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Polio Polio

POLIO 13

Polio

Polio

Poliois an infectious disease that results in physical impairment, and abug called poliovirus causes it. It results in the weakness ofmuscles hence, causing inability to move. The disease has been a bigchallenge to eradicate. According to Lahariya (2012), governmentsfrom across the world and the World Health Organization (WHO) havebeen conducting vaccination to prevent people from contracting theillness. There have been major achievements in the war againstpolio, but it has not been contained fully. Once someone is infected,it becomes difficult to reverse its effects because it eats up themuscles, as well as makes the bones weak (Dowdle, 2013). The virususually spreads from one individual to another through ingestion ofinfected fecal matter. In about 0.5% of infections, there is muscleweakness resulting in inability to move. The effect may occur withina few hours to a few days after infection. The weakness mostlyaffects the legs, but may less commonly impinge on the muscles of thehead, neck, and diaphragm (Lahariya, 2012). With elaborate planning,the disease can be eradicated completely.

Prevalence

Thereare few cases of polio all over the world. In some parts of the worldsuch as the Americas, the disease has been controlled successfully.However, the remaining cases are primarily concentrated in threecountries that include Pakistan, Afghanistan, and Nigeria. Polioattacks individuals who are not immunized against its causative virus(Dowdle, 2013). However, vaccinated individuals have little chancesof being infected. Many, but not everyone, recover fully when theinfection is discovered at an early stage. In most patients withmuscle weakness, about 2% to 5% of children and 15% to 30% of adultsdie from complications that arise from the illness. Another 25% ofthe patients have minor symptoms such as fever and a sore throat, andup to 5% experience headache, neck stiffness as well as pain in thehands and legs. Nonetheless, these symptoms often disappear withinone or two weeks (Kew et al., 2014). It is noteworthy that about 70%of the polio infections have no symptoms. Years after recovery,post-polio syndrome may occur, but with a slow development of muscleweakness, which resembles the symptoms a patient had during theinitial infection (Dowdle, 2013).

Typesof Polio

Spinalpolio

Spinalpolio is the most widespread form of paralytic poliomyelitis. Itresults from viral infection of the neurons of the forward horncells. It can also originate from viral attack on the ventral graysubstance part of the spinal column that is responsible for themovement of the muscle, counting those of the limbs, trunks, and theintercostals ones (Kew et al., 2014). Virus invasion leads toswelling of the nerve cells, thus, causing damage to the motor neuronganglia. When the spinal neurons become inactive, Walleriandeterioration occurs, resulting in the weakness of the musclespreviously innervated by the now inactive neurons (Cooney, 2013).Themuscles no longer get signals from the spinal cord of brain due tothe destruction of nerve cells. With no nerve stimulus, the muscleswaste away, become weak, poorly controlled and floppy. Lastly, theybecome paralyzed completely.

Forpatients suffering from severe paralysis, the condition may progressin 2- 4 days. The main symptoms mainly include muscle ache and fever. According to Kew et al. (2014), intense tendon reflex is alsoinvolved. There is also a diminished feeling in the paralyzed limbseven though they are not affected. The intensity of spinal paralysisrelies on the area of the string affected. The virus can affectmuscles on all sides of the body, except that paralysis is irregular.A few limbs or a mixture of limbs might be affected. This caninclude one arm and one leg, or both arms and both legs. Paralysisis frequently harsher at the point where the limb joins the body thanthe fingertips and toes (Kew et al., 2014).

BulbarPolio

Bulbarpolio has a prevalence rate of two percent of infantile paralysiscases. The infection occurs when the virus attacks and destroysnerves inside the bulbar region of the mind stem. The bulbar area isa path made of white substance that connects the cerebral cortex tothe brain stalk. The destruction of the nerves weakens the musclessupplied by the cranial nerves. This produces characteristics ofencephalitis, and results in difficulties in inhalation, talking, andswallowing. One of the most affected critical nerves include thegloss pharyngeal, which are involved in controlling swallowing andthe functions of the gullet, tongue movement, and flavor. Similarly,the accessory nerves that send signals to the heart, intestines, andlungs, as well as control the upper neck movement are alsosubstantially distressed. Rogers (2013) notes that secretions ofmucus may build up in the airway thereby, causing suffocation due tothe effect on swallowing. According to Kew et al. (2014), other signsand symptoms of bulbar polio comprise of facial flaws brought aboutby the obliteration of trigeminal and facial nerves, which innervatethe cheeks, tear ducts, gums, and muscles of the face among otherstructures. Additional symptoms of the disease could include doublevision, difficulty in chewing, and abnormal respiratory rate, depth,as well as rhythm that may lead to respiratory arrest. Deadlypulmonary edema is also likely to occur (Kew et al., 2014).

