Poliomyelitis Research Articles

Insurgency in Northern Nigeria: Implication for Polio Eradication in Nigeria

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Objective Signs of Foot Deformities in Children with Spastic Form of Cerebral Paralysis: Justification of Individual Approach to Footwear Support

Relevance. Foot deformities are the most common locomotor pathology in children with infantile cerebral paralysis. At the same time many children suffering from this pathology wear standard shoes that do not take into account the individual foot anatomy. Purpose of the study — to justify the expedience of individual approach to orthopaedic support for children with infantile cerebral paralysis. Materials and methods. The authors examined 220 feet in 110 patients aging from 3 to 18 years: 62 patients with spastic form of infantile cerebral paralysis and 48 children who were examined during periodic screening at general education institutions (control group). Clinical examination methods, computerized plantography and podometry by flatbed foot scanning (ventrally, posteriorly, medially) in standing position were used in the present study. Results. Statistically significant variances (p*0.005) were obtained for 8 indicators of foot deformity in three planes in children with infantile cerebral paralysis as compared to the norm, as well as differences between the groups of patients with varying degree of disorders in gross motor functions. The authors established pathological foot deformities in children with infantile cerebral paralysis; statistically significant variances in types and degrees of these disorders for patient groups with different levels of gross motor functions disorders; distinctiveness of foot deformities within each of the groups. Conclusion. Objectively instrumental method was used to identify the main components of foot deformities in patients with infantile cerebral paralysis with preservation and realization of walking capability: loss of height of longitudinal arches, midfoot pronation and hindfoot valgus, hallux valgus. Increased elevation of longitudinal arches (cavus foot), midfoot supination and hindfoot varus are rarer components of deformities occurring more often in patients with severer forms of the pathology. Strong variation in the spread of foot anatomy parameters observed within different groups of motor dysfunctions indicates the expediency of individual approach to footwear recommendations: standard, less or more complex orthopaedic shoes. Implementation of obtained data into the clinical practice requires additional series of biomechanical trials aimed at elaboration of criteria for recommendations and efficiency evaluation of various footwear types that take into account not only specifics of foot anatomy but also its statodynamic function as well as the level of gross motor functions of a particular patient.

Borders and Blood Fractions: Gamma Globulin and Canada's Fight against Polio, 1950-55.

During the early 1950s, Canada's efforts to prevent polio became heavily influenced by developments in the United States. America's foremost polio charity, the National Foundation for Infantile Paralysis, sponsored University of Pittsburgh researcher Dr. William McD. Hammon to evaluate the efficacy of a human blood fraction, gamma globulin (GG), to prevent paralytic polio. When the resulting clinical trial data appeared to show that the blood fraction offered some protection against the disease, Canadians embraced the concept for reasons of historical trust, parental demand, and public health pragmatism. They established Canada's first national immunization program to fight polio before the vaccine, as well as developed a plan to produce, evaluate, and distribute GG to epidemic areas. Despite being an expensive enterprise for a geographically vast and sparsely populated nation, Canada's GG program was extended to citizens and it became an important response to polio before a safe and effective vaccine was licensed. Although the blood fraction was not as effective at preventing polio paralysis as researchers had anticipated, its systematic use reveals how Canadian health leaders drew on transnational relationships to reduce the incidence of disease.

Growing up with a disability following paralytic poliomyelitis: experiences from persons with late effects of polio

Purpose To describe the experiences of growing up after acute paralytic poliomyelitis and strategies used to adapt to the new situation. Methods Seven women and seven men (mean age 70 years, min–max 61–78 years) with late effects of polio, who had contracted paralytic polio in their childhood. Data were collected using semi-structured interviews, transcribed verbatim, and analyzed by systematic text condensation. Results Memories of contracting acute paralytic poliomyelitis involved being immobilized and sent away from home for surgical and physiotherapeutic treatment. Growing up in a social context that was often tough and unfriendly resulted in the development of strategies, such as optimistic thinking, trying to blend in, trusting one’s ability to manage, and to handle the preconceptions and expectations of others. At the onset of late effects of polio, some of these strategies were still functioning, whereas overachieving, disregarding pain, and weariness were not. Conclusion The challenges of growing up with a disability following paralytic polio led to the development of various psychological strategies for managing daily life. By understanding these experiences and strategies, knowledge may be gained in assisting rehabilitation professionals to better support persons with late effects of polio in adapting to the new situation. Implications for rehabilitation At the onset of late effects of polio, strategies developed earlier in life, such as overachieving, disregarding pain, and weariness, may not function anymore. Understanding the experiences of growing up with poliomyelitis can support rehabilitation professionals to provide targeted interventions for people with late effects of polio and enable them to develop new adaptive strategies. Developing new strategies, such as accepting increased symptoms, and augmenting self-esteem and self-efficacy, may improve daily functioning among people with late effects of polio.

