Presentation
Environmental surveillance (ES) can detect circulating polioviruses from sewage without relying on clinical presentation. [ncbi.nlm.nih.gov]
Molecular serotyping conducted at PHO laboratory should identify poliovirus if present. [publichealthontario.ca]
Laboratory animal- associated infections have not been reported, but infected nonhuman primates should be considered to present a risk. [ehs.unc.edu]
Entire Body System
- Weakness
People with ongoing muscle weakness may need physical therapy to help improve muscle strength. If the breathing muscles are affected and become weak, the affected person may need a machine to help with breathing. [ada.com]
In March 2001, a 13-month-old unvaccinated Roma (i.e., gypsy) girl from Bourgas, Bulgaria, had onset of bilateral leg weakness. [ncbi.nlm.nih.gov]
After one to two days, weakness and paralysis sets in. The weakness is classically an asymmetrical, flaccid paralysis that peaks at 48 hours after onset. This is classified as an acute flaccid paralysis (AFP). [ecdc.europa.eu]
Physical or occupational therapy can help improve arm or leg weakness and other long-term outcomes. [dhs.wisconsin.gov]
Less than 1% of people infected with poliovirus develop severe muscle weakness (acute flaccid paralysis) affecting the limbs, diaphragm muscle (essential for breathing), and the head and neck muscles. [sahealth.sa.gov.au]
Respiratoric
- Cough
The infection can occur by fecal-oral route, by ingesting contaminated water or food, or saliva and droplets emitted by sick people during coughing and sneezing. [diesse.it]
The poliovirus, which is highly contagious, is spread from person-to-person through the oral route, primarily from: fecal contamination of food and water or hand to mouth (most common) large respiratory droplets from sneezing or coughing (less common) [apic.org]
[…] handkerchiefs or discarded tissues contact with objects or surfaces touched by an infected person whose hands contain traces of faeces or alternatively having direct contact with the infected persons hands inhaling or ingesting airborne droplets from the coughs [sahealth.sa.gov.au]
Poliovirus spreads through contact with the stool (feces) of an infected person or droplets from a sneeze or cough. [nfid.org]
Gastrointestinal
- Diarrhea
The majority of polio cases include only diarrhea symptoms or the individual is completely asymptomatic. Five percent of polio cases show flu-like symptoms of fever, malaise, headache, nausea, sore throat, upset stomach, and achy muscles. [web.uconn.edu]
"Specimens of common diarrhea may actually contain poliovirus. It's very difficult to eradicate from laboratories." But does this unveil a new smallpox threat? No, says Wimmer. "Polio is a very simple virus," he tells WebMD. [webmd.com]
Water can become contaminated when someone who has diarrhea swims in it. Coughing or sneezing. Being in close contact with someone with polio. Touching contaminated surfaces. Is polio contagious? Yes, polio is highly contagious. [my.clevelandclinic.org]
Skin reactions, including hives and itching and flushed or pale skin Low blood pressure (hypotension) Narrowing of the airways and a swollen tongue or throat, which can cause wheezing and trouble breathing A weak and fast pulse Nausea, vomiting or diarrhea [mayoclinic.org]
Approximately 72% of susceptible children who were infected remained asymptomatic, while another 24% reported nonspecific symptoms such as low-grade fever, headaches, sore throat, nausea, diarrhea, and malaise. [consultant360.com]
Cardiovascular
- Hypotension
Watch for: Skin reactions, including hives and itching and flushed or pale skin Low blood pressure (hypotension) Narrowing of the airways and a swollen tongue or throat, which can cause wheezing and trouble breathing A weak and fast pulse Nausea, vomiting [mayoclinic.org]
Neurologic
- Flaccid Paralysis
These results reaffirm the importance of active surveillance for acute flaccid paralysis and poliovirus in both polio-free and polio-endemic countries. [ncbi.nlm.nih.gov]
Acute Flaccid Paralysis (AFP) Surveillance AFP surveillance, or finding and reporting children with acute flaccid paralysis (AFP), is fundamental in detecting polio cases. [endpolio.com.pk]
- Seizure
Her only lasting symptom has been seizures, which medicines help control. The treatment causes a lot of brain inflammation, and two thirds of patients had side effects. [tampabay.com]
This causes other side effects like muscle weakness and paralysis, seizures, limb swelling and tingling, speech impairment and headaches. [learningenglish.voanews.com]
However, there were some side effects associated with the treatment, with 19 percent of patients having an adverse event of grade 3 or higher, displaying headaches and seizures. There was also one death as a result of the treatment. [cnet.com]
The treatment can cause a dangerous swelling in the brain that can lead to seizures and other complications, the researchers found. One patient suffered a life-threatening blood clot in the brain that required surgery. [npr.org]
