Until recently, poliomyelitis was considered a "disease of the past," since it was extremely rare. But in connection with new sudden outbreaks of the disease in different regions, the questions: "What is polio?" And "How can we protect ourselves from it?" Again at everyone's ears.
It is important to understand more about this topic in order to do everything possible and protect your children.
Poliovirus and poliomyelitis
So, what is polio? This is an acute disease caused by poliovirus. It affects the gray matter of the spinal cord and other parts of the central nervous system. The virus multiplies in the cytoplasm of the affected cells.
Typically, the disease is diagnosed in young children, less often in adolescents.
Classification of poliomyelitis
Poliomyelitis can be classified according to several parameters, depending on the type, severity and nature of the course of the disease.
1. The type of infection can be divided into two forms:
- typical, during which the central nervous system is affected;
- atypical, when the disease passes without visible symptoms ("small disease").
2. By severity of the disease, poliomyelitis can be divided into three types:
- heavy form;
- of medium gravity;
- light form.
In this case, only the doctor can determine the severity level, having estimated the volume of motor disorders and determining how much intoxication is expressed.
3. The nature of the course of the disease can be:
- smooth when it passes without any complications;
- nonsmooth, during which there are complications in the form of exacerbation of chronic diseases, attachment of a secondary infection, etc.
The causes and ways of spreading the disease
Poliovirus, which is the causative agent of poliomyelitis, can be of three types. They are denoted by Roman numerals I, II and III.
Sources of infection: patients with poliomyelitis and carriers of the virus.
The virus is transmitted in three ways:
- Airborne droplets. If the pathogen is found in the pharyngeal mucus in a patient or carrier of the infection, during a cough or sneeze, the poliovirus can enter the respiratory tract of a healthy person and provoke the development of the disease.
- Oral-fecal route. In this case, infection occurs due to the use of unboiled milk with a virus, unwashed fresh vegetables or fruits. To get on a foodstuff the virus can from excrements of the sick person by means of carriers - flies.
- Household ways. The virus is transmitted by sharing objects of common use and common utensils.
How to identify poliomyelitis in a child
The incubation period of the disease lasts on average from 8 to 12 days. Although there are situations when it can take from 5 to 35 days. This is the time that passes from the moment of infection to the appearance of the first signs of the disease. In this case, severe symptoms of poliomyelitis in children are found only in 10% of patients. In other cases, you can find out about a possible disease only by conducting clinical studies.
Before considering the symptoms, it is necessary to recall what polio is and what kinds of poliomyelitis it is divided into, because depending on the type of disease, the accompanying symptoms will also differ.
During the atypical form of infection ("small disease"), the symptoms of poliomyelitis in children will be as follows:
- a sharp short-term rise in body temperature to 39-40 degrees;
- moderate intoxication of the body, which manifests itself in the form of diarrhea and vomiting;
- stomach ache;
- general malaises;
- drowsiness or insomnia;
- increased sweating.
In addition, there may be a runny nose and sore throat.
An atypical (or abortive) form of infection can often be confused with any other viral disease, since there are no characteristic signs of poliomyelitis.
If the "small disease" does not move to the next (pre-paralytic) stage, the child completely recovers after 3-7 days.
If the child has become infected with a typical form of infection, the phase of "small disease" smoothly turns into a "big disease" and is accompanied by additional signs:
- increased headache;
- pain in the back and neck;
- pain in the limbs;
- increased fatigue of muscles.
Clinical examinations and tests during this stage show an increase in pressure in the cerebrospinal fluid, a decrease in the level of protein in the body, an increase in the number of leukocytes.
In the absence of paralysis, the body temperature is normalized towards the end of the second week of the disease, and by the end of the third, all other symptoms disappear.
In the paralytic form the disease passes only in 1 case of 1000. Then the main symptoms are joined by the following:
- muscle twitching;
- retention of urination;
- the appearance of paresis and paralysis of the muscles of the limbs and trunk.
Depending on the affected part of the spinal cord, paralysis can occur in the lumbar, thoracic or cervical spine. The most common paralysis of the lumbar region.
The end of the paralytic period is accompanied by curvature of the spine, deformity and shortening of the limbs, which leads to their complete disability.
Complications and consequences after advanced poliomyelitis
If poliomyelitis was abortive, it will not have any negative consequences and will not affect the further life of the child in any way.
If the disease has passed into the phase of paralysis, the situation for the patient becomes critical. When the spinal cord is affected, its dimensions are significantly reduced, and the motor abilities of the limbs are reduced. In cases of untimely or complete absence of necessary treatment, a person becomes disabled for life because of muscle and paresis atrophy.
If the paralysis reaches the thoracic region, even a lethal outcome is possible because of the delay in breathing that occurs during the paralysis of the intercostal muscles and the diaphragm.
Treatment of poliomyelitis
Treatment is carried out exclusively in a hospital.
There is no special polio medicine, so the therapy is symptomatic. The patient is regularly knocked down by heat, painkillers and sedatives are injected. In addition, a course of vitamin therapy (vitamins B6, B12, B1, C), amino acids, gamma globulin is prescribed.
During the acute stage of the disease, patients are shown a strict bed rest for up to 3 weeks.
If paralysis of the thoracic region is observed, the patient is placed on artificial ventilation of the lungs.
