Poliomyelitis: symptoms, treatment, complications, prevention
Poliomyelitis is an acute viral disease, the causative agent of which affects the gray matter of the spinal cord, causing the development of flaccid paralysis( paralysis is a complete lack of movement in one or more parts of the body, the lethargic epithet indicates that the muscles in the affected limb completely relaxAnd gradually atrophy).Table of contents: Poliomyelitis: symptoms Poliomyelitis is dangerous Polio vaccine terms Vaccine-associated poliomyelitis Poliomyelitis in Ukraine
In the human body, the poliovirus agent( poliovirus) lives in the gastrointestinal tract and enters the environment with droplets of salivaAnd feces of the patient.You can get infected with poliomyelitis in the following way: by contacting a sick person, using water and foods that have a virus, or not following the simplest hygiene rules( washing hands after toilet, before meals, etc.).
Due to the fact that children have a large circle of communication, they often forget about hygiene, they can easily drink raw water from a tap or swallow it in a pool, river, poliomyelitis is a big danger for them.Although adults are also not insured, especially if they have problems with immunity.Therefore, to protect both children and adults from a dangerous infection, the world medical community developed special vaccines.Their effectiveness is not questioned, because in many countries around the world, thanks to vaccination, it was possible to forget about poliomyelitis.Exceptions are some regions of Asia and Africa, in which outbreaks of polio are regularly recorded.In this regard, the risk of importation of dangerous wild poliovirus from disadvantaged countries is always preserved.
Poliomyelitis in children and adults can be paralytic and non-paralytic.The last form of the disease occurs most often and is considered less dangerous.Paralysis also develops rarely - approximately one in 100 patients.
The first symptoms of poliomyelitis usually resemble ARI or acute intestinal infection. Patients may be troubled by :
- high body temperature;
- pain in the limbs;
- liquid stool;
- weakness, fatigue, headache.
This progression of the disease may stop.If the virus penetrates into the gray matter of the spinal cord, muscle twitchings begin, a strong muscle weakness appears, then one or more limbs are immobilized.
In addition, poliomyelitis can also occur without significant symptoms, but patients with this form of illness are no less contagious to others than people with a typical clinical picture of the disease.
What is dangerous is poliomyelitis
Poliomyelitis is a disease that can lead to disability .
Paralyzed limbs, even if they begin to move somehow, remain deformed( shortened, with atrophied muscles).In addition, in the case of paralysis, the likelihood that the pathological process will affect not only the muscles of the arms and legs, but also the muscles responsible for breathing.This is fraught with the development of serious respiratory disorders, from which the patient may even die.
Of course, the paralytic form of the disease, which provokes serious consequences of poliomyelitis, is not so common, but the risk still exists, and it must be remembered, especially since specific drugs that are effective for polioviruses have not yet been developed.
To date, has two anti-poliomyelitis vaccines :
- live( OPV);
- inactivated( IPV).
The live poliovirus vaccine contains attenuated live polioviruses.It is released in the form of drops, which are buried in the baby's mouth, hence the name OPV - oral polio vaccine( that is, injected through the oral cavity).This vaccine is considered to be the most effective because it completely mimics the infection with poliomyelitis.The viruses contained in the vaccine live for about a month in the intestines of the immunized person and contribute to the accumulation of a large number of protective antibodies in the blood( so general immunity is formed) and secretory immunoglobulins in the intestinal mucosa( local immunity).
Oral poliomyelitis drops have a slightly saline bitter taste.The health worker should take the necessary dose of this medication to the tongue or palatine tonsils of the small patient so that the vaccine is not immediately swallowed.After vaccination, one can not give an hour to a child to drink and eat.The effectiveness of vaccination depends on compliance with these rules.
For the parents and loved ones who have weakened immunity due to some diseases or chemotherapy, a baby immunized with a live vaccine can be dangerous, since his feces contain the polio virus.Therefore, in such situations, children are vaccinated with an inactivated vaccine.However, due to the fact that people may not know about their illnesses, doctors recommend that all parents do not kiss the vaccinated child on the lips for 2 months( that's how much the virus stands out), do not eat after it, wash hands thoroughly after any possible contact with fecesThe kid.
