenta|
WHO will cease OPV production after accomplishing the
campaign
وج 2
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Have a nice day