Sporadic poliomyelitis: (A study of 200 cases) V. Clinical studies in poliomyelitis

Abstract

Summary 1.Two hundred cases of sporadic poliomyelitis have been analyzed. The fact that only six cases were admitted to the hospital without paralysis is evidence of the difficulty of making a diagnosis of preparalytic poliomyelitis in inter-epidemic years. Further indication that in interepidemic times a diagnosis is made in the preparalytic stage with great infrequency is furnished by the fact that the sporadic cases came under observation at a later stage of the disease than the epidemic cases. In addition the less frequent involvement of the upper extremities as compared with the lower extremities affords possible corroborating evidence of the difficulty of establishing a diagnosis of preparalytic poliomyelitis in inter-epidemic times. 2.These cases were analyzed according to (a) mortality, (b) symptoms by various age groups, (c) signs according to age groups, (d) number of cases by day of illness admitted to the hospital, (e) deaths by day of disease, (f) distribution of paralysis and corresponding mortality, and (g) the relation of the presence of eye signs to mortality. 3.The results of the analysis of these sporadic cases are compared with the 1931 epidemic cases as presented in the report of the Committee of the New York City Department of Hospitals. The following facts are noted: The mortality in the sporadic cases is slightly higher, probably due to the nonrecognition of the preparalytic type of case. A close correspondence between sporadic and epidemic cases is found when these cases are analyzed according to (a) type of onset (sudden or gradual), (b) percentage and sequence of symptoms and signs, (c) distribution of paralyses and accompanying mortality, and (d) the death rate in cases having bulbar involvement. Summary 1.Two hundred cases of sporadic poliomyelitis have been analyzed. The fact that only six cases were admitted to the hospital without paralysis is evidence of the difficulty of making a diagnosis of preparalytic poliomyelitis in inter-epidemic years. Further indication that in interepidemic times a diagnosis is made in the preparalytic stage with great infrequency is furnished by the fact that the sporadic cases came under observation at a later stage of the disease than the epidemic cases. In addition the less frequent involvement of the upper extremities as compared with the lower extremities affords possible corroborating evidence of the difficulty of establishing a diagnosis of preparalytic poliomyelitis in inter-epidemic times. 2.These cases were analyzed according to (a) mortality, (b) symptoms by various age groups, (c) signs according to age groups, (d) number of cases by day of illness admitted to the hospital, (e) deaths by day of disease, (f) distribution of paralysis and corresponding mortality, and (g) the relation of the presence of eye signs to mortality. 3.The results of the analysis of these sporadic cases are compared with the 1931 epidemic cases as presented in the report of the Committee of the New York City Department of Hospitals. The following facts are noted: The mortality in the sporadic cases is slightly higher, probably due to the nonrecognition of the preparalytic type of case. A close correspondence between sporadic and epidemic cases is found when these cases are analyzed according to (a) type of onset (sudden or gradual), (b) percentage and sequence of symptoms and signs, (c) distribution of paralyses and accompanying mortality, and (d) the death rate in cases having bulbar involvement.