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Poliomyelitis
Classification and external resources

A man with an atrophied right leg due to poliomyelitis
ICD-10 A80., B91.
ICD-9 045, 138
DiseasesDB 10209
MedlinePlus 001402
eMedicine ped/1843 pmr/6
MeSH C02.182.600.700
.Poliomyelitis, often called polio or infantile paralysis, is an acute viral infectious disease spread from person to person, primarily via the fecal-oral route.^ Poliomyelitis (Polio) Poliomyelitis is caused by the Polio virus and can be spread from person to person.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ Lyme disease cannot be spread from person to person.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ Polio is an infectious disease.
  • polio Facts, information, pictures | Encyclopedia.com articles about polio 13 January 2010 15:33 UTC www.encyclopedia.com [Source type: FILTERED WITH BAYES]

[1] .The term derives from the Greek poliós (πολιός), meaning "grey", myelós (µυελός), referring to the "spinal cord", and the suffix -itis, which denotes inflammation.^ Long-term changes in the spinal cords of patients with old poliomyelitis.
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ [Greek words for gray and marrow (the gray marrow of the spinal cord), and the Latin suffix for inflammation are root words for poliomyelitis.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

^ The word poliomyelitis , the medical term used to describe the effect of poliovirus (PV) on the spinal cord, is derived from the Greek words for gray ( polio ) and marrow ( myelon ).
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

[2] .Although around 90% of polio infections cause no symptoms at all, affected individuals can exhibit a range of symptoms if the virus enters the blood stream.^ In the other study, although muscle strength increased by 30%, there was no improvement in polio survivors' ability to do daily activities, and muscle fatigue increased as much as 300%!
  • Polio News 13 January 2010 15:33 UTC www.mindspring.com [Source type: FILTERED WITH BAYES]

^ Activities that had previously caused no problems for the individual now produce new challenges.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Muscle Weakness New muscle weakness, with or without associated muscle atrophy, can involve both previously affected muscles which were partially or fully recovered, or muscles that appeared to be unaffected by the original polio infection.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

[3] .In about 1% of cases the virus enters the central nervous system, preferentially infecting and destroying motor neurons, leading to muscle weakness and acute flaccid paralysis.^ If the virus accesses the circulatory system and a viremia results, the central nervous system is exposed to the infection and acute paralytic polio may result.1 Poliovirus has a predilection for the motor neurons of the anterior horn of the cervical and lumbar regions of the spinal cord, which can result in the cell death or injury of these motor neurons.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Following death of the anterior horn cells, wallerian degeneration results and the muscle fibres associated with those neurons become “orphaned" (denervated), producing clinical weakness.8 The localisation and degree of paralysis depends on the site and the severity of neuronal lesions.7 1 T H E L ATE E F F E C TS O F P O L I O Studies undertaken more recently have shown that the involvement of the central nervous system is more diffuse than simply the motor neurons.9 -11 Lesions are also observed in the intermediate and posterior grey columns, and occasionally in the dorsal root ganglia.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Because of the variability in which the motor neurons to different muscle groups may have been affected in a particular patient, both asymmetric and scattered weakness may be present.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

.Different types of paralysis may occur, depending on the nerves involved.^ The proportion of inapparent or asymptomatic infection to paralytic infection may be as high as 1000:1 in children and 75:1 in adults, depending on the poliovirus type and social and environmental conditions.
  • Immunise - 3.16 Poliomyelitis 16 January 2010 21:22 UTC www.health.gov.au [Source type: Academic]

^ The site of paralysis depends on the site of nerve cell damage in the spinal column or the brain stem.
  • Poliomyelitis (polio) - Notifiable Diseases On-Line 16 January 2010 21:22 UTC dsol-smed.hc-sc.gc.ca [Source type: FILTERED WITH BAYES]

^ Paralysis of respiratory muscles may occur if the poliovirus invades the central nervous system and destroys nerve cells controlling muscular movement, or if nerve cells in respiratory centers, which control breathing, are damaged.
  • POLIOMYELITIS, 16 January 2010 21:22 UTC www.history.com [Source type: FILTERED WITH BAYES]

.Spinal polio is the most common form, characterized by asymmetric paralysis that most often involves the legs.^ The legs are most often affected.
  • Neuroscience for Kids - Polio 13 January 2010 15:33 UTC faculty.washington.edu [Source type: FILTERED WITH BAYES]

^ Most often the muscles of the legs are affected.
  • Department of Health and Ageing - Poliomyelitis 16 January 2010 21:22 UTC www.health.gov.au [Source type: Academic]

^ It is characterised by asymmetric paralysis that most often involves the legs.
  • Poliovirus (Polio, Poliomyelitis) 16 January 2010 21:22 UTC www.medic8.com [Source type: FILTERED WITH BAYES]

.Bulbar polio leads to weakness of muscles innervated by cranial nerves.^ Bulbar polio leads to weakness of muscles innervated by cranial nerves and accounted for 2% of cases during this period.
  • Poliovirus (Polio, Poliomyelitis) 16 January 2010 21:22 UTC www.medic8.com [Source type: FILTERED WITH BAYES]

^ The polio virus harms the nerves that control muscles, and it makes the muscles weak.
  • Post-Polio Syndrome-Topic Overview 13 January 2010 15:33 UTC www.webmd.com [Source type: FILTERED WITH BAYES]
  • Post-Polio Syndrome - Topic Overview - Yahoo! Health 16 January 2010 21:22 UTC health.yahoo.com [Source type: General]

^ Have had serious, lasting muscle weakness from polio.
  • Post-Polio Syndrome - Topic Overview - Yahoo! Health 16 January 2010 21:22 UTC health.yahoo.com [Source type: General]

.Bulbospinal polio is a combination of bulbar and spinal paralysis.^ Bulbospinal polio, a combination of bulbar and spinal paralysis, accounted for 19% of cases.
  • Poliovirus (Polio, Poliomyelitis) 16 January 2010 21:22 UTC www.medic8.com [Source type: FILTERED WITH BAYES]

^ Broader terms: Central nervous system -- Diseases Enterovirus diseases Spinal cord -- Diseases Narrower terms: Poliomyelitis -- Prevention Poliomyelitis -- Vaccination Used for: Anterior spinal paralysis Infantile paralysis Paralysis, Anterior spinal Paralysis, Infantile Polio .

^ When, however, first exposure to polio comes at a later age, the virus is much more likely to spread to the spinal cord and/or brain and cause paralysis or death.
  • Jack Hamann | After the Rains: Pursuing polio to the ends of the earth 13 January 2010 15:33 UTC www.jackhamann.com [Source type: FILTERED WITH BAYES]

[4]
.Poliomyelitis was first recognized as a distinct condition by Jakob Heine in 1840.[5] Its causative agent, poliovirus, was identified in 1908 by Karl Landsteiner.^ Poliomyelitis was first transmitted to monkeys experimentally in 1908 by Landsteiner and Popper.
  • THE STORY OF THE SALK ANTI-POLIOMYELITIS VACCINE BY M. BEDDOW BAYLY, M.R.C.S.,L.R.C.P. 16 January 2010 21:22 UTC www.whale.to [Source type: FILTERED WITH BAYES]

^ PV was discovered to be the causative agent of poliomyelitis in 1909 by Karl Landsteiner and Erwin Popper, two Austrian physicians [ 109 ].
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

^ Interestingly, Poliomyelitis had become a fixed term, not able to withstand more evolutionary change, when its causative agent - the virus - was discovered in 1908.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

[5] .Although major polio epidemics were unknown before the late 19th century, polio was one of the most dreaded childhood diseases of the 20th century.^ Polio was a very scary word to me because I vividly remembered the summer I was 5 being rushed to a hospital by my parents very late one night.
  • Do You Remember...? | 50th Anniversary of the Polio Vaccine 13 January 2010 15:33 UTC www.polio.umich.edu [Source type: General]

^ In the late 1940s one of my playmate friends from elementary school was stricken with polio; it was the summer of a severe polio epidemic in the country and parents everywhere were frightened for their children.
  • Do You Remember...? | 50th Anniversary of the Polio Vaccine 13 January 2010 15:33 UTC www.polio.umich.edu [Source type: General]

^ Only in the 19th century did descriptions of polio epidemics begin to appear.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

.Polio epidemics have crippled thousands of people, mostly young children; the disease has caused paralysis and death for much of human history.^ Legionnaire's disease may cause death.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ Rabies, Human Rabies disease is caused by Rabies virus.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ Avian influenza in humans can cause death.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

.Polio had existed for thousands of years quietly as an endemic pathogen until the 1880s, when major epidemics began to occur in Europe; soon after, widespread epidemics appeared in the United States.^ The year 1916 saw a large outbreak of polio in the United States.
  • Poliomyelitis: A Brief History 16 January 2010 21:22 UTC www.cloudnet.com [Source type: FILTERED WITH BAYES]

^ Over millennia, polio survived quietly as an endemic pathogen until the 1880s when major epidemics began to occur in Europe; soon after, widespread epidemics appeared in the United States.
  • History of poliomyelitis 16 January 2010 21:22 UTC www.lumrix.net [Source type: FILTERED WITH BAYES]

^ Symptoms can occur as soon as 15 years after you had polio.
  • CIGNA - Post-Polio Syndrome 13 January 2010 15:33 UTC www.cigna.com [Source type: FILTERED WITH BAYES]
  • Post-Polio Syndrome-Topic Overview 13 January 2010 15:33 UTC www.webmd.com [Source type: FILTERED WITH BAYES]

[6] .By 1910, much of the world experienced a dramatic increase in polio cases and frequent epidemics became regular events, primarily in cities during the summer months.^ By 1910, frequent epidemics became regular events throughout the developed world, primarily in cities during the summer months.
  • History of poliomyelitis 16 January 2010 21:22 UTC www.lumrix.net [Source type: FILTERED WITH BAYES]

^ Finally, many of the adults who had polio in the 1950s epidemic are now experiencing a return of symptoms in "post-polio syndrome".
  • Polio and IPT 13 January 2010 15:33 UTC iptq.com [Source type: General]

^ Poliomyelitis (polio) epidemics occurred in the 1940s and 50s, with first cases in Canada reported in 1927, last, not the result of vaccination, were in 1962.
  • Post Poliomyelitis Sequelae 16 January 2010 21:22 UTC www.polioalberta.ca [Source type: Academic]

.These epidemics—which left thousands of children and adults paralyzed—provided the impetus for a "Great Race" towards the development of a vaccine.^ Summer Polio epidemics & development of polio vaccines - 11/28/1999 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ The Milwaukee Health Department (MHD) provides free MMR vaccinations for children and adolescents at several clinic locations.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ The Milwaukee Health Department (MHD) plans to provide free rotavirus vaccinations for children and adolescents at several clinic locations.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

.Developed in the 1950s, polio vaccines are credited with reducing the global number of polio cases per year from many hundreds of thousands to around a thousand.^ Two forms of polio vaccine have been developed, the Salk Inactivated Polio Vaccine and Sabin Oral Polio Vaccine.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Summer Polio epidemics & development of polio vaccines - 11/28/1999 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ By the end of the year, 6.4 million people had had two inoculations 47 and the number of polio cases declined rapidly thereafter.
  • Vaccine Innovation and Adoption: Polio Vaccines in the UK, the Netherlands and West Germany, 1955–1965 13 January 2010 15:33 UTC www.ncbi.nlm.nih.gov [Source type: FILTERED WITH BAYES]

[7] .Enhanced vaccination efforts led by the World Health Organization, UNICEF and Rotary International could result in global eradication of the disease.^ We can distinguish effects due to international standards, economic pressures (reflecting, for example, growing concentration in the vaccines industry), and political pressures (e.g., the rivalry between countries, the growing importance of global forums in seeking to structure global vaccination efforts and vaccine development).
  • Vaccine Innovation and Adoption: Polio Vaccines in the UK, the Netherlands and West Germany, 1955–1965 13 January 2010 15:33 UTC www.ncbi.nlm.nih.gov [Source type: FILTERED WITH BAYES]

^ W Muraskin, The politics of international health: the Children's Vaccine Initiative and the struggle to develop vaccines for the third world , Albany, SUNY Press, 1998.
  • Vaccine Innovation and Adoption: Polio Vaccines in the UK, the Netherlands and West Germany, 1955–1965 13 January 2010 15:33 UTC www.ncbi.nlm.nih.gov [Source type: FILTERED WITH BAYES]

^ In 1967, in line with recommendations made by a WHO Expert Committee on Smallpox 3 years earlier to vaccinate the entire world's population as a means of furthering efforts to eradicate the variola virus, the WHO introduced the Intensified Smallpox Eradication Program.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

[8]

Contents

Classification

Outcomes of poliovirus infection
Outcome Proportion of cases[4]
Asymptomatic 90–95%
Minor illness 4–8%
Non-paralytic aseptic
meningitis
1–2%
Paralytic poliomyelitis 0.1–0.5%
— Spinal polio 79% of paralytic cases
— Bulbospinal polio 19% of paralytic cases
— Bulbar polio 2% of paralytic cases
.The term poliomyelitis is used to identify the disease caused by any of the three serotypes of poliovirus.^ Poliomyelitis is caused by the polioviruses serotypes 1, 2 and 3.
  • British HIV Association Guidelines for Immunization of HIV-Infected Adults: Poliomyelitis 16 January 2010 21:22 UTC www.medscape.com [Source type: Academic]

^ Enteroviruses cause a number of wellknown diseases and symptoms in humans, from subclinical infections and the common cold to poliomyelitis with paralysis.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ Polio (pronounced POH-lee-oh) is a serious disease caused by a virus called the poliovirus.
  • polio Facts, information, pictures | Encyclopedia.com articles about polio 13 January 2010 15:33 UTC www.encyclopedia.com [Source type: FILTERED WITH BAYES]

.Two basic patterns of polio infection are described: a minor illness which does not involve the central nervous system (CNS), sometimes called abortive poliomyelitis, and a major illness involving the CNS, which may be paralytic or non-paralytic.^ Poliomyelitis in which illness is mild with no involvement of central nervous system.
  • Glossary.13. poliomyelitis, Pott's fracture and proprioceptive 16 January 2010 21:22 UTC italian.kneelsit.com [Source type: Academic]

^ Symptoms There are three basic patterns of polio infection: subclinical infections, nonparalytic, and paralytic.
  • What is Poliomyelitis? 16 January 2010 21:22 UTC www.medhelp.org [Source type: FILTERED WITH BAYES]

^ Sometimes it does not cause serious illness.
  • Learn about Polio Vaccine from Consumer Reports Health. 13 January 2010 15:33 UTC www.consumerreports.org [Source type: FILTERED WITH BAYES]

[9] .In most people with a normal immune system, a poliovirus infection is asymptomatic.^ Because HIV/AIDS attacks the immune system, individuals with HIV/AIDS tend to get sick very easily with infections and cancers that are extremely rare in a healthy population.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ For most of its recorded history, the poliovirus was an endemic infection in regions with poor sanitation.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ The dead viruses cause the immune system to start making antibodies against the poliovirus.
  • polio Facts, information, pictures | Encyclopedia.com articles about polio 13 January 2010 15:33 UTC www.encyclopedia.com [Source type: FILTERED WITH BAYES]

.Rarely the infection produces minor symptoms; these may include upper respiratory tract infection (sore throat and fever), gastrointestinal disturbances (nausea, vomiting, abdominal pain, constipation or, rarely, diarrhea), and influenza-like illness.^ Symptoms may include fever, headache, vomiting, diarrhoea, constipation and sore throat.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Symptoms of avian influenza in humans may include flu-like symptoms (fever, sore throat, body aches, cough), pneumonia, trouble breathing, and eye infections.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ Common symptoms of foodborne illnesses include diarrhea, upset stomach, and vomiting.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

[4]
.The virus enters the central nervous system in about 3% of infections.^ The infection is cut short by the host’s defences before it can enter the central nervous system.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Morrison L. Direct spread of reovirus from the intestinal lumen to the central nervous system through vagal autonomic nerve fibers.

^ The disease is caused by a virus which invades the central nervous system of an individual and multiplies in the intestines resulting in various degrees of paralysis.

.Most patients with CNS involvement develop non-paralytic aseptic meningitis, with symptoms of headache, neck, back, abdominal and extremity pain, fever, vomiting, lethargy and irritability.^ These symptoms can include headache, tiredness, fever, and irritability.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ Symptoms of bacterial meningitis can include fever, vomiting, stiff neck, and weakness.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ Symptoms may include headache, neck, back, abdominal and extremity pain, fever, vomiting, lethargy and irritability.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

[2][10] .Approximately 1 in 200 to 1 in 1000 cases progress to paralytic disease, in which the muscles become weak, floppy and poorly controlled, and finally completely paralyzed; this condition is known as acute flaccid paralysis.^ They first become floppy and weak.
  • polio Facts, information, pictures | Encyclopedia.com articles about polio 13 January 2010 15:33 UTC www.encyclopedia.com [Source type: FILTERED WITH BAYES]

^ The muscles become weak, floppy, and then totally paralyzed.
  • polio Facts, information, pictures | Encyclopedia.com articles about polio 13 January 2010 15:33 UTC www.encyclopedia.com [Source type: FILTERED WITH BAYES]

^ Abstract: Post-polio syndrome (PPS) describes the clinical onset of progressive muscular weakness many years after survival of acute paralytic poliomyelitis, often in muscle groups clinically unaffected by the original disease process.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

[11] .Depending on the site of paralysis, paralytic poliomyelitis is classified as spinal, bulbar, or bulbospinal.^ The destruction of motor neurons leads to the development of flaccid paralysis, which may be bulbar or spinal in distribution.
  • Poliomyelitis: eMedicine Pediatrics: General Medicine 16 January 2010 21:22 UTC emedicine.medscape.com [Source type: Academic]

^ Bulbar paralytic polio (5 to 35% of paralytic cases of polio) This causes paralysis of the soft palate, pharynx and larynx resulting in difficulty in swallowing and breathing.
  • Ministry of Health: FAQs 16 January 2010 21:22 UTC www.pqms.moh.gov.sg [Source type: FILTERED WITH BAYES]

^ The extent of paralysis depends on the level of the spinal cord lesions, which may be cervical, thoracic, or lumbar.
  • Poliomyelitis - Definition, Causes, Symptoms and Treatments: 16 January 2010 21:22 UTC www.health-diseases.org [Source type: Academic]

.Encephalitis, an infection of the brain tissue itself, can occur in rare cases and is usually restricted to infants.^ Rarely, acute encephalitis can occur from poliovirus.
  • Poliomyelitis | Doctor | Patient UK 16 January 2010 21:22 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

^ In cases such as his, the virus reaches the brain and spinal cord where it multiplies and destroys the nerve tissue.

