Poliomyelitis - what is it? Symptoms and treatment, prognosis

Poliomyelitis is an acute viral disease that affects the central nervous system, primarily the spinal cord, and sometimes causes paralysis. The main method of spread is considered to be direct or indirect contact with the patient (through hands, handkerchiefs, clothing, etc.). Also spreads through food, water, and air.

What it is? Poliomyelitis is caused by polioviruses (poliovirus hominis) of the Picornaviridae family of the Enterovirus genus. There are three serotypes of the virus (type I predominates): I - Brunhilda (isolated from a sick monkey with the same nickname), II - Lansing (isolated in the town of Lansing) and III - Leon (isolated from a sick boy McLeon).

In some cases, the disease occurs in a mild or asymptomatic form. A person can be a carrier of the virus, releasing it into the external environment along with feces and nasal discharge, and still feel absolutely healthy. Meanwhile, susceptibility to polio is quite high, which is fraught with the rapid spread of the disease among the child population.

How is polio transmitted, and what is it?

Poliomyelitis (from the ancient Greek πολιός - gray and µυελός - spinal cord) is infantile spinal paralysis, an acute, highly contagious infectious disease caused by damage to the gray matter of the spinal cord by poliovirus and characterized mainly by pathology of the nervous system.

Mostly occurs in an asymptomatic or erased form. Sometimes it happens that poliovirus penetrates the central nervous system and multiplies in motor neurons, which leads to their death, irreversible paresis or paralysis of the muscles they innervate.

Infection occurs in several ways:

1. Airborne transmission - occurs when air with viruses suspended in it is inhaled.
2. Alimentary transmission - infection occurs through consumption of contaminated food.
3. Contact-household way - possible when different people use the same utensils for eating.
4. Water route – the virus enters the body with water.

Particularly dangerous in terms of infectious diseases are persons who suffer from diseases asymptomatically (in hardware form) or with nonspecific manifestations (slight fever, general weakness, increased fatigue, headache, nausea, vomiting) without signs of central nervous system damage. Such people can infect a large number of those in contact with them, because It is very difficult to diagnose sick people, and, therefore, these individuals are practically not subject to isolation.

General information about the disease

Poliomyelitis is caused by polio viruses. There are three types of poliovirus (type I, type II and type III). All three types of the virus are widespread and have been found in various countries and parts of the world. As a result of the disease, damage to the nervous system and gray matter of the spinal cord can occur, which leads to paralysis or even death, as well as inflammatory changes in the mucous membrane of the intestine and nasopharynx (these changes can be identified as an intestinal infection or acute respiratory infection), and most people with the virus polio cases do not experience any symptoms of the disease and will never become aware of the infection.

The polio virus is very stable in the external environment - it is not destroyed in the digestive system, is not killed by antibiotics, chemicals, is resistant to freezing and drying, but dies when boiled, exposed to ultraviolet irradiation and disinfectants.

The source of infection can be a sick person or a virus carrier. Infection occurs by airborne droplets (when coughing, sneezing, talking), oral-fecal (“dirty hand disease”), through food and water, and mechanically from flies carrying the virus.

Outbreaks of the disease often occur in the summer-autumn period, as with other classic viral intestinal diseases.

The vast majority of the disease affects children of preschool age, up to 5 years, and it does not depend on gender. But also in rare cases, adults become infected with polio, and then these are predominantly women; the reasons for this are not clear.

Vaccination against polio

Specific prevention is vaccination against polio. There are 2 types of polio vaccines:

• Sebin live vaccine (OPV - contains live attenuated viruses)
• inactivated (IPV - contains polioviruses of all three serotypes killed by formaldehyde).

Currently, the only manufacturer of polio vaccine in Russia is the Federal State Unitary Enterprise “Enterprise for the production of bacterial and viral preparations of the Institute of Poliomyelitis and Viral Encephalitis named after. M.P. Chumakova produces only live polio vaccines.

Other drugs for vaccination are traditionally purchased abroad. However, in February 2015, the company presented the first samples of an inactivated vaccine of its own development. Its use is scheduled to begin in 2021.

The history of the polio vaccine

On February 23, 1954, mass trials of the first polio vaccine began. From that day on, civilization began to crawl away from the edge of the abyss that threatened to swallow every second person.

