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Poliomyelitis. U.S. Centers for Disease Control and Prevention. Ijeoma Ohadugha 4/1/10 Infectious Diseases. U.S. Centers for Disease Control and Prevention. http://www.immune.org.nz/site_resources/Professionals/Diseases/Polio/Polio.jpg. Poliomyelitis is an infection of the CNS.

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Poliomyelitis

Poliomyelitis

U.S. Centers for Disease Control and Prevention

Ijeoma Ohadugha

4/1/10

Infectious Diseases

U.S. Centers for Disease Control and Prevention

http://www.immune.org.nz/site_resources/Professionals/Diseases/Polio/Polio.jpg


Poliomyelitis is an infection of the cns
Poliomyelitis is an infection of the CNS

  • poliós -Greek word “grey”, + myelós “spinal cord’ + suffix –itis “inflammation =poliomyelitis

    • Viral infection of the nerves of the CNS


Poliomyelitis is caused by an enteric rna virus
Poliomyelitis is caused by an enteric RNA virus

  • Caused by an Enterovirus called the poliovirus

  • Enteric, small RNA virus

F.P. Williams, U.S. EPA


Transmission by fecal oral route
Transmission by fecal-oral route

http://www.co.washington.or.us/HHS/EnvironmentalHealth/PublicPools/


Risk factors
Risk Factors

  • Not being vaccinated in areas where polio is common

  • infants, pregnant women, immunocompromised (eg. HIV)



Three basic patterns
Three basic patterns

  • Subclinical infection(95% of infections),


Three basic patterns1
Three basic patterns

  • Subclinical infection(95% of infections),

  • Nonparalytic poliomyelitis(1-2%)


Three basic patterns2
Three basic patterns

  • Subclinical infection(95% of infections),

  • Nonparalytic poliomyelitis(1-2%)

  • Paralytic poliomyelitis(0.1–0.5%)

  • -result of accidental transfer of virus from GI tissue to neural tissue

  • Spinal polio - 79% of paralytic cases— Bulbospinal polio - 19% of paralytic cases— Bulbar polio - 2% of paralytic cases


Polio afflicted everyone socially as well as medically
Polio afflicted everyone socially as well as medically

  • Franklin Delano Roosevelt

  • “Once you’ve spent two years trying to wiggle one toe, everything is in proportion.”—Franklin D. Roosevelt, 1945

http://americanhistory.si.edu/polio/howpolio/fdr.htm


Heine named polio as a clinical condition lansteiner discovered the virus
Heine named polio as a clinical condition; Lansteiner discovered the virus

Jakob Heine(1840)

Karl Landsteiner (1909)


  • Virus production at this site leads to a transient viremia, following which the virus may infect the CNS

  • http://cmbi.bjmu.edu.cn/www-learn/micro-ac-uk/335/Picornaviruses.html


    Dual tropism thought to be the cause of poliomyelitis from poliovirus
    Dual Tropism Thought to be the Cause of Poliomyelitis from Poliovirus

    • Reflects the distribution of the poliovirus receptor CD155 on cells lymphoid cells as well as the epithelial cells in the gut and on neurons in the CNS

    • Viral Tropism relies on host cell permissiveness and receptor susceptibility


    Virus replicates through viropexis
    Virus Replicates Through Viropexis Poliovirus

    • attachment of the virus to specific cellular receptors of cells with CD155

    • penetration and uncoating of the virus is energy dependent, and occurs by receptor-mediated endocytosis (viropexis)


    Interferons may prevent susceptibility of most cells with cd155
    Interferons May Prevent Susceptibility of Most Cells with CD155

    • CD155 is present on most human cells, so does not explain why it infects certain tissues

    • Recent studies-suggest human type I interferon receptors possibly prevent

    • Interferon- protein released by lymphocyte in response to pathogen to trigger immune defenses


    Only ipv used in us today
    Only IPV used in US today CD155

    • OPV known to in rare cases become virulent and cause iatrogenic (vaccine-induced) polio

    • Both used today in the world

    • IN US, only IPV used since 1990s from policy changes

      • Only cases of polio (8-10 per year) were from people with vaccine-induced polio


    Jonas salk injected poliovirus vaccine ipv albert sabin oral live attenuated virus opv
    Jonas Salk- Injected Poliovirus Vaccine(IPV) Albert Sabin – oral live attenuated virus (OPV)

    1952

    1957


    Sv40 contamination concerns
    SV40 Contamination Concerns – oral live attenuated virus (OPV)

    • In 1960, SV40 (Simian Vius-40) found in vaccine from rhesus monkey kidney cells used to prepare vaccine


    Vaccines with sv40 contamination was accused as cause for hiv
    Vaccines with SV40 contamination was accused as cause for HIV

    • Accusations in 1990s that vaccines with SV40 caused conditions favorable for SIV jump from monkey to humans, causing HIV/AIDS


    Accusation now debunked but stigma lingers for new reasons
    Accusation now debunked, but stigma lingers for new reasons HIV

    • New reasons for vaccination stigma such as rumors of sterility in some areas


    Treatment in the past often ineffective until elizabeth kenny s procedures
    Treatment in the past often ineffective until Elizabeth Kenny’s procedures

    • crutches or wheelchair for motor muscle degeneration

    • “convalescent serum”-1920s

    • iron lung for respiratory failure

    • early 1940s- Sister Elizabeth Kenny’s procedures- hotpacks and heating pads w/massages, still used today


    Present treatments offer relief to symptoms
    Present Treatments Offer Relief to Symptoms Kenny’s procedures

    • No current cure

    • Respiratory apparatus

    • Antibiotics for UTIs, medication for urine retention

    • Heating pads and towels for muscle spasms & pain

    • Physical therapy, braces, or orthopedic surgery for recovery of muscle strength/function


    What still needs to be done
    What still needs to be done Kenny’s procedures

    • Eradication efforts

      • Get rid of stigma surrounding vaccine in Africa and other polio-afflicted places

      • Develop new targets for polio cure


    References
    References Kenny’s procedures

    • http://www.polioeradication.org/

    • https://health.google.com/health/ref/Poliomyelitis

    • http://www.mayoclinic.com/health/polio/DS00572/DSECTION=risk-factors

    • http://www.cloudnet.com/~edrbsass/poliotimeline.htm

    • http://www.vaccineinformation.org/polio/qandavax.as


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