^ Transmission of the infection to susceptible household contacts occurs in 73 to 96 percent of cases, depending on the person's age.
  • Poliovirus Vaccine Options - January 1, 1999 - American Academy ofFamily Physicians 16 January 2010 21:22 UTC www.aafp.org [Source type: Academic]

.It is characterized by confusion, changes in mental status, headaches, fever, and less commonly seizures and spastic paralysis.^ Symptoms may include headache, stiff neck, sensitivity to light, tiredness, vomiting, upset stomach, fever, and confusion.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ Symptoms of animal rabies include behavior change, loss of appetite, increased aggression, seizures, increased growling/barking, confusion, trouble swallowing and paralysis.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

[12]

Cause

A TEM micrograph of poliovirus
.Poliomyelitis is caused by infection with a member of the genus Enterovirus known as poliovirus (PV).^ The word poliomyelitis , the medical term used to describe the effect of poliovirus (PV) on the spinal cord, is derived from the Greek words for gray ( polio ) and marrow ( myelon ).
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

^ Abstract: It has been suggested that late onset neurological deterioration after poliomyelitis may be due in some cases to persistent poliovirus infection of the central nervous system.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ Ancient positive selection on CD155 as a possible cause for susceptibility to poliovirus infection in simians - -2006 Suzuki Y [ABSTRACT] - 03/01/2006 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

This group of RNA viruses prefers to inhabit the gastrointestinal tract.[1] .PV infects and causes disease in humans alone.^ Rabies, Human Rabies disease is caused by Rabies virus.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ Poliomyelitis is a communicable disease caused by viral infection and occurs through direct contact with infected secretions.
  • Immunizations - Poliomyelitis 16 January 2010 21:22 UTC www.healthcentral.com [Source type: FILTERED WITH BAYES]
  • Poliomyelitis: Poliomyelitis is a communicable disease caused by viral infection ... 16 January 2010 21:22 UTC www.henryfordhealth.org [Source type: Academic]
  • Poliomyelitis | Caremark Health Resources 16 January 2010 21:22 UTC health-healthresources.caremark.com [Source type: FILTERED WITH BAYES]
  • Poliomyelitis, Henry Ford Hospital, Detroit, MI 16 January 2010 21:22 UTC www.henryford.com [Source type: Academic]

^ Inadequately vaccinated individuals were apparently infected by a vaccine-derived virus strain capable of causing disease.
  • POLIOMYELITIS, 16 January 2010 21:22 UTC www.history.com [Source type: FILTERED WITH BAYES]

[3] .Its structure is very simple, composed of a single (+) sense RNA genome enclosed in a protein shell called a capsid.^ Stem-loop D of the cloverleaf RNA binds the viral protein 3CD (and, very poorly, 3C pro ).
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

^ Nomoto A, Kitamura N, Golini F, Wimmer E: The 5'-terminal structures of poliovirion RNA and poliovirus mRNA differ only in the genome linked protein VPg.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

^ Najita L, Sarnow P: Oxidation-reduction sensitive interaction of a cellular 50-kDa protein with an RNA hairpin in the 5' noncoding region of the poliovirus genome.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

[3] .In addition to protecting the virus’s genetic material, the capsid proteins enable poliovirus to infect certain types of cells.^ The virus, known as poliovirus, infects nerves.
  • CGH Medical Center - ADAM Health Library 16 January 2010 21:22 UTC www.cghmc.com [Source type: FILTERED WITH BAYES]
  • Poliomyelitis - Edward Hospital, Naperville IL Area 16 January 2010 21:22 UTC www.edward.org [Source type: FILTERED WITH BAYES]
  • HowStuffWorks "Poliomyelitis - Medical Dictionary" 16 January 2010 21:22 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]
  • Poliomyelitis; Baltimore, Maryland MD 16 January 2010 21:22 UTC www.harborhospital.org [Source type: FILTERED WITH BAYES]

^ Poliovirus infection provides lifelong immunity against the disease, but this protection is limited to the particular type of poliovirus involved.
  • Poliomyelitis (Polio) 16 January 2010 21:22 UTC www.irishhealth.com [Source type: FILTERED WITH BAYES]

^ In a very small number of people the virus enters the blood stream and infects cells in the nervous system.
  • Parenting and Child Health - Health Topics - Polio 13 January 2010 15:33 UTC www.cyh.com [Source type: FILTERED WITH BAYES]

.Three serotypes of poliovirus have been identified—poliovirus type 1 (PV1), type 2 (PV2), and type 3 (PV3)—each with a slightly different capsid protein.^ Two determinants in the capsid of a persistent type 3 poliovirus exert different effects on mutant virus uncoating - -1999 Duncan, Colbere-Garapin ABSTRACT - 11/10/1999 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ There are three different types of plague: bubonic, septicemic, and pneumonic.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ Indeed, genetically, these three C-cluster coxsackie A viruses differ notably from the polioviruses only in the structural (P1) capsid region [ 31 ].
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

[13] .All three are extremely virulent and produce the same disease symptoms.^ PPS is a clinical diagnosis that requires exclusion of all other medical, neurological, orthopedic or psychiatric diseases that could explain the cause of the new symptoms.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ The inoculum required to produce paralysis and/or death in half the mice inoculated (PLD 50 ) was markedly increased over that required to produce the same signs of disease with wt PV1(M).
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

^ Pontiac fever shares many of the same symptoms with Legionnaire's disease.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

[3] .PV1 is the most commonly encountered form, and the one most closely associated with paralysis.^ Type 1 is the most common form and the one most closely associated with severe symptoms and paralysis.

^ In its most severe form, it causes paralysis, difficulty breathing and sometimes death.
  • U. collecting polio survivors' stories - Salt Lake Tribune 13 January 2010 15:33 UTC www.sltrib.com [Source type: News]

^ Although the risk of vaccine-associated paralysis is minimal, vaccinees (or their parents) and their susceptible, close, personal contacts should be informed of this risk.

[14]
.Individuals who are exposed to the virus, either through infection or by immunization with polio vaccine, develop immunity.^ Who shouldn't get the polio vaccine?
  • The polio vaccine | BabyCenter 13 January 2010 15:33 UTC www.babycenter.com [Source type: General]

^ Over 1/3 of these individuals developed paralytic polio.
  • Infectious Diseases - Poliomyelitis (Polio) 16 January 2010 21:22 UTC www.schneiderchildrenshospital.org [Source type: FILTERED WITH BAYES]
  • Poliomyelitis (Polio) 16 January 2010 21:22 UTC www.allkids.org [Source type: FILTERED WITH BAYES]
  • Health Tips - Infectious Diseases - Poliomyelitis (Polio) 16 January 2010 21:22 UTC www.driscollchildrens.org [Source type: FILTERED WITH BAYES]

^ Who developed the polio vacine?
  • WikiAnswers - Who was the doctor who developed a vaccine for polio 13 January 2010 15:33 UTC wiki.answers.com [Source type: General]

.In immune individuals, IgA antibodies against poliovirus are present in the tonsils and gastrointestinal tract and are able to block virus replication; IgG and IgM antibodies against PV can prevent the spread of the virus to motor neurons of the central nervous system.^ If the virus accesses the circulatory system and a viremia results, the central nervous system is exposed to the infection and acute paralytic polio may result.1 Poliovirus has a predilection for the motor neurons of the anterior horn of the cervical and lumbar regions of the spinal cord, which can result in the cell death or injury of these motor neurons.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Because of the variability in which the motor neurons to different muscle groups may have been affected in a particular patient, both asymmetric and scattered weakness may be present.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ Unique Identifier 97123696 Authors: Arya SC. Title: Poliovirus genomic sequences in the central nervous systems of patients with postpolio syndrome [letter; comment].
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

[15] .Infection or vaccination with one serotype of poliovirus does not provide immunity against the other serotypes, and full immunity requires exposure to each serotype.^ Unfortunately, infection with one type does not protect an individual against infection with the other two types.
  • POLIOMYELITIS 16 January 2010 21:22 UTC rrtd.nic.in [Source type: FILTERED WITH BAYES]

^ The polio vaccine protects against the poliovirus.
  • The polio vaccine | BabyCenter 13 January 2010 15:33 UTC www.babycenter.com [Source type: General]

^ Vaccination simply does not provide high-level protection against poliovirus infection.
  • Importation of Poliomyelitis by Travelers | CDC EID 16 January 2010 21:22 UTC origin.cdc.gov [Source type: Academic]

[15]
.A rare condition with a similar presentation, nonpoliovirus poliomyelitis, may result from infections with non-poliovirus enteroviruses.^ Our results do not provide any evidence that such enterovirus infection is related to late functional deterioration in patients with previous poliomyelitis, which could be attributed to other medical conditions in most instances, and do not support the hypothesis that MND is associated with enterovirus infection of the CNS. Nucleotide sequence analysis of enterovirus RNA sequences detected indicated that enteroviruses detected were of the non-polio type.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ Such musculo-skeletal problems would be expected to occur in these clients with advancing years, as indeed they would in non-polio subjects who may have a similar degree of weakness or skeletal abnormalities from any other condition.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Enteroviruses cause a number of wellknown diseases and symptoms in humans, from subclinical infections and the common cold to poliomyelitis with paralysis.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

[16]

Transmission

.Poliomyelitis is highly contagious and spreads easily by human-to-human contact.^ H5N1 is spread to humans through direct contact with infected birds and can be spread from person to person only with great difficulty.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

[15] .In endemic areas, wild polioviruses can infect virtually the entire human population.^ Travelers to areas where poliomyelitis is endemic or epidemic,* Laboratory workers handling specimens which may contain polioviruses,* Health-care workers in close contact with individuals who may be excreting wild polioviruses,* and Individuals who are members of specific population groups currently supervening an outbreak of polio caused by wild polioviruses.
  • Polio Vaccine 16 January 2010 21:22 UTC www.aetna.com [Source type: Academic]

^ Most of the world's population resides in areas considered free of wild poliovirus circulation.
  • Poliomyelitis (infantile paralysis, polio) 13 January 2010 15:33 UTC www.health.state.ny.us [Source type: FILTERED WITH BAYES]

^ Feces, respiratory secretions, and environmental sewage and water samples collected for any purpose at a time and in a geographic area where wild polioviruses were suspected to be present.
  • Laboratory Containment of Wild Poliovirus - Frequently Asked Questions 13 January 2010 15:33 UTC www.hhs.gov [Source type: FILTERED WITH BAYES]

[17] It is seasonal in temperate climates, with peak transmission occurring in summer and autumn.[15] These seasonal differences are far less pronounced in tropical areas.[17] .The time between first exposure and first symptoms, known as the incubation period, is usually 6 to 20 days, with a maximum range of 3 to 35 days.^ Symptoms of shigellosis usually appear 1-2 days after exposure.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ Symptoms of tularemia usually appear 3-5 days after exposure.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ The incubation period of polio is 3–21 days.
  • British HIV Association Guidelines for Immunization of HIV-Infected Adults: Poliomyelitis 16 January 2010 21:22 UTC www.medscape.com [Source type: Academic]

[18] .Virus particles are excreted in the feces for several weeks following initial infection.^ After initial infection with poliovirus, the virus is shed intermittently in faeces (excrement) for several weeks.
  • The disease and the virus 13 January 2010 15:33 UTC www.polioeradication.org [Source type: FILTERED WITH BAYES]
  • healthyNJ--Information for Healthy Living--Polio 13 January 2010 15:33 UTC www.healthynj.org [Source type: FILTERED WITH BAYES]

^ The virus is shed in oral secretions for several weeks and in the feces for several months.
  • Poliomyelitis: eMedicine Orthopedic Surgery 16 January 2010 21:22 UTC emedicine.medscape.com [Source type: Academic]

^ Because polioviruses multiply in the intestinal tract for several weeks after infection, specimen of faeces is most suitable for virus isolation.
  • Guidelines on Standard Operating Procedures for MICROBIOLOGY - Poliomyelitis 16 January 2010 21:22 UTC www.searo.who.int [Source type: Academic]

[18] .The disease is transmitted primarily via the fecal-oral route, by ingesting contaminated food or water.^ In its natural host, PV transmits via the fecal-oral route.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

^ Eating food or drinking beverages that have been contaminated/handled by an infected person can spread the disease.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ All travellers should be given advice about risk of infection through contaminated water and food and about the importance of hand hygiene (C, IV).
  • British HIV Association Guidelines for Immunization of HIV-Infected Adults: Poliomyelitis 16 January 2010 21:22 UTC www.medscape.com [Source type: Academic]

.It is occasionally transmitted via the oral-oral route,[14] a mode especially visible in areas with good sanitation and hygiene.^ Does good, even lighting exist over the stove, sink and countertop work areas especially where food is sliced or cut?
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

[15] .Polio is most infectious between 7–10 days before and 7–10 days after the appearance of symptoms, but transmission is possible as long as the virus remains in the saliva or feces.^ Poliomyelitis and its symptoms: Poliomyelitis (polio) is a highly infectious disease caused by a virus.

^ Transmission of the virus is possible for as long as the virus is excreted.
  • Poliomyelitis- Blue Book: IDEAS - Victorian Government 16 January 2010 21:22 UTC www.health.vic.gov.au [Source type: FILTERED WITH BAYES]

^ Risk of infection is greatest for the 7 to 10 days before and after onset of symptoms.
  • POLIOMYELITIS Control Guideline - NSW Department of Health 16 January 2010 21:22 UTC www.health.nsw.gov.au [Source type: Academic]

[14]
.Factors that increase the risk of polio infection or affect the severity of the disease include immune deficiency,[19] malnutrition,[20] tonsillectomy,[21] physical activity immediately following the onset of paralysis,[22] skeletal muscle injury due to injection of vaccines or therapeutic agents,[23] and pregnancy.^ Does cross-sex transmission increase the severity of polio infection?
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ Cardiac risk factors in polio survivors.
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ The gradual or abrupt onset of new weakness in polio-affected muscles.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

[24] .Although the virus can cross the placenta during pregnancy, the fetus does not appear to be affected by either maternal infection or polio vaccination.^ Polio virus infections.

^ Does cross-sex transmission increase the severity of polio infection?
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ In countries that use the OPV — vaccine made with live, but weakened (attenuated) polio virus — the risk of paralytic polio to travelers is extremely low, but not zero.
  • Polio: Symptoms - MayoClinic.com 13 January 2010 15:33 UTC www.mayoclinic.com [Source type: FILTERED WITH BAYES]

[25] .Maternal antibodies also cross the placenta, providing passive immunity that protects the infant from polio infection during the first few months of life.^ In 1995, 64 cases of the disease were identified and 32 cases were reported during the first four months of 1996.
  • ProjectDisaster » Blog Archive » Haiti: Socioeconomic, Political, and Demographic Overview 16 January 2010 21:22 UTC projectdisaster.com [Source type: Academic]

^ During the first six months of 1997, 31 cases of neonatal tetanus were reported by 39 sentinel sites from the nine departments.
  • ProjectDisaster » Blog Archive » Haiti: Socioeconomic, Political, and Demographic Overview 16 January 2010 21:22 UTC projectdisaster.com [Source type: Academic]

^ RIG-I is cleaved during picornavirus infection (polio) - -2009 Barral PM, Sarkar D, Fisher PB, Racaniello VR [ABSTRACT] - 07/25/2009 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

[26]

Pathophysiology

A blockage of the lumbar anterior spinal cord artery due to polio (PV3)
.Poliovirus enters the body through the mouth, infecting the first cells it comes in contact with—the pharynx (throat) and intestinal mucosa.^ Poliovirus transcytosis through M-like cells.
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ The disease is spread through an infected person's mucus or when a person comes into contact with the wounds of an infected person.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ H5N1 is spread to humans through direct contact with infected birds and can be spread from person to person only with great difficulty.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

.It gains entry by binding to an immunoglobulin-like receptor, known as the poliovirus receptor or CD155, on the cell membrane.^ Poliovirus transcytosis through M-like cells.
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ Cryo-electron microscopy reconstruction of a poliovirus-receptor-membrane complex - -2005 Bubeck D, Filman DJ, Hogle JM ABSTRACT - 06/27/2005 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ Poliovirus protein 3A binds and inactivates LIS1, causing block of membrane protein trafficking and deregulation of cell division - -2006 Kondratova AA, Neznanov N, Kondratov RV, Gudkov AV [ABSTRACT] - 05/04/2006 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

[27] .The virus then hijacks the host cell's own machinery, and begins to replicate.^ This in turn is suggestive of variation in the efficiency of IRES-mediated translation depending on the infected host cell, and consequently on the ability of the virus to produce pathologic changes.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

^ One such question pertains to the determinants of neuropathogenesis, specifically regions of the virus genome important for aspects of virus replication in the cells which it targets.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

^ To date, the specific sites and cell types in which the virus initially replicates following entry into the host remain enigmatic.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

.Poliovirus divides within gastrointestinal cells for about a week, from where it spreads to the tonsils (specifically the follicular dendritic cells residing within the tonsilar germinal centers), the intestinal lymphoid tissue including the M cells of Peyer's patches, and the deep cervical and mesenteric lymph nodes, where it multiplies abundantly.^ Viruses multiply in the lymphoid tissues of the oropharynx and intestine during the one- to three-week incubation period.7 In most cases, the virus is present in the oropharyngeal secretions for one to two weeks and is excreted in the stools for several weeks to months.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Nevertheless, the ability to isolate virus from the lymphatic tissues of the gastrointestinal tract, including the tonsils, Peyer's patches of the ileum, and mesenteric lymph nodes [ 24 , 25 , 106 , 173 , 174 ], as well as the feces [ 106 , 174 ], prior to the onset of illness suggests susceptible cells in these tissues may be sites of primary replication.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