Before the advent of the vaccine, half of the cases of polio began and ended as the flu. Approximately 40% of patients were crippled by paralysis, and 10% died from respiratory failure. Only the “iron lungs” - chambers in which the work of the paralyzed respiratory muscles is performed by a change in air pressure - were saved. Victims of poliovirus in industrialized countries spent the rest of their days in these boxes, with their heads and legs sticking out.

Poliomyelitis occurred among the ancient Egyptians, but it took on the nature of an epidemic with the advent of urban comfort, when a person in infancy stopped contacting the causative agent of the disease. The child's inherited supply of antibodies from the mother lasts for several months. If poliovirus does not enter the body during this time, immunity to it does not arise. This underbelly of hygiene was reliably revealed in the Moroccan city of Casablanca, where in the clean European quarter there were 20 times more polio patients than in the unsanitary canister.

Since the cursed virus was discovered in 1908, it has been advancing all the time. Thus, in 1952 in the United States, polio killed 3,145 people and paralyzed 21,269. Six years later, the Soviet Union suffered comparable losses. The sanatoriums were filled with paralyzed sufferers, mostly children.

The creator of the first polio vaccine, Jonas Salk, was not too interested in this disease. Having trained as a doctor, he realized that he did not want to engage in regular practice, and became a microbiologist. During the war, he participated in the development of a flu vaccine and discovered a new strain. It turned out that in peacetime they don’t give you a laboratory for this, except maybe a room in a hospital basement. The only grantor capable of funding a full-scale study was the National Foundation for Infantile Paralysis. With the money of this organization, specialists have already learned to breed viruses on monkey kidney cells and clear them of microbes with antibiotics. Salk actually came up with everything ready: all that was left was to kill polioviruses of all 3 types with formaldehyde and test the immunogenicity on monkeys.

In 1952, Salk administered the vaccine to himself, his wife and three sons. The process was carefully filmed. This film was then shown to children during mass vaccination to reassure them before the injection. The vaccine turned out to be safe and did not cause allergies. To the surprise of the scientific community, the head of the National Trust convinced health officials to allow vaccination of more than a million children across the country with a largely untested drug. On February 23, 1954, Salk and several doctors vaccinated 5 thousand schoolchildren in Pittsburgh. Nothing bad happened. The analysis showed the presence of antibodies. On April 26, the “millionth” campaign began. A year later, on April 12, 1955, the foundation’s specialists announced the results: the vaccine is harmless and causes immunity. This news shocked the Americans so much that the working day ended. Polio was feared like a nuclear war. The foundation immediately received $67 million in donations; enough for universal vaccination of all children in the United States and a lot of new important research.

Experts from all over the world have flown to America to study the production of the vaccine. The director of the Polio Research Institute, Mikhail Chumakov, and his wife Marina Voroshilova, who in 1945 isolated the first Soviet strain of poliovirus, arrived from the Soviet Union.

Chumakov was director for almost a week; before that, he headed the laboratory of endemic fevers at the Institute of Neurology on a voluntary basis, without a full-time position or pay. His graduate students were not accepted anywhere. Before the Doctors' Plot, Mikhail Petrovich headed the Institute of Virology. In 1953, he refused to expel Jewish employees, saying he had a different understanding of the party's national policy. He received a reprimand, and then flew out of both the party and the institute. Working for free among neurologists, he fought trachoma and encephalitis, and also discovered the exotic Q fever in Central Asia. His wife Marina Konstantinovna, meanwhile, was shedding poliovirus and became infected, so she went to work with a stick for a year.

After Stalin's death, medicine in the Central Committee was supervised by Anastas Mikoyan. In 1954, the polio epidemic reached the USSR, and Mikoyan feared for his grandchildren. He decided to create a specialized institute and put the most combat-ready virologist at its head. Friends pointed to Chumakov. Mikhail Petrovich was returned a “clean” party card, but he asked to leave a reprimand “for the Jews” there, which he was proud of as a reward. On November 1, 1955, the institute was formed, in the winter Chumakov visited America, and six months later he established the production of 2 tons of the Salk vaccine per year. It made it possible to stop polio outbreaks in the largest cities, but there were no fewer victims. As Salk's scientific opponents predicted, the immunity created by his vaccine did not last long. But with funds from its sale, scientific work was carried out that shed light on the mechanism of virus reproduction. In 1958, Albert Sabin, who worked at the Cincinnati Children's Hospital, drew a conclusion from a new theory: when viruses are bred at low temperatures, natural selection among them “wins” non-pathogenic mutants. If you swallow such mutants and drink something sweet, the virus enters the gastrointestinal tract, where it multiplies. This is a live vaccine: it is not pathogenic, but antibodies to it also act on wild poliovirus. Moreover, children playing in the sandbox will re-infect each other with the vaccine virus - as a result, those who have not been vaccinated will also be immunized. Infection prevention has never seen anything like this before.