At a weight of pluses at OPV there is also one essential minus, more correctly complication - a vaccine-associated poliomyelitis about which speech below will be spoken.
Inactivated poliomyelitis vaccine( IPV) contains completely killed viruses.It is administered to patients intramuscularly( mainly in the thigh), while rarely, but such side effects as local inflammatory and general allergic reactions develop.
It should be noted that the effectiveness of inactivated polio vaccine is lower than that of live.However, the absence of serious side effects and the possibility of using IPV in children with immunodeficiency makes it irreplaceable in the prevention of poliomyelitis.
Terms of polio vaccination
The actual timing of vaccination against poliomyelitis in 2015 can be seen in the table:
For the first two polio vaccinations, an inactivated vaccine is always used, then healthy babies are vaccinated with live vaccine, andIf there are contraindications( for example, immunodeficiency), is applied further on IPV.Such a scheme was developed for good reason.The introduction of two doses of killed polio vaccine promotes the formation of immunity, which reduces to zero the likelihood that vaccination against poliomyelitis in children living vaccine will cause some serious side effects.That is, a child at a meeting with live poliovirus will have the necessary level of protective antibodies.The vaccination of OPV will make immunity even stronger and more persistent.
In addition, many parents are concerned about the safety of one-day vaccination against polio and other infections.Indeed, in the national immunization calendar, polio vaccinations coincide in time with vaccinations from diphtheria, tetanus and pertussis( DTP).To be afraid it is not necessary, for immunization of small children the special preparations which contain a DTP and a poliomyelitis are developed.The use of such vaccines can reduce the likelihood of complications and the child's anxiety, since it is enough to make one injection, not two.Vaccination of DTP and poliomyelitis OPV( live vaccine) is also well tolerated by children, and if some side effects occur, they are most often associated with DTP.
Vaccine-associated poliomyelitis, which is frightened by many parents, is a disease that causes a vaccine poliovirus( the one found in live polio vaccines).
About vaccinations for the doubters the pediatrician, Dr. Komarovsky:
Vaccine-associated poliomyelitis.That is, such poliomyelitis develops after vaccination.This complication is considered extremely rare and in most cases associated with the undiagnosis of the child's health problems( in particular the immune system) or the first ever vaccination of polio from a child with OPV.
There is also a notion of poliomyelitis of vaccine origin, which occurs in populations where there are many unvaccinated people.This poliomyelitis is also caused by vaccine strains of polioviruses, but have undergone a number of genetic changes.Why is this happening?
Normally, polio vaccination made by OPV promotes the colonization of the intestine of a child with weakened polioviruses.These viruses, freely released into the environment with the feces of the vaccinated baby, enter the organisms of other children.For children with normal formed poliomyelitis immunity it is not dangerous, the virus very quickly ceases to exist in their body and circulation among the population as a whole.If most people( in particular children) do not have immunity, the virus will "wander" from one intestine to another very long.In the process of such an ongoing transfer, it will genetically change, acquiring dangerous pathogenic properties.
Poliomyelitis in Ukraine
The situation described in the previous section just happened in Ukraine, where the outbreak of poliomyelitis in Transcarpathian region was registered.During the outbreak, two young children were ill who had not been vaccinated.They developed a paralytic form of the disease.This extraordinary incident has a simple explanation - in recent years, the level of immunization of children in Ukraine has reached critically low figures, so polio 2015 in the Transcarpathian region can only be the beginning of a whole chain of polio outbreaks.
To summarize, I would like to note once again that poliomyelitis is a very contagious and very dangerous disease, which can only be protected from vaccination.No medicine will help kill the virus if it gets into the body and starts to affect the nervous system.Through vaccination, parents can protect their child from potential dangers and protect themselves from the problems faced by families raising children with disabilities.Read:
You can get more information about poliomyelitis by reviewing the video review:
Zubkova Olga Sergeevna, medical reviewer, epidemiologist