^ Blinzinger K, Simon J, Magrath D, Boulger L: Poliovirus crystals within the endoplasmic reticulum of endothelial and mononuclear cells in the monkey spinal cord.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

.The virus is subsequently absorbed into the bloodstream.^ Pathophysiology 5 The virus may invade lymphatic tissue and spread into the bloodstream.
  • Poliomyelitis | Doctor | Patient UK 16 January 2010 21:22 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

[28]
.Known as viremia, the presence of virus in the bloodstream enables it to be widely distributed throughout the body.^ Muscle spasm is present in the extensors of the neck and back, usually present in the hamstring muscles, and of variable presence in other muscles throughout the body.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

.Poliovirus can survive and multiply within the blood and lymphatics for long periods of time, sometimes as long as 17 weeks.^ The virus can survive outside of the body for a long period of time.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ During this time, it is absorbed into the blood and lymphatics from the gastrointestinal tract where it can reside and multiply, sometimes for as long as 17 weeks.
  • polio Facts, information, pictures | Encyclopedia.com articles about polio 13 January 2010 15:33 UTC www.encyclopedia.com [Source type: FILTERED WITH BAYES]

^ Viruses multiply in the pharynx and intestine during the one-to-three-week incubation period before blood-borne dissemination occurs.
  • Lincolnshire Post-Polio Library [Poliomyelitis] 16 January 2010 21:22 UTC www.ott.zynet.co.uk [Source type: Academic]

[29] .In a small percentage of cases, it can spread and replicate in other sites such as brown fat, the reticuloendothelial tissues, and muscle.^ As the infection progresses, the virus will spread further to other sites of the reticuloendothelial system.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

^ IPV had reached only a very small percentage of the population and there were still more than 4,000 cases of acute polio per annum.
  • Vaccine Innovation and Adoption: Polio Vaccines in the UK, the Netherlands and West Germany, 1955–1965 13 January 2010 15:33 UTC www.ncbi.nlm.nih.gov [Source type: FILTERED WITH BAYES]

^ Thus, it appears that some apparently "ectopic" sites of PVR expression may in fact be sites for PV replication, whereas other sites may indeed be restricted.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

[30] .This sustained replication causes a major viremia, and leads to the development of minor influenza-like symptoms.^ Abortive infection (4 - 8%) - this group of patients only suffer the minor illness which comprises of influenza-like symptoms such as fever, malaise, drowsiness, headache, nausea, vomiting, constipation and sore throat.
  • Poliomyelitis, Poliovirus, Polioviruses 16 January 2010 21:22 UTC virology-online.com [Source type: Academic]

^ The virus infects the bowel, and from there can attack the nervous system causing meningitis or paralysis.Infection may be without symptoms or with only minor bowel upset.
  • Consumer Medicine Information 16 January 2010 21:22 UTC www.medsafe.govt.nz [Source type: FILTERED WITH BAYES]

^ Following initial replication of the virus in susceptible cells of the pharynx and gastrointestinal tract, in the majority of infected individuals a minor, transient viremia, but no neurologic complications, will develop.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

.Rarely, this may progress and the virus may invade the central nervous system, provoking a local inflammatory response.^ Unique Identifier 97123696 Authors: Arya SC. Title: Poliovirus genomic sequences in the central nervous systems of patients with postpolio syndrome [letter; comment].
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ The infection is cut short by the host’s defences before it can enter the central nervous system.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ We have recently examined the central nervous system from a PPS patient.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

.In most cases this causes a self-limiting inflammation of the meninges, the layers of tissue surrounding the brain, which is known as non-paralytic aseptic meningitis.^ Non-paralytic aseptic meningitis .
  • NaTHNaC | Poliomyelitis Information Sheet, Health Professionals 16 January 2010 21:22 UTC www.nathnac.org [Source type: FILTERED WITH BAYES]

^ This is due to an inflammation of the meninges (tissues which cover the spinal cord and brain).
  • polio Facts, information, pictures | Encyclopedia.com articles about polio 13 January 2010 15:33 UTC www.encyclopedia.com [Source type: FILTERED WITH BAYES]

^ Non-paralytic aseptic meningitis Occurs in 1%-2% of infections and is characterised by a non-specific prodrome followed by stiffness of the neck, back, and/or legs.
  • Jabs 16 January 2010 21:22 UTC www.jabs.org.uk [Source type: FILTERED WITH BAYES]

[2] .Penetration of the CNS provides no known benefit to the virus, and is quite possibly an incidental deviation of a normal gastrointestinal infection.^ "No explanation for the Cutter vaccine incident has yet been found, but it is possible that certain batches contained live virus."
  • THE STORY OF THE SALK ANTI-POLIOMYELITIS VACCINE BY M. BEDDOW BAYLY, M.R.C.S.,L.R.C.P. 16 January 2010 21:22 UTC www.whale.to [Source type: FILTERED WITH BAYES]

^ No drug can kill the virus once an infection has begun.
  • Polio - Polio Description - Polio Symptoms - Polio Prevention - Polio Treatment 13 January 2010 15:33 UTC symptomchecker.about.com [Source type: FILTERED WITH BAYES]

[31] .The mechanisms by which poliovirus spreads to the CNS are poorly understood, but it appears to be primarily a chance event—largely independent of the age, gender, or socioeconomic position of the individual.^ In the event of infection, this will protect the individual against polio paralysis by preventing the spread of poliovirus to the nervous system.
  • POLIOMYELITIS 16 January 2010 21:22 UTC rrtd.nic.in [Source type: FILTERED WITH BAYES]

^ Additionally, the precise mechanism(s) of PV invasion of the CNS is not well understood.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

[31]

Paralytic polio

Denervation of skeletal muscle tissue secondary to poliovirus infection can lead to paralysis.
.In around 1% of infections, poliovirus spreads along certain nerve fiber pathways, preferentially replicating in and destroying motor neurons within the spinal cord, brain stem, or motor cortex.^ Bacterial meningitis is a serious infection around the brain and spinal cord.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ If the virus accesses the circulatory system and a viremia results, the central nervous system is exposed to the infection and acute paralytic polio may result.1 Poliovirus has a predilection for the motor neurons of the anterior horn of the cervical and lumbar regions of the spinal cord, which can result in the cell death or injury of these motor neurons.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Enterovirus RNA was detected in tissue from the spinal cord from 3 patients, but not in the cerebral cortex.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

.This leads to the development of paralytic poliomyelitis, the various forms of which (spinal, bulbar, and bulbospinal) vary only with the amount of neuronal damage and inflammation that occurs, and the region of the CNS that is affected.^ Significant damage occurs in only the spinal cord and brain.
  • Poliomyelitis: Enteroviruses: Merck Manual Professional 16 January 2010 21:22 UTC www.merck.com [Source type: Academic]

^ The spinal form affects the limbs.

^ Depending on the spinal levels of anterior horn cells affected, various extensor and flexor muscles were left with more or less severe impairment of function.
  • Swaim-A Dogma Upended 13 January 2010 15:33 UTC www.skally.net [Source type: FILTERED WITH BAYES]

.The destruction of neuronal cells produces lesions within the spinal ganglia; these may also occur in the reticular formation, vestibular nuclei, cerebellar vermis, and deep cerebellar nuclei.^ He was convinced of Charcots theory that motor cells were the sight of destruction (myelitis) caused by some injurious agent, on the heels of which neuronal degeneration rapidly occurred, leaving atrophy and scarring in its wake.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

^ Because the impact of the late effects of polio is also variable in these muscle groups, the effect of therapies may be different not only from patient to patient and from limb to limb, but also from muscle to muscle within the same limb.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ Blinzinger K, Simon J, Magrath D, Boulger L: Poliovirus crystals within the endoplasmic reticulum of endothelial and mononuclear cells in the monkey spinal cord.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

[31] .Inflammation associated with nerve cell destruction often alters the color and appearance of the gray matter in the spinal column, causing it to appear reddish and swollen.^ The theory is that any injury to the body causes changes in the nerve-cells supplying the part so that they are rendered less able to resist infection with the virus.
  • THE STORY OF THE SALK ANTI-POLIOMYELITIS VACCINE BY M. BEDDOW BAYLY, M.R.C.S.,L.R.C.P. 16 January 2010 21:22 UTC www.whale.to [Source type: FILTERED WITH BAYES]

^ Scottish neurologist Abercombe, uniquely aware of separate functions of different parts of the spinal cord, surmised in 1828 that only part of the gray matter the anterior segment that controlled motor nerves, not the posterior segment that controlled sensation was involved.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

^ [Greek words for gray and marrow (the gray marrow of the spinal cord), and the Latin suffix for inflammation are root words for poliomyelitis.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

[2] .Other destructive changes associated with paralytic disease occur in the forebrain region, specifically the hypothalamus and thalamus.^ This can occur due to brain diseases (such as some examples of PPS) or cardiovascular diseases, and may co- exist with other breathing problems.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ And, she regularly informs and entertains at gatherings sponsored by the Parkinson's Disease Association of San Diego, as well as other community organizations.
  • Polio News 13 January 2010 15:33 UTC www.mindspring.com [Source type: FILTERED WITH BAYES]

[31] .The molecular mechanisms by which poliovirus causes paralytic disease are poorly understood.^ Poliomyelitis is a disease caused by infection with the poliovirus.
  • FloridaHealthFinder.gov | Health Encyclopedia | Poliomyelitis 16 January 2010 21:22 UTC www.floridahealthfinder.gov [Source type: FILTERED WITH BAYES]

^ Antigenic and molecular characterization of wild type 1 poliovirus causing outbreaks of poliomyelitis in Albania and neighboring countries in 1996.
  • A Dynamic Model of Poliomyelitis Outbreaks: Learning from the Past to Help Inform the Future -- Duintjer Tebbens et al. 162 (4): 358 -- American Journal of Epidemiology 16 January 2010 21:22 UTC aje.oxfordjournals.org [Source type: Academic]

^ Molecular mechanism of tissue-specific infection of poliovirus - -2004 Satoshi K ABSTRACT - 03/13/2005 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

.Early symptoms of paralytic polio include high fever, headache, stiffness in the back and neck, asymmetrical weakness of various muscles, sensitivity to touch, difficulty swallowing, muscle pain, loss of superficial and deep reflexes, paresthesia (pins and needles), irritability, constipation, or difficulty urinating.^ Symptoms may include fever, headache, vomiting, diarrhoea, constipation and sore throat.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Symptoms may include headache, neck, back, abdominal and extremity pain, fever, vomiting, lethargy and irritability.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ In addition to the symptoms of non-paralytic polio, tremors and muscle weakness appear.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

.Paralysis generally develops one to ten days after early symptoms begin, progresses for two to three days, and is usually complete by the time the fever breaks.^ In non-paralytic polio, symptoms generally tend to subside after one to three days.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ These symptoms usually last two or three days.
  • polio Facts, information, pictures | Encyclopedia.com articles about polio 13 January 2010 15:33 UTC www.encyclopedia.com [Source type: FILTERED WITH BAYES]

^ Lasts from two to ten days with complete recovery.
  • NaTHNaC | Poliomyelitis Information Sheet, Health Professionals 16 January 2010 21:22 UTC www.nathnac.org [Source type: FILTERED WITH BAYES]
  • Jabs 16 January 2010 21:22 UTC www.jabs.org.uk [Source type: FILTERED WITH BAYES]

[32]
.The likelihood of developing paralytic polio increases with age, as does the extent of paralysis.^ The frequency of paralytic disease increases with age.
  • Immunisation Advisory Centre (IMAC) NZ 16 January 2010 21:22 UTC www.immune.org.nz [Source type: FILTERED WITH BAYES]

^ The risk for paralysis from the virus increases with age.
  • Main Line Health - Poliomyelitis (Polio) 16 January 2010 21:22 UTC www.mainlinehealth.org [Source type: FILTERED WITH BAYES]
  • Main Line Health - Poliomyelitis (Polio) 16 January 2010 21:22 UTC www.mainlinehealth.org [Source type: Academic]
  • Medical Center - Infectious Diseases 16 January 2010 21:22 UTC www.mccg.org [Source type: FILTERED WITH BAYES]
  • Poliomyelitis (Polio) - Carilion Clinic 16 January 2010 21:22 UTC www.carilionclinic.org [Source type: Academic]
  • Greenwich Hospital Health Library 16 January 2010 21:22 UTC www.greenhosp.org [Source type: Academic]

^ When, however, first exposure to polio comes at a later age, the virus is much more likely to spread to the spinal cord and/or brain and cause paralysis or death.
  • Jack Hamann | After the Rains: Pursuing polio to the ends of the earth 13 January 2010 15:33 UTC www.jackhamann.com [Source type: FILTERED WITH BAYES]

.In children, non-paralytic meningitis is the most likely consequence of CNS involvement, and paralysis occurs in only 1 in 1000 cases.^ In children, paralysis due to polio occurs in 1/1000 cases, while in adults, paralysis occurs in 1/75 cases.
  • History of poliomyelitis 16 January 2010 21:22 UTC www.lumrix.net [Source type: FILTERED WITH BAYES]

^ Non-paralytic aseptic meningitis .
  • NaTHNaC | Poliomyelitis Information Sheet, Health Professionals 16 January 2010 21:22 UTC www.nathnac.org [Source type: FILTERED WITH BAYES]

^ The proportion of inapparent or asymptomatic infection to paralytic infection may be as high as 1000:1 in children and 75:1 in adults, depending on the poliovirus type and social and environmental conditions.
  • Immunise - 3.16 Poliomyelitis 16 January 2010 21:22 UTC www.health.gov.au [Source type: Academic]

.In adults, paralysis occurs in 1 in 75 cases.^ In children, paralysis due to polio occurs in 1/1000 cases, while in adults, paralysis occurs in 1/75 cases.
  • History of poliomyelitis 16 January 2010 21:22 UTC www.lumrix.net [Source type: FILTERED WITH BAYES]

^ Death rates are generally 2%-5% of cases in children and up to 15%-30% of cases in adults (depending on age), increasing to 25%-75% of cases with bulbar involvement.
  • NaTHNaC | Poliomyelitis Information Sheet, Health Professionals 16 January 2010 21:22 UTC www.nathnac.org [Source type: FILTERED WITH BAYES]
  • Jabs 16 January 2010 21:22 UTC www.jabs.org.uk [Source type: FILTERED WITH BAYES]

^ The remaining three cases occurred in previously healthy unimmunised adolescent or adult contacts of infants who had received their first immunisation.
  • Lincolnshire Post-Polio Library [Poliomyelitis] 16 January 2010 21:22 UTC www.ott.zynet.co.uk [Source type: Academic]

[33] .In children under five years of age, paralysis of one leg is most common; in adults, extensive paralysis of the chest and abdomen also affecting all four limbs—quadriplegia—is more likely.^ By age 5 years, 41% of all children were severely stunted.
  • ProjectDisaster » Blog Archive » Haiti: Socioeconomic, Political, and Demographic Overview 16 January 2010 21:22 UTC projectdisaster.com [Source type: Academic]

^ Exercise the limbs least affected or those completely unaffected by polio, while avoiding the more affected extremities.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

^ In four to eight percent of cases there is a non-specific viral syndrome and only one to two percent of cases are associated with paralysis.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

[34] Paralysis rates also vary depending on the serotype of the infecting poliovirus; the highest rates of paralysis (1 in 200) are associated with poliovirus type 1, the lowest rates (1 in 2,000) are associated with type 2.[35]

Spinal polio

The location of motor neurons in the anterior horn cells of the spinal column.
.Spinal polio is the most common form of paralytic poliomyelitis; 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, which are responsible for movement of the muscles, including those of the trunk, limbs and the intercostal muscles.^ Sp i n a l Po l i o This condition is characterised by flaccid paralysis of muscles innervated by the motor neurons of the spinal cord and is the most common type of paralytic polio.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ If the virus accesses the circulatory system and a viremia results, the central nervous system is exposed to the infection and acute paralytic polio may result.1 Poliovirus has a predilection for the motor neurons of the anterior horn of the cervical and lumbar regions of the spinal cord, which can result in the cell death or injury of these motor neurons.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ This cooling produces a slowing in the nerve conduction velocity, an increase in the muscle fibre membrane refractory period, a decrease in muscle spindle firing and an increase in muscle viscosity resulting in a decreased muscle response to motor stimuli.95 Respiratory Insufficiency One of the most feared complications of acute paralytic polio was impaired respiratory function, which resulted in significant disability and, in many cases, death.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

[11] .Virus invasion causes inflammation of the nerve cells, leading to damage or destruction of motor neuron ganglia.^ He was convinced of Charcots theory that motor cells were the sight of destruction (myelitis) caused by some injurious agent, on the heels of which neuronal degeneration rapidly occurred, leaving atrophy and scarring in its wake.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

^ Weakness Weakness is the cardinal sign of motor neuron dysfunction in PPS. Therefore, the exclusion of other causes of new weakness is essential.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Predisposition to motor neuron degeneration because of glial, vascular, and lymphatic changes caused by acute polio 6.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

.When spinal neurons die, Wallerian degeneration takes place, leading to weakness of those muscles formerly innervated by the now dead neurons.^ The destruction of motor neurons leads to the development of flaccid paralysis, which may be bulbar or spinal in distribution.
  • Poliomyelitis: eMedicine Pediatrics: General Medicine 16 January 2010 21:22 UTC emedicine.medscape.com [Source type: Academic]

^ Respiratory therapists consulted for those with breathing problems Physical therapy works with weak or wasted (atrophic) muscles and to prevent contractures (freezing in one place) of knees and elbows, or to reduce spasm and pain.
  • Poliomyelitis -- eCureMe.com 16 January 2010 21:22 UTC www.ecureme.com [Source type: Academic]

^ Because of the variability in which the motor neurons to different muscle groups may have been affected in a particular patient, both asymmetric and scattered weakness may be present.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

[36] .With the destruction of nerve cells, the muscles no longer receive signals from the brain or spinal cord; without nerve stimulation, the muscles atrophy, becoming weak, floppy and poorly controlled, and finally completely paralyzed.^ They first become floppy and weak.
  • polio Facts, information, pictures | Encyclopedia.com articles about polio 13 January 2010 15:33 UTC www.encyclopedia.com [Source type: FILTERED WITH BAYES]

