A REPORT OF

ABARCA, MARK
NERZA, LOURELI E
BSN3-A
1
polio= gray matter
Myelitis= inflammation of the spinal
cord
This disease result in the destruction of
motor neurons caused by the
poliovirus.
Polio is caused by a virus that attacks
the nerve cells of the brain & spinal
cord although not all infections result
in severe injuries and paralysis.

What is Poliomyelitis?
2
Poliomyelitis, often called polio
or infantile paralysis, is an
infectious disease caused by a
virus.
An infectious disease caused by
one of the three polioviruses.
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Poliovirus
This virus is a
member of the
enterovirus
subgroup of the
Picornaviridae family
and has three
serotypes: PV1, PV2
and PV3.

Etiologic Agent:
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Immunity to one
serotype of the
virus does not
provide
significant
protection against
the other
serotypes.

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The principal mode of transmission
is from person to person, by the
fecal-oral route.
Transmission via oral secretions,
such as saliva, is possible and may
account for some cases.

Mode of Transmission:
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Enter through Mouth,
Multiplies in Oropharynx tonsils and
Intestines,
Excreted in Stool.
Enters the CNS from Blood.
Spread along the Axons of peripheral
nerves to CNS.
Progress along the fibers of the lower
motor neurons spinal cord or brain.

Pathogenesis & Pathology:
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Destroy the Anterior horn cells of
the Spinal Cord
Do not Multiply in Muscles only
muscles manifest with weakness and
flaccid paralysis result is secondary.
Occasionally produce
- Myocarditis,
- Lymphatic hyperplasia.

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Paralytic Poliomyelitis
Nonparalytic Poliomyelitis
(Abortive Poliomyelitis)
Two Types of Polio:
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Spinal polio is the most common
form of paralytic polio; it results
from viral invasion of the motor
neurons of the anterior horn
cells, or the ventral (front) gray
matter section in the spinal
column responsible for
movement of the muscles,
including those of the trunk,
limbs and the intercostal
muscles. Virus invasion causes
inflammation of the nerve cells,
leading to damage or destruction
of motor neuron ganglia.
Spinal Poliomyelitis:
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Making up about 2% of cases of
paralytic polio, bulbar polio
occurs when poliovirus invades
and destroys nerves within the
bulbar region of the brain stem.
The bulbar region is a white
matter pathway that connects
the cerebral cortex to the brain
stem. The destruction of these
nerves weakens the muscles
supplied by the cranial nerves,
producing symptoms of
encephalitis.
Bulbar Poliomyelitis:
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Nonparalytic polio
Some people who develop symptoms from the poliovirus
contract nonparalytic polio a type of polio that doesn't lead
to paralysis (abortive poliomyelitis). This usually causes the
same mild, flu-like signs and symptoms typical of other viral
illnesses.
Signs and symptoms, which generally last two to 10 days,
include:
- Fever - Back pain or stiffness
- Sore throat - Headache
- Vomiting - Fatigue
- Neck pain or stiffness
- Pain or stiffness in the arms or legs
- Muscle spasms or tenderness
- Meningitis
Signs & Symptoms:
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Paralytic Poliomyelitis
Fewer than 1 percent of people infected with poliovirus
develop paralytic polio, the most serious form of the
disease. Initial signs and symptoms of paralytic polio, such
as fever and headache, often mimic those of nonparalytic
polio.
Between one and 10 days later however, signs and
symptoms specific to paralytic polio appear, including:
Loss of reflexes
Severe muscle aches or spasms
Loose and floppy limbs (acute flaccid paralysis),
often worse on one side of the body
Signs & Symptoms:
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Viral isolation from Throat swabs, Rectal
swabs, Stool specimens, and CSF.
If poliovirus is isolated from a patient
experiencing acute flaccid paralysis, it is
further tested through oligonucleotide
mapping (genetic fingerprinting), or
more recently by PCR amplification, to
determine whether it is wild type" (that is,
the virus encountered in nature) or "vaccine
type" (derived from a strain of poliovirus used
to produce polio vaccine).
Diagnostic Tests:
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It is important to determine the source of the
virus because for each reported case of
paralytic polio caused by wild poliovirus, an
estimated another 200 to 3,000 contagious
asymptomatic carriers exist.
Estimation of Antibodies IgM


Diagnostic Tests:
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There is no cure for polio. The focus of modern
treatment has been on providing relief of
symptoms, speeding recovery and preventing
complications. Supportive measures include
antibiotics to prevent infections in weakened
muscles, analgesics for pain, moderate exercise
and a nutritious diet. Treatment of polio often
requires long-term rehabilitation, including
physical therapy, braces, corrective shoes and,
in some cases, orthopedic surgery

Treatment:
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Orthotic treatment (AFO/KAFO)
Surgical Care: Total hip arthroplasty is a surgical
therapeutic options for patients with paralytic
sequelae of poliomyelitis who develop of hip
dysplasia and degenerative disease.
Bladder involvement may require catheterization
respiratory muscle involvement may require
mechanical ventilation
Postural drainage & suction may be sufficient to
manage pooling of secretions in patients with
nonparalytic polio.


