Poliomyelitis is an infectious viral disease instigated by the wild polio virus (as opposed to the polio vaccine virus used in oral vaccines).
It is a very contagious disease that can be fatal. The virus spreads from one person to another mainly through the fecal-oral route or less frequently through the ingestion of contaminated water or food.
Fever, headache, fatigue, stiff neck, vomiting, and pain in the limbs are the first symptoms.
The polio virus invades the nervous system and causes paralysis of the muscles, reaching a major part of the spinal cord (the anterior cords of the spinal cord), where the nerve roots pass. Between 5 and 10% of paralyzed patients expire when their respiratory muscles cease to function.
Poliomyelitis is being eradicated today thanks to the large vaccination campaigns that have been carried out around the world for decades, whether in industrialized countries or in developing countries.
Poliomyelitis is now encountered in only a dozen countries and especially in India, Pakistan, Afghanistan, Niger and Nigeria. A few cases persist in other African countries.
Since there is no treatment, prevention is the only option. The vaccine, together with its recalls, gives the child lifetime protection.
The cause of poliomyelitis is contamination by the polio virus.
Since the reservoir of the virus is human, the transmission takes place from one contaminated individual to another during skin contact. A simple handshake can, for example, be called into question. Less often, contamination occurs indirectly, by ingesting water or food contaminated with the virus.
Some people contract the virus without getting sick. In this case, we speak of healthy carriers. Since they are carriers of the virus, they are just as likely to contaminate another individual.
Children aged 3 months to 5 years are the most affected by poliomyelitis.
By 2014, the disease is endemic only in parts of 3 countries (Afghanistan, Nigeria and Pakistan). The decline can be explained by the policy of eradicating the disease globally, largely thanks to the poliomyelitis vaccine, which has proven to be effective.
Nowadays, people who are likely to become infected and become ill are suffering from incomplete vaccination or lack of vaccination.
The symptoms of poliomyelitis make the severity of this pathology.
The first symptoms of poliomyelitis are influenza-like. They associate: fever, fatigue, headache, vomiting, stiff neck and pain in the limbs.
The characteristic symptoms of the disease are rapid acute flaccid paralysis, accompanied by fever.
These paralysis can affect any muscle. Gravity is at its maximum when the virus reaches the respiratory muscles. Between 5 and 10% of paralyzed patients die when their respiratory muscles are paralyzed.
In surviving patients, residual disabling paralysis can be observed. These range from minor paralysis, leaving complete independence to extremely disabling paralysis requiring respiratory assistance.
The in apparent forms of poliomyelitis, that is to say without symptoms, are frequent. There are also forms of partial paralysis such as facial paralysis.
Further testing is required to confirm the diagnosis.
A virological examination of the stools makes it possible to look for the virus in the laboratory. This examination makes it possible to differentiate the polio virus from the polio vaccine virus. A blood test (serology) also makes it possible to diagnose poliomyelitis, and thus to know the responsible virus.
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There is no cure for poliomyelitis. The only treatment is preventive, and it consists of a vaccination.
Oral vaccination with live attenuated vaccine (OPV) is highly protective and very practical for developing countries. It makes it possible to do a vaccination not only individual but also enlarged. In fact, vaccinated persons can in turn “contaminate” unvaccinated persons by transmitting this attenuated virus via feco-oral route. Thus, people who have not had a vaccination can be indirectly vaccinated.
The problem with this vaccination is that in very rare cases a mutation of the genome of this attenuated virus into virulent virus occurs. This can then give a poliomyelitis disease as serious as poliomyelitis contracted by the wild polio virus.
Another preventive treatment: the oldest vaccine by subcutaneous injection appears to be the one that protects against all strains of viruses, whether wild or from a mutant vaccine virus. This is the best preventive treatment.
Primary vaccination consists of three subcutaneous injections: one dose at the age of 2 months (8 weeks) and 4 months, followed by a booster dose at 11 months. Then the reminders must take place at 6 years, between 11 and 13 years, at 25 years, then every 20 years.
Poliomyelitis is a reportable disease.
International epidemiological surveillance is very important, as long as there are polio viruses in circulation around the world, vaccination campaigns must be continued on a global scale.