^ The polio virus harms the nerves that control muscles, and it makes the muscles weak.
  • CIGNA - Post-Polio Syndrome 13 January 2010 15:33 UTC www.cigna.com [Source type: FILTERED WITH BAYES]
  • Post-Polio Syndrome-Topic Overview 13 January 2010 15:33 UTC www.webmd.com [Source type: FILTERED WITH BAYES]

^ The muscles become weak, floppy, and then totally paralyzed.
  • polio Facts, information, pictures | Encyclopedia.com articles about polio 13 January 2010 15:33 UTC www.encyclopedia.com [Source type: FILTERED WITH BAYES]

[11] .Progression to maximum paralysis is rapid (two to four days), and is usually associated with fever and muscle pain.^ Fever peaks in two to three days and then rapidly subsides, and patients recover within three to four days without the development of paralysis.
  • polio (pathology) -- Britannica Online Encyclopedia 13 January 2010 15:33 UTC www.britannica.com [Source type: FILTERED WITH BAYES]

^ However, the proportion of AFP cases with two stool specimens collected within 14 days of onset of paralysis declined from 35% in 1998 to 31% in 1999.
  • Progress Toward Poliomyelitis Eradication — African Region, 1999-March 2000 | Morbidity and Mortality Weekly Report | Find Articles at BNET 16 January 2010 21:22 UTC findarticles.com [Source type: News]

^ Minor illnesses The minor associated illnesses occur 1–3 days before the onset of paralysis, with gastrointestinal complaints such as nausea and vomiting, abdominal cramps and pain, and diarrhea.
  • Poliomyelitis: eMedicine Orthopedic Surgery 16 January 2010 21:22 UTC emedicine.medscape.com [Source type: Academic]

[36] Deep tendon reflexes are also affected, and are usually absent or diminished; sensation (the ability to feel) in the paralyzed limbs, however, is not affected.[36]
.The extent of spinal paralysis depends on the region of the cord affected, which may be cervical, thoracic, or lumbar.^ If the virus accesses the circulatory system and a viremia results, the central nervous system is exposed to the infection and acute paralytic polio may result.1 Poliovirus has a predilection for the motor neurons of the anterior horn of the cervical and lumbar regions of the spinal cord, which can result in the cell death or injury of these motor neurons.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Recovery may be prolonged by two or three times beyond what is expected for the general population, depending on the individual’s age, extent of paralysis and length of surgery.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ He concluded that the central nervous system, the spinal cord, was affected.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

[37] .The virus may affect muscles on both sides of the body, but more often the paralysis is asymmetrical.^ Because of the variability in which the motor neurons to different muscle groups may have been affected in a particular patient, both asymmetric and scattered weakness may be present.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ Muscle Weakness New muscle weakness, with or without associated muscle atrophy, can involve both previously affected muscles which were partially or fully recovered, or muscles that appeared to be unaffected by the original polio infection.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Symptoms of the tertiary stage may include paralysis, blindness, dementia, numbness, and lessened muscle control.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

[28] .Any limb or combination of limbs may be affected—one leg, one arm, or both legs and both arms.^ Because of the variability in which the motor neurons to different muscle groups may have been affected in a particular patient, both asymmetric and scattered weakness may be present.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ New weakness is also commonly found in the “good" limb that was thought to be spared by the poliovirus, but which, in fact, may have had subclinical polio and has overworked over the years to compensate for the more affected limb.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Many polio survivors can do heart conditioning by using their less affected limbs, usually their arms, in a carefully monitored program of paced and non-fatiguing exercise (see PPS Forum May 2001).
  • Polio News 13 January 2010 15:33 UTC www.mindspring.com [Source type: FILTERED WITH BAYES]

.Paralysis is often more severe proximally (where the limb joins the body) than distally (the fingertips and toes).^ More than one-third of all children who survived their first birthday showed signs of severe growth retardation.
  • ProjectDisaster » Blog Archive » Haiti: Socioeconomic, Political, and Demographic Overview 16 January 2010 21:22 UTC projectdisaster.com [Source type: Academic]

^ It often occurs when tampons, contraceptive sponges, and contraceptive diaphragms are left in the vagina too long (more than 24 hours).
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ There are 2 medical schools, 10 nursing schools, more than 40 training facilities for nursing auxiliaries, and several medical technology institutes.
  • ProjectDisaster » Blog Archive » Haiti: Socioeconomic, Political, and Demographic Overview 16 January 2010 21:22 UTC projectdisaster.com [Source type: Academic]

[28]

Bulbar polio

The location and anatomy of the bulbar region (in orange)
.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.^ Paralytic polio can cause an infected person to lose the use of their arms and legs, make breathing difficult, and can cause death.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ PICO/PICO.html Provides information about the poliovirus and links to Grace Young’s Web Page other polio information.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Re s e a r c h : This phenomenon, which occurs during recovery from paralytic polio (i.e.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

[4] .The bulbar region is a white matter pathway that connects the cerebral cortex to the brain stem.^ The bulbar form involves nerves of the brain stem* and can cause problems with breathing, talking, and swallowing.
  • Polio – FREE Polio information | Encyclopedia.com: Find Polio research 13 January 2010 15:33 UTC www.encyclopedia.com [Source type: FILTERED WITH BAYES]

^ Check blood pressure frequently, especially in bulbar poliomyelitis, which can cause hypertension or shock because of its effect on the brain stem.
  • Poliomyelitis - Definition, Causes, Symptoms and Treatments: 16 January 2010 21:22 UTC www.health-diseases.org [Source type: Academic]

.The destruction of these nerves weakens the muscles supplied by the cranial nerves, producing symptoms of encephalitis, and causes difficulty breathing, speaking and swallowing.^ These symptoms may include high fever, headache, tiredness, muscle aches, and a rash.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ These symptoms are not only themselves causing distress but are also preventing these individuals from making lifestyle changes necessary to manage these symptoms.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Cranial nerve involvement is known to occur in acute poliomyelitis; therefore, there is a possibility that the involvement of the cranial nerves in our case might be a delayed progressive symptoms.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

[10] .Critical nerves affected are the glossopharyngeal nerve, which partially controls swallowing and functions in the throat, tongue movement and taste; the vagus nerve, which sends signals to the heart, intestines, and lungs; and the accessory nerve, which controls upper neck movement.^ It is involved in controlling vital functions, movement, sensation, and nerves supplying the head and neck.
  • polio Facts, information, pictures | Encyclopedia.com articles about polio 13 January 2010 15:33 UTC www.encyclopedia.com [Source type: FILTERED WITH BAYES]

^ Motor nerves are nerves that control the movement of muscles.
  • polio Facts, information, pictures | Encyclopedia.com articles about polio 13 January 2010 15:33 UTC www.encyclopedia.com [Source type: FILTERED WITH BAYES]

^ In fact, in most cases the person never knew that polio had affected the nerves that control those muscles.
  • CIGNA - Post-Polio Syndrome 13 January 2010 15:33 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

.Due to the effect on swallowing, secretions of mucus may build up in the airway causing suffocation.^ Secretions collect in the throat and may lead to suffocation by blocking the airway.
  • polio (pathology) -- Britannica Online Encyclopedia 13 January 2010 15:33 UTC www.britannica.com [Source type: FILTERED WITH BAYES]

[32] .Other signs and symptoms include facial weakness, caused by destruction of the trigeminal nerve and facial nerve, which innervate the cheeks, tear ducts, gums, and muscles of the face, among other structures; double vision; difficulty in chewing; and abnormal respiratory rate, depth, and rhythm, which may lead to respiratory arrest.^ Other symptoms may include weight loss and depression.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ B u l b a r Po l i o This condition involves damage of neurons in the reticular formation and the nuclei of cranial nerves in the brainstem, which may lead to dysphagia, dysphonia, facial weakness, nasal voice, regurgitation of fluids through the nose, weakness of the sternocleidomastoid and trapezius muscles, difficulty in chewing, inability to swallow or expel saliva and respiratory tract secretions.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Symptoms may include fever, headache, vomiting, diarrhoea, constipation and sore throat.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

Pulmonary edema and shock are also possible, and may be fatal.[37]

Bulbospinal Polio

.Approximately 19% of all paralytic polio cases have both bulbar and spinal symptoms; this subtype is called respiratory polio or bulbospinal polio.^ Infants under 5 comprised 51.7% of all paralytic polio cases.
  • Poliomyelitis in the U.S. 16 January 2010 21:22 UTC www.wellwithin1.com [Source type: FILTERED WITH BAYES]

^ At least a dozen children developed cases of paralytic polio attributable to the vaccine and nine of those were fatal.
  • Feature Story: More Than a March of Dimes: New fund-raising tactics, intense research rivalry spurred polio cure, historian says 13 January 2010 15:33 UTC www.utexas.edu [Source type: FILTERED WITH BAYES]

^ Since 1979 (when wild polio was eliminated in the United States), the approximately 10 cases per year of polio seen in this country were traced to OPV. .
  • Polio 2004-12-01 00:00:00.0 13 January 2010 15:33 UTC www.devoschildrens.org [Source type: FILTERED WITH BAYES]

[4] .Here the virus affects the upper part of the cervical spinal cord (C3 through C5), and paralysis of the diaphragm occurs.^ He concluded that the central nervous system, the spinal cord, was affected.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

^ Different and opposing theories continued to exist about whether polio lesions affected the brain or spinal cord.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

^ These have emphasized the presence of persistent or new inflammation in the meninges, spinal cord, and muscles of affected patients.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

.The critical nerves affected are the phrenic nerve, which drives the diaphragm to inflate the lungs, and those that drive the muscles needed for swallowing.^ Antidiarrhea medicines containing narcotics (especially for those with paralysis of the muscles or diaphragm) Lomotil, Paregoric, etc.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

.By destroying these nerves this form of polio affects breathing, making it difficult or impossible for the patient to breathe without the support of a ventilator.^ Muscle Weakness New muscle weakness, with or without associated muscle atrophy, can involve both previously affected muscles which were partially or fully recovered, or muscles that appeared to be unaffected by the original polio infection.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Disability and functional assessment in former polio patients with and without postpolio syndrome - 1999 Nollet et al ABSTRACT - -1999 Nollet, Beelen et al ABSTRACT - 10/11/1999 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ Paralytic polio can cause an infected person to lose the use of their arms and legs, make breathing difficult, and can cause death.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

.It can lead to paralysis of the arms and legs and may also affect swallowing and heart functions.^ Approximately one in 200 infections leads to irreversible paralysis, usually in the legs.
  • Milestones in Global Polio Eradication 16 January 2010 21:22 UTC www.unicef.org [Source type: FILTERED WITH BAYES]

^ If the virus gets into the brainstem (bulbar polio), muscles needed for breathing, swallowing and other vital functions become paralyzed, and the person may die.
  • Polio - March of Dimes 13 January 2010 15:33 UTC www.marchofdimes.com [Source type: FILTERED WITH BAYES]

^ Severe scoliosis can make breathing more difficult and can affect heart function.
  • CIGNA - Post-Polio Syndrome 13 January 2010 15:33 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[38]

Diagnosis

.Paralytic poliomyelitis may be clinically suspected in individuals experiencing acute onset of flaccid paralysis in one or more limbs with decreased or absent tendon reflexes in the affected limbs, that cannot be attributed to another apparent cause, and without sensory or cognitive loss.^ Paralytic poliomyelitis - the name for polio when it progresses to cause paralysis.
  • Polio Symptoms, Diagnosis, Treatments and Causes - WrongDiagnosis.com 13 January 2010 15:33 UTC wrongdiagnosis.com [Source type: Academic]

^ This paper reviews the clinical syndrome of acute paralytic poliomyelitis and its sequelae.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ Based on the specific manifestation, paralytic poliomyelitis without apparent affect in sensation or cognition is classified as either: (i) spinal poliomyelitis, characterized by acute flaccid paralysis secondary to selective destruction of spinal motor neurons and subsequent dennervation of the associated skeletal musculature; (ii) bulbar poliomyelitis, presenting with paralysis of respiratory muscles following attack of neurons in the brain stem that control breathing; and (iii) bulbospinal poliomyelitis, exhibiting effects on both the brain stem and spinal cord [ 26 , 35 ].
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

[39]
.A laboratory diagnosis is usually made based on recovery of poliovirus from a stool sample or a swab of the pharynx.^ If poliovirus is detected, repeat administration of HNIG at 3-weekly intervals will be required until two consecutive stool samples test negative.
  • British HIV Association Guidelines for Immunization of HIV-Infected Adults: Poliomyelitis 16 January 2010 21:22 UTC www.medscape.com [Source type: Academic]

^ For many of the conditions that result in weakness, specific assessment procedures and tests are available and accurate diagnosis can usually be made.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

.Antibodies to poliovirus can be diagnostic, and are generally detected in the blood of infected patients early in the course of infection.^ Diagnosis requires isolation of the poliovirus from throat washings early in the disease, from stools throughout the disease, and from cerebrospinal fluid (CSF) cultures in CNS infection.
  • Poliomyelitis - Definition, Causes, Symptoms and Treatments: 16 January 2010 21:22 UTC www.health-diseases.org [Source type: Academic]

^ Since the advent of the polio vaccine during the early 1950's, infections from the poliovirus have nearly been eradicated.
  • Poliomyelitis (Polio), Robert Wood Johnson University Hospital, New Brunswick, NJ, 08903 16 January 2010 21:22 UTC www.rwjuh.edu [Source type: Academic]
  • Poliomyelitis (Polio) - Carilion Clinic 16 January 2010 21:22 UTC www.carilionclinic.org [Source type: Academic]

^ Poliovirus-specific genomic sequences in the 5' untranslated region and in the capsid region (VP1) were detected by reverse transcription PCR in 5 of 10 patients with PPS but in none of the control patients.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

[4] .Analysis of the patient's cerebrospinal fluid (CSF), which is collected by a lumbar puncture ("spinal tap"), reveals an increased number of white blood cells (primarily lymphocytes) and a mildly elevated protein level.^ Non-paralytic aseptic meningitis occurs in 1–2% of PV infections and is associated with rigidity of the neck, back, and lower limbs as well as an augmented number of leukocytes (10–200 cell/mm 3 ) and slightly above-normal protein levels (40–50 mg/dL) in the cerebrospinal fluid (CSF) [ 35 ].
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

^ Increasing the number of hepatitis B injections augments anti-HBs response rate in HIV-infected patients.
  • British HIV Association Guidelines for Immunization of HIV-Infected Adults: Poliomyelitis 16 January 2010 21:22 UTC www.medscape.com [Source type: Academic]

^ Since elevated CK levels can be a marker for muscle injury, the increased CK levels may indicate muscle injury or overuse in post-polio individuals.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

.Detection of virus in the CSF is diagnostic of paralytic polio, but rarely occurs.^ An importation can result in virus transmission being re-established in an area that is considered polio-free, if the importation is not detected and responded to quickly.
  • Milestones in Global Polio Eradication 16 January 2010 21:22 UTC www.unicef.org [Source type: FILTERED WITH BAYES]

^ Before that, polio occurred in epidemic* form, with more than 21,000 paralytic cases (mostly children) in the United States in 1952 alone.
  • Polio – FREE Polio information | Encyclopedia.com: Find Polio research 13 January 2010 15:33 UTC www.encyclopedia.com [Source type: FILTERED WITH BAYES]

^ "Polio virus with natural recombinant genomes isolated from vaccine associated paralytic poliomyelitis."
  • Immunization Studies: Adverse Vaccine Reactions. Thinktwice! 16 January 2010 21:22 UTC www.thinktwice.com [Source type: Academic]

[4]
.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).^ Genetic changes in strains of poliovirus type 2 isolated from patients with vaccine associated paralytic poliomyelitis - -2003 Sosa Diaz RY, Mas Lago P, Valdes Ramirez O, Sarmiento Perez L ABSTRACT - 05/12/2003 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ Rapid RT-PCR amplification of full-length poliovirus genomes allows rapid discrimination between wild-type and recombinant vaccine-derived polioviruses.
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ Genetic changes in strains of poliovirus type 2 isolated from patients with vaccine associated paralytic poliomyelitis - -2003 Sosa Diaz RY, Mas Lago P, Valdes Ramirez O, Sarmiento Perez L ABSTRACT - 04/30/2003 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

[40] .It is important to determine the source of the virus because for each reported case of paralytic polio caused by wild poliovirus, it is estimated that another 200 to 3,000 contagious asymptomatic carriers exist.^ Non-Paralytic Polio The vast majority of infected individuals remain asymptomatic or experience a self-limited illness.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Predisposition to motor neuron degeneration because of glial, vascular, and lymphatic changes caused by acute polio 6.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ The mass vaccination strategy employed to eradicate an agent, estimated to have caused 10–15 million cases of smallpox as early as 1967, eventually paid off.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

[41]

Prevention

Passive immunization

.In 1950, William Hammon at the University of Pittsburgh purified the gamma globulin component of the blood plasma of polio survivors.^ Manitoba health authorities, while holding that gamma-globulin is useful, concluded that it is not a final answer in curbing outbreaks of polio.
  • THE STORY OF THE SALK ANTI-POLIOMYELITIS VACCINE BY M. BEDDOW BAYLY, M.R.C.S.,L.R.C.P. 16 January 2010 21:22 UTC www.whale.to [Source type: FILTERED WITH BAYES]

^ We should still have to do this with polio even when safe antigens and abundant gamma-globulin were available."
  • THE STORY OF THE SALK ANTI-POLIOMYELITIS VACCINE BY M. BEDDOW BAYLY, M.R.C.S.,L.R.C.P. 16 January 2010 21:22 UTC www.whale.to [Source type: FILTERED WITH BAYES]

^ Gamma-Globulin is contained in the blood of a person who has had the disease.
  • THE STORY OF THE SALK ANTI-POLIOMYELITIS VACCINE BY M. BEDDOW BAYLY, M.R.C.S.,L.R.C.P. 16 January 2010 21:22 UTC www.whale.to [Source type: FILTERED WITH BAYES]

[42] .Hammon proposed that the gamma globulin, which contained antibodies to poliovirus, could be used to halt poliovirus infection, prevent disease, and reduce the severity of disease in other patients who had contracted polio.^ Poliomyelitis is a disease caused by infection with the poliovirus.

