A Simple Guide to Poliomyelitis

A Simple Guide to Poliomyelitis
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What is Poliomyelitis?
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Poliomyelitis is an acute highly contagious viral illness with a wide range of severity caused by the poliovirus.
It attacks the muscles and nerves throughout the body resulting in possible permanent paralysis or death.

What causes Poliomyelitis?
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The polio virus is an enteric virus classified into type 1, 2 and 3 according to tissue culture.

The disease is transmitted by human contact with discharges from the nose, mouth or faeces of an infected person.

From the nose and mouth, the virus proliferates in the nose and intestinal tract.

Once in the body it can spread through the blood and lymphatic system to attack the muscles and nerves.
The incubation period is 7 -14 days.

What are the symptoms of Poliomyelitis?
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There are 3 patterns of polio infection;
1.subclinical -does not involve the central nervous system(CNS),
95% are subclinical infections which go unnoticed.

2.non-paralytic-involve the CNS but without paralysis

3.paralytic -involve the CNS with paralysis.
Bulbar Poliomyelitis affects the cranial nerves affecting paralysis of the facial movement,swallowing and larynx

Sufferers of polio have the following symptoms:

1.mild cases -
headache,
slight fever,
nausea and vomiting for up to 3 days.

2.slightly more severe cases -
moderate fever,
muscle pain,
stiff neck and back
fatigue.

3.severe cases -
high fever,
muscle pain or spasms,
muscle weakness,
stiffness of neck and body muscles,
constipation,
tremor
difficulty with swallowing.
difficulty in breathing

Symptoms post-polio( after the fever subsided):
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1.progressive muscular weakness in muscles affected during the original infection.
Other muscles not to be affected during the original infection may also become weak.

2.Joint pain

3.extended periods of fatigue

4.Memory and concentration levels may be poorer.

5.Muscles may become smaller (atrophy) in some cases.

6.Difficulty with swallowing

7.Difficulty in breathing

8.Difficulty in walking

What are the investigation needed in Poliomyelitis?
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1.CSF fluid-high leucocytes and protein

2.blood virological studies

What is the treatment for Poliomyelitis?
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There is no cure for polio so treatment is symptomatic.
1.Bed rest

2.antibiotics are used to treat urinary tract infections.

3.Bethanechol can help reduce urine retention.

4.Analgesics are used to reduce headaches and muscle pain.

5.Assisted breathing with tracheostomy and respirator and intravenous fluids may be required in severe cases.

How can Poliomyelitis be prevented?
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Vaccination against polio using oral doses or injection is recommended for all children from every month from 3rd to 5th month and a booster at 18 months of age.

Booster doses are also given at 6 years and 12 years of age.

Since immunisation with polio vaccines started, the cases of poliomyelitis has declined worldwide.

What is the prognosis of Poliomyelitis?
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Majority of patients has subclinical and non-paralytic Poliomyelitis and recovered completely.

The remainder has paralytic Poliomyelitis.
Half has complete recovery in 4-6 weeks.

25% has mild disability.

The last 25% suffer severe permanent damage of muscles and nerves.
These patients are usually crippled with difficulty in walking and may need special aids such as wheelchairs,walking sticks etc to help them in their everyday life.

Mortality is in children is 1-3%.
Bulbar Poliomyelitis and adult patients have higher mortality.

A Simple Guide to Anthrax

A Simple Guide to Anthrax

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What is Anthrax?

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Anthrax is a disease caused by a gram positive spore forming bacterium that primarily infects mainly animals but can cause serious illness in humans if one is exposed to these spores.

It can affect the skin, the intestines or the lungs.

What are the different forms of Anthrax?

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1.Cutaneous anthrax is the most common type of anthrax.

It occurs 1-2 days after the skin is scratched and exposed to soil, animal parts or faeces containing the spores of Anthrax.

The affected skin forms an itchy black swelling that becomes a blister that breaks into an ulcer.

The bacteria can then enter the bloodstream and cause septicaemia (blood poisoning). 20% of cases will die if they are not treated promptly.

2.Intestinal anthrax happens 2 to 5 days after one eats contaminated meat containing the spores.

The intestinal lining breaks and bleeding occurs. The victim feels nausea, loss of appetite, vomiting, fever and suffers from severe abdominal pain, bloody vomiting and diarrhoea.

Blood poisoning occurs and the loss of blood can result in shock.

25% to 75% of cases will eventually die.

3.Inhalation anthrax is the least common of the 3 types.

However it is the most serious form of anthrax because the spores are inhaled into the lungs.

Flu-like symptoms occur for 2 to 3 days with fever, cough and then breathlessness starts.

Then the lungs starts to bleed internally like a person drowning in his own blood. Death occurs rapidly most of the time.

This is the type that is used as a biological weapon by terrorists who will send the spores by envelopes to their victims.

What is the treatment of Anthrax?

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The bacterium is easily killed by several antibiotics(penicillin,tetracycline etc), the most effective one being ciprofloxacin given intravenously or directly into the bloodstream.

Oral ciprofloxacin is also effective in less severe cases.

There is no need to take antibiotics to prevent anthrax.

Doing so may cause the bacteria to become resistant to the antibiotic and make it more difficult to treat.

A cell-free vaccine has been developed for people who are at risk of contracting anthrax. This vaccine may be mass produced in the future for common use.

Although anthrax is a much feared disease, it can be prevented and treated with careful and alert practices.

Its use as a biological warfare agent is currently very limited with very effective counter measures in place.