Encephalitis and Poliomyelitis in a vaccinated 12 year old

12 y/o healthy male with altered mental status. H/o 2 days of vomiting, slurred speech, headache, progressing to altered sensorium. No seizures/rash. H/o camping in East Texas 1-week ago; playing with dogs at home. No diving in lakes/tick bites/cats/farm-animals. Patient had received all age appropriate vaccines. O/E, comatose, febrile at 39.5C. Pupils minimally reactive, gag reflex absent, hypotonic with diminished DTRs. Meningeal signs absent. …

Степень зависимости от окружающих в повседневной жизни как показатель эффективности реабилитации детей с детским церебральным параличом

Степень зависимости от окружающих в повседневной жизни как показатель эффективности реабилитации детей с детским церебральным параличом

Post-poliomyelitis syndrome.

Most developed countries eliminated paralytic poliomyelitis (polio) in the 1970s to 1980s. It was believed that after recovery from acute paralytic poliomyelitis, the physical condition of survivors would remain stable for the rest of their lives. However, the elimination of polio does not equate the end of medical management of polio. Hundreds of thousands of polio survivors worldwide are still at risk of developing the late effects of the disease. Here, we report a case of post-polio syndrome who attended our clinic for the presence of new weakness and neuromuscular problems six decades after recovery from paralytic polio. It is essential that health professionals be aware of these conditions and have an understanding of the underlying pathophysiology of the symptoms.

Surging cases have dashed all hope that polio might be eradicated in 2019

Surging cases have dashed all hope that polio might be eradicated in 2019

Two Novel Monovalent Serotype-2 Poliovirus Vaccines

Polio eradication requires withdrawing live-attenuated oral poliovirus vaccines (OPV) because of the potential for vaccine-derived polioviruses (VDPV)

Pathogenic role of CD4+ T cells in the progression of neurotropic mouse hepatitis virus induced neuroinflammation

Abstract Neurotropic Mouse hepatitis virus (MHV) induced demyelination serves as a model to understand the mechanisms of demyelination and concomitant axonal loss in CNS, which mimics the pathological symptoms of the human neurological disease Multiple Sclerosis (MS). Inflammation triggered by MHV consists of mixed population of inflammatory cells, predominantly microglia/macrophages, which differs from autoimmune model of MS, where infiltrating T cells are the major contributors to the pathology. Though the acute phase of MHV inflammation is controlled by microglia/microglia, the role of T and B cells in viral induced axonal degeneration and demyelination is controversial. In order to explore the role of CD4+ T cells during transition from an early protective innate response to a highly regulated adaptive response following MHV infection, MHV-infected CD4−/− mice were compared with MHV-infected CD4+/+ (wildtype) mice at days 5/6, 10, 15 and 30 post infection. Viral titre estimation and nucleocapsid gene amplification confirm enhanced replication of the virions in the absence of functional CD4 + T cells in brain tissue. Viral anti-nucleocapsid antigen staining further shows the persistence of virus at day 30 p.i. in CD4−/− mice unlike CD4+/+ mice. Moreover, histopathological analysis of liver, brain and spinal cord showed an elevated susceptibility of CD4−/− mice to encephalitis and axonal degeneration with augmented progression of acute poliomyelitis, bulbar vacuolation, and dorsal root ganglionic inflammation rarely observed in CD4+/+ infected mice. In summary, current study suggests that CD4 T cell is critical for viral clearance, resolving microglial activation, and controlling chronic progressive axonal degeneration.

Polio's Precarious Future A Review of Polio: The Odyssey of Eradication and an Interview with Dr. T. Jacob John.

Polio's Precarious Future A Review of Polio: The Odyssey of Eradication and an Interview with Dr. T. Jacob John.