Much attention is paid to the paralyzed limbs and spine. Doctors ensure that all parts of the body are in a natural position.
The legs are placed parallel to each other, under the knees and hip joints, rollers are placed. The feet must be perpendicular to the legs, for this under the soles a thick cushion is placed.
Hands are bent to the sides and bent at elbows at an angle of 90 degrees.
To improve neuromuscular conduction, the patient is prescribed Neuromidine, Dibazol, and Proserin.
In the infectious department treatment lasts about 2-3 weeks. After it follows the recovery period - first in the hospital, then out-patient. Restoration consists in lessons with the orthopedist, water procedures, medical gymnastics, physiotherapy.
After poliomyelitis, sanatorium-and-spa treatment is recommended.
Prevention of poliomyelitis
It is important to remember that a patient with poliomyelitis should be isolated from others for a period of at least 6 weeks, since he is a carrier of the virus.
To protect yourself from this disease, you should not forget about the reasons for its occurrence (if this is not an epidemic). All the vegetables and fruits to be eaten should be well washed under clean running water. Be sure to wash your hands (preferably with soap) before eating and after walking on the street and going to the toilet.
Unfortunately, the above measures only reduce the likelihood of the disease, but do not protect against it. The most effective and effective method of protection from the virus remains the development of immunity from poliomyelitis. This is due to modern vaccination, which begins to be carried out in the first months of the baby's life.
Vaccines against poliomyelitis
Vaccination is one of the main ways of preventing from poliomyelitis.
There are two types of vaccines:
- OPV (weakened poliovirus) is a living poliomyelitis virus (Sabin vaccine).
- IPV (inactivated poliovirus) - contains polioviruses, killed with formalin.
Each type of vaccine has its own characteristics and contraindications, so it is worth considering each of them separately.
Vaccination OPV is carried out by instillation of 2-4 drops of the drug into the baby's mouth (on the lymphoid tissue of the pharynx or amygdala, depending on the child's age).
To prevent the vaccine from escaping into the stomach, after a drop of poliomyelitis, you can not feed and water the baby for one hour.
Before vaccination, it is forbidden to introduce new products into the baby's diet.
Before the vaccination, it is necessary to buy in advance antipyretic and antiallergic drugs.
As precautions for some time after vaccination, you can not kiss the baby on the lips and you should definitely wash your hands after hygienic procedures and washings of the baby.
Vaccination OPV is contraindicated if:
- the child or family members have congenital immunodeficiency or HIV;
- surrounded by pregnant or lactating women;
- the parents of the child are planning another pregnancy;
- there were side effects after a previous vaccination with OPV;
- there is an allergy to the components of the vaccine (streptomycin, polymyxin B, neomycin).
Many parents are interested in the question of whether it is possible to do poliomyelitis (vaccination), when a child is diagnosed with infectious or viral diseases. The answer is unequivocal: no! In this case, the vaccine is done only after recovery.
IPV is injected into the body subcutaneously or intramuscularly. It is shown in cases when:
- a weak immunity from birth;
- the child has a pregnant mother.
Also this vaccine is used by medical workers who often contact patients.
Before vaccination, it is necessary to check the presence in the home medicine cabinet of antiallergenic agents and antipyretic drugs.
It is forbidden to introduce new foods into the diet in order to avoid a possible allergic reaction.
Poliomyelitis (vaccination): complications and side effects
In the case of the following effects, medical intervention is not required:
- nausea, vomiting, or diarrhea (one-time);
- increased nervousness;
- edema or pain at the injection site;
- temperature after vaccination of poliomyelitis - can reach 38.5 degrees.
To help the child and improve his state of health, you need to give him an antipyretic agent in the form of a suspension or paracetamol candle. As a rule, as soon as the temperature drops to normal, the accompanying signs of malaise also disappear: nausea, vomiting, headaches, muscle aches.
In some cases, the doctor advises giving the child a febrifuge immediately after returning home, without waiting for a rise in temperature.
However, there are situations when it is necessary to contact the doctor as soon as possible or to call an ambulance:
- the child had shortness of breath or difficulty breathing;
- the temperature has risen above 39 degrees and is not knocked down by means of antipyretics;
- the child became listless and inactive;
- the baby is drowsy and apathetic;
- there was an itching or urticaria at the site of inoculation or throughout the body;
- there were even minor edema of the face or eyes;
- there are difficulties in swallowing.
Vaccination of poliomyelitis: schedule of vaccination of children
Vaccination against poliomyelitis is carried out according to the schedule approved by the Ministry of Health:
1. The first injection of diphtheria and poliomyelitis is made to the child at the age of three months.
2. The second injection is done 45 days after the first - at 4.5 months.
3. The third and last injection of a vaccine against poliomyelitis is done when the child turns 6 years old.
Revaccination as an obligatory component of protection against disease
The procedure for revaccination of poliomyelitis helps to develop a lifelong immunity in the child for this disease. It is done at the age of 18 and 24 months, and after - at 6 years, after the last vaccination.
The conducted examinations showed that after the DPT and polio vaccinations the likelihood of the disease is approaching zero. This once again proves the effectiveness of vaccination, and parents of vaccinated children know what poliomyelitis is, only theoretically and, fortunately, will never see its manifestations in practice.