Poliomyelitis is an acute epidemic

Poliomyelitis is an acute epidemic (children's spinal paralysis), an acute viral disease caused by damage to the cells of the anterior horns of the spinal cord and the nuclei of the motor cranial nerves, leading to the development of flaccid paralysis with areflexia and muscle atrophy.

Etiology, pathogenesis. The causative agent is a polio virus, which causes acute inflammation of the peripheral motor neuron bodies at the height of the viremia.

Symptoms, course. The incubation period averages 7-14 days. Then, against the background of common infectious and shell symptoms, flaccid paralysis develops. Depending on the prevalence of the affected muscles, spinal and bulbar forms of the disease are isolated. The most dangerous complication of poliomyelitis is respiratory failure - it can be caused either by paralysis of the respiratory muscles or by damage to bulbar nuclei. Their involvement in the process is sometimes accompanied by arterial hyper-hypotension or tachycardia. The prevalence of paralysis is very different: mono-, paratetraplegii with varying degrees of involvement in the process of bulbar musculature and musculature of the trunk are observed. In cerebrospinal fluid - lymphocytic pleocytosis with normal protein and glucose content; In 5% of cases the liquid is normal.

The differential diagnosis of abortive and non-paralytic forms of poliomyelitis with serous meningitis caused by enteroviruses is difficult and without virological research is possible only with an epidemic outbreak of poliomyelitis. Diagnosis is difficult to differentiate with Guillain-Barre spoliradiculoneuropathy, in which flaccid paralysis also appears acutely, but in the cerebrospinal fluid, the protein content (protein-cell dissociation) is usually increased from the first days of the disease; In addition, in some cases paralysis is accompanied by loss of sensitivity by the type of "gloves" and "socks". Complications of an acute period may include pneumonia, urinary tract infection, pulmonary edema; In the residual stage - deformation of the skeleton due to muscle paralysis, osteoporosis, urolithiasis (in bedridden patients).

Treatment is symptomatic; When respiratory failure appears, ventilation is indicated. In the recovery period - massage, physiotherapy exercises.

Forecast. Diffuse muscle weakness is prognostically much more favorable than the rough paralysis of several important muscles; The most serious is bulbar paralysis (10-20% of all cases of the disease). The mortality from poliomyelitis does not exceed 5-10%, but the residual phenomena in a number of patients remain for life.

Prevention. The contagiousness of poliomyelitis is very high; Patients should be placed in specialized hospitals. Mandatory vaccination in childhood is carried out by oral vaccine Sabin. Due to vaccination, poliomyelitis in Russia is practically not found at present.