^ Gamma-Globulin is contained in the blood of a person who has had the disease.
  • THE STORY OF THE SALK ANTI-POLIOMYELITIS VACCINE BY M. BEDDOW BAYLY, M.R.C.S.,L.R.C.P. 16 January 2010 21:22 UTC www.whale.to [Source type: FILTERED WITH BAYES]

^ Those who did fully recover might go on to develop post-polio syndrome (PPS) as many as 30 to 40 years after contracting polio.
  • Polio 2004-12-01 00:00:00.0 13 January 2010 15:33 UTC www.devoschildrens.org [Source type: FILTERED WITH BAYES]

.The results of a large clinical trial were promising; the gamma globulin was shown to be about 80% effective in preventing the development of paralytic poliomyelitis.^ Abstract: Post Polio Syndrome, or PPS, is defined as a clinical syndrome of new weakness, fatigue, and pain in people who have previously recovered from acute paralytic poliomyelitis.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ FRANCE The Pasteur Institute stated that an anti-poliomyelitis vaccine, developed by Professor Pierre Lepine would soon be produced in large quantities.
  • THE STORY OF THE SALK ANTI-POLIOMYELITIS VACCINE BY M. BEDDOW BAYLY, M.R.C.S.,L.R.C.P. 16 January 2010 21:22 UTC www.whale.to [Source type: FILTERED WITH BAYES]

^ Among cases of paralytic poliomyelitis, it is estimated that fatalities result in 2–5% of children and 15–30% of adults, numbers which are drastically increased in cases featuring bulbar paralysis [ 35 ].
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

[43] .It was also shown to reduce the severity of the disease in patients that developed polio.^ Nee L, Damborisa J and Bern R. Post-polio syndrome in twins and their siblings: evidence that post-polio syndrome can develop in patients with non-paralytic polio.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Promoting a Healthy Lifestyle The maintenance of a healthy lifestyle is essential for post-polio patients to limit the possible development of future problems.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Paralytic Polio Some individuals proceed to develop more severe symptoms.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

[42] .The gamma globulin approach was later deemed impractical for widespread use, however, due in large part to the limited supply of blood plasma, and the medical community turned its focus to the development of a polio vaccine.^ Monkey kidneys are used to develop polio vaccines.
  • Immunization Studies: Adverse Vaccine Reactions. Thinktwice! 16 January 2010 21:22 UTC www.thinktwice.com [Source type: Academic]

^ However, with widespread vaccination, wild-type polio , or polio occurring through natural infection, was eliminated from the United States by 1979 and the Western hemisphere by 1991.
  • Polio 2004-12-01 00:00:00.0 13 January 2010 15:33 UTC www.devoschildrens.org [Source type: FILTERED WITH BAYES]

^ Polio had been endemic for thousands of years until the mid-twentieth century when the development of vaccines against polio by Drs.
  • The Global Fight Against Polio 13 January 2010 15:33 UTC www.state.gov [Source type: News]

[44]

Vaccine

A child receives oral polio vaccine.
.Two types of vaccines are used throughout the world to combat polio.^ Two forms of polio vaccine have been developed, the Salk Inactivated Polio Vaccine and Sabin Oral Polio Vaccine.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Ren RB, Moss EG, Racaniello VR: Identification of two determinants that attenuate vaccine-related type 2 poliovirus.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

^ Despite the extensive, worldwide use of polio vaccines, polio has not been eradicated.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

.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).^ There is no vaccine that protects against Type A streptococcal disease but there are medications that can be given to treat the disease.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ No specific data are available on wild-type poliomyelitis in HIV-infected persons.
  • British HIV Association Guidelines for Immunization of HIV-Infected Adults: Poliomyelitis 16 January 2010 21:22 UTC www.medscape.com [Source type: Academic]

^ Poliovirus vaccine shedding among persons with HIV in Abidjan, Cote d'Ivoire.
  • British HIV Association Guidelines for Immunization of HIV-Infected Adults: Poliomyelitis 16 January 2010 21:22 UTC www.medscape.com [Source type: Academic]

[45]
.The first candidate polio vaccine, based on one serotype of a live but weakened (attenuated) virus, was developed by the virologist Hilary Koprowski.^ Two forms of polio vaccine have been developed, the Salk Inactivated Polio Vaccine and Sabin Oral Polio Vaccine.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Summer Polio epidemics & development of polio vaccines - 11/28/1999 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ He confirmed the report that Wellcome’s had been preparing a vaccine that could be taken by mouth, probably from a virus cultivated in eggs and known as an "attenuated virus."
  • THE STORY OF THE SALK ANTI-POLIOMYELITIS VACCINE BY M. BEDDOW BAYLY, M.R.C.S.,L.R.C.P. 16 January 2010 21:22 UTC www.whale.to [Source type: FILTERED WITH BAYES]

Koprowski's prototype vaccine was given to an eight-year-old boy on February 27th, 1950. Koprowski continued to work on the vaccine throughout the 1950s, leading to large-scale trials in the then Belgian Congo and the vaccination of seven million children in Poland against serotypes PV1 and PV3 between 1958 and 1960.[46]
.The first inactivated virus vaccine was developed in 1952 by Jonas Salk, and announced to the world on April 12, 1955.[47] The Salk vaccine, or inactivated poliovirus vaccine (IPV), is based on poliovirus grown in a type of monkey kidney tissue culture (Vero cell line), which is chemically inactivated with formalin.^ Sweden for the manufacture of a vaccine derived from a virus grown in human tissue.
  • THE STORY OF THE SALK ANTI-POLIOMYELITIS VACCINE BY M. BEDDOW BAYLY, M.R.C.S.,L.R.C.P. 16 January 2010 21:22 UTC www.whale.to [Source type: FILTERED WITH BAYES]

^ Inactivated Japanese encephalitis virus vaccine.
  • British HIV Association Guidelines for Immunization of HIV-Infected Adults: Poliomyelitis 16 January 2010 21:22 UTC www.medscape.com [Source type: Academic]

^ The first vaccine to be produced was the inactivated (or "killed") PV vaccine (IPV) by Jonas Salk on April 12, 1955.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

[15] .After two doses of IPV (given by injection), 90% or more of individuals develop protective antibody to all three serotypes of poliovirus, and at least 99% are immune to poliovirus following three doses.^ Full protection is not conferred until three injections have been given.
  • THE STORY OF THE SALK ANTI-POLIOMYELITIS VACCINE BY M. BEDDOW BAYLY, M.R.C.S.,L.R.C.P. 16 January 2010 21:22 UTC www.whale.to [Source type: FILTERED WITH BAYES]

^ Where the information is available, HNIG is not indicated if the HIV patient is known to be antibody-positive to all three polio virus types.
  • British HIV Association Guidelines for Immunization of HIV-Infected Adults: Poliomyelitis 16 January 2010 21:22 UTC www.medscape.com [Source type: Academic]

^ Paralytic Polio Some individuals proceed to develop more severe symptoms.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

[4]
.Subsequently, Albert Sabin developed another live, oral polio vaccine (OPV).^ Two forms of polio vaccine have been developed, the Salk Inactivated Polio Vaccine and Sabin Oral Polio Vaccine.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Then, in 1963, the development of a second vaccine, the Sabin polio vaccine, was announced.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

^ A second vaccine which was demonstrated to be both safe and effective was the oral (or "live") PV vaccine (OPV) developed by Albert Sabin in 1963.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

.It was produced by the repeated passage of the virus through non-human cells at sub-physiological temperatures.^ This in turn is suggestive of variation in the efficiency of IRES-mediated translation depending on the infected host cell, and consequently on the ability of the virus to produce pathologic changes.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

^ The Lymphatic System Of Human Body - Antibody-mediated (humoral) immunity is regulated by B cells and the antibodies they produce.
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ Modulation of gene expression in a human cell line caused by poliovirus, vaccinia virus and interferon - -2007 Grinde B, Gayorfar M, Hoddevik G [ABSTRACT] - 03/07/2007 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

[48] .The attenuated poliovirus in the Sabin vaccine replicates very efficiently in the gut, the primary site of wild poliovirus infection and replication, but the vaccine strain is unable to replicate efficiently within nervous system tissue.^ Unique Identifier 97123696 Authors: Arya SC. Title: Poliovirus genomic sequences in the central nervous systems of patients with postpolio syndrome [letter; comment].
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ The infection is cut short by the host’s defences before it can enter the central nervous system.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Molecular mechanism of tissue-specific infection of poliovirus - -2004 Satoshi K ABSTRACT - 03/13/2005 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

[49] .A single dose of Sabin's oral polio vaccine produces immunity to all three poliovirus serotypes in approximately 50% of recipients.^ Approximately 50% of patients in both the fibromyalgia and borderline fibromyalgia groups responded to low-dose, nighttime amitriptyline therapy.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ Two forms of polio vaccine have been developed, the Salk Inactivated Polio Vaccine and Sabin Oral Polio Vaccine.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Where the information is available, HNIG is not indicated if the HIV patient is known to be antibody-positive to all three polio virus types.
  • British HIV Association Guidelines for Immunization of HIV-Infected Adults: Poliomyelitis 16 January 2010 21:22 UTC www.medscape.com [Source type: Academic]

.Three doses of live-attenuated OPV produce protective antibody to all three poliovirus types in more than 95% of recipients.^ After the second dose of OPV, humoral immunity was greater than 95% to all serotypes.
  • Poliomyelitis Prevention: Recommendations for Use of Inactivated Poliovirus Vaccine and Live Oral Poliovirus Vaccine -- Committee on Infectious Diseases 99 (2): 300 -- Pediatrics 16 January 2010 21:22 UTC pediatrics.aappublications.org [Source type: Academic]

^ OPV Trivalent OPV, the live-attenuated vaccine, in a three-dose series results in sustained, probably lifelong protection against paralytic disease caused by each of three poliovirus serotypes in more than 95% of recipients.
  • Poliomyelitis Prevention: Recommendations for Use of Inactivated Poliovirus Vaccine and Live Oral Poliovirus Vaccine -- Committee on Infectious Diseases 99 (2): 300 -- Pediatrics 16 January 2010 21:22 UTC pediatrics.aappublications.org [Source type: Academic]

^ IPV The original inactivated viral vaccines against polio were replaced in the late 1980s by those of greater antigenic content and have been denoted as enhanced-potency IPV. Administration of enhanced-potency vaccine in most studies has resulted in seroconversion to the three poliovirus types in 94% to 100% of vaccinees after two doses and high titers of serum-neutralizing antibody in 99% to 100% of recipients after three doses.
  • Poliomyelitis Prevention: Recommendations for Use of Inactivated Poliovirus Vaccine and Live Oral Poliovirus Vaccine -- Committee on Infectious Diseases 99 (2): 300 -- Pediatrics 16 January 2010 21:22 UTC pediatrics.aappublications.org [Source type: Academic]

[4] .Human trials of Sabin's vaccine began in 1957,[50] and in 1958 it was selected, in competition with the live vaccines of Koprowski and other researchers, by the US National Institutes of Health.^ Within two hours of Dr. Francis’s declaration that the New Salk vaccine was ‘safe, powerful, and effective’, the National Health Institute, a branch of the United States Public Health Service, issued an official licence.
  • THE STORY OF THE SALK ANTI-POLIOMYELITIS VACCINE BY M. BEDDOW BAYLY, M.R.C.S.,L.R.C.P. 16 January 2010 21:22 UTC www.whale.to [Source type: FILTERED WITH BAYES]

^ Safety and immunogenicity of hepatitis A vaccine in human immunodeficiency virus-infected patients: a double-blind, randomized, placebo-controlled trial.
  • British HIV Association Guidelines for Immunization of HIV-Infected Adults: Poliomyelitis 16 January 2010 21:22 UTC www.medscape.com [Source type: Academic]

^ On the other hand, the whole of Dr. Sabin’s claims as to the effectiveness of his vaccine are based upon estimations of the antibodies present (as the result of vaccination) in the blood-serum of the chimpanzees and human "volunteers" taking part in the experiment.
  • THE STORY OF THE SALK ANTI-POLIOMYELITIS VACCINE BY M. BEDDOW BAYLY, M.R.C.S.,L.R.C.P. 16 January 2010 21:22 UTC www.whale.to [Source type: FILTERED WITH BAYES]

[46] .It was licensed in 1962[50] and rapidly became the only polio vaccine used worldwide.^ Despite the extensive, worldwide use of polio vaccines, polio has not been eradicated.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ The vaccine viruses can revert rapidly to virulence and may give rise to vaccine-associated paralytic polio (VAPP) in vaccinees or in their contacts.
  • British HIV Association Guidelines for Immunization of HIV-Infected Adults: Poliomyelitis 16 January 2010 21:22 UTC www.medscape.com [Source type: Academic]

^ Human fetal brain cell culture (use for polio vaccine) - -2004 Mattson MP ABSTRACT - 10/21/2004 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

[46]
.Because OPV is inexpensive, easy to administer, and produces excellent immunity in the intestine (which helps prevent infection with wild virus in areas where it is endemic), it has been the vaccine of choice for controlling poliomyelitis in many countries.^ The Centers for Disease Control (CDC) estimates that in the United States, while OPV was being used, one case of vaccine-associated paralytic poliomyelitis (VAPP) emerged for every 2 to 3 million doses of OPV administered, which accounted for 8 to 10 cases of VAPP in this country per year.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

^ Indeed, OPV was the weapon of choice in the fight against vaccine-preventable poliomyelitis of the Pan American Health Organization (PAHO) under the leadership of Ciro de Quadros, M.D., M.P.H. By transforming vaccines and immunization against PV into a top priority of governments, vaccine producers, and public health experts, de Quadros was able to institute teams to further his cause at the Ministry of Health in nearly every country in the Americas.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

^ As a result of continuing efforts to interrupt wild polio virus transmission, poliomyelitis continues to occur in only a few countries and is now exceedingly rare in the UK. The last indigenous case of wild-type infection was in 1984, and in the last decade the handful of cases have all been OPV-related VAPP. Susceptible adults may be at greater risk of paralytic polio than children.
  • British HIV Association Guidelines for Immunization of HIV-Infected Adults: Poliomyelitis 16 January 2010 21:22 UTC www.medscape.com [Source type: Academic]

[51] .On very rare occasions (about 1 case per 750,000 vaccine recipients) the attenuated virus in OPV reverts into a form that can paralyze.^ The inactivated flu vaccine (more commonly known as the "flu shot") is injected, usually into the arm, and contains flu virus that has been killed.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ [Medline] Ogra PL, Faden HS, Abraham R, Duffy LC, Sun M, Minor PD Effect of prior immunity on the shedding of virulent revertant virus in feces after oral immunization with live attenuated poliovirus vaccines.
  • Poliomyelitis Prevention: Recommendations for Use of Inactivated Poliovirus Vaccine and Live Oral Poliovirus Vaccine -- Committee on Infectious Diseases 99 (2): 300 -- Pediatrics 16 January 2010 21:22 UTC pediatrics.aappublications.org [Source type: Academic]

^ Since 1979 (when wild polio was eliminated in the United States), the approximately 10 cases per year of polio seen in this country were traced to OPV. .
  • Polio 2004-12-01 00:00:00.0 13 January 2010 15:33 UTC www.devoschildrens.org [Source type: FILTERED WITH BAYES]

[18] .Most industrialized countries have switched to IPV, which cannot revert, either as the sole vaccine against poliomyelitis or in combination with oral polio vaccine.^ Two forms of polio vaccine have been developed, the Salk Inactivated Polio Vaccine and Sabin Oral Polio Vaccine.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ The vaccine, he said, only gave 62 to 68 per cent, protection against the most prevalent strain of virus.
  • THE STORY OF THE SALK ANTI-POLIOMYELITIS VACCINE BY M. BEDDOW BAYLY, M.R.C.S.,L.R.C.P. 16 January 2010 21:22 UTC www.whale.to [Source type: FILTERED WITH BAYES]

^ The vaccine viruses can revert rapidly to virulence and may give rise to vaccine-associated paralytic polio (VAPP) in vaccinees or in their contacts.
  • British HIV Association Guidelines for Immunization of HIV-Infected Adults: Poliomyelitis 16 January 2010 21:22 UTC www.medscape.com [Source type: Academic]

[52]

Treatment

A modern negative pressure ventilator (iron lung)
.There is no cure for polio.^ There is no cure to HPV, but the disease sometimes goes away on its own.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ Overall, there is no evidence to indicate that any pharmacological agent improves the symptoms of weakness or fatigue in post-polio syndrome patients.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ There is no vaccine that prevents gonorrhea but there are antibiotics that can be given to cure the disease.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

.The focus of modern treatment has been on providing relief of symptoms, speeding recovery and preventing complications.^ Your treatment will focus on controlling symptoms and learning new ways to stay active despite having muscle weakness.
  • CIGNA - Post-Polio Syndrome 13 January 2010 15:33 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Definition Alternative Names Causes, incidence, and risk factors Symptoms Signs and tests Treatment Expectations (prognosis) Complications Calling your health care provider Prevention References Definition .

