Polio myelitis in children

Polio (poliomyelitis) mainly affects children under five years of age. Polio is a contagious viral illness. In its most severe form, polio causes paralysis, difficulty breathing and sometimes death.

Polio is a highly infectious disease caused by a virus. It invades the nervous system, and can cause total paralysis in a matter of hours. The virus enters the body through the mouth and multiplies in the intestine. Initial symptoms are fever, fatigue, headache, vomiting, stiffness in the neck and pain in the limbs. One in 200 infections leads to irreversible paralysis (usually in the legs). Among those paralyzed, 5% to 10% die when their breathing muscles become immobilized.
People most at risk
Polio mainly affects children under five years of age.

Objectives

The objectives of the Global Polio Eradication Initiative are:

• To interrupt transmission of the wild poliovirus as soon as possible;
• To achieve certification of global polio eradication;
• To contribute to health systems development and strengthening routine immunization and surveillance for communicable diseases in a systematic way.

There are two types of polio:

Non paralytic polio: It does not causes paralysis. It is also called as abortive poliomyelitis. It causes the same mild, flu-like signs and symptoms — sore throat, fever, nausea, vomiting, and constipation or diarrhea — typical of other viral illnesses. Most people recover from abortive polio in less than a week.

Signs and symptoms, which generally last two to 10 days, include:

• Fever
• Headache
• Vomiting
• Diarrhea
• Fatigue
• Back pain or stiffness
• Neck pain or stiffness
• Pain or stiffness in the arms or legs
• Muscle spasms or tenderness

Paralytic polio: Fewer than 1 percent of people infected with poliovirus develop paralytic polio. It is  the most serious form of the disease. Paralytic polio often begins with a fever. Five to seven days later, other signs and symptoms appear, including:

• Headache
• Neck and back stiffness
• Constipation.
• Increased sensitivity to touch

The paralytic polio symptom that causes limbs to appear loose and floppy (acute flaccid paralysis) often comes on suddenly and usually is worse on one side of the body.

Paralytic polio has historically been divided into several types, depending primarily on which part of the body is affected.

They are:

• Spinal polio: It is the common type of paralytic polio which attacks the motor neurons of the spinal cord and cause paralysis of the muscles that control breathing and those of arms and legs. Children under 5 are more prone to become paralyzed in a single extremity, while an adult, polio usually affects both arms and legs.
• Bulbar polio: In this the virus affects the motor neurons in the brain stem where the centers of the cranial nerves are located. Theses nerves are involved in your ability to see, hear, smell, taste and swallow. This type of polio can be fatal due to respiratory support.
• Bulbospinal polio: It is the combination of both bulbar and spinal paralytic polio which can lead to paralysis of arms and legs and may affect breathing, swallowing and heart function.

Post-polio syndrome:

Affecting some people who have recovered from polio, post-polio syndrome is a cluster of disabling signs and symptoms that appears decades — between 10 and 40 years — after the initial illness. Common signs and symptoms include:

New muscle weakness in limbs that may or may not have been affected initially

• General fatigue and exhaustion after minimal activity
• Muscle and joint pain
• Breathing or swallowing problems
• Sleep-related breathing disorders, such as sleep apnea
• Decreased tolerance of cold temperatures.
• Complications of polio:
• Pulmonary edema.
• Aspiration pneumonia.
• Urinary tract infections.
• Kidney stones.
• Intestinal obstruction.
• Myocarditis.
• Cor pulmonale.

Treatment of polio:

There is no cure for polio. The treatment is mainly to increase the comfort, speedy recovery and to prevent complications:

• Antibiotics for secondary infections (none for poliovirus)
• Analgesics for pain
• Portable ventilators to assist breathing
• Moderate exercise.
• A nutritious diet.

Prevention of polio:

Oral polio vaccines: They are usually given at 2 months, 4 months, between 6 and 18 months. A booster dose between 4 and 6 years of age,