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Poliomyelitis
The poliomyelitis is an infectious virus illness of the central nervous system. Europe and America are regarded as polio free. This is thanks to comprehensive vaccinating measures. The poliomyelitis still is spread primarily in Central Africa and the Indian subcontinent. Not vaccinated travelers can bring in the infection. The name implies that only children fall ill are, however, just as concerned, adults! The virus is transferred mainly fecal orally that is by polluted water, food or smear infections. The illness can lead to permanent paralyses and to the death. The therapy is only symptomatically carried out. A vaccination is available prophylactically with a dead man vaccine.
The illness only appears occasionally at vaccination gaps by viruses brought in in countries with a high by vaccination degree. Before the introduction of the oral vaccination (1962) there were epidemics also in the industrial countries with disastrous extents. Results of the illness, like death, respiratory paralysis and permanent defects, had to be found frequently. We find the illness in countries with high population density and bad hygienic conditions primarily in India, parts of Africa and Southeast Asia, certainly today.
The causative agents are polioviruses which belong to the family to the Picornaviridae and have only RNA as a genetic information. Three serotypes are distinguished with a different virulence. The transmission of the shoot is carried out fecal orally in the initial stage also about droplet infection. The fallen ill eliminate the virus about the intestine. The infection is then carried out via the photo of water or foods which had contact with the stool of infected. The Baden also can be dangerous in warm, stationary waters. The virus increases in the pharynx and stomach intestine area (admission gate of the virus) and can reach the spinal cord and the brain stem over the bloodstream. It settles there and destroys nerve cells. It comes to paralyses of the musculature.
Poliomyelitis is a notifiable infection illness in Germany after the infection protection law.
5 is the incubation period, that is the period of time between infection and the appearance of the first symptoms until 14 days, maximal 4 weeks.
Few hours after the infection are the fallen ill infectious until time on which the causative agent cannot be proved in the excrement any more.
The course is so light (inapparent) and ineffective at 90 to 95% of the infected that they don't notice the illness. You are then their life lasting immune to one of the three serotypes (vaccination offers protection against all 3 types!)
One distinguishes four phases at fully developed syndrome:
- The initial stage is nonspecific, lasts for 2 to 3 days and reminds of a common cold with a light fever (to 38.5 º C), cough, common cold, head and rheumatic pains.
- The patients feel healthy in the latency stage free of fever (1 to 3 day).
- The preparalytic stage (beginning main illness) then starts. The fever rises again. It comes to symptoms of a meningitis (meningitis) with headaches, consciousness ring opacity, vomiting, photosensitivity, stiffness of the neck and psychic changes. Bladder emptying disturbances and constipation, back and rheumatic pains as well as a stiff spinal column also appear in this stage. The patients use their arms at the touchdown to relieve the spinal column. Some fallen ill isn't capable of keeping the head straight in lie put up either. It also can come to muscle weakness which can change into paralyses.
- The paralytic stage (definite paralysis stage) follows days to not more than two after the preparalytic stage (7 to 10 days after the beginning of the first fever increase) after few hours. However only 0.5 to 1% of all infected go through this stage. The paralyses suddenly appear. The children go healthily to bed in the evening and wake up paralyzedly in the morning. The species and the extent of the paralyses are different. The muscles of the shoulder girdle and the legs are concerned mainly. The paralyses then reach their peak after 4 to 5 days and form back. The involution can completely be carried out (30% of the cases). Heavy damages stay behind at further 30% of the cases be able to light damages stay behind, fallen ill at as well many. These are particularly malpositions of the extremitieses by failure of whole muscle groups. The poliomyelitis causes a respiratory paralysis indium up to 10% of the cases which can lead to the death.
An involution of the paralysis appearances can be expected also after around two years. An intensive physiotherapy is necessary to this, though.
The illness can come to the interruption in all stadia. It is important, too, to stress once that only 0.5 to 1% of all infected go through the paralytic stage.
You should immediately go to the physician at a suspicion of polio. If rheumatic pains and lacking motion ability appear simultaneously at fever, they should immediately go to it. At polio cases in your surroundings already get poorly soundproofed at fever with rheumatic pains, too and consult your physician. Report to him of your suspicion.
At a suspicion of poliomyelitis your attending doctor must immediately introduce your child to the hospital. There is risk of infection.
The causative agent can be isolated and proved from the stool, the pharynx secretion and the liquor (fluid surrounding brain substance). An exact diagnosis position alone with the symptoms doesn't have to be beyond all doubt put in the early stadia (initial stage -- preparalytic stage).
There isn't a causative therapy at poliomyelitis. Only the symptoms can be treated. First measure is in principle absolute confinement to bed. The fever is lowered. It comes to drink troubles or breath problems get artificial gives artificial respiration. Storages of the patient which are muscle easing and changing are carried out at appearing paralyses. Physiotherapy can be started with two to four weeks after the illness.
Complications at a poliomyelitis are bacterial secondary infections of the air routes. It also can come to a myocarditis which then can lead to a cardiac insufficiency.
Has gone the symptomless after a gone polio infection or it can come to the so-called mail polio syndrome (PPS) after the illness also at a heavy course decades. The symptoms are unusual tiredness, joint and muscle pains, muscle weakness, respiratory troubles, by lacking function ability of the mamma musculature. Headaches, insomnia and general exhaustion can appear in the consequence. The group of people affected by it in Germany must be born without in front of 1960 and the polio or with symptoms have gone through. One comes to the age test by the fact that the poliomyelitis is valid since 1960 when almost wiped out in Germany.
The best prophylaxis against the poliomyelitis is the vaccination. It protects serotypes in front of three. Since the beginning of 1998 poliomyelitis has been vaccinated against with a dead man vaccine. It is injected. The vaccinating shoots aren't reproduction capable and can trigger the illness neither at the vaccinated nor at contact persons. Contact the drink vaccination usual in front of this with weakened causative agents caused vaccinating poliomyelitis in extremely rare cases (1 on > 4 million vaccinations) at vaccinated and still more rarely at contact persons (1 on > 15 million vaccinations) a so-called vaccinating poliomyelitis.
The basic immunization contains four vaccinations. It is carried out in the third, fourth and fifth life month as well as between the 12th and 15th life months. A combination vaccination simultaneously is also offered against other infectious diseases. Tetanus (tetanus), diphtheria, whooping cough (pertussis), Hib and hepatitis B, are part of it.
Further booster vaccinations are necessary between the 11th and 18th years of life.
Adults should let themselves be vaccinated into endangering fields before journeys.
These informations may be considered a substitute for a piece of medical advice in no case. The content of health-illness.com doesn't can and may be put into any case to make diagnoses or carry out self medical treatment independently.
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