But in America, the National Foundation did not want to switch to Sabin’s live vaccine: after all, Salk’s drug works. Then Sabin donated his strain to Chumakov in order to test the possibility of vaccination “in the sandbox” on the broad masses of unimmunized children. Chumakov’s biography inspired confidence - he is clearly a decent person and will not take credit for the creation of the vaccine to himself.

Scientific work at the Polio Research Institute came to a standstill, and people and resources were thrown into producing millions of doses of the live Sabin vaccine. In the Soviet Ministry of Health, the idea of ​​​​using a foreign drug that was abandoned at home was considered crazy. Americans were hated and idolized at the same time - they already know what they are doing.

Mikhail Petrovich’s own deputy also expressed common sense concerns: what if a harmless mutant in the child’s intestines remembers the vile habits of his ancestors? Indeed, such reverse mutations occur once in 2.5 million cases, and in the 21st century this is a problem with the live polio vaccine. But in an epidemic situation, when thousands of children were suffocating to death, it was worth the risk. Taking advantage of the secretary’s mistake, Chumakov entered the minister’s office and called the Kremlin using the turntable. Mikoyan picked up the phone. He asked: “Do you believe in this vaccine?” "Yes!" “Vaccinate!”

In January '59 we started from Estonia. Not a single new case of polio. Estonian doctors did not believe their colleagues from Moscow. Chumakov repeatedly swallowed large doses of his vaccine, convincing him of its harmlessness. Then there was Lithuania - only two cases in a year. In total, in 1959, 15 million children were vaccinated in different republics of the Union. The epidemic began to decline, and “sandbox immunity” was observed everywhere. Sabin rushed to Moscow to see the results and was happy.

Chumakov took him to his home, poured him vodka and began campaigning for socialism. This is how we know how to throw all our strength at what is most important, and there are no fortresses that the Bolsheviks would not take. Sabin replied that there are no fortresses that General Chumakov would not take, but maybe he is the only one in the entire Soviet Union.

The victory of the live vaccine in the world was complete: it stopped the epidemic everywhere, including in the USA, where the Salk vaccine did not solve the problem. Poliomyelitis has become a rare diagnosis. Chumakov and Sabin became friends. The only thing that irritated me was the constant communist propaganda performed by Mikhail Petrovich. Sabin began asking uncomfortable questions: if the vaccine is so cheap, then why is the Soviet state so greedy? Why did it fleece millions from Japan? Why do they even charge poor Egyptians 10 kopecks per dose? After all, “antipoliodrage” is not worth a penny. Chumakov replied that he was not interested. And why should our Ministry of Foreign Trade refuse “honest earnings”?

Sabin saw that the USSR was behaving like an ordinary monopolist in the market. Chumakov refused to even think about it. If they told him anything unpleasant about the Soviet state, he literally stopped hearing. Deafness, a consequence of encephalitis, allowed him to dose out information and live in an imagined harmonious world.

But Mikhail Petrovich could dance with young employees without even hearing the music. He didn’t miss out on his female side, compensating for his difficult youth and disability. Marina Konstantinovna was worried, sick, gaining weight, and moving away from her husband, she was more and more drawn to the children. In their circle they joked about their parents, but they did not believe in communism. Marina Konstantinovna herself began to doubt something, and these sentiments grew in her with every trip abroad. Finally, after the trial of Sinyavsky and Daniel, she brought a book by Abram Tertz (Sinyavsky’s pseudonym) from Paris and gave it to her son with the words: “I don’t know if I’m doing the right thing... although I don’t agree with many things, it’s impossible not to read it.” Then Marina Konstantinovna brought worse literature, and after the invasion of Czechoslovakia in 1968 she finally “saw the light.”

