Poliomyelitis

The poliomyelitis (of the Greek polios “gray” , myelos “marrow” and ite “Ignition”), also called disease of Heine-Medin or simply polio , is a acute Infectious illness which attacks the gray Substance of the Spinal-cord.

Description

It is caused by a Virus, whose Homme is the only natural host, who is transmitted by féco-oral way or postilions emitted at the time of Toux or sneezes. The Poliovirus (Virus with ARN of the family of the Picornaviridae , Entérovirus kind) generally attacks the digestive system by causing symptoms close to those of the Grippe and it is in the majority of the case eliminated by the Immune system. But it arrives in approximately 1 case out of 100 that this one extends to the nervous cells and causes lesions with the driving former horns of the Spinal-cord. The virus then attacks the nervous cells which order the muscles (Motoneurone S) by leaving intact the adjacent Neuron S which order the sensitive functions, urinary, sexual… Up to 95% of the motoneurones can be touched, but after the acute phase of the disease the surviving motoneurones are able to establish new connections and the patient can lose up to 10% of his motoneurones without final neurological after-effects.

When the attack is massive, it causes local Paralysie S, mortals in approximately 10% of the cases, and the often irreversible muscular atrophies. It assigns usually the children of less than five years, and was one of the most terrible plagues of childhood. The poliomyelitis touched more 600  000 children per annum in the world and locked up of them thousands in iron lungs. These apparatuses were used to create a negative pressure around the thorax, which involves the air inside the lungs and allows an artificial respiration.

The poliomyelitis does not have treatment, only the Vaccination can protect effectively. It is carried out by subcutaneous injection or ingestion. For the child, it ensures an immunity for 5 years provided that there were a recall after 12 months. For the adults the recall can be done every 10 years. The vaccine was developed by the microbiologist states-unien Jonas Edward Salk in 1952. Massive vaccination campaigns were then installation, which made it possible cause a drop in quickly the frequency of the disease. “Type 2” disappeared from planet in 1999. “Type 3” seems to be confined with the Africa, except Egypt.
The oral monovalent vaccine, baptized mOPV, “type 1”, induced an immunizing response of 70%.

History

During centuries, the virus remained endemic and relatively benign, causing only some sporadic cases.

Towards 1880, the improvement of the Hygiène results in reducing the immunizing infections natural to the poliovirus in the young child. The first clinical cases appear in the north of Europe.

The disease strikes the area of New York in 1916. In 1952, more than 50.000 people are touched with the the United States, in France the polio makes a victim for 100.000 inhabitants.

The first tests of the injectable vaccine of Jonas Salk are carried out in 1954. The first vaccination campaign of mass was marked by the supply of an important defective batch (virus living not attenuated) outcome with nearly 220.000 contaminations including 70.000 patients, 164 severe paralyzes and 10 deaths

Albert Sabin created an oral vaccine in 1961.

A epidemic is stopped in the United States in 1965. The rate of new contaminations fell to 1 per 10 million people.

The polyomyélite nowadays

In 1988, at the time of its 41e Parliament, the the World Health Organization (WHO), cash 166 Member States, launched a world initiative for éradiquer the poliomyelitis about the year 2005. The target was secondarily delayed with 2010.

In 1992 is discovered a hearth of polio to the Netherlands, in a group which refuses vaccination.

End 1999 the number of cases had moved back of 95% with: 7094 new cases listed for: 20000 patients on the whole and the number of countries reached passed from 125 to 30, disappearing from all the American continent, the Western Pacific, the China and the Europe.

The year 2004 knew an increase in the cases of polio (: 1300 compared with 800 in 2003). The number of case declared in 2005 reached: 1650 and exceed: 1760 cases in 2006.

The disease remains big problems of public health for many countries of Africa and Asia, where it remains present in an alarming way in Afghanistan, in Egypt, in India (more than 500 cases in 2006), with the Niger, the Nigeria (close to: 1000 cases in 2006) and with the Pakistan.

The causes of this stagnation, even of this regression are complex. They are due in particular to the delay taken by the vaccination campaigns in two States (Kano and Zamfara) in the north of Nigeria, where the Moslem persons in charge launch Rumeur S showing the Americans to want to contaminate them by the to make AIDS and them sterile. The increase in the cases of polio in Nigeria propagated the disease in Saudi Arabia at the time of the Pèlerinage of Mecque, for then reaching the Indonesia, or more than 100 cases were declared at the beginning of July 2005.

The disease also reappeared in Indonesia; 225 cases were diagnosed in 2004. A large 24 million campaign vaccinations in one day was carried out the August 29th 2005 with a media mobilization without precedent in the country. The last case describes in this country goes back to February 2006.

The cases are primarily confined geographically at the places where the vaccine cover is sub-optimal (30% children not vaccinated in Nigeria, Indian cases being also limited to a reticent area with vaccinations). The presence of sporadic cases at people duly vaccinated raises question.

Risk factors

  • the age
  • touches more the men than the women
  • muscular pregnancy
  • exercise and muscular tiredness
  • intramuscular Injection
  • congenital immunizing deficit
  • Amygdalectomie
  • genetic factors (chromosome 19)

The Syndrome post-polio

Thirty to forty years after the acute phase of the disease, whereas their general state was for a long time stabilized, the patients feel a great tiredness, a progressive muscular weakness and joint pains. Sometimes these Symptôme S is accompanied by breathing difficulties or muscular atrophy.

The syndrome post-polio was described for the first time by the neurologists Jean-Martin Charcot and Fulgence Raymond in 1875. It touches approximately a survivor on two.

Famous patients

Reference

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