.Supportive measures include antibiotics to prevent infections in weakened muscles, analgesics for pain, moderate exercise and a nutritious diet.^ Yarnell clearly warns polio survivors to stop if they become fatigued during their exercise program, or if they experience pain or aches in their muscles.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

^ Symptoms may include fever, headache, chills, muscle/joint pain, cough, tiredness, and diarrhea.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ In particular, the patients should be instructed to avoid activities that cause increasing muscle or joint pain or excessive fatigue, either during or after their exercise program.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

[53] .Treatment of polio often requires long-term rehabilitation, including physical therapy, braces, corrective shoes and, in some cases, orthopedic surgery.^ Weiss M. Physical therapy examination and treatment of the polio survivor.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Post Polio Clinic - St. John Physical Rehabilitation Services Post-Polio Clinic - 02/18/1998 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ In the review of post-polio which follows, the term Late Effects of Polio (LEOP) will be used when discussing the myriad of problems that individuals with a history of polio often experience.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

[37]
Portable ventilators may be required to support breathing. .Historically, a noninvasive negative-pressure ventilator, more commonly called an iron lung, was used to artificially maintain respiration during an acute polio infection until a person could breathe independently (generally about one to two weeks).^ Viruses multiply in the lymphoid tissues of the oropharynx and intestine during the one- to three-week incubation period.7 In most cases, the virus is present in the oropharyngeal secretions for one to two weeks and is excreted in the stools for several weeks to months.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Slowly, Sr Kenny’s ideas won acceptance and by the mid 20th century had become the hallmark for the treatment of paralytic polio.2 5 T H E L ATE E F F E C TS O F P O L I O A significant development which saved the lives of many with severe respiratory problems was the development and introduction of the mechanical tank respirator (or iron lung) during the 1930s.13 Other respiratory aids, such as the “rocking bed" were used in patients with less critical breathing difficulties.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ The ADL [activities of daily living] ability and use of technical aids in persons with late effects of polio.
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

.Today many polio survivors with permanent respiratory paralysis use modern jacket-type negative-pressure ventilators that are worn over the chest and abdomen.^ Abstract: PURPOSE: Noninvasive mechanical ventilation with nasal or face mask using either BiPAP or IPPV (intermittent positive pressure ventilation) modes is meanwhile the standard type of mechanical ventilation instead of endotracheal intubation or tracheostomy in many patients with chronic and acute respiratory failure.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ Post-polio syndrome (PPS) will be used to describe the new neurological problems of fatigue and weakness that polio survivors are experiencing many years after their original illness.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Historical Background It has been recognised for more than 100 years that new muscle weakness can occur in survivors of polio many years after their initial illness.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

[54]
.Other historical treatments for polio include hydrotherapy, electrotherapy, massage and passive motion exercises, and surgical treatments such as tendon lengthening and nerve grafting.^ Treatment programs for the post-polio patient may include the following: • Prescription of an exercise program, designed for the individual; • Correction of postural alignment; • Pain management; • Application of therapeutic modalities; • Joint mobilisation; • Referral to appropriate services; • Hydrotherapy; and • Prescription and training in the use of mobility aids and/or braces.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Hydrotherapy Hydrotherapy is often the exercise method of choice for post-polio patients.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ He was perhaps the first to practice sensible treatment for paralyzed polio limbs exercise, baths, simple surgical procedures, bracing.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

[11] .Devices such as rigid braces and body casts—which tended to cause muscle atrophy due to the limited movement of the user—were also touted as effective treatments.^ Degenerative arthritis of joints that have been over-stressed due to compensatory body mechanics; and • Other repetitive motion problems such as tendonitis, bursitis and failing joint fusions.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ This is due to the number, complexity and diversity of symptoms, the absence of special diagnostic tests, the uncertainty of the underlying cause and the lack of curative medications or treatments.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ This prolonged casting often resulted in disuse and atrophy of muscles both affected and not affected by the disease.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

[55]

Prognosis

.Patients with abortive polio infections recover completely.^ The patient usually recovers completely from this illness within several days.
  • polio Facts, information, pictures | Encyclopedia.com articles about polio 13 January 2010 15:33 UTC www.encyclopedia.com [Source type: FILTERED WITH BAYES]

^ Muscle Weakness New muscle weakness, with or without associated muscle atrophy, can involve both previously affected muscles which were partially or fully recovered, or muscles that appeared to be unaffected by the original polio infection.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ These “revertant” viruses are not wild-type, and the virus recovered from patients with vaccine-associated cases of polio is not always a revertant.
  • Options for Poliomyelitis Vaccination in the United States: Workshop Summary 16 January 2010 21:22 UTC www.nap.edu [Source type: FILTERED WITH BAYES]

.In those that develop only aseptic meningitis, the symptoms can be expected to persist for two to ten days, followed by complete recovery.^ Poliovirus infection manifests as (in decreasing order of frequency): subclinical infection (in up to 95 percent of cases); nonspecific viral illnesses with complete recovery (about 5 percent of cases); nonparalytic aseptic meningitis (1 to 2 percent of cases); and paralytic poliomyelitis (less than 2 percent of cases).
  • Poliovirus Vaccine Options - January 1, 1999 - American Academy ofFamily Physicians 16 January 2010 21:22 UTC www.aafp.org [Source type: Academic]

^ Non-paralytic polio (flu-like symptoms plus aseptic meningitis ) - about 4%.
  • Poliomyelitis | Doctor | Patient UK 16 January 2010 21:22 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

^ Whereas many patients have progressive symptoms many years after poliomyelitis, only a minority develop the post-polio syndrome.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

[56] .In cases of spinal polio, if the affected nerve cells are completely destroyed, paralysis will be permanent; cells that are not destroyed but lose function temporarily may recover within four to six weeks after onset.^ Fortunately, the nerve cells are not always completely destroyed.
  • polio Facts, information, pictures | Encyclopedia.com articles about polio 13 January 2010 15:33 UTC www.encyclopedia.com [Source type: FILTERED WITH BAYES]

^ These individuals generally recover completely within a week.
  • Polio - March of Dimes 13 January 2010 15:33 UTC www.marchofdimes.com [Source type: FILTERED WITH BAYES]

^ If the nerve cells are completely destroyed; however, paralysis is permanent.
  • polio Facts, information, pictures | Encyclopedia.com articles about polio 13 January 2010 15:33 UTC www.encyclopedia.com [Source type: FILTERED WITH BAYES]

[56] .Half the patients with spinal polio recover fully, one quarter recover with mild disability and the remaining quarter are left with severe disability.^ Depending on the spinal levels of anterior horn cells affected, various extensor and flexor muscles were left with more or less severe impairment of function.
  • Swaim-A Dogma Upended 13 January 2010 15:33 UTC www.skally.net [Source type: FILTERED WITH BAYES]

^ Muscle Weakness New muscle weakness, with or without associated muscle atrophy, can involve both previously affected muscles which were partially or fully recovered, or muscles that appeared to be unaffected by the original polio infection.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Disability and functional assessment in former polio patients with and without postpolio syndrome - 1999 Nollet et al ABSTRACT - -1999 Nollet, Beelen et al ABSTRACT - 10/11/1999 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

[57] The degree of both acute paralysis and residual paralysis is likely to be proportional to the degree of viremia, and inversely proportional to the degree of immunity.[31] Spinal polio is rarely fatal.[32]
A child with a deformity of her right leg due to polio
.Without respiratory support, consequences of poliomyelitis with respiratory involvement include suffocation or pneumonia from aspiration of secretions.^ They include: (1) new muscle weakness and atrophy in the limbs, the bulbar or the respiratory muscles [post-poliomyelitis muscular atrophy (PPMA)] and (2) excessive muscle fatigue and diminished physical endurance.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

[54] .Overall, 5–10% of patients with paralytic polio die due to the paralysis of muscles used for breathing.^ If the virus gets into the brainstem (bulbar polio), muscles needed for breathing, swallowing and other vital functions become paralyzed, and the person may die.
  • Polio - March of Dimes 13 January 2010 15:33 UTC www.marchofdimes.com [Source type: FILTERED WITH BAYES]

^ The therapist may also recommend exercises to strengthen the muscles that are used in breathing.
  • CIGNA - Post-Polio Syndrome 13 January 2010 15:33 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Muscle fibre hypertrophy contributes further to the recovery of strength after paralytic polio.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

.The mortality rate varies by age: 2–5% of children and up to 15–30% of adults die.^ This revealed that children over the age of 3 and up to age 5 were affected.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

^ Among cases of paralytic poliomyelitis, it is estimated that fatalities result in 2–5% of children and 15–30% of adults, numbers which are drastically increased in cases featuring bulbar paralysis [ 35 ].
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

^ THE Francis Report reveals, at any rate, that in one large section of the trials the inoculated children were not of the same age-group as the uninoculated controls.
  • THE STORY OF THE SALK ANTI-POLIOMYELITIS VACCINE BY M. BEDDOW BAYLY, M.R.C.S.,L.R.C.P. 16 January 2010 21:22 UTC www.whale.to [Source type: FILTERED WITH BAYES]

[4] .Bulbar polio often causes death if respiratory support is not provided;[38] with support, its mortality rate ranges from 25 to 75%, depending on the age of the patient.^ Inhalation anthrax often causes death.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ Hydrotherapy Hydrotherapy is often the exercise method of choice for post-polio patients.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ These results indicate that subjective symptoms and physical disability connected with polio increased with increasing age in these patients with post-polio syndrome, and cardio-respiratory deconditioning and weight gain also became more serious problems in most patients.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

[4][58] .When positive pressure ventilators are available, the mortality can be reduced to 15%.^ The lowest pneumonia and hospitalization rates (P < 0.001) were by full-time, noninvasive intermittent positive pressure ventilation users.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ The strategies and methods of artificial ventilation used in poliomyelitis are long established, and indications for the use of long term domiciliary positive and, occasionally, negative pressure ventilation have been described.
  • Poliomyelitis and the postpolio syndrome 16 January 2010 21:22 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ One hundred forty-five PPIs were managed by noninvasive alternatives to intermittent positive pressure ventilation (IPPV) via an indwelling tracheostomy.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

[59]

Recovery

.Many cases of poliomyelitis result in only temporary paralysis.^ In four to eight percent of cases there is a non-specific viral syndrome and only one to two percent of cases are associated with paralysis.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ For 12 years after 1947 we treated about 1500 cases of acute anterior poliomyelitis demonstrating various degrees of paralysis.
  • The Clevedon Ventilator and Poliomyelitis 16 January 2010 21:22 UTC www.johnpowell.net [Source type: Academic]

^ Poliomyelitis is the only common disease in which sudden paralysis can occur in a previously healthy infant or young child.
  • The Clevedon Ventilator and Poliomyelitis 16 January 2010 21:22 UTC www.johnpowell.net [Source type: Academic]

[11] .Nerve impulses return to the formerly paralyzed muscle within a month, and recovery is usually complete in six to eight months.^ Within six months, according to Dr Simon Flexner, definite announcement of a specific remedy may be expected.

^ This stage lasts usually for 2–3 weeks but may extend for up to 2 months; the presence of any tenderness in the muscles is evidence that the acute stage is not over.
  • Poliomyelitis: eMedicine Orthopedic Surgery 16 January 2010 21:22 UTC emedicine.medscape.com [Source type: Academic]

^ During this entire period, there is gradual recovery of the muscles; the recovery is rapid in the first 6 months but is slower during the subsequent months.
  • Poliomyelitis: eMedicine Orthopedic Surgery 16 January 2010 21:22 UTC emedicine.medscape.com [Source type: Academic]

[56] .The neurophysiological processes involved in recovery following acute paralytic poliomyelitis are quite effective; muscles are able to retain normal strength even if half the original motor neurons have been lost.^ Sharrard W. Muscle recovery in poliomyelitis.

^ Muscle tone is lost when motor neurons are damaged and can't turn on muscle fibers.
  • Polio News 13 January 2010 15:33 UTC www.mindspring.com [Source type: FILTERED WITH BAYES]

^ Palmucci L. Motor neuron disease following poliomyelitis.

[60] .Paralysis remaining after one year is likely to be permanent, although modest recoveries of muscle strength are possible 12 to 18 months after infection.^ Paralysis that lingers after 12 months usually is considered permanent.
  • Polio – FREE Polio information | Encyclopedia.com: Find Polio research 13 January 2010 15:33 UTC www.encyclopedia.com [Source type: FILTERED WITH BAYES]

^ Paralysis: The inability to move one's muscles.
  • polio Facts, information, pictures | Encyclopedia.com articles about polio 13 January 2010 15:33 UTC www.encyclopedia.com [Source type: FILTERED WITH BAYES]

^ Approximately one in 200 infections leads to irreversible paralysis, usually in the legs.
  • Milestones in Global Polio Eradication 16 January 2010 21:22 UTC www.unicef.org [Source type: FILTERED WITH BAYES]

[56]
.One mechanism involved in recovery is nerve terminal sprouting, in which remaining brainstem and spinal cord motor neurons develop new branches, or axonal sprouts.^ Terminal Sprouting During the recovery process following acute paralytic polio, remaining brainstem and spinal cord motor neurons can elaborate new branches, or axonal sprouts.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Because of this, Flexner surmised that polio entered the body through the nasal passages and traveled via nerve endings to the spinal cord.
  • Feature Story: More Than a March of Dimes: New fund-raising tactics, intense research rivalry spurred polio cure, historian says 13 January 2010 15:33 UTC www.utexas.edu [Source type: FILTERED WITH BAYES]

^ During the acute illness there is a large loss of motor neurons; during recovery the terminal axons of surviving motor neurons sprout in an attempt to re-innervate muscle fibres orphaned by the death of their parent motor neurons giving rise to the development of large motor units.
  • Lincolnshire Post-Polio Library [Poliomyelitis] 16 January 2010 21:22 UTC www.ott.zynet.co.uk [Source type: Academic]

[61] .These sprouts can reinnervate orphaned muscle fibers that have been denervated by acute polio infection,[62] restoring the fibers' capacity to contract and improving strength.^ The physiological basis for axonal sprouting is believed to be related to the expression of neural-cell adhesion molecules by the denervated myofibres.14 These molecules seem to provide a chemotactic stimulus to the terminal axons of neighbouring, surviving motor neurons, causing these neurons to send axonal sprouts to denervated muscle fibres.15 These sprouts can reinnervate orphaned muscle fibres that have been denervated by the acute polio infection.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Muscle Weakness New muscle weakness, with or without associated muscle atrophy, can involve both previously affected muscles which were partially or fully recovered, or muscles that appeared to be unaffected by the original polio infection.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Strength, Endurance, and Work Capacity After Muscle Strengthening Exercise in Postpolio Subjects-1997 Agre, Rodriquez, Franke ABSTRACT 02/18/1999 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

[63] .Terminal sprouting may generate a few significantly enlarged motor neurons doing work previously performed by as many as four or five units:[33] a single motor neuron that once controlled 200 muscle cells might control 800 to 1000 cells.^ Sprouting (or collateral innervation) can restore the capacity of voluntary muscle fibres to contract and thus improve clinical strength.8 There is considerable electrophysiological evidence, including single fibre and macro- electromyography (EMG) and muscle morphological data to support this concept of reinnervation.16-20 Muscle biopsy studies have shown that the remaining motor neurons may innervate up to eight times or more the normal number of muscle fibres.21 Survivors of acute polio may be left with a few, significantly enlarged motor units doing the work previously performed by many units.5 Figure 1 provides a schematic illustration of this process.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Because of the variability in which the motor neurons to different muscle groups may have been affected in a particular patient, both asymmetric and scattered weakness may be present.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ Changes in type of employment (retraining, job relocation), changes to how work is performed, modifying work schedule and ergonomic changes to the workplace may be required.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

.Other mechanisms that occur during the rehabilitation phase, and contribute to muscle strength restoration, include myofiber hypertrophy—enlargement of muscle fibers through exercise and activity—and transformation of type II muscle fibers to type I muscle fibers.^ Myofibre Hypertrophy In addition to sprouting, the remaining innervated muscle fibres hypertrophy through exercise and activity during the rehabilitation phase after the acute illness.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ What types of exercises are considered resistance or strength?
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

^ Muscle fibre hypertrophy contributes further to the recovery of strength after paralytic polio.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

[62][64]
.In addition to these physiological processes, the body possesses a number of compensatory mechanisms to maintain function in the presence of residual paralysis.^ In addition to these physiological processes, the body possesses a number of compensatory mechanisms to maintain function in the presence of residual paralysis.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ In addition, there is a possibility of reinstating function in some of the previously involved areas affected by the initial disease process.

^ Such extensive compensatory physiological processes mask the profound neurological deficits caused by the disease.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

.These include the use of weaker muscles at a higher than usual intensity relative to the muscle's maximal capacity, enhancing athletic development of previously little-used muscles, and using ligaments for stability, which enables greater mobility.^ These compensations include: • Use of weak muscles at a higher level of capacity; • Substitution of strong muscles with increased energy expenditure for the tasks; and • Use of ligaments for stability with resulting hypermobility.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Clinicians using manual muscle testing should determine their maximal vertical push force and the extent of weakness they can detect.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ These symptoms may include high fever, headache, tiredness, muscle aches, and a rash.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

[64]

Complications

.Residual complications of paralytic polio often occur following the initial recovery process.^ Re s e a r c h : This phenomenon, which occurs during recovery from paralytic polio (i.e.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Residual Complications Residual complications often result following the initial recovery process.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Abstract: Post-polio syndrome (PPS) describes the clinical onset of progressive muscular weakness many years after survival of acute paralytic poliomyelitis, often in muscle groups clinically unaffected by the original disease process.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

[10] .Muscle paresis and paralysis can sometimes result in skeletal deformities, tightening of the joints and movement disability.^ These may include: • Muscle paresis and paralysis, which may result in skeletal deformities, joint contractures and movement disability; • Growth retardation of an affected limb; • Osteoporosis and increased likelihood of fractures; • Pain from wear and tear due to abnormal body mechanics; • Compression neuropathy from the use of calipers or wheelchairs; • Venous stasis due to pooling of blood in paralysed lower limbs; • Chronic colonic distension; • Respiratory insufficiency; and • Intolerance to cold due to circulatory disturbances.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Chronic strain causes polymer lengthening of collagen fibres.93 Repeated tension results in longer fibres with increased collagen turnover and susceptability for muscle fibres to rupture or increased curvature of an already deformed joint.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Among the 21 PPMA cases in the past in which the acute poliomyelitis had resulted in paralysis of the only one limb, ours was the only case that had muscle atrophy of all the limbs.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

.Once the muscles in the limb become flaccid, they may interfere with the function of other muscles.^ If the virus gets into the brainstem (bulbar polio), muscles needed for breathing, swallowing and other vital functions become paralyzed, and the person may die.
  • Polio - March of Dimes 13 January 2010 15:33 UTC www.marchofdimes.com [Source type: FILTERED WITH BAYES]

^ Other abnormal movements while sleeping that disturb your rest may include muscle twitching and jerking.
  • CIGNA - Post-Polio Syndrome 13 January 2010 15:33 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Yarnell clearly warns polio survivors to stop if they become fatigued during their exercise program, or if they experience pain or aches in their muscles.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