Chumakov did not change his attitude towards the party because of the “Prague Spring,” making the excuse that he is not involved in foreign policy. In 1968 something else upset him. A book by Health Minister Boris Petrovsky, “Soviet Health Care,” was published, which stated that a live polio vaccine was created in the USSR. Sabin demanded an explanation. The minister had to apologize through his deputy at the WHO session. Since then, Petrovsky began methodically destroying the Chumakov Institute.

Saving his team, Mikhail Petrovich resigned, with two conditions: 1) his closest student will become the new director, 2) universal vaccination against measles. Petrovsky fulfilled the first condition, but did not fulfill the second. 10 million doses of the live measles vaccine developed by Chumakov were destroyed. This infection remained in the USSR, for which all those who suffered from measles after 1969 can personally thank Comrade. Petrovsky. However, Chumakov, as deputy director for scientific work, still controlled the production of the Sabin vaccine.

In 1975, Brazil and its neighbors, wanting to use the non-convertible rubles with which the USSR paid for bananas, turned to the World Health Organization: “Should we buy a Soviet polio vaccine with rubles? Do you recommend it? WHO sent a commission to Moscow headed by Sabin, who directly told Chumakov that his production was outdated and certain standards were not met. Mikhail Petrovich swore so much that Sabin’s remarks were translated one after another: “We have been making this vaccine for the longest time and have produced it the most. It's not your place to teach us! Let's go to hell!

Correspondence was resumed a few years later, when the terminally ill Sabin, gathering his last strength, traveled to South America. There, according to his scheme, vaccination against measles was carried out. Successful: Measles eventually disappeared from the Western Hemisphere. The American complained that administering the vaccine with disposable syringes was too expensive. There is nowhere to get a simple nebulizer for inhalation administration. Can Chumakov organize the production of such cheap and reliable devices at home? “Soviet industry is capable of producing what is not done in our countries due to lack of profit.” Sabin wrote this on September 5, 1989. Soviet industry was already collapsing, and the paralyzed recipient was unable to answer letters without outside help.

Thus ended the debate about the advantages of socialism. Two and a half years later, Sabin gave Chumakov’s son Konstantin a very flattering description for the US Immigration and Naturalization Service: “I believe he will be a very valuable asset to our scientific community.” Before leaving, Konstantin went to visit his father at the Kuntsevo hospital, where retired Soviet commanders were dying from stuffiness. In parting, Chumakov Sr. listed his students working abroad. “Well,” he concluded, “it seems that I have trained good personnel for world science.”

Hall of the American Children's Infectious Diseases Hospital in the early 1950s. Patients with acute paralysis of the respiratory muscles are permanently placed in an iron lung. The last patient doomed to spend his life in such a device died in 2008 due to a power outage.

Celebrities in the fight against polio. Above: The most famous victim of the infection is American President Franklin Delano Roosevelt (1882-1945), who was permanently confined to a wheelchair by the disease. In 1938 he created a public fund known as the March of Dimes. The organization collected donations to help those suffering from polio, accepting even small coins in denomination... More - with ELVIS PRESLEY, Roosevelt, Franklin, Lvov, Andre and Marilyn Monroe.

Above: creator of the first (killed, inactivated) polio vaccine Jonas Salk (1914-1995) with his vaccine concentrates, photo from 1955. Bottom: Species of monkeys used in experiments to develop the polio vaccine and still used today for its production and immunogenicity testing. The victory over polio came at the cost of the lives of one and a half million experimental monkeys. From left to right: rhesus monkey, cynomolgus monkey, vervet monkey. Vervet monkeys, or pygmy green monkeys, are especially prized for the absence of foreign viruses in their kidneys. — from Salk, Jonas.

Above in the group photo are the researchers who worked on the introduction of the live polio vaccine. Far left Marina Konstantinovna Voroshilova (1922-1986), Soviet virologist. The first in the USSR to isolate the polio virus; in the production of the vaccine was responsible for the genetic homogeneity of the strains. In the center is Mikhail Petrovich Chumakov (1909-1993), Soviet virologist. Participant in the discovery of tick-borne enze... More - with Chumakov, Mikhail Petrovich, Sabin, Albert, Basil O'Connor and Voroshilova, Marina Konstantinovna.