Treatment:
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Paralytic polio can lead to temporary or
permanent muscle paralysis, disability, and
deformities of the hips, ankles and feet.
Although many deformities can be corrected
with surgery and physical therapy, these
treatments may not be options in developing
nations where polio is still endemic. As a
result, children who survive polio may spend
their lives with severe disabilities.
Risk Factors:
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You're at greatest risk of polio if you haven't
been immunized against the disease. In areas
with poor sanitation and sporadic or
nonexistent immunization programs, the most
vulnerable members of the population
pregnant women, the very young and those
with weakened immune systems are
especially susceptible to poliovirus.
Risk Factors:
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These factors also increase your risk if you
haven't been vaccinated:
Travel to an area where polio is common or
that has recently experienced an outbreak
Living with or caring for someone who may be
shedding poliovirus
Handling laboratory specimens that contain
live poliovirus
Risk Factors:
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A compromised immune system, such as
occurs with HIV infection
Having had your tonsils removed
(tonsillectomy)
Extreme stress or strenuous physical activity
after being exposed to poliovirus, both of
which can depress your immune system
Risk Factors:
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Paralytic polio can lead to temporary or
permanent muscle paralysis, disability, and
deformities of the hips, ankles and feet.
Although many deformities can be corrected
with surgery and physical therapy, these
treatments may not be options in developing
nations where polio is still endemic. As a
result, children who survive polio may spend
their lives with severe disabilities.
Complications:
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Two types of vaccine are
used throughout the world
to combat polio. Both types
induce immunity to polio,
efficiently blocking person-
to-person transmission of
wild poliovirus, thereby
protecting both individual
vaccine recipients and the
wider community (so-called
herd immunity).

VACCINE:
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Albert Sabin
(Virologist)

Pioneers of the Vaccines:
=> Jonas Salk
(Medical Scientist)
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Two types of vaccines used in the
prevention of poliomyelitis:
1. inactivated poliovirus vaccine IPV
administered parenterally
(Salk Vaccine given by injection)
2. oral attenuated poliovirus vaccine
OPV. (Sabin Vaccine)

VACCINE:
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IPV was the first polio vaccine available
on the market, and its widespread
administration began in the 1950s.
An enhanced inactivated poliovirus
vaccine (eIPV) formulation is now
available.

Inactivated PV
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Nonenhanced early formulations had
the disadvantages of not being as
immunogenic as OPV, not being able to
induce mucosal immunity, and having
to be administered parenterally, which
increased costs and decreased
compliance.
One of the major advantages of IPV is
that it contains an inactivated virus;

Inactivated PV
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for that reason, IPV is not associated
with the development of vaccine-
associated poliomyelitis and can be
given to immunocompromised patients.
This vaccine is administered when
individuals are aged 2 months, 4
months, and 6-12 months and before
school entry, which is usually at age 4
years.


Inactivated PV
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Trivalent OPV has been used since the
early 1960s.
Immunization with this formulation was
responsible for the significant decrease
in the prevalence of disease throughout
the world.
This formulation has the advantages of
inducing mucosal immunity,

Oral Attenuated PV
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providing appropriate herd immunity,
and increasing vaccine uptake because
of oral administration.
Additionally, it is cost-effective,
especially in countries in the developing
world.
The major disadvantage of
trivalent OPV is its association with


Oral Attenuated PV
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vaccine-associated paralytic
poliomyelitis (VAPP). Although the virus
contained in this formulation is
attenuated, it may occasionally become
neurotropic and be able to produce
disease similar to wild-type virus.
Trivalent OPV is being administered in
developing countries when individuals
are aged 2 months, 4 months, and 6


Oral Attenuated PV
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months and with a booster at age 4
years.
VAPP occurs most frequently after the
first dose of OPV but may also occur
after administration of the second or
third doses.


Oral Attenuated PV
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Administration of OPV is
contraindicated in children who are
immunocompromised and in children
whose caretakers are
immunocompromised.
A risk for development of poliomyelitis
is present in those individuals who
receive this vaccine and are
immunocompromised

Oral Attenuated PV
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Children
Children are recommended a primary
course of 3 doses of an IPV-containing
vaccine at 2, 4 and 6 months of age and
a booster dose at 4 years of age.
The recommended interval between 2
doses is 2 months, but, for catch-up, the
minimum interval can be 1 month
Who should be vaccinated
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Adults
The schedule for unvaccinated adults
is 3 doses administered at intervals of
12 months.
Booster doses
A booster dose is not required for fully
vaccinated children or adults unless
they are at increased risk of infection,
Who should be vaccinated
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such as:
o Travelling to areas or countries
where poliomyelitis is epidemic or
endemic.
o Healthcare workers, including
laboratory workers, in possible
contact with poliomyelitis cases.
Who should be vaccinated
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For those exposed to a continuing risk
of infection, booster doses are
desirable every 10 years.
Who should be vaccinated
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Inactivated poliomyelitis vaccines can be
safely administered to either persons with
impaired immunity or to persons living with
someone with impaired immunity.
IPV vaccines may cause erythema, pain, and
induration at the injection site. Other
symptoms reported following administration
of IPV vaccines in young babies include fever,
crying and decreased appetite.
Vaccine Safety:
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Disturbed Body Image
Impaired Physical Mobility

Nursing Diagnosis
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