BulbSpinal Polio

Thistype of polio contributes to approximately 19% of all paralytic polioinfections, and it is characterized by both bulbar and spinalsymptoms. The subtype is also known as respiratory or bulbs spinalpolio. In this case, the virus affects a big fraction of the cervicalspinal cord, which causes paralysis of the diaphragm (Cooney, 2013).Other significant nerves that are distressed by the illness are theones that make the diaphragm to inflate the lungs, as well as thegroup responsible for moving the muscles needed for swallowing. Thedestruction of these nerves affects inhalation adversely, making ithard or impossible for one to breathe with no respiratory support. Itcan also lead to the paralysis of the hands and legs. In some cases,it might also affect the heart functions and swallowing. Thecondition is normally fatal because it often affects sensitive bodyorgans (Hampton, 2011).

ParalyticPolio

Paralyticpolio contributes to about one percent of all infections. In thiscase, the poliovirus spread along the convinced nerve fiber pathway,preferentially replicating and destroying the movement of neuronsinside the motor cortex spinal cord or the brain stem. This leads tothe progress of paralytic poliomyelitis. Cooney (2013) notes thedifferent forms of the disease, including bulbar, bulb spinal andspinal conditions differ merely by the quantity of neuronal harm andswelling that occurs, as well as the area of the central nervoussystem affected. The damage of neuronal cells produces lesions insidethe spinal ganglion, which might also occur in the reticularconfiguration, vestibular nuclei, cerebellar vermis, and profoundcerebellar nuclei. The swelling is linked to the nerve cellobliteration, and often alters the color and look of the graysubstance in the spinal path that makes it appear rosy and inflamed(Cooney, 2013). Additional unhelpful changes linked with paralyticillness occur in the forebrain area, particularly the thalamus andhypothalamus. The molecular mechanisms by which the virus causesparalytic disease are inadequately tacit (Cooney, 2013).

Accordingto Kaufmann et al. (2013), premature signs of paralytic poliocomprise of soaring fever, head pain, rigidity in the rear and neck,an asymmetrical flaw of various muscles, sensitivity to touch,difficulty in swallowing, muscle pain, loss of superficial and deepreflexes, pins and needles, touchiness, constipation, or complexityurinating. Paralysis normally develops within one to ten days afterthe initial signs appear and progresses for two to three days, and isobviously visible by the period the fever ends (Kaufmann et al.(2013). The possibility of contracting paralytic polio goes up withage, as does the degree of paralysis. In kids, paralytic meningitisoccurs mainly as a result of the central nervous system involvement.However, this occurs in merely one in a thousand cases. In 75grownups, only one of them is likely to get this type of polio.Additionally, kids below five years have the highest possibility ofgetting this disease (Kaufmann et al., 2013).

Diagnosis

Paralyticpoliomyelitis may be clinically suspected in individuals experiencingacute onset of flaccid paralysis in one or more limbs. The absence oftendon reflexes in the affected limbs that cannot be attributed toanother apparent cause and without sensory or memory loss can beearly signs of polio (Lima, 2013). A laboratory diagnosis is usuallydone based on recovery of poliovirus from a stool test. Also,antibodies to poliovirus may be diagnostic and are normallydiscovered in the blood of infected individuals in the early stagesof infection (Lima, 2013). Diagnosis can also be done by the analysisof a person`s cerebrospinal liquid that is collected by a lumbarPierce. If there is an increased number of primary lymphocytes and ameekly high protein level the individual might be having thepoliovirus. (Hampton , 2011). If the virus is cut off from anindividual experiencing sensitive flaccid paralysis, it is auxiliarydiagnosed through oligonucleotide genetic fingerprinting, or morelately by PCR intensification (Lima, 2013). This is to determine ifit is a wild type or it was as a result of a strain of poliovirusused to create the polio vaccine. It is significant to know the basisof the virus since for each reported case of paralytic polio broughtby untamed poliovirus there are more likely cases of the disease thatwill be reported (Lahariya, 2014).

Analysisof polio with and without treatment

Vaccinesare mostly administered to prevent the spreading of the disease. Theimmunization is very effective because once administered there are nochances of contracting the disease. It is important to note thatthere is no cure for polio once it has gotten into the body. However,if one happens to get infected, treatment can be done to try andprevent further damages (Nugent, 2011). The major focus of moderntreatment has been on preventing complications and relief ofsymptoms. If the disease is not controlled at an early stage, thereare high chances of it worsening. Supportive measures include theadministration of antibiotics which prevent infections on theaffected muscles and long-term rehabilitation (Lima, 2013).