Symptoms of polio

According to WHO, polio mainly affects children under 5 years of age. The incubation period lasts from 5 to 35 days, symptoms depend on the form of polio. According to statistics, most often the disease occurs without impairment of motor functions - for every one paralytic case there are ten non-paralytic ones. The initial form of the disease is the preparalytic form (non-paralytic poliomyelitis). It is characterized by the following symptoms:

1. General malaise;
2. Temperature increase up to 40°C;
3. Decreased appetite;
4. Nausea;
5. Vomit;
6. Muscle pain;
7. Sore throat;
8. Headache.

The listed symptoms gradually disappear within one to two weeks, but in some cases they can last longer. As a result of headache and fever, symptoms arise that indicate damage to the nervous system.

In this case, the patient becomes more irritable and restless, and emotional lability is observed (mood instability, constant change). Muscle rigidity (that is, numbness) also occurs in the back and neck, and Kernig-Brudzinski signs appear, indicating the active development of meningitis. In the future, the listed symptoms of the preparalytic form may develop into the paralytic form.

What kind of disease is this

Poliomyelitis is an acute infectious disease caused by the poliovirus hominis virus, which belongs to the group of enteroviruses, that is, intestinal viruses.

The disease is characterized by high contagiousness, that is, there is a high probability of infecting a random person with the disease.

The gray matter in the spinal cord is affected, leading to depression of the central nervous system and muscle paralysis.

At risk are children aged six months to seven years - they are the ones most likely to develop pathologies, but older people can also get sick.

Future US President Franklin Roosevelt suffered from polio at the age of thirty-nine!

A child of kindergarten age is prone to violating the rules of cleanliness, and in countries with a low level of sanitary culture, morbidity rates have always been higher.

Parents should be wary if they observe the following symptoms:

temperature up to 39-40 °C;

headaches and muscle pain;

indigestion: nausea, vomiting, abnormal bowel movements, loss of appetite.

The incubation period lasts from three days to a month , usually about ten days - during this period the virus spreads throughout the body.

Forms of poliomyelitis depending on the nature of pathogenesis:

Spinal – the upper parts of the spinal cord are affected, up to the lumbar.

Bulbar - effects on the nuclei of the cranial nerves inside the spinal cord trunk.

Pontine - the nucleus of the facial nerve is affected.

Mixed forms, as derivatives of those listed.

Abortive form of polio

With the abortive form of polio, sick children complain of an increase in body temperature to 38 °C. Against the background of temperature, the following is observed:

• malaise;
• weakness;
• lethargy;
• mild headache;
• cough;
• runny nose;
• abdominal pain;
• vomiting

In addition, redness of the throat, enterocolitis, gastroenteritis or catarrhal tonsillitis are observed as concomitant diagnoses. The duration of manifestation of these symptoms is about 3-7 days. Poliomyelitis in this form is characterized by pronounced intestinal toxicosis; in general, there is a significant similarity in manifestations with dysentery; the course of the disease can also be cholera-like.

IPV vaccine against polio

The inactivated vaccine was created by Jonas Salk in 1950. It is a drug that is injected into the body using a disposable syringe. Where is the polio vaccine given in this case? In the thigh or shoulder, the main thing is intramuscularly.

The advantage of this vaccine is its relative safety. The fact is that it contains a killed virus. Once in the body, it also forces the immune system to work, but since in this case no one is reproducing, there is no risk of developing vaccine-associated polio. And the reactions to its introduction are somewhat easier.

Consequences of introducing IPV into the body:

1. redness and swelling at the injection site (no more than 8 cm in diameter);
2. increase in temperature in the first two days;
3. loss of appetite;
4. irritability, anxiety;
5. the development of an allergic reaction is already considered a complication.

Meningeal form of polio

This form is characterized by its own severity, while symptoms similar to the previous form are noted:

• temperature;
• general weakness;
• malaise;
• stomach ache;
• headaches of varying degrees of intensity;
• runny nose and cough;
• decreased appetite;
• vomit.

Upon examination, the throat is red, there may be plaque on the palatine arches and tonsils. This state lasts 2 days. Then the body temperature normalizes, catarrhal symptoms decrease, and the child looks healthy within 2-3 days. After this, the second period of increasing body temperature begins. Complaints become more distinct:

• sharp deterioration in condition;
• Strong headache;
• vomit;
• pain in the back and limbs, usually the legs.