Neurological Symptoms in Danes with a History of Poliomyelitis: Lifelong Follow-Up of Late Symptoms, their Association with Initial Symptoms of Polio, and Presence of Postpolio Syndrome

Background: Previous studies suggest that patients with a history of poliomyelitis (PM) later in life experience a variety of symptoms. These studies were carried out in patients who later in life were admitted to hospital or became members of polio societies and may therefore not be representative of all polio patients. Little data have been published concerning patients actually discharged from hospital with a diagnosis of acute paralytic PM. Objectives: The aim of this study was to compare the prevalence of late symptoms in individuals with a history of paralytic PM with that of controls, and to study whether late symptoms in individuals with a history of PM were associated with symptoms at the acute stage of polio, and finally to compare the prevalence of symptoms in polio patients with postpolio syndrome (PPS) with the prevalence of symptoms in polio patients without PPS. Methods: A questionnaire concerning various symptoms was sent to a previously established cohort of patients, who during the polio epidemics were discharged from the Department of Infectious Disease at Blegdamshospitalet, Copenhagen, with a diagnosis of paralytic PM, and to age- and gender-matched controls without PM. Information about symptoms at the acute stage of disease was obtained from hospital records. Logistic regression analysis with adjustment for age and gender was applied to compare the occurrence of late symptoms in cases and controls and within the above-mentioned groups of individuals with a history of PM. Results: (i) Compared with controls, individuals with a history of polio significantly more often reported muscle symptoms, pain, neuropathic sensory symptoms, and bulbar symptoms; (ii) the occurrence of symptoms did not seem to be related to symptoms of the initial PM; and (iii) symptom prevalence was significantly higher in individuals with a history of polio who reported PPS as compared with those who did not. Conclusion: Our data indicate that individuals with a history of PM late in life experience a variety of symptoms that cannot be attributed to lesions of the anterior horn. Furthermore, late symptoms do not seem to be related to initial symptoms of the acute stage of PM but to reported PPS. The last finding supports the perception that the cause of PPS is not just normal ageing.

An investigation of vaccination in children with human immunodeficiency virus infection

To investigate the status of vaccination in children with human immunodeficiency virus (HIV) infection. A questionnaire survey was performed in 148 children in Hunan province, China who were registered in China's Acquired Immune Deficiency Syndrome Comprehensive Response Information Management System up to December 31, 2016 and were aged <15 years at the time of confirmed diagnosis of HIV infection. The information on vaccination, diagnosis of HIV infection, and diagnosis and treatment of related diseases was collected. Of the 148 children with HIV infection, there were 70 boys (47.3%) and 78 girls (52.7%); 140 children had an age of 3.8 (0.2-14.8) years at the time of confirmed diagnosis, and 8 children refused to answer this question. Mother-to-child transmission was found in 133 children (91.7%), blood transmission in 1 child (0.7%), and unknown in 14 children (9.5%). Of the 148 children, 129 (87.2%) received antiviral therapy and 19 (12.8%) did not receive such treatment. The vaccination rates of hepatitis B vaccine, bacille Calmette-Guérin vaccine, poliomyelitis live attenuated vaccine and diphtheria-pertussis-tetanus vaccine ranged from 70.9% to 77.7%, which was significantly lower than the national level (≥97%); the vaccination rates of the other vaccines in the National Immunization Program gradually decreased with age. No severe adverse effects were reported after vaccination. Mother-to-child transmission is the main route of HIV infection in Chinese children. The diagnosis of children with HIV infection is significantly delayed, with low vaccination rates. Efforts should be made to strengthen early diagnosis, early treatment and vaccination in children with HIV infection, in order to improve their quality of life.

Today's vaccination policies in Italy: The National Plan for Vaccine Prevention 2017-2019 and the Law 119/2017 on the mandatory vaccinations.

The National Plan for Vaccine Prevention 2017-2019 has expanded the vaccination offer including new vaccines, enlarging the target population and introducing for the first time in Italy a life-course approach to vaccination. A "lifetime immunization schedule" is aimed to reduce the burden and the related costs of vaccine-preventable diseases through effective vaccination programs. However, to counteract the national steady downward trend in the uptake of vaccinations that caused a drop of the vaccination coverage below the 95% threshold to allow herd immunity, it was decided to make 10 vaccinations mandatory by the law 119/2017. In particular, in addition to already mandatory vaccinations against diphtheria, tetanus, hepatitis B and poliomyelitis, those against measles, mumps, rubella (MMR), varicella, pertussis and Haemophilus influenzae type b (Hib) were added to the list. According to the law, all unvaccinated children cannot attend preschool services until the age of 6 years and fines (from 100 to 500 Euros) are provided for parents. Moreover, this law provided, in its first application, a catch-up campaign for children up to the age of 16 years and the free-of-charge offer of all mandatory and recommended vaccines to each child not yet vaccinated according to the previous NPVP. The NPVP includes also several at risk categories, such as pregnant women, healthcare workers and subjects suffering from chronic diseases, to whom specific vaccinations, free of charge, are offered. The vaccinations of pregnant women have different purposes. In order to decrease the pertussis risk in newborns in the first months of life, a booster immunization of DTPa is recommended, at every pregnancy, between week 27th and 36th. Instead, the influenza vaccine administration to pregnant women during the second or third quarter is mainly aimed to avoid the risk of serious disease complications for both the mother and the fetus. Another group of at risk subjects included in the NPVP is that made up by healthcare workers. According to the plan, "an adequate immunization of the healthcare workers is essential for the prevention and control of infections (anti-hepatitis B, anti-influenza, anti-measles-mumps-rubella, anti-varicella, anti-pertussis)". Finally, almost all the vaccinations foreseen by the NPVP are offered free of charge to subjects suffering from specific diseases. These include cardiovascular, respiratory, hepatic, neoplastic, renal and metabolic disorders, in addition to immunosuppression that exposes them to an increased risk of contracting invasive infectious diseases.

