Epidemiology: that in areas with poor vaccine coverage,

According to research Poliomyelitis, also known as polio is an infectious
disease caused by the poliovirus. Poliomyelitis is an acute communicable
disease caused by any of 3 poliovirus serotypes (types 1, 2 or 3). In the pre-vaccine
era when poliovirus was the leading cause of permanent disability in children,
almost all children became infected by polioviruses, with on average 1 in 200
susceptible individuals developing paralytic poliomyelitis. Polioviruses are
spread by fecal-to-oral and oral-to-oral transmission. Oral transmission of the
virus is seen mostly in places where sanitization is poor

Pathogen:  Research show that Polioviruses are human enteroviruses
of the Picornaviruses family. Polioviruses are composed with a single-stranded
RNA genome and a protein capsid. The 3 serotypes of polioviruses have different
antigenic sites in the capsid proteins. Polioviruses share most of their
biochemical and biophysical properties with other enteroviruses. They are
resistant to inactivation by many common detergents and disinfectants,
including soaps, but are rapidly inactivated by exposure to ultraviolet light.
Viral infectivity is stable for months at +4 °C and for several days at +30
°C.2 (Record, 2016)

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As stated in the above
paragraph, there are three types of polioviruses. Type 1 being the most
widespread, 2 being globally eradicated, and 3 being intermediately distributed. Serotype 1 is the most virulent of
the three serotypes. The most epidemics of poliomyelitis are usually associated
with serotype 1, while cases of serotype 3 are more irregular, as was the
pattern with serotype 2 before it was eliminated. In the past, it has been
shown that in areas with poor vaccine coverage, WPV serotypes 2 and 3 were
previously found at the same rate, while in areas with increased coverage,
circulation of WPV serotype 2 was found to decrease dramatically (WHO, 1996).

Disease:  According to research, most people infected
with poliovirus do not have symptoms; viral replication in the pharynx and
gastrointestinal tract results in virus excretion in saliva and feces. About
25% of the infected people develop transient minor symptoms, including fever,
headache, malaise, nausea, vomiting and sore throat. In some individuals
(approximately 4%) with this minor illness, signs of meningeal irritation
develop, with neck stiffness, severe headache, and pain in limbs, the back and
the neck, suggestive of aseptic meningitis (non-paralytic polio). This form of
polio lasts between 2 and 10 days and in almost all cases recovery is complete.

 According to the WHO the world health organization,
paralytic poliomyelitis is rare and result only when poliovirus enters the
central nervous system by peripheral or cranial nerve axonal flow and
replicates in anterior horn cells (motor neurons) of the spinal cord. It is
observed in <1% of poliovirus infections in children <5 years of age, varying with serotype and age. The ratio of paralytic cases to infections was estimated per 100 infections at approximately 0.5 for serotype 1, 0.05 for serotype 2, and 0.08 for serotype 3, based on data from 15 countries. Based on the degree and level to which the motor neurons are affected, temporary or permanent paralysis of the affected muscles may result. In some cases, viral destruction of bulbar cells may cause respiratory paralysis and death. (Boyer & Tiffreau, 2010) clinical manifestation:  Researchers have concluded that the actual disease caused by poliovirus is called poliomyelitis. The clinical manifestation of paralytic poliomyelitis is called acute flaccid paralysis (AFP) affecting the limbs, mainly the legs, usually lopsidedly, while sensation remains intact. Signs and symptoms of non-paralytic polio can last from one to 10 days. These signs and symptoms can be flu-like and can include:  fever, sore throat, headache, vomiting, fatigue, meningitis. About 1 percent of polio cases can develop into paralytic polio. Paralytic polio leads to paralysis in the spinal cord (spinal polio), brainstem (bulbar polio), or both (bulbospinal polio). Initial symptoms are like non-paralytic polio. But after a week, more severe symptoms will appear. These symptoms include: loss of reflexes, severe spasms and muscle pain loose and floppy limbs, sometimes on just one side of the body sudden paralysis, temporary or permanent deformed limbs, especially the hips, ankles, and feet. Less than 1 percent of all polio cases will result in permanent paralysis. In 5–10 percent of the polio paralysis cases, the virus will attack the muscles that help you breathe and cause death. The clinical paralysis affects the nervous system, once the virus reach the cells in the medulla oblongata, it destroys the brain stem that controls respiration, leading to paralysis and arrest (Johnson, 2016) Diagnosis: The diagnosis of paralytic poliomyelitis based on research is supported by: clinical course, virological testing, and residual neurologic deficit 60 days after onset of symptoms. Laboratory testing, such as the measurement of antibodies especially pre- and post-onset of paralysis and other studies, such as magnetic resonance imaging, electromyography, and/or nerve conduction tests, can help strengthen or exclude the diagnosis of poliomyelitis (Gonzalez, 2009) Treatment:  According to research, there is no cure for poliomyelitis. For this reason, vaccines are extremely important, to prevent infection from occurring in the first place. President Roosevelt, who contracted poliomyelitis himself in 1921 at the age of 39, Franklin Delano Roosevelt put his remarkable political skills to work on behalf of other polio victims to develop a rehabilitation center ha Warm Springs, Georgia. In 1928, the demands of his campaign to become governor of New York led him to transfer leadership of the rehabilitation center development to his law partner, Basil O'Connor. O'Connor made Warm Springs a nonprofit foundation, created the National Foundation for Infantile Paralysis, and used the prestige of the Roosevelt name and position in his fund-raising efforts. At first, these projects depended on charitable gifts as well as a series of annual balls, pegged to Roosevelt's birthday at the end of January and promoted with the slogan "Dance so that others may walk." The funds were used for patient care at Warm Springs mad for financing research into the causes and prevention of polio (Helfand, 2001).  So according to the research, President Roosevelt initiated a campaign that, in 1955, resulted in Dr. Jonas Salk developing the inactivated polio vaccine (IPV). This vaccine, which is administered primarily through intramuscular injection was developed using the known technique of growing the virus in the kidney cells of monkeys, then isolating it and inactivating it with formaldehyde. In 1961, Dr. Albert Sabin developed the oral polio vaccine (OPV), using a live, attenuated strain of the virus. This vaccine is created by passage of the parent wild poliovirus strain through non-human animal cells. OPV is administered orally, usually in the form of drops. "The March of Dimes" was the name of a wordplay on the contemporary newsreel series "The March of Time" by Eddie Cantor who was a popular star of vaudeville, films, and radio. Through the popular media of the day--radio, posters, broadsides, and film shorts-the country's most popular entertainers backed a campaign for the public to send their dimes directly to the White House in Washington. Postcards like this one, showing a well-dressed child with polio, accompanied a card into which one could insert as many as twenty dimes; there was space for bills as well. A dime in the 1930s was worth $1.27 in today's money, and the March of Dimes proved to be worth its weight in gold (Helfand, 2001).  Based on the research, Polio has been considered eliminated from the United States since 1979, thanks to the effectiveness of these two vaccines. No specific anti-viral drugs are available for poliomyelitis, although some poliovirus antiviral compounds are currently being developed. Treatment consists of supportive, symptomatic care during the acute phase, including respiratory support in cases with respiratory muscle paralysis. Neuromuscular sequelae are mitigated by physiotherapy and orthopedic treatment. Vaccines first developed and licensed in 1955, is given by injection and is available only in trivalent form containing the 3 virus serotypes PV1, PV2 and PV3.