Prognosis

Thedifferent types of polio have different prognosis. Individualsinfected by abortive polio recover completely (Nugent, 2011).Patients that develop only aseptic meningitis, the conditions areexpected to persist for two or ten days before complete recovery isexperienced. In the case of spinal polio paralysis will be permanentif the affected nerve cells are destroyed. On the other hand, losefaction temporarily may recover in four or six weeks after onset.However, Spinal polio is rarely fatal. One critical case is whenpolio affects the respiratory organs (Lima, 2013). This can amount tosuffocation of pneumonia. Averages of 5-10 percent of patients withparalytic polio die because of the paralysis of the muscles. Bulbarpolio always leads to death if a respiratory help is not provided.The disease is not fatal, but its effects can be so devastating. Itcan either lead to complete incapability to walk or partial lameness.The age of the patient also determines the extent and seriousness ofthe condition (Lima, 2013).

Research

Untilnow, vaccination is the best method to control the poliovirus. Thereare two types of vaccines that have been proven to curb the disease. These two types lead to immunity against the disease and effectivelyprevent an individual to individual transmission of the virus. Sincethe disease has no cure, scientists have been working hard trying tofind a cure that can control the disease upon infection. Currently,there is little that can be done when one gets affected with polio(Nugent, 2011).

LiteratureReview

TheHuman Qualities Needed to Complete the Global Eradication of Polio

Inan article titled “The human qualities need to complete eradicationof polio,” the author Maher Dermot sought to determine why polioneeds to be eradicated completely. Even though there has been aremarkable decline of 99% of polio cases all over the world, the onepercent remaining has proven to very difficult to end. The 1% ofpolio that is remaining is difficult to control because of humanconflicts that are experienced in the areas that the condition hasnot ended (Maher, 2013). According to this article, countries likeNigeria and the borderline of Afghanistan and Pakistan are mostaffected. The technical and security challenges that are facing theseareas make it very difficult for vaccination to be done. However, theauthor urges that human qualities of realism, articulacy,imagination, collaboration, energy and tactical awareness can endthis problem. By taking into consideration these human qualities, thestakeholders are more likely to attain complete polio eradication(Maher, 2013). Even though these challenges are real, human beingscan use brains to go through this murky path and eradicate theproblem. The main point is to embrace the goal, and all will bepossible. The author illustrates that the effort to eradicate malariaand yellow fever are founded on the rock of doubtful technicalfeasibility. However, he notes that the war against polio is based ona sound and adaptable strategy which is similar to the one that wasused in eradicating polio in the Americas. This article acts as awake-up call for stakeholders to apply more sober approaches indealing with this problem (Maher, 2013).

ParentalPerceptions

Anotherarticle called “Parental perceptions surrounding polio and self-reported on- participation in polio supplementary immunization activein Karachi, Pakistan” endeavored to know the perspectives ofparents on polio. This paper assesses parent`s knowledge andperceptions surrounding polio and polio vaccination, self-reportedparticipation in polio supplementary immunization activities(Khowaja, 2013). This article was passed on Pakistan because it isstill faced with the challenge of fighting polio. In a study that wasdone in the country, 412 of the 1017 parents that were surveyed hadnever heard of polio before. A high percentage refused to take partin the survey. Reasons frequently mentioned among the surveyed fordeclining vaccination included fear of infertility lack of faith inthe vaccine and doubt about the vaccination program, and fear thatthe vaccine might contain religiously outlawed ingredients (Khowaja,2013). This might be the main reason as to why Pakistan is stillamong the three countries in the world that are still struggling tocurb this disease. In deepness, examination discovered parentalperceptions surrounding the disease and its vaccination. It alsorevealed evidence of polio immunization and the reason some kids didnot receive it during the two latest polio campaigns. Many of theparents had the notion that the vaccine caused infertility inparenthood. Some also consider the vaccination to be part of a schemeagainst Muslim countries, including Pakistan (Khowaja, 2013). Poliovaccine is made in the West and sent there. They believe that it isgiven to kids so that they cannot reproduce in future. Furthermore,about a good number of the parents reported that they do not believein the polio vaccine and perceived it ineffective or useless againstthe disease. One person reported that one of his friends had thecondition but was vaccinated against it. Other parents feel thatbecause their kids had received numerous doses of the vaccine in therecent past, they did not require to get immunized again (Khowaja,2013). Some expressed worries about the government`s camouflagedstrategy of making extensive efforts against the disease. They arguedthat the government is concentrating on this disease while there areothers that need the same attention too. They doubt that there arehidden agendas in the concentration of this particular one. Anadditional significant concern was that the vaccine might havereligiously prohibited ingredients. A small number of parents alsomentioned other reasons, including a bad cold chain, complexity incommunicating to the polio vaccinator because of a language obstacleand fear of side effects (Khowaja, 2013). However, to curb thedisease more, efforts should be put towards eradicating thesebarriers that have seen Pakistan lead in cases of polio.