Vaccination and adolescent knowledge: health education and disease prevention.

A cross-sectional study in conjunction with a health extension program was conducted with 605 adolescents aged between 13 and 18 years from 22 public schools in Divinópolis, Brazil. The aim of the study was to determine the vaccination status of the adolescents and their level of knowledge of communicable and vaccine-preventable diseases. Three-stage cluster sampling was used comprising schools, classes, and students. The findings show that vaccination coverage among adolescents was 45.1% and yellow fever was shown to have the lowest coverage rate (64%). The most mentioned diseases when the adolescents were asked which vaccinations they had had were infantile paralysis (60.7%), yellow fever (56%), tetanus (34%), and measles (28.6%). Extension activities were conducted with 6,650 people, comprising vaccination (2,334 doses administered), aimed at expanding vaccination coverage, and health education activities with 2,839 adolescents directed at sexually transmitted diseases, family planning; and licit and illicit drugs. The study had a positive impact in terms of the expansion of vaccination coverage and the extension activities played an essential role in increasing the adolescents' knowledge of the themes addressed.

Jonas Salk (1914-1995): A vaccine against polio.

Jonas Salk (1914-1995): A vaccine against polio.

The use of functionality scales in patients with Post-Polio Syndrome

Post-Polio Syndrome (PPS) is a neurological disease, resulting in the decrease of the neuromuscular functions being characterized by a set of clinical manifestations that occur in individuals who had acute paralytic poliomyelitis. The patients with PPS begin to present new limitations on the performance of their ADLs and, at the same time, tend to ignore them, continuing their daily work with greater physical effort. The need for a functional evaluation is therefore necessary to find out where the commitments are in the ADLs and to help them without aggravating the degenerative PPS. To identify the main functional assessment scales used in individuals with PPS. A study review of the literature was performed on the functional scales used in patients with PPS described in the articles in the database. We found 12 functional scales in activities of daily living, as follows: Nottingham Health Profile (NHP), International Classification of Impairments, Disability's and Handicaps (ICIDH), Functional Status Questionnaire (FSQ), Physical Activity Scale for the Elderly (PASE), Sunnas ADL Index, Katz Index, Falls Efficacy Scale (FES), ADLs-Staircase, Barthel Index, Functional Independence Measure (FIM), Older Adult Resource Survey (OARS), and Self-Reporter ADL. None of the 12 scales mentioned in our study is validated for the use in patients with PPS, the most scales found in the literatures reviewed in this research were NHP and ICIDH. Therefore, we found 9 scales validated in Brazil, Barthel Index, Functional Independence Measure (FIM), Functional Status Questionnaire (FSQ), Falls Efficacy Scale (FES), Nottingham Health Profile (NHP), International Classification of Impairments, Disability's and Handicaps (ICIDH), Older Adult Resource Survey (OARS), Katz Index and Self-Reporter ADL.

Postpolio Syndrome: A Review of Lived Experiences of Patients.

Postpolio syndrome (PPS) refers to a group of conditions that are present in patients, years after recovery from initial acute paralytic poliomyelitis. About 15%–80% of 20 million polio survivors worldwide will experience exacerbation of symptoms which typically appear 15–30 years after the resolution of initial poliomyelitis. Symptoms include new muscle weakness, fatigue, myalgia, joint pain, dysphagia, and difficulty breathing. Other reported symptoms include cold intolerance, sleep disorder, dysphonia, loss of stamina, musculoskeletal deformities, cardiovascular disorders, psychosocial problems, and restless legs syndrome. These symptoms are attributed to the superimposed neuronal loss of aging with inflammatory mechanisms, but without any convincing evidence of viral reactivation. Risk factors include female gender, respiratory symptoms, normal aging, permanent disability caused by motor neuron damage, muscle overuse and disuse, aging, and immunologic mechanisms. Hypothyroidism-induced myopathy and fibromyalgia are a differential diagnosis for PPS, and exclusion diagnosis is required as confirmatory criteria for PPS. The symptoms of PPS presented determine the course of management.

