"That was a
disease which disabled thousands of young life's across the globe, leaving them
as a
Painful reminder to the society, hence for a time
it was called as infantile paralysis. "
This is nothing but Poliomyelitis often
called polio or infantile paralysis, is a crippling and
potentially Deadly infectious disease caused by a virus that
spreads from person to person invading the brain and Spinal cord and
causing paralysis.1
History:
An Egyptian carving
from 1300 BC depicts a man with crippled leg similar to the one caused
by
polio, this
indicates that, polio has plagued humans from thousands of years.
The first clinical description of polio was given
by Dr. Michael Underwood in his work “Debility of lower Extremities" in 1789.
Poliomyelitis was first recognized as a distinguished
condition by Jacob Heine in 1840.3
Contagious nature of polio virus was identified in 1905 after
a series of polio epidemics in Sweden.4
Three years later in 1908 Karl Landsteiner, and Erwin
Popper discovered that infectious agent in Polio Was a virus, and is
called as polio virus which is an enteric pathogen
Who are effected???
Polio can strike at any age, but is more prevalent in
children under the age of five. 5
How it enters ???
Transmission –
two routes of transmission
Fecal-
oral is an intestinal source and oral-oral is an oropharyngeal source.
Pathophysiology –
Polio virus which entered the body, if
never extends beyond the small intestine, it will not cause any
apparent damage. If it enters the blood stream, it will then target the nerve
cells and cause serious damage
Symptoms –
Most infected people (90%) have no symptoms or very mild
symptoms and usually go unrecognized. In others, initial symptoms include
fever, fatigue, headache, vomiting, and stiffness in the neck and pain in the
limbs.
Moderate to acute conditions –
Headache, vomiting, fever, and stiffness of the back or
legs. Less than 1% of polio patients, about one in two
hundred infections, result in paralysis.
Why is it a Public health problem?
Polio survived as a quite endemic pathogen until 1800’s.
First ever documented Polio epidemic occurred in 1894
in Rutland County, Vermont, United states of America.
Small localized paralytic polio epidemics began to
appear in Europe and the United States around 1900.
By 1910, much of the world experienced a dramatic increase in
polio cases and epidemics became regular events, primarily in cities during the
summer months.
In 1916 New York City polio epidemic
was reported, which took the lives of about 6,000 people, leaving about
thousands more paralyzed.
Summer epidemics became common in this era
and would lead to widespread in areas like, closures of Pools, amusements parks, and other places where
children gathered.
In 1952 there was a worst polio outbreak in the United
States history. 58,000 cases were reported That year, among them 3,145 died and 21,269 were
left with mild to disabling paralysis.
All these epidemics heightened parents’ fears of
the disease and an immediate need for a vaccine Urged worldwide.
Eradication:
An enormous fundraising effort called "March of dimes"
raised tens of 1000's of dollars, much of which went to the effort to find
a vaccine.
Researchers were working hard
to explore about the causative organism, etiology of this disease and
cure. Some studies were successful giving more details about the polio
virus and strains, whereas as some studies were disastrous killing innocent
children, on whom the then supposed vaccine was tried.
Finally in 1955 Dr.
Jonas Salk developed the first
safe and effective polio vaccine from inactivated or dead polio virus, with the
support of the March of Dimes.
“Safe, effective and
potent “
With these
words Dr Jonas Salk is declared a hero and hailed as
“The man who saved
children”
Albert
Sabin in 1957 developed a vaccine using attenuated polio virus which was licensed in
1962.
They were a tremendous success, the average number of polio
cases in the U.S before the discovery of vaccine was more than 45,000. By
1962, that number had dropped to 910.
Lameness survey between 1970 to 1980 demonstrated that polio
is widespread in many developing countries, which gave birth to "Global eradication
of poliomyelitis"
Global eradication of poliomyelitis !!!!
Epidemiological patterns:
The epidemiological pattern of polio
depends upon the degree of the socioeconomic development and health care
services of a country.
The pattern of the disease has been
considerably modified by widespread immunization.
According to the
WHO-
Three epidemiological patterns have now been delineated:
Countries with
no immunization: the virus infects all children, and by age 5 years almost all
children develop antibodies to at least one of the 3 types of polio virus. In
that pattern paralytic polio cases are frequent in infants.
Countries with
partial immunization: In these countries, wild polio virus is largely replaced by
vaccine virus in the environment.
Countries with almost total immunization coverage: in these countries polio is becoming rare, however,
sporadic cases do occur rarely
Global eradication of poliomyelitis !!!!
Established in 1988, it is a public-private partnership
led by national governments and spearheaded by the World Health Organization
(WHO), Rotary International, the US Centers for Disease Control and Prevention
(CDC), and the United Nations Children’s Fund (UNICEF). Its goal is to
eradicate polio worldwide.
Achievements:
Huge achievements have been made in the global fight
against polio since 1988.
The
number of polio cases worldwide has decreased by more than 99%, from 350 000 in
1988 to less than 2000 cases in 2009 and to less than 1000 cases today.
1994- The WHO Region of the Americas is certified
polio-free
2000- The WHO Western
Pacific Region is certified polio-free
2002- The WHO European Region is certified
polio-free.
2011- India is certified polio free
The
number of endemic countries has decreased from over 125 in 1988 to just three –
Afghanistan, Nigeria and Pakistan by the end of 2011.
Challenges:
Tackling the last 1% of polio cases in endemic countries
is proving to be difficult and expensive.
Each country offering unique challenges like Conflict,
political instability, hard-to-reach populations, and poor
infrastructure, to eradicating the disease. And this is the biggest
challenge before us right now ...
As
as a result, a long term strategic plan is designed, to address, “what
is needed to deliver a polio free world by 2018" (2013-18)
Hope
we succeed in ending this game by 2018 and save those innocent lives,
which are still in danger, and waiting for our help!!!!
REFERENCES
1 Centers for Disease control and
prevention http://www.cdc.gov/polio/about/
2 What is polio
http://whatispolio.weebly.com/history.html?
3 Poliomyelitis http://en.wikipedia.org/wiki/Poliomyelitis#Epidemiology
4 The history of vaccines http://www.historyofvaccines.org/content/timelines/polio
5 Polio and prevention http://www.polioeradication.org/Polioandprevention.aspx