A typical manifestation of this problem is equinus foot (similar to club foot). .This deformity develops when the muscles that pull the toes downward are working, but those that pull it upward are not, and the foot naturally tends to drop toward the ground.^ In neglected cases, gross fixed deformities of the hip, knee, and foot occur with severe wasting of muscles.
  • Poliomyelitis: eMedicine Orthopedic Surgery 16 January 2010 21:22 UTC emedicine.medscape.com [Source type: Academic]

If the problem is left untreated, the Achilles tendons at the back of the foot retract and the foot cannot take on a normal position. .Polio victims that develop equinus foot cannot walk properly because they cannot put their heel on the ground.^ Today, the names Salk and Sabin are associated with polio because their vaccines eliminated it from the developed world.
  • Swaim-A Dogma Upended 13 January 2010 15:33 UTC www.skally.net [Source type: FILTERED WITH BAYES]

^ Iremember that they closed the wadding pool at Palmer Park in Detroit because there was a feeling that it could spread the polio virus.
  • Do You Remember...? | 50th Anniversary of the Polio Vaccine 13 January 2010 15:33 UTC www.polio.umich.edu [Source type: General]

^ These strategies may be difficult to accomplish because they often require the patient to develop behaviours unlike the old, familiar ones.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

A similar situation can develop if the arms become paralyzed.[65] .In some cases the growth of an affected leg is slowed by polio, while the other leg continues to grow normally.^ Paralytic polio also requires long-term rehabilitation using physical therapy, braces, corrective shoes and, in some cases, orthopedic surgery.
  • Poliomyelitis - Definition, Causes, Symptoms and Treatments: 16 January 2010 21:22 UTC www.health-diseases.org [Source type: Academic]

^ Abstract: Because polio and ALS are both manifestations of anterior horn cell disease, consideration of some etiologic or pathogenetic relationship continues to recur.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ In the following days more and more cases were reported, some of then after inoculation with other brands of the vaccine.
  • THE STORY OF THE SALK ANTI-POLIOMYELITIS VACCINE BY M. BEDDOW BAYLY, M.R.C.S.,L.R.C.P. 16 January 2010 21:22 UTC www.whale.to [Source type: FILTERED WITH BAYES]

.The result is that one leg is shorter than the other and the person limps and leans to one side, in turn leading to deformities of the spine (such as scoliosis).^ This can lead to abnormal curvature of the spine ( scoliosis ).
  • CIGNA - Post-Polio Syndrome 13 January 2010 15:33 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ One leg was shorter and my spine had a curvature.
  • Do You Remember...? | 50th Anniversary of the Polio Vaccine 13 January 2010 15:33 UTC www.polio.umich.edu [Source type: General]

^ Respiratory insufficiency is associated with progressive nocturnal hypoventilation due to chest wall deformity, progressive scoliosis or other factors stressing critically compromised ventilation.
  • Lincolnshire Post-Polio Library [Poliomyelitis] 16 January 2010 21:22 UTC www.ott.zynet.co.uk [Source type: Academic]

[65] .Osteoporosis and increased likelihood of bone fractures may occur.^ Further improvement may continue over the next two years.6 Muscle strength recovery and increase in functional ability occur by several physiological processes.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

.Extended use of braces or wheelchairs may cause compression neuropathy, as well as a loss of proper function of the veins in the legs, due to pooling of blood in paralyzed lower limbs.^ These may include: • Muscle paresis and paralysis, which may result in skeletal deformities, joint contractures and movement disability; • Growth retardation of an affected limb; • Osteoporosis and increased likelihood of fractures; • Pain from wear and tear due to abnormal body mechanics; • Compression neuropathy from the use of calipers or wheelchairs; • Venous stasis due to pooling of blood in paralysed lower limbs; • Chronic colonic distension; • Respiratory insufficiency; and • Intolerance to cold due to circulatory disturbances.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ He was perhaps the first to practice sensible treatment for paralyzed polio limbs exercise, baths, simple surgical procedures, bracing.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

^ Benefits you may not notice include lower blood pressure levels, improved blood cholesterol levels, and lower blood sugar levels to name a few.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

[38][66] .Complications from prolonged immobility involving the lungs, kidneys and heart include pulmonary edema, aspiration pneumonia, urinary tract infections, kidney stones, paralytic ileus, myocarditis and cor pulmonale.^ Of the latter group, more than 90% of the pneumonias and hospitalizations were triggered by otherwise benign intercurrent upper respiratory tract infections.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ Symptoms for adults with Group B streptococcal disease may include pneumonia and blood, skin, and urinary tract infections.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

[38][66]

Post-polio syndrome

.Around a quarter of individuals who survive paralytic polio in childhood develop additional symptoms decades after recovering from the acute infection, notably muscle weakness, extreme fatigue, or paralysis.^ The main symptoms are new muscle weakness, fatigue, and pain in the muscles and joints.
  • CIGNA - Post-Polio Syndrome 13 January 2010 15:33 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Paralytic Polio Some individuals proceed to develop more severe symptoms.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Overexertion can make symptoms of fatigue, muscle weakness, and pain worse.
  • CIGNA - Post-Polio Syndrome 13 January 2010 15:33 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

.This condition is known as post-polio syndrome (PPS).^ Was ist das Post-Polio-Syndrom?
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ Post-polio syndrome.
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ Title: Post polio syndrome.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

[67] .The symptoms of PPS are thought to involve a failure of the over-sized motor units created during recovery from paralytic disease.^ [PubMed Abstract] Russell WR. Paralytic poliomyelitis - the early symptoms and the effect of physical activity on the course of the disease.
  • Lincolnshire Post-Polio Library [Poliomyelitis] 16 January 2010 21:22 UTC www.ott.zynet.co.uk [Source type: Academic]

^ Further studies, involving monitoring PPS subjects, documented a number of abnormal movements during sleep.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ The symptoms of PPS may resemble those of amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease), a disease of the nerves that control movement (motor neurons) that usually leads to death within several years.
  • CIGNA - Post-Polio Syndrome 13 January 2010 15:33 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[68][69] .Factors that increase the risk of PPS include the length of time since acute poliovirus infection, the presence of permanent residual impairment after recovery from the acute illness, and both overuse and disuse of neurons.^ Poliovirus infection manifests as (in decreasing order of frequency): subclinical infection (in up to 95 percent of cases); nonspecific viral illnesses with complete recovery (about 5 percent of cases); nonparalytic aseptic meningitis (1 to 2 percent of cases); and paralytic poliomyelitis (less than 2 percent of cases).
  • Poliovirus Vaccine Options - January 1, 1999 - American Academy ofFamily Physicians 16 January 2010 21:22 UTC www.aafp.org [Source type: Academic]

^ The normal aging process and the overuse or disuse of muscles may be contributing factors in development of PPS. "We are having difficulty in alerting the world medical community to the problems of PPS," says Dr. Rowland.
  • After Effects of Polio Can Harm Survivors 40 Years Later - March of Dimes 13 January 2010 15:33 UTC www.marchofdimes.com [Source type: FILTERED WITH BAYES]

^ Much evidence, however, suggests that the febrile response is strongly associated, at least when infection is present, with both shorter duration of illness and greater likelihood of survival.
  • Swaim-A Dogma Upended 13 January 2010 15:33 UTC www.skally.net [Source type: FILTERED WITH BAYES]

[67] .Post-polio syndrome is not an infectious process, and persons experiencing the syndrome do not shed poliovirus.^ Was ist das Post-Polio-Syndrom?
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ Post-polio syndrome.
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ What are the symptoms of post-polio syndrome?
  • CIGNA - Post-Polio Syndrome 13 January 2010 15:33 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[4]

Eradication

Disability-adjusted life year for poliomyelitis per 100,000 inhabitants.
     no data      ≤ 0.35      0.35-0.7      0.7-1.05      1.05-1.4      1.4-1.75      1.75-2.1      2.1-2.45      2.45-2.8      2.8-3.15      3.15-3.5      3.5-3.85      ≥ 3.85
WHO 2002
.While now rare in the Western world, polio is still found principally in Asia and Northern Africa.^ Poliomyelitis (infantile paralysis), commonly referred to as “polio", is a viral infection that was common in the Western world until the early 1960s.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ However, the disease is still common in other parts of the world, and polio usually comes to the United States by people who travel here from other countries.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ Poliovirus transmission is now largely confined to southern Asia and parts of Africa.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

.Following the widespread use of poliovirus vaccine in the mid-1950s, the incidence of poliomyelitis declined dramatically in many industrialized countries.^ With the introduction of effective vaccines, the incidence of poliomyelitis rapidly declined.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

^ Following the introduction of mass vaccination programmes in the late 1950s and early 1960s the incidence of paralytic poliomyelitis has been dramatically reduced in countries with these programmes.
  • Lincolnshire Post-Polio Library [Poliomyelitis] 16 January 2010 21:22 UTC www.ott.zynet.co.uk [Source type: Academic]

^ These successes are attributable primarily to the widespread use of oral polio vaccine (OPV), which is the vaccine recommended by the WHO. Continued progress in poliomyelitis elimination clearly necessitates the use of OPV in those countries in which wild poliovirus remains or recently has been endemic.
  • Poliomyelitis Prevention: Recommendations for Use of Inactivated Poliovirus Vaccine and Live Oral Poliovirus Vaccine -- Committee on Infectious Diseases 99 (2): 300 -- Pediatrics 16 January 2010 21:22 UTC pediatrics.aappublications.org [Source type: Academic]

.A global effort to eradicate polio began in 1988, led by the World Health Organization, UNICEF, and The Rotary Foundation.^ Global Polio Eradication Initiative Website - World Health Organization 06/16/2000 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ Less than a decade later, in 1988, the World Health Organization (WHO) launched a global campaign to eradicate PV. .
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

^ In 1980, the 33 rd World Health Assembly announced the first successful eradication of a major human disease – smallpox [ 56 ].
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

[70] .These efforts have reduced the number of annual diagnosed cases by 99%; from an estimated 350,000 cases in 1988 to 1,310 cases in 2007.[71][72] Should eradication be successful it will represent only the second time mankind has ever completely eliminated a disease.^ All of these are case reports on a small number of patients only.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ As of that point in time, only a few viruses had been detected as agents of human or animal diseases the viruses of smallpox and vaccinia, rabies, and foot-and-mouth disease.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

^ The mass vaccination strategy employed to eradicate an agent, estimated to have caused 10–15 million cases of smallpox as early as 1967, eventually paid off.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

.The first such disease was smallpox, which was officially eradicated in 1979.[73] A number of eradication milestones have already been reached, and several regions of the world have been certified polio-free.^ However, the disease is still common in other parts of the world, and polio usually comes to the United States by people who travel here from other countries.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ The first polio epidemic in America was in Vermont, summer 1893 (26 cases), but the first substantial epidemic was in Vermont in 1894 (132 cases) and was the largest reported in one year anywhere in the world.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

^ Global Polio Eradication Initiative Website - World Health Organization 06/16/2000 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

.The Americas were declared polio-free in 1994.[74] In 2000 polio was officially eradicated in 36 Western Pacific countries, including China and Australia.^ Post-Polio Network of Western Australia 10/09/2000 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ In the study by Lynch (2000)74 on a sample of the Queensland post-polio population, 57 percent of subjects reported sensitivity to the cold.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Polio has now almost certainly been eradicated from Australia.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

[75][76] .Europe was declared polio-free in 2002.[77] As of 2006, polio remains endemic in only four countries: Nigeria, India (specifically Uttar Pradesh and Bihar), Pakistan, and Afghanistan.^ In four to eight percent of cases there is a non-specific viral syndrome and only one to two percent of cases are associated with paralysis.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Neuromyotonia: Clinical profile of twenty cases from northwest India - -2006 Panagariya A, Kumar H, Mathew V, Sharma B [ABSTRACT] polio - 11/23/2006 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

[71][78]
.Much of the work towards eradication was documented by Brazilian photographer Sebastião Salgado, as a UNICEF Goodwill Ambassador, in the book The End of Polio: Global Effort to End a Disease.^ Vaccine-derived poliovirus from long term excretors and the end game of polio eradication - -2006 Martin J. [ABSTRACT] - 05/04/2006 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ Global Polio Eradication Initiative Website - World Health Organization 06/16/2000 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ Fortunately, since its inception in 1988, the WHO's Global Polio Eradication Initiative, along with great economic and intellectual efforts, has served to greatly reduce the number of documented cases of poliomyelitis worldwide.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

[79]

History

An Egyptian stele thought to represent a polio victim, 18th Dynasty (1403–1365 BC)
.The effects of polio have been known since prehistory; Egyptian paintings and carvings depict otherwise healthy people with withered limbs, and children walking with canes at a young age.^ Because the impact of the late effects of polio is also variable in these muscle groups, the effect of therapies may be different not only from patient to patient and from limb to limb, but also from muscle to muscle within the same limb.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ Abstract: Over half a million Americans who had paralytic poliomyelitis as children or young adults are at risk for experiencing the unexpected late effects of post-poliomyelitis syndrome (PPS).
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ Effects of assistive technology on functional decline in people aging with a disability - -2009 Wilson DJ, Mitchell JM, Kemp BJ, Adkins RH, Mann W [ABSTRACT] polio - 01/14/2010 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

[5] .The first clinical description was provided by the English physician Michael Underwood in 1789, where he refers to polio as "a debility of the lower extremities".[80] The work of physicians Jakob Heine in 1840 and Karl Oskar Medin in 1890 led to it being known as Heine-Medin disease.^ The first term used - Debility of the lower extremities is credited to a pediatricians description in 1789.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

^ Michael Underwood, a London pediatrician under the heading Debility of the Lower Extremities.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

^ The relationship of lower extremity strength and gait parameters in patients with post-polio syndrome - -1993 Perry, Mulroy, Renwick ABSTRACT - 08/11/1999 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

[81] .The disease was later called infantile paralysis, based on its propensity to affect children.^ French terminology of fatty atrophic paralysis of infancy and essential infantile paralysis was later anglicized and shortened to infantile paralysis notwithstanding the fact that withered limbs were not always involved and the disease was not restricted to infants.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

^ Kawasaki Syndrome Kawasaki syndrome is a disease that usually affects young children (under 5 years).
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ Nevertheless, with support from the National Foundation for Infantile Paralysis (later the March of Dimes) Salk pushed ahead.
  • Vaccine Innovation and Adoption: Polio Vaccines in the UK, the Netherlands and West Germany, 1955–1965 13 January 2010 15:33 UTC www.ncbi.nlm.nih.gov [Source type: FILTERED WITH BAYES]

.Before the 20th century, polio infections were rarely seen in infants before six months of age, most cases occurring in children six months to four years of age.^ A. Aseptic Meningitis - coxsackievirus meningitis is seen most frequently in children under 5 years of age.
  • Poliomyelitis, Poliovirus, Polioviruses 16 January 2010 21:22 UTC virology-online.com [Source type: Academic]

^ For four years, very few cases of polio occurred.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Oral polio vaccine is recommended for infants from two months of age.
  • Lincolnshire Post-Polio Library [Poliomyelitis] 16 January 2010 21:22 UTC www.ott.zynet.co.uk [Source type: Academic]

[82] .Poorer sanitation of the time resulted in a constant exposure to the virus, which enhanced a natural immunity within the population.^ As a result, infants were exposed to the virus early and subsequently developed lifelong immunity.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

.In developed countries during the late 19th and early 20th centuries, improvements were made in community sanitation, including better sewage disposal and clean water supplies.^ During the 20th century, improvements in sanitation in developed countries led to a decrease in endemic infection.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Family members should be included in all aspects of this process so that they may develop a better understanding of the new problems facing these individuals.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ It is suggested that poliomyelitis most probably dates back to the dawn of written history, even though early twentieth century epidemics made it a disease of that era.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

.These changes drastically increased the proportion of children and adults at risk of paralytic polio infection, by reducing childhood exposure and immunity to the disease.^ As a result of continuing efforts to interrupt wild polio virus transmission, poliomyelitis continues to occur in only a few countries and is now exceedingly rare in the UK. The last indigenous case of wild-type infection was in 1984, and in the last decade the handful of cases have all been OPV-related VAPP. Susceptible adults may be at greater risk of paralytic polio than children.
  • British HIV Association Guidelines for Immunization of HIV-Infected Adults: Poliomyelitis 16 January 2010 21:22 UTC www.medscape.com [Source type: Academic]

^ A change in the recommendations for routine immunization of children is indicated because of the reduced risk of exposure to wild-type polio viruses and the continued occurrence of vaccine-associated paralytic poliomyelitis after oral polio vaccine (OPV).
  • Poliomyelitis Prevention: Recommendations for Use of Inactivated Poliovirus Vaccine and Live Oral Poliovirus Vaccine -- Committee on Infectious Diseases 99 (2): 300 -- Pediatrics 16 January 2010 21:22 UTC pediatrics.aappublications.org [Source type: Academic]

^ Recommendations for Polio Pre-exposure Prophylaxis in HIV-infected Adults .
  • British HIV Association Guidelines for Immunization of HIV-Infected Adults: Poliomyelitis 16 January 2010 21:22 UTC www.medscape.com [Source type: Academic]

.Small localized paralytic polio epidemics began to appear in Europe and the United States around 1900.[6] Outbreaks reached pandemic proportions in Europe, North America, Australia, and New Zealand during the first half of the 20th century.^ Polio is very rare in the United States.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ Scandinavia was the site of the first polio epidemic.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

^ Serious hepatitis A: an analysis of patients hospitalised during an urban epidemic in the United States.
  • British HIV Association Guidelines for Immunization of HIV-Infected Adults: Poliomyelitis 16 January 2010 21:22 UTC www.medscape.com [Source type: Academic]

.By 1950 the peak age incidence of paralytic poliomyelitis in the United States had shifted from infants to children aged five to nine years, when the risk of paralysis is greater; about one-third of the cases were reported in persons over 15 years of age.^ In subsequent years, additional cases of poliomyelitis would be reported.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

^ He had suffered from poliomyelitis at the age of 2 years.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ The risk for paralysis from the virus increases with age.