Polio: The Odyssey of Eradication by Thomas Abraham

Reviewed by: Polio: The Odyssey of Eradication by Thomas Abraham Svea Closser Thomas Abraham. Polio: The Odyssey of Eradication. London: Hurst & Co., 2018. xxviii + 252 pp. £25.00 (978-1-84904-956-6). Polio: The Odyssey of Eradication is a comprehensive history of the effort to eradicate polio, spanning from Roosevelt's founding of the National Foundation for Infantile Paralysis to the modern program's struggles to eliminate polio from Pakistan. The book is quite simply the best comprehensive history of polio eradication I've [End Page 472] ever read. It is an accurate, illuminating narrative suitable not just for those interested in polio but for those considering the ethics and methods of eradication programs more generally. It would work well in the classroom and is highly recommended reading for anyone interested in the history of global health programs. The book opens in Karachi, Pakistan, where vaccinators struggle to deliver the oral polio vaccine in a community that doesn't trust them. The area is one of the world's last reservoirs of wild poliovirus, which has proven stubbornly resistant to eradication despite the Global Polio Eradication Initiative spending a billion dollars a year on the effort. This vignette introduces many of the themes that resonate throughout the book, including the tension between global goals (polio eradication) and community needs (basic sanitation and health services), and the ethical complexities that arise while attempting to eradicate a vaccine-preventable disease in places with poor routine immunization. Much of the story in Abraham's book has been told before, in excellent histories including David Oshinsky's Pulitzer Prize–winning Polio: An American Story and William Muraskin's Polio Eradication and Its Discontents.1 These earlier books cover specific time periods in depth. Abraham's achievement is in tying all of this material together into a comprehensive narrative, showing how midcentury fears of polio in the United States led to a global eradication program with deep tensions at its heart. Abraham's thoughtful, balanced discussion avoids the hubris of polio eradication's champions as well as the cynicism of the project's detractors. He gives polio eradicators credit for a heroic effort that has reached long-neglected populations, even while he explores complex ethical questions about the project's history and trajectory. Abraham conducted many interviews with key players in the eradication program and followed the program in settings from the Rotary Convention in Atlanta to door-to-door vaccination in Karachi. This original research, along with a vibrant writing style (Abraham has spent much of his career working in health communications), gives the book an engaging immediacy. Abraham makes beautiful use of South Asian examples to illuminate the ethical debates at the center of polio eradication efforts. In a few scattered places discussions of some areas in India and Pakistan can lean on stereotype. For example, health systems in Bihar are far from perfect, but it's not true, as Abraham states, that they have "changed little" since the smallpox eradication era (p. 157). Overall, however, the discussion is nuanced and sensitive. This is the rare book that would work well in the classroom at a variety of levels. Abraham does not assume preexisting knowledge on the part of his readers, and he gives comprehensive explanations of key issues including the biology and epidemiology of the poliovirus, the structure of global health institutions, the debate between those favoring vertical programs and those championing primary [End Page 473] health care, and political aspects of global health programs. All of this, coupled with the easy, accessible writing style, would make the book work beautifully in an undergraduate classroom, giving a vivid view of the complexity of programs that look good on the surface. At the same time this book would also have a great deal to offer a doctoral seminar. In particular, its detailed description of the complex politics of global health decision making is illuminating, providing surprising insights into a range of issues including the exact mechanisms by which dissenting voices are sometimes sidelined and how blame for problems is shifted from global decisions to local implementation. Pairing this volume with a book on smallpox eradication like William Foege's House on Fire...

Using of new control methods of efficiency of hippotherapy for children with singularities of psychophysical development

The number of disabled people is increasing, and the problem of their rehabilitation and social adaptation is important. In the Republic of Belarus, hippotherapy began to be applied about ten years ago. Within this time, about 200 children sick with cerebral spastic infantile paralysis (severity levels I–III), epilepsy, autism and other diseases underwent rehabilitation. About 70 of them started moving independently; the disability degree of 25 children was lowered or removed.&#x0D; The study on using the method of X-ray fluorescent analysis (RFA) during hippotherapy was the first of its kind in the Republic of Belarus.&#x0D; The aim of the research was the detection of efficiency of impact of hippotherapy on children with psychophysical peculiarities with use of modern control methods.&#x0D; The need for correction of the following elements – calcium, potassium, ferrum, cuprum, zinc, selenium, iodine – in children’s ration at the time of hippotherapy sessions was shown. The need for increasing the frequency of sessions of hippotherapy from once a week to three times a week was established.