Conclusion

Insum, polio has been a major world epidemic. It leads to physicalimpairment to the affected individuals. Immunization is used toprevent the spared of the disease from person to person or from wildpolio to people. Once affected, it is impossible to reverse thecomplications thus the importance of vaccination. The world hasachieved remarkable strides in the endeavor to eradicate polio. However, due to some logistical problems such as war, culture,religion, and stereotypes, there has not been a 100 percentachievement. The areas that still record cases of the disease areaffected by these variables that make it very hard to eradicate thevirus. If different approaches are applied to deal with the problem,there are high chances of it being a thing of the past. Countrieslike Pakistan and Afghanistan should change their attitudes and missconceptions about the disease and vaccine. The world healthorganization should involve parties from these places in themanufacturing of the vaccine so as to prevent the fear that they haveconcerning the components of the vaccine.

References

Cooney,E. (2013, Apr 04). Celebrating life polio survivors to reunite 50years after jonas salk introduced vaccine. Telegram &amp GazetteRetrieved fromhttp://search.proquest.com/docview/268929450?accountid=45049

Dowdle,W. R., Wolff, C., Sanders, R., Lambert, S., &amp Best, M. (2012).Will containment of wild poliovirus in laboratories and inactivatedpoliovirus vaccine production sites be effective for globalcertification? World Health Organization.Bulletin of the WorldHealth Organization, 82(1), 59-62. Retrieved fromhttp://search.proquest.com/docview/229567140?accountid=45049

Hampton,Lee,M.D., M.Sc. (2011). Albert sabin and the coalition to eliminatepolio from the americas. American Journal of Public Health, 99(1),34-44. Retrieved fromhttp://search.proquest.com/docview/215089165?accountid=45049

Kaufmann,J. R., &amp Feldbaum, H. (2014). Diplomacy and the polioimmunization boycott in northern nigeria. Health Affairs, 28(4),1091-101. Retrieved fromhttp://search.proquest.com/docview/204618556?accountid=45049

Kew,O. M., Wright, P. F., Agol, V. I., Delpeyroux, F., &amp al, e.(2014). Circulating vaccine-derived polioviruses: Current state ofknowledge. World Health Organization.Bulletin of the World HealthOrganization, 82(1), 16-23. Retrieved fromhttp://search.proquest.com/docview/229578464?accountid=45049

Khowaja,A. R., Khan, S. A., Nizam, N., Omer, S. B., &amp Zaidi, A. (2012).Parental perceptions surrounding polio and self-reportednon-participation in polio supplementary immunization activities inkarachi, pakistan: A mixed methods study. World HealthOrganization.Bulletin of the World Health Organization, 90(11),822-30. Retrieved fromhttp://search.proquest.com/docview/1243040427?accountid=45049

Lahariya,C. (2014). Global eradication of polio: The case for &quotfinishingthe job&quot. World Health Organization.Bulletin of the WorldHealth Organization, 85(6), 487-92. Retrieved fromhttp://search.proquest.com/docview/229594095?accountid=45049

Lima,P. (2012, Mar 25). Decades later, suit is filed in bergen county,N.J., over polio vaccination. Knight Ridder Tribune Business NewsRetrieved fromhttp://search.proquest.com/docview/461848897?accountid=45049

Maher,D. (2013). The human qualities needed to complete the globaleradication of polio. World Health Organization.Bulletin of theWorld Health Organization, 91(4), 283-9. Retrieved fromhttp://search.proquest.com/docview/1355671024?accountid=45049

Nugent,K. (2011, Dec 19). Warnings issued about polio outbreaks abroad.Telegram &amp Gazette Retrieved fromhttp://search.proquest.com/docview/268776550?accountid=45049

Rogers,N. (2013). Race and the politics of polio: Warm springs, Tuskegee,and the march of dimes. American Journal of Public Health, 97(5),784-95. Retrieved fromhttp://search.proquest.com/docview/215093495?accountid=45049