[83] .Accordingly, the rate of paralysis and death due to polio infection also increased during this time.^ Paralysis may occur at any time during the febrile period.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ He is convinced that the injection of diphtheria-pertussis vaccine not only localises the paralysis of persons infected with virus but also increases the attack-rate.
  • THE STORY OF THE SALK ANTI-POLIOMYELITIS VACCINE BY M. BEDDOW BAYLY, M.R.C.S.,L.R.C.P. 16 January 2010 21:22 UTC www.whale.to [Source type: FILTERED WITH BAYES]

^ Do that 3-4 times per week for one month and then increase the rate (time) of exercise by another 10%.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

[6] .In the United States, the 1952 polio epidemic became the worst outbreak in the nation's history.^ The largest epidemic of polio in Queensland’s history was in 1951–1952.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

^ Polio is very rare in the United States.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ Serious hepatitis A: an analysis of patients hospitalised during an urban epidemic in the United States.
  • British HIV Association Guidelines for Immunization of HIV-Infected Adults: Poliomyelitis 16 January 2010 21:22 UTC www.medscape.com [Source type: Academic]

.Of nearly 58,000 cases reported that year 3,145 died and 21,269 were left with mild to disabling paralysis.^ Between 1981 and 1990, more than 6,000 new cases of tuberculosis were notified each year to WHO; 10,237 cases or 154.7 per 100,000 were reported in 1991, date of the last notification.
  • ProjectDisaster » Blog Archive » Haiti: Socioeconomic, Political, and Demographic Overview 16 January 2010 21:22 UTC projectdisaster.com [Source type: Academic]

^ Yemen, which was declared polio-free in 1996, had reported 473 cases this year as of Nov.
  • Polio Eradication Efforts Redouble After Startling Worldwide Outbreak - Population Reference Bureau 13 January 2010 15:33 UTC www.prb.org [Source type: News]

^ Authorities reported a total of 13 confirmed cases and 13 polio-compatible cases, with the last confirmed case showing paralysis onset on January 25, 2001.
  • A Dynamic Model of Poliomyelitis Outbreaks: Learning from the Past to Help Inform the Future -- Duintjer Tebbens et al. 162 (4): 358 -- American Journal of Epidemiology 16 January 2010 21:22 UTC aje.oxfordjournals.org [Source type: Academic]

[84]
.The polio epidemics changed not only the lives of those who survived them, but also affected profound cultural changes; spurring grassroots fund-raising campaigns that would revolutionize medical philanthropy, and giving rise to the modern field of rehabilitation therapy.^ Exercise the limbs least affected or those completely unaffected by polio, while avoiding the more affected extremities.
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

^ Attention to this finding was minimal in the original epidemics as many persons with bulbar polio who may have been dysphagic did not survive.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ Because the impact of the late effects of polio is also variable in these muscle groups, the effect of therapies may be different not only from patient to patient and from limb to limb, but also from muscle to muscle within the same limb.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

.As one of the largest disabled groups in the world, polio survivors also helped to advance the modern disability rights movement through campaigns for the social and civil rights of the disabled.^ Title: Psychological distress, social support and coping behaviour among polio survivors: a 5-year perspective on 63 polio patients.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ San Francisco Bay Area (California) Polio Survivors (SFBAPS) - Support Group - 12/30/2000 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ Depression and life satisfaction in aging polio survivors versus age-matched toward disability - -1997 Kemp, Adams, Campbell ABSTRACT - 01/08/2001 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

.The World Health Organization estimates that there are 10 to 20 million polio survivors worldwide.^ In the other study, although muscle strength increased by 30%, there was no improvement in polio survivors' ability to do daily activities, and muscle fatigue increased as much as 300%!
  • Polio News 13 January 2010 15:33 UTC www.mindspring.com [Source type: FILTERED WITH BAYES]

^ Geneva, Switzerland: World Health Organization, 1993.
  • A Dynamic Model of Poliomyelitis Outbreaks: Learning from the Past to Help Inform the Future -- Duintjer Tebbens et al. 162 (4): 358 -- American Journal of Epidemiology 16 January 2010 21:22 UTC aje.oxfordjournals.org [Source type: Academic]

^ The mass vaccination strategy employed to eradicate an agent, estimated to have caused 10–15 million cases of smallpox as early as 1967, eventually paid off.
  • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

[85] .In 1977 there were 254,000 persons living in the United States who had been paralyzed by polio.^ Polio is very rare in the United States.
  • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

^ The ADL [activities of daily living] ability and use of technical aids in persons with late effects of polio.
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ Attention to this finding was minimal in the original epidemics as many persons with bulbar polio who may have been dysphagic did not survive.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

[86] .According to doctors and local polio support groups, some 40,000 polio survivors with varying degrees of paralysis live in Germany, 30,000 in Japan, 24,000 in France, 16,000 in Australia, 12,000 in Canada and 12,000 in the United Kingdom.^ Polio Regina - saskatchewan Canada support group post-polio - 04/12/2005 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ S u n s h i n e Special Post Polio Support Group of Palm Beach County "is dedicated to the Special People who survived the effects of Polio and the Very Special People who have assisted them, care for them and love them throughout every day of their lives."
  • polio support 13 January 2010 15:33 UTC www.polionet.org [Source type: General]

^ Disability World: Report on Post-Polio Syndrome in Australia, Canada, France, Germany, Japan, UK & USA - undated - 06/13/2003 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

[85] .Many notable individuals have survived polio and often credit the prolonged immobility and residual paralysis associated with polio as a driving force in their lives and careers.^ Abstract: Post-polio syndrome (PPS) describes the clinical onset of progressive muscular weakness many years after survival of acute paralytic poliomyelitis, often in muscle groups clinically unaffected by the original disease process.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ Attention to this finding was minimal in the original epidemics as many persons with bulbar polio who may have been dysphagic did not survive.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ Many of these individuals overcame a serious and often life-changing illness by developing coping strategies and behaviours.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

[87]
.The disease was very well publicized during the polio epidemics of the 1950s, with extensive media coverage of any scientific advancements that might lead to a cure.^ Disease eradication as a public health strategy: A case study of polio eradication.

^ How the disease spread throughout the body and the community came under intense scrutiny during the devastating 1905 Swedish epidemic (1,031 cases).
  • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

^ Perceptions might well depend on how successful reduction in the incidence of polio with IPV had been and—perhaps still more importantly—what still needed to be accomplished.
  • Vaccine Innovation and Adoption: Polio Vaccines in the UK, the Netherlands and West Germany, 1955–1965 13 January 2010 15:33 UTC www.ncbi.nlm.nih.gov [Source type: FILTERED WITH BAYES]

.Thus, the scientists working on polio became some of the most famous of the century.^ In 1982, the American physiologist Philip Drinker (1893 – 1977) invented the most famous of all devices for helping polio patients to breathe.
  • polio Facts, information, pictures | Encyclopedia.com articles about polio 13 January 2010 15:33 UTC www.encyclopedia.com [Source type: FILTERED WITH BAYES]

.Fifteen scientists and two laymen who made important contributions to the knowledge and treatment of poliomyelitis are honored by the Polio Hall of Fame, which was dedicated in 1957 at the Roosevelt Warm Springs Institute for Rehabilitation in Warm Springs, Georgia, USA. In 2008 four organizations (Rotary International, the World Health Organization, the U.S. Centers for Disease Control and UNICEF) were added to the Hall of Fame.^ Roosevelt Warm Springs Institute for Rehabilitation-Warm Springs, Georgia 02/18/1998 .
  • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

^ This finding suggests reduction in forebrain control of compromised bulbar respiratory centers during NREM sleep in PPS. <9> Unique Identifier 98193963 Authors: Halstead LS. Institution: National Rehabilitation Hospital in Washington, D.C., USA. Title: Post-polio syndrome.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ This is a webforum to discuss and comment on PPS. Gazette International Networking Institute (GINI) Polio Experience Network http://www.post-polio.org http://www.polionet.org Consists of: Large post-polio resource site including library, PPS disease • International Polio Network – provides information to and treatment information, instructional material, newsletter polio survivors, their families and the health care and vaccine information.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

[88][89]
Intensive-care medicine has its origin in the fight against polio. Most hospitals in the 1950s had limited access to iron lungs for patients unable to breathe without mechanical assistance. .The establishment of respiratory centers to assist the most severe polio patients, was hence the harbinger of the subsequent ICUs.^ These results indicate that subjective symptoms and physical disability connected with polio increased with increasing age in these patients with post-polio syndrome, and cardio-respiratory deconditioning and weight gain also became more serious problems in most patients.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ Most patients experienced increasing symptoms and physical disability related to their polio, while the majority reported that their mental health were unchanged or improved.
  • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

^ Physiotherapist Through a variety of hands-on treatments, education and exercise prescription, physiotherapists can assist the post-polio patient in maximising their level of function and minimising future deterioration.
  • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

[90]

See also

Notes and references

  1. ^ a b Cohen JI (2004). "Chapter 175: Enteroviruses and Reoviruses". in Kasper DL, Braunwald E, Fauci AS, et al. (eds.). Harrison's Principles of Internal Medicine (16th ed.). McGraw-Hill Professional. pp. 1144. ISBN 0071402357. 
  2. ^ a b c d Chamberlin SL, Narins B (eds.) (2005). The Gale Encyclopedia of Neurological Disorders. Detroit: Thomson Gale. pp. 1859–70. ISBN 0-7876-9150-X. 
  3. ^ a b c d Ryan KJ, Ray CG (eds.) (2004). "Enteroviruses". Sherris Medical Microbiology (4th ed.). McGraw Hill. pp. 535–7. ISBN 0-8385-8529-9. 
  4. ^ a b c d e f g h i j k l Atkinson W, Hamborsky J, McIntyre L, Wolfe S (eds.) (2007). "Poliomyelitis" (PDF). Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book) (10th ed.). Washington DC: Public Health Foundation. pp. 101–14. http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/polio-508.pdf. 
  5. ^ a b c Paul JR (1971). A History of Poliomyelitis. Yale studies in the history of science and medicine. New Haven, Conn: Yale University Press. pp. 16–18. ISBN 0-300-01324-8. 
  6. ^ a b c Trevelyan B, Smallman-Raynor M, Cliff A (2005). "The Spatial Dynamics of Poliomyelitis in the United States: From Epidemic Emergence to Vaccine-Induced Retreat, 1910–1971". Ann Assoc Am Geogr 95 (2): 269–93. doi:10.1111/j.1467-8306.2005.00460.x. PMID 16741562. 
  7. ^ Aylward R (2006). "Eradicating polio: today's challenges and tomorrow's legacy". Ann Trop Med Parasitol 100 (5–6): 401–13. doi:10.1179/136485906X97354. PMID 16899145. 
  8. ^ Heymann D (2006). "Global polio eradication initiative". Bull. World Health Organ. 84 (8): 595. doi:10.2471/BLT.05.029512. PMID 16917643. PMC 2627439. http://209.85.215.104/search?q=cache:bdeN6aDyjY4J:www.scielosp.org/scielo.php%3Fscript%3Dsci_arttext%26pid%3DS0042-96862003000900020+site:scielosp.org+polio&hl=en&ct=clnk&cd=1&gl=us. 
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Further reading

  • Frauenthal HWA, Manning JVV (1914). .Manual of infantile paralysis, with modern methods of treatment: Pathology..^ Unique Identifier 98007320 Authors: Ananian SG. Bezrukov VM. Avetisian EK. Title: [A new method for the surgical treatment of patients with paralysis of the tongue].
    • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

    ^ Nurse Irene Shea studies the "Kenny method" of treatment of infantile paralysis, 1942-1943 - -2010 Golden J, Rogers N [ABSTRACT] - 01/14/2010 .
    • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

    Philadelphia: Davis. pp. 79–101. OCLC 2078290. http://books.google.com/books?vid=029ZCFMPZ0giNI1KiG6E&id=piyLQnuT-1YC&printsec=titlepage.
      (Full text available from Google Books, with hundreds of pictures.)
  • Huckstep RL (1975). .Poliomyelitis — a guide for developing countries including appliances and rehabilitation for the disabled.^ Pulmonary rehabilitation, originally developed to address functional impairment and disability related to chronic obstructive pulmonary disease, can benefit patients with postpolio syndrome.
    • postpoliosyndrome.html 13 January 2010 15:33 UTC www.indiana.edu [Source type: Academic]

    ^ PV1(M), adult CD155 tg mice often developed neurological signs characteristic of poliomyelitis, including flaccid paralysis and even death.
    • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

    Edinburgh: Churchill Livingstone. ISBN 0443013128. .http://www.worldortho.com/index.php?option=com_content&task=view&id=522&Itemid=267.  (A look at the modern polio patient and polio treatment techniques.
    ^ Evaluation, treatment, and follow-up results of post polio patients with dysphagia - -1991 Silbergleit, Waring, Sullivan, Maynard ABSTRACT - 08/12/1999 .
    • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

    ^ Polio Survivor’s Page • Post-Polio Task Force – a task force of clinicians and http://www.eskimo.com/~dempt/polio/html researchers who specialise in diagnosing and treating polio survivors and symptoms of PPS, as well as Polio and post-polio resources including articles, patient advocates for survivors of polio: and newsletters, an information package and related links.
    • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

    ^ The most important aspect of the treatment of fatigue is educating the patient regarding energy conservation techniques.
    • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

    )
  • Tony Gould (1995). .A Summer Plague: Polio and its Survivors.^ Summer Plague: Polio and its Survivors 02/18/1998 .
    • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

    Yale University Press.
  • Kluger Jefferey (2004). Splendid Solution - Jonas Salk and the Conquest of Polio. New York: G. P. Putnam's Sons. pp. 319. ISBN 039915216. .http://www.amazon.com/Splendid-Solution-Jonas-Conquest-Polio/dp/0425205703/ref=pd_bbs_sr_1?ie=UTF8&s=books&qisbn=1219368729&sr=8-1.  (A social history of the effects of Polio on early twentieth century America and the search for a vaccine.^ In the review of post-polio which follows, the term Late Effects of Polio (LEOP) will be used when discussing the myriad of problems that individuals with a history of polio often experience.
    • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

    ^ Late-Nineteenth and Early-Twentieth Centuries.
    • FLORIDA  EAST  COAST  POST 16 January 2010 21:22 UTC home.iag.net [Source type: FILTERED WITH BAYES]

    ^ Resources: Anthrax http://www.bt.cdc.gov/agent/anthrax/ Anthrax: What You Need To Know http://www.bt.cdc.gov/agent/anthrax/needtoknow.asp Anthrax Q & A: Vaccination http://www.bt.cdc.gov/agent/anthrax/faq/vaccination.asp .
    • http://www.city.milwaukee.gov/mrsa 13 January 2010 15:33 UTC www.city.milwaukee.gov [Source type: FILTERED WITH BAYES]

    )
  • Marc Shell (2005). Polio and its Aftermath: The Paralysis of Culture. Harvard University Press.
  • Oshinsky David (2006). Polio - An American Story. .New York: Oxford University Press.^ Edited by: Fields BN, Knipe DM. New York, NY: Raven Press; 1990:507-548.
    • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

    ^ Department of Molecular Genetics & Microbiology, Stony Brook University School of Medicine, Stony Brook, New York, USA .
    • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

    pp. 368. ISBN 0195307143. .http://www.oup.com/us/catalog/general/subject/HistoryAmerican/Since1945/~~/dmlldz11c2EmY2k9OTc4MDE5NTMwNzE0Ng==.  (A Pulitzer Prize-winning account of the development of the Salk and Sabin rivalry, and of the key role of the National Foundation for Infantile Paralysis ("March of Dimes")).
  • Whatever Happened to Polio? Smithsonian Institution National Museum of American History online interactive exhibit.^ Whatever happened to Polio?
    • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

    ^ Smithsonian National Museaum of American History - 04/14/2005 .
    • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

    ^ In 1938, in efforts to support care for patients with poliomyelitis as well as fund research to combat the illness, the National Foundation for Infantile Paralysis (now the March of Dimes) was established.
    • Virology Journal | Full text | Epidemics to eradication: the modern history of poliomyelitis 16 January 2010 21:22 UTC www.virologyj.com [Source type: Academic]

    .The exhibit is now on permanent display at the Roosevelt Warm Springs Institute for Rehabilitation in Georgia, USA.
  • George McKay (2009).^ Roosevelt Warm Springs Institute for Rehabilitation-Warm Springs, Georgia 02/18/1998 .
    • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

    ^ By 1984, a growing awareness of LEOP prompted researchers to organise an international conference at the Warm Springs Institute for Rehabilitation in the United States of America.
    • late effect of polio 13 January 2010 15:33 UTC www.slideshare.net [Source type: Academic]

    ^ The Polio Chronicle: life at Roosevelt Warm Springs during the 30s in letters,txt & pics - Disability Museum.Org - 06/26/2002 .
    • PPS CENTRAL - Specific Links 16 January 2010 21:22 UTC www.skally.net [Source type: Academic]

    '"Crippled with nerves": popular music and polio, with particular reference to Ian Dury'. Popular Music vol. 28:3, pp. 341-365. (Examines the pop and polio generation, including Dury, Neil Young, Joni Mitchell, Steve Harley, Israel Vibration.)

External links



Simple English

File:Polio
A man's right leg, affected by polio

Poliomyelitis or polio is a virus that causes a serious disease. It is spread from person to person.[1] Most of the time, polio has no symptoms unless it goes into the blood.[2] It is uncommon for it to enter the brain or spinal cord. If this does happen, it can cause one to become paralyzed. Vaccines from World Health Organization, UNICEF, and Rotary International could stop the disease all over the world.[3] Franklin Delano Roosevelt probably had polio.

References

  1. Cohen JI (2004). "Chapter 175: Enteroviruses and Reoviruses". In Kasper DL, Braunwald E, Fauci AS, et al (eds.). Harrison's Principles of Internal Medicine (16th ed. ed.). McGraw-Hill Professional. pp. 1144. ISBN 0071402357. 
  2. Ryan KJ, Ray CG (eds.) (2004). "Enteroviruses". Sherris Medical Microbiology (4th ed. ed.). McGraw Hill. pp. 535–7. ISBN 0-8385-8529-9. 
  3. Heymann D (2006). "Global polio eradication initiative". Bull. World Health Organ. 84 (8): 595. PMID 16917643. http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862006000800006&lng=en&nrm=iso&tlng=en. 


Citable sentences

Up to date as of December 30, 2010

Here are sentences from other pages on Poliomyelitis, which are similar to those in the above article.








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