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poliomyelitis

An inflammatory disorder caused by polio virus involving gray matter of the spinal cord & medulla oblongata. Epidemiology: - known as summer plague - peak incidence in summer - epidemic - occurred more frequently in boys - virus enters through GI tract - outbreak of 42 cases after importation of a wild-type strain into Xinjiang, China in 2013 [4] - outbreak rapidly brought under control by widespread vaccination program - 3 nations pose the greatest risk for exporting the virus in 2014: Cameroon, Pakistan, & the Syrian Arab Republic [5] - Africa has been polio-free for 1 year (2015) [7] - 2 cases of polio reported in Nigeria July 2016 [8] - type 2 was declared eradicated wordwide in 2015 [9] - risk for wild poliovirus transmission is still a Public Health Emergency of International Concern in 2018 [11] - 14 cases in Afghanistan in 2017; 3 cases in 2018 as of Feb 14 - Lake Chad basin, Nigeria of concern [11] - 1st case of polio since 2013 reported in New York City metropolitan area in July of 2022 [12] Clinical manifestations: 1) fever 2) pain 3) gastrointestinal distress 4) flaccid paralysis of one or more muscle groups 5) muscle atrophy (later manifestation) 6) paralysis of lower cranial motor nerves Laboratory: - see polio virus Complications: - nocturnal ventilatory impairment may precede awakend-state hypoventilation Management: - prophylaxis (2 vaccines) a) poliovirus vaccine live (Sabin) b) poliovirus vaccine inactivated (Saulk) (now recommended vaccine) [2] Notes: History: - Franklin Rosevelt probably most famous victim - began March of Dimes to find cure - Saulk developed killed virus vaccine - Sabin developed live virus vaccine

Related

polio virus polio virus vaccine, inactivated (IPOL, IPV, Poliovax, Salk vaccine) polio virus vaccine,live, trivalent, oral (Orimune, OPV, Sabin vaccine, TOPV) post-polio syndrome

General

enteroviral infection myelitis

References

  1. Stedman's Medical Dictionary 26th ed, Williams & Wilkins, Baltimore, 1995
  2. Centers for Disease Control (CDC) Updated Recommendations of the Advisory Committee on Immunization Practices (ACIP) Regarding Routine Poliovirus Vaccination MMWR August 7, 2009 / 58(30);829-830 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5830a3.htm
  3. Medical Knowledge Self Assessment Program (MKSAP) 15, American College of Physicians, Philadelphia 2009
  4. Luo H-M et al. Identification and control of a poliomyelitis outbreak in Xinjiang, China. N Engl J Med 2013 Nov 21; 369:1981 PMID: 24256377 http://www.jwatch.org/na32738/2013/11/20/poliomyelitis-outbreak-china
  5. World Health Organization. May 2014. WHO statement on the meeting of the International Health Regulations Emergency Committee concerning the international spread of wild poliovirus. http://www.who.int/mediacentre/news/statements/2014/polio-20140505/en/
  6. World Health Organization. May 5, 2015. Statement on the 5th IHR Emergency Committee meeting regarding the international spread of wild poliovirus. http://www.who.int/mediacentre/news/statements/2015/polio-5th-statement/en/
  7. Polio Global Eradication Initiative. August 11, 2015 Is Africa polio-free? http://www.polioeradication.org/mediaroom/newsstories/Is-Africa-polio-free-/tabid/526/news/1264/Default.aspx
  8. World Heatlh Organization (WHO). Aug 11, 2016 Government of Nigeria reports 2 wild polio cases, first since July 2014. http://www.who.int/mediacentre/news/releases/2016/nigeria-polio/en/
  9. Marin M, Patel M, Oberste S, Pallansch MA. Guidance for Assessment of Poliovirus Vaccination Status and Vaccination of Children Who Have Received Poliovirus Vaccine Outside the United States. MMWR Morb Mortal Wkly Rep 2017;66:23-25
  10. World Heatlh Organization (WHO). Aug 3, 2017 Statement of the 14th IHR Emergency Committee regarding the international spread of poliovirus http://www.who.int/mediacentre/news/statements/2017/14th-ihr-polio/en/
  11. World Heatlh Organization (WHO) Statement. Feb 14, 2018 Statement of the Sixteenth IHR Emergency Committee Regarding the International Spread of Poliovirus. http://www.who.int/mediacentre/news/statements/2018/16th-ihr-polio/en/
  12. Lou N First U.S. Polio Case Detected in Close to a Decade. Vaccine clinics to be set up just north of New York City. MedPage Today July 21, 2022 https://www.medpagetoday.com/infectiousdisease/generalinfectiousdisease/99837