Initially, the study researchers planned to increase the dose of the poliovirus therapy given to patients, but they found that at higher doses, some patients experienced inflammation that led to serious side effects, such as seizures. [livescience.com]
- Confusion
At higher dosages of the experimental therapy, some of the patients experienced severe inflammation, which resulted in seizures, cognitive difficulties (including confusion and language difficulties) and other side effects such as nausea. [edition.cnn.com]
To avoid confusion however the Committee also confirmed that the test in simians remains the gold standard for evaluating the neurovirulence of OPV, and should be used to validate new virus seed lots or changes in the manufacturing process. [scielosp.org]
Less common adverse events that were attributed to PVSRIPO (occurring in 10 to 20% of the patients in the dose-expansion phase) included hemianopia (in 19%), confusion (in 18%), paresthesia (in 13%), fatigue (in 12%), nausea (in 10%), and gait disturbance [nejm.org]
Compared with the low fluorescence background of the probe MB in non-pv infection Vero cells ( Figure 1A ), specific fluorescent signals of pv plus-strand RNA could be detected by using MB ( Figure 1B ) and P 3 ( Figure 1C ) in pv-infected cells, although confusion [academic.oup.com]
Workup
Diagnostic workup and treatment were performed in Italy. Poliovirus replicated in the gut for 7 months. The 5' non coding region (NCR), VP1, VP3 capsid proteins and the 3D polymerase genomic regions of sequential isolates were sequenced. [ncbi.nlm.nih.gov]
Treatment
The experimental treatment seems to have extended survival in a small group of patients with glioblastoma who faced a grim prognosis because standard treatments had failed, Duke University researchers say. [npr.org]
“There doesn’t seem to be any resistance to re-treatment,” Bigner says. [sciencenews.org]
Treatment There is no specific cure for poliovirus infection. Treatment aims to relieve symptoms. This may mean simple pain relief for headaches and muscle aches. [ada.com]
Two patients remained alive at more than 5 years following treatment. [medpagetoday.com]
The results from this phase 1 clinical trial show great promise, but there is still a long way to go before the treatment receives approval. Success in phase 1 trials do not always lead to treatments. [cnet.com]
Prognosis
Intratumoral infusion of PVSRIPO is showing promise in the therapy of recurrent WHO grade IV malignant glioma (glioblastoma), a notoriously treatment-refractory cancer with dismal prognosis. [ncbi.nlm.nih.gov]
Unfortunately, it has a poor prognosis, with most patients dying about 14 months after it’s diagnosed. [abcnews.go.com]
The experimental treatment seems to have extended survival in a small group of patients with glioblastoma who faced a grim prognosis because standard treatments had failed, Duke University researchers say. [npr.org]
Etiology
Poliovirus is the etiological agent of poliomyelitis. [ncbi.nlm.nih.gov]
Poliovirus is the etiologic agent of the paralytic disease known as poliomyelitis. It’s also the virus I’ve worked on for most of my career. [virology.ws]
Etiology Acute poliomyelitis is caused by small RNA viruses of the Enterovirus genus of the Picornaviridae family. [emedicine.medscape.com]
Epidemiology
However, the Biysk outbreak completely blurred the borderline between Sabin-like viruses and VDPVs in epidemiological terms. [ncbi.nlm.nih.gov]
Google Scholar, 3 PAHO/WHO Epidemiological alert: detection of vaccine-derived poliovirus type 2 (VDPV2) in the United States: implications for the region of the Americas—21 July 2022. [thelancet.com]
III, Madrid, Spain 5 Coordinating Centre for Health Alerts and Emergencies (CCAES), Directorate General of Public Health, Ministry of Health, Madrid, Spain 6 National Centre of Epidemiology, Carlos III Health Institute, Madrid, Spain 7 Research Group [eurosurveillance.org]
Pathophysiology
Starting in 2015, injectable trivalent inactivated poliovirus vaccine (IPV) has been introduced as a part of routine immunization program in place of oral polio vaccine (OPV). [9] Pathophysiology Poliovirus is spread by the fecal-oral route and by aerosol [emedicine.medscape.com]
Prevention
European Journal of Immunology 37 (8): 2214–25. 17) “Poliomyelitis: Epidemiology and Prevention of Vaccine-Preventable Disease”. (2012). Center for Disease Control and Prevention. 18) Mangal, T. D., Aylward, R. B., & Grassly, N. C. (2013). [microbewiki.kenyon.edu]
Modeling particularly indicates the need for more tOPV SIAs to prevent serotype 2 cVDPV (cVDPV2) outbreaks after OPV2 cessation [ 4 ]. [bmcinfectdis.biomedcentral.com]
Prevention of poliomyelitis: recommendations for use of only inactivated poliovirus vaccine for routine immunization. Pediatrics. 1999 ; 104 ( 6 ): 1404 – 1406 2. ↵ Centers for Disease Control and Prevention. [pediatrics.aappublications.org]
We’ll discuss that goal, and obstacles that might prevent it from being attained, in subsequent posts. [virology.ws]
Prevention Poliovirus infection can be prevented through vaccination. It is important to keep to the recommended vaccination schedule. Other names for poliovirus infection Polio Infantile paralysis Poliomyelitis [ada.com]