An objective examination reveals symptoms characteristic of meningism (positive Kernig and Brudzinski signs, rigidity in the back and neck muscles). Improvement is achieved by the second week.

OPV vaccine against polio

OPV, or oral live vaccine , is the same red drops with a bitter taste that are administered by instillation through the mouth. Moreover, for babies they try to get to the root of the tongue, where there are no taste buds, in order to exclude the possibility of regurgitation, and for older children - to the palatine tonsil. They were created by medical scientist Albert Sabin in 1955.

The principle of the vaccine is simple: the strain of the virus enters the intestines, where it begins to multiply. The immune system immediately reacts to its presence, synthesizing antibodies that can subsequently fight real polio. However, this is not the only advantage of this vaccine. The fact is that children vaccinated with it release the weakened strain of the virus they introduced into the environment up to 2 months after vaccination. This happens when you sneeze or cough. And that, in turn, further spreads among other children, as if once again “vaccinating” them. And everything would be fine, but the consequences of OPV vaccination against polio are sometimes disastrous.

Consequences of introducing OPV into the body:

1. an increase in temperature to 37.5 C, which may not be recorded immediately, but on days 5–14;
2. changes in stool on days 1–2 (increased frequency or weakening);
3. various allergic reactions;
4. development of vaccine-associated polio.

If the first reactions to the polio vaccine are considered normal, then the last one is a real complication. The fact is that if the rules of vaccination are violated, the incoming virus provokes the development of ordinary polio, which can result in paralysis. The IPV vaccine is another matter.

Paralytic polio

It develops quite rarely, but, as a rule, leads to disruption of many body functions and, accordingly, to disability:

• Bulbarnaya. Particularly serious is the development of bulbar palsy. The entire group of caudal nerves is affected. Selective damage to one or two nerves is not typical for polio. If the reticular formation, respiratory and vascular centers are damaged, consciousness and respiratory disorders of central origin may be impaired.
• Pontina. This type of polio is characterized by the development of paresis and paralysis of the facial nerve, in which partial or complete loss of facial movements occurs.
• Encephalitic. The brain substance and subcortical nuclei are affected (very rarely). Central paresis, convulsive syndrome, aphasia, and hyperkinesis develop.
• Spinal. Weakness and muscle pain are gradually replaced by paralysis, both general and partial. Muscle damage in this form of polio can be symmetrical, but paralysis of individual muscle groups throughout the body occurs.

There are 4 periods during the course of the disease:

• preparalytic;
• paralytic;
• restorative;
• residual.

Preparalytic stage

It is characterized by a rather acute onset, high body temperature, general malaise, headache, gastrointestinal disorders, rhinitis, pharyngitis. This clinical picture persists for 3 days, then the condition normalizes for 2-4 days. Afterwards there comes a sharp deterioration in the condition with the same symptoms, but more pronounced intensity. The following signs are included:

• pain in legs, arms, back;
• decreased reflexes;
• increased sensitivity;
• decreased muscle strength;
• convulsions;
• confusion;
• excessive sweating;
• spots on the skin;
• "goose pimples".

Is it possible to get polio from a vaccinated child?

Unfortunately yes. However, this applies to completely unvaccinated children. That is why, in the case of collective vaccination with live vaccines (drops), those are sent to quarantine for 2 - 4 weeks.

Interestingly, there have been cases when a vaccinated older child infected a younger one, or worse, pregnant women picked up the virus. But in order to prevent this from happening, it is necessary to especially carefully observe the rules of personal hygiene - wash your hands more often, if possible, do not use shared household items (toys, potty, etc.)

We also suggest watching the video in order to finally decide whether to get vaccinated against polio. In it, Dr. Komarovsky touches on the issue of all enteroviruses, which include the causative agent of polio:

Paralytic stage

This is the stage when the patient suddenly suffers from paralysis (within a couple of hours). This stage lasts from 2-3 to 10-14 days. Patients during this period often die from severe respiratory and circulatory disorders. It has the following symptoms:

• flaccid paralysis;
• defecation disorders;
• decreased muscle tone;
• limitation or complete absence of active movements in the limbs and body;
• damage mainly to the muscles of the arms and legs, but the muscles of the neck and torso may also be affected;
• spontaneous muscle pain syndrome;
• damage to the medulla oblongata;
• urinary disorders;
• damage and paralysis of the diaphragm and respiratory muscles.

During the recovery period of polio, which lasts up to 1 year, tendon reflexes are gradually activated and movements in individual muscle groups are restored. The mosaic nature of the lesion and uneven recovery causes the development of atrophy and muscle contractures, growth retardation of the affected limb, the formation of osteoporosis and bone tissue atrophy.

The residual period, or the period of residual effects, is characterized by the presence of persistent paresis and paralysis, accompanied by muscle atrophy and trophic disorders, the development of contractures and deformation in the affected limbs and parts of the body.

Post-polio syndrome

After suffering from polio, some patients continue to have limited capabilities and a number of manifestations for many years (on average 35 years), the most common of which are:

• progressive muscle weakness and pain;
• general weakness and fatigue after minimal exertion;
• amyotrophy;
• breathing and swallowing disorders;
• breathing disorders during sleep, especially sleep apnea;
• poor tolerance to low temperatures;
• cognitive impairment - such as decreased concentration and difficulty remembering;
• depression or mood swings.

Diagnostics

In the case of polio, diagnosis is based on laboratory tests. In the first week of the disease, the polio virus can be isolated from nasopharyngeal secretions, and starting from the second week, from feces. Unlike other enteroviruses, the causative agent of polio can rarely be isolated from the cerebrospinal fluid.

If it is impossible to isolate and study the virus, a serological analysis is performed, which is based on the isolation of specific antibodies. This method is quite sensitive, but it does not distinguish between post-vaccination and natural infections.

When is the polio vaccine given?

It is worth noting that the use of both types of vaccines is officially permitted in Russia. Moreover, vaccination can be carried out according to several schemes, depending on the one chosen.

At what age is OPV , or polio drops, administered?

• At 3 months three times with an interval of 4 - 6 weeks;
• 18 months (revaccination);
• 20 months (revaccination);
• 14 years old.

According to the vaccination schedule, IPV is given to children aged:

• 3 months;
• 4.5 months;
• 6 months;
• 18 months (revaccination);
• 6 years (revaccination).

Meanwhile, at present, a mixed scheme is most often used, when both IPV and OPV are given to the same child. In this way, it is possible to minimize the occurrence of side effects associated with vaccination.

In this case, he receives a dose of the drug in:

• 3 months (IPV);
• 4.5 months (IPV);
• 6 months (OPV);
• 18 months (OPV, revaccination);
• 20 months (OPV, revaccination);
• 14 years old.

How is vaccination done if for some reason it was not possible to follow the schedule? Here everything is decided by a pediatrician or an immunoprophylaxis specialist. True, if at least one vaccination has been given, vaccination is not started all over again, but continued.

By the way, along with children, adults are also vaccinated, for example, if they plan to travel to countries where there are polio outbreaks.

Forecast for life

Mild forms of poliomyelitis (occurring without damage to the central nervous system and meningeal) pass without a trace. Severe paralytic forms can lead to permanent disability and death.

Thanks to many years of targeted vaccine prevention of polio, the structure of the disease is dominated by mild inapparent and abortive forms of infection; paralytic forms occur only in unvaccinated individuals.

Prevention

Nonspecific is aimed at general strengthening of the body, increasing its resistance to various infectious agents (hardening, proper nutrition, timely sanitation of chronic foci of infection, regular physical activity, optimization of the sleep-wake cycle, etc.), combating insects that are carriers of pathogenic microorganisms ( various types of disinfestation), compliance with personal hygiene rules (primarily washing hands after going outside and after visiting the toilet), careful processing of vegetables, fruits and other products before eating them.

To prevent the development of polio, vaccination is used, which is carried out using live attenuated viruses - they cannot cause the development of the disease, but cause a specific immune response of the body with the formation of long-term stable immunity. For this purpose, in most countries of the world, anti-polio vaccination is included in the compulsory vaccination calendar. Modern vaccines are polyvalent - they contain all 3 serological groups of the polio virus.

Poliomyelitis is a very rare infection today due to the use of vaccination. Despite this, isolated cases of the disease are still being recorded on the planet. Therefore, knowledge of the main symptoms and methods of prevention is simply necessary. Forewarned is forearmed!