Acute paralytic polio
True about polio :
| A |
Paralytic polio is most common |
|
| B |
Spastic paralysis |
|
| C |
Increased muscular activity leads to increased paralysis |
|
| D |
Polio drop given only in <3 year |
True about polio :
| A |
Paralytic polio is most common |
|
| B |
Spastic paralysis |
|
| C |
Increased muscular activity leads to increased paralysis |
|
| D |
Polio drop given only in <3 year |
increased muscular activity increases the risk of paralytic polio [ Ref O.P. Ghai 6thie p 210-212]
- The incubation period of poliovirus from contact to initial clinical symptoms is usually considered to be 8-12 days with a range of 5-35 days.
Poliovirus infection may follow one of the several courses:
(i) Inapparent infection
- It occurs in 80-95% of cases and causes no disease and no sequale
(ii) Abortive poliomyelitis
- It occurs in about 5% of patients.
- It is a non specific influenza like syndrome which occurs 1-2 week after infection.
- Fever, malaise, anorexia and headache are prominent features and there may be sore throat and abdominal or muscular pain.
- The illness is shortlived for upto 2-3 days.
- The physical examination may be normal or may reveal nonspecific pharyngitis, abdominal or muscular 1 tenderness and weakness.
- Recovery is complete and no neurological signs or sequalae develop.
(iii) Nonparalytic poliomyelitis
- It occurs in 1% of patients infected with poliovirus.
- They present as soreness and stiffness of the posterior muscles of the neck, trunks and limbs.
(iv) Paralytic poliomyelitis
- Paralytic poliomyelitis develops in about 1% patients causing 3 clinically recognizable syndromes which are
(i) Spinal paralytic poliomyelitis
(ii) Bulbar poliomyelitis
(iii) Polioencephalitis
- “Pulse polio immunisation is given to all children less than 5 years of age (not 3 years of age)”
The risk factors found to precipitate an attack of paralytic polio in individuals infected with polio include:
- Physical activity immediately following onset of paralysis
- Skeletal muscle injury due to injection of vaccines or therapeutic agents
- Pregnancy
- Malnutrition
- Immune deficiency
- Tonsillectomy
Which of the following statement is TRUE about polio?
| A |
Paralytic polio is most common |
|
| B |
Spastic paralysis |
|
| C |
Increased muscular activity leads to increased paralysis |
|
| D |
Polio drop given only in |
Which of the following statement is TRUE about polio?
| A |
Paralytic polio is most common |
|
| B |
Spastic paralysis |
|
| C |
Increased muscular activity leads to increased paralysis |
|
| D |
Polio drop given only in |
Most of the Polio infections(95%) are asymptomatic. Paralysis occurs in only 0.01% cases of all poliovirus infections.
The risk factors found to precipitate an attack of paralytic polio in individuals already infected with polio include, fatigue, trauma, IM injections, operative procedures like tonsillectomy undertaken especially during epidemics of polio and administration of immunizing agents.
Pulse polio immunization is given to all children less than 5 years of age and not 3 years of age.
- Vaccine-associated poliomyelitis is a remote risk with OPV.
- The hallmark of paralytic poliomyelitis is asymmetric flaccid paralysis, with no significant sensory loss.
Vaccine associated paralytic poliomyelitis is suspected if AFP develops within how many days of receipt of OPV?
| A |
30 |
|
| B |
45 |
|
| C |
60 |
|
| D |
90 |
Vaccine associated paralytic poliomyelitis is suspected if AFP develops within how many days of receipt of OPV?
| A |
30 |
|
| B |
45 |
|
| C |
60 |
|
| D |
90 |
All are true about poliovirus, except-
| A |
Type I is responsible for most epidemics |
|
| B |
Very difficult to eliminate type I |
|
| C |
Type I responsible for vaccine paralytic polio myelitis |
|
| D |
Type I most commonly associated with paralysis |
All are true about poliovirus, except-
| A |
Type I is responsible for most epidemics |
|
| B |
Very difficult to eliminate type I |
|
| C |
Type I responsible for vaccine paralytic polio myelitis |
|
| D |
Type I most commonly associated with paralysis |
Ans. is ‘c’ i.e., Type I responsible for vaccine induced paralytic poliomyelitis
Polio Virus
. Belongs to Picornavirus
. A nonenveloped RNA virus (ss RNA).
. Has four viral proteins, VP1-VP4. VP 1 Carries the major antigenic site.
. Three types Type I , 2 and 3
. Type 1 is most common and causes most epidemics
. Type 2 usually causes endemic infections
. Type 3 also causes epidemics.
Pathology
. Virus multiplies selectively in neurons and destroys them.
– Earliest change
Chromatolysis (Degeneration of nissel bodies)
– Lesions are mostly in the anterior horns of the spinal cord.
Which of the following dieases is under surveillance by WHO for notification by National health Authorities –
| A |
Louse-borne typhus fever |
|
| B |
Relapsing fever |
|
| C |
Paralytic polio |
|
| D |
All of the above |
Which of the following dieases is under surveillance by WHO for notification by National health Authorities –
| A |
Louse-borne typhus fever |
|
| B |
Relapsing fever |
|
| C |
Paralytic polio |
|
| D |
All of the above |
Ans. is ‘d’ i.e., All of the above
Diseases under international surveillance (WHO)
o Rabies o Poliomyelitis o Salmonellosis o Louse born typhus fever
o Malaria o Relapsing fever o Human influenza
International notification is a must in the following except –
| A |
Plague |
|
| B |
Cholera |
|
| C |
Yellow |
|
| D |
Paralytic polio |
International notification is a must in the following except –
| A |
Plague |
|
| B |
Cholera |
|
| C |
Yellow |
|
| D |
Paralytic polio |
Ans. is ‘d’ i.e., Paralytic polio
Which of the following is affected in spinal paralytic polio:
September 2011
| A |
Anterior horn cells |
|
| B |
Spinothalamic tract |
|
| C |
Cerebral cortex |
|
| D |
Cranial nerve lesion |
Which of the following is affected in spinal paralytic polio:
September 2011
| A |
Anterior horn cells |
|
| B |
Spinothalamic tract |
|
| C |
Cerebral cortex |
|
| D |
Cranial nerve lesion |
Ans. A: Anterior horn cells
Spinal paralytic poliomyelitis, most common form of paralytic poliomyelitis, results from a lower motor neuron lesion of the anterior horn cells of the spinal cord and affects the muscles of the legs, arms and/ or trunk
Polio:
- Tonsillectomy and intramuscular injections should be avoided in polio epidemic because of risk of paralytic polio increases then
- Cause of death in polio: Respiratory paralysis
- Pulse polio was introduced in 1995
- Pulse polio is give below 5 years of age
- A country is said to be polio free if no polio case has been confirmed for last 5 years
- In acute flaccid paralysis, examination for residual paralysis should be done after 60 days
