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Poliomyelitis

Poliomyelitis. Katie Hunold BIO 62. http://img.dailymail.co.uk/i/pix/2007/12_03/polioDM_468x707.jpg. Caused by poliovirus Destroys nervous system  paralysis. http://www.usaid.gov/our_work/global_health/mch/ch/news/photogallery/polio/images/polio01.jpg.

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Poliomyelitis

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  1. Poliomyelitis Katie Hunold BIO 62 http://img.dailymail.co.uk/i/pix/2007/12_03/polioDM_468x707.jpg

  2. Caused by poliovirus • Destroys nervous system  paralysis http://www.usaid.gov/our_work/global_health/mch/ch/news/photogallery/polio/images/polio01.jpg http://media-2.web.britannica.com/ebmedia/24 /82624-004-8C092B0B.jpg (http://www.healthsystem.virginia.edu/UVAHealth/peds_infectious/polio.cfm)

  3. Poliovirus • Subgroup: Enterovirus • gastrointestinal tract • Acidic pH http://www.npspindia.org/images/Polio-Virus.jpg • (http://pathmicro.med.sc.edu/misc/polio.pdf)

  4. Poliovirus • Family: Picornavirus • Small • RNA-genome http://www.npspindia.org/images/Polio-Virus.jpg • (http://pathmicro.med.sc.edu/misc/polio.pdf)

  5. PoliovirusTransmission • Reservoir: humans only http://www.humanbody3d.com/human3dbody.jpg (http://pathmicro.med.sc.edu/misc/polio.pdf)

  6. PoliovirusTransmission • Transmission: • person-to-person • Infected mucus/phlegm • Infected feces http://www.co.cowlitz.wa.us/health/environmentalhealth/PHEPR/sneeze.jpg (http://www.umm.edu/ency/article/001402.htm)

  7. Pathogenesis • Within One week: • little virus in throat • Invades local lymphoid tissue • Blood stream • Central nervous system http://www.albanyent.com/images/ThroatDiag.jpg • (http://pathmicro.med.sc.edu/misc/polio.pdf)

  8. http://graphics8.nytimes.com/images/2006/03/19/international/20060320_POLIO_GRAPHIC_2.gifhttp://graphics8.nytimes.com/images/2006/03/19/international/20060320_POLIO_GRAPHIC_2.gif

  9. Polio Infection: Three Types • Subclinical (inapparent, abortive) infection • Nonparalytic poliomyelitis • Paralytic poliomyelitis http://data2.archives.ca/e/e101/e002505051.jpg (http://www.umm.edu/ency/article/001402.htm)

  10. Subclinical Infection • Up to 95% of infections • May or may not have symptoms • 72 hours or less http://beccamcutie.wikispaces.com/file/view/happy-face.gif (http://www.umm.edu/ency/article/001402.htm) (http://pathmicro.med.sc.edu/misc/polio.pdf)

  11. Nonparalytic poliomyelitis • 5% of infections • Usually complete recovery in 1-2 weeks (http://pathmicro.med.sc.edu/misc/polio.pdf) (http://www.umm.edu/ency/article/001402.htm) http://blogs.guardian.co.uk/news/archives/headache.jpg

  12. Paralytic poliomyelitis • 1%-2% of infections • Can still return to normal functions • Many left with weakness or paralysis http://www.brown.edu/Courses/Bio_160/Projects1999/polio/images/walkingaids.jpg (http://pathmicro.med.sc.edu/misc/polio.pdf)

  13. Paralytic poliomyelitis • Three types: • Spinal polio • Bulbar polio • Bulbospinal polio http://www.taf.org/graphics/spine.gif

  14. Spinal Polio • 79% of paralytic cases (1969-1979) www.ipvrc.org/polio.htm

  15. Bulbar Polio • 2% of paralytic cases • Muscle weakness http://www.dinf.ne.jp/doc/english/global/david/dwe002/dwe002g/dwe00209g01.gif

  16. Bulbospinal Polio • 19% of paralytic cases (1969-1979) • Combination of spinal and bulbar polio http://www.idph.state.ia.us/common/images/125/nurse_child_polio_1960.jpg http://www.reiseklinikken.no/Webbilder/polio.jpg

  17. What did we do about Polio? http://www.granitegrok.com/pix/question%20mark.jpg

  18. Timeline • 1789: Dr. Michael Underwood and “Debility of the Lower Extremities” http://upload.wikimedia.org/wikipedia/commons/thumb/8/8a/Polio_sequelle.jpg/180px-Polio_sequelle.jpg http://www.rotary.org/SiteCollectionImages/Images/polio/1.jpg (http://www.polioeradication.org/history.asp)

  19. Early 19th Century: first outbreaks in Europe http://www.fems.org/images/europe-map.gif (http://pathmicro.med.sc.edu/misc/polio.pdf)

  20. 1840: Dr. Jacob von Heine – develops idea of contagiousness (http://en.wikipedia.org/wiki/Jakob_Heine) (http://www.polioeradication.org/history.asp)

  21. 1894: First significant out break of infantile paralysis documented in United States http://geology.com/world/satellite-image-of-the-united-states-of-america.jpg (http://www.polioeradication.org/history.asp)

  22. 1908: Austrian physicians Karl Landsteiner and Erwin Popper – Virus hypothesis http://image.guardian.co.uk/sys-images/Guardian/Pix/gallery/2001/02/26/virus.gif http://www.primidi.com/images/h3n2_flu_virus.jpg (http://www.polioeradication.org/history.asp)

  23. 1931: Sir Macfarlane Burnet and Dame Jean MacNamara – several types of poliovirus http://upload.wikimedia.org/wikipedia/commons/thumb/1/13/Burnet_2jpg.jpg/225px-Burnet_2jpg.jpg http://www.portrait.gov.au/collection/0/760/med_Dame%20Macnamara-Donovan.jpg (http://www.polioeradication.org/history.asp)

  24. 1955: Dr. Jonas Salk – inactivated vaccine http://www.famousscientists.net/images/jonas-salk.jpg (http://www.polioeradication.org/history.asp)

  25. 1961: Dr. Albert Sabin – oral vaccine http://www.umw.edu/hisa/resources/Student%20Projects/McCreedy/students.umw.edu/_lmccr9sd/poliovaccine/images/alternative.jpg (http://www.polioeradication.org/history.asp)

  26. Before the Salk Vaccine (U.S.) • Iron Lung • Kept people alive with polio affecting respiratory muscles http://pathmicro.med.sc.edu/lecture/images/ilung2.jpg • (http://www.polioeradication.org/disease.asp)

  27. http://ccat.sas.upenn.edu/goldenage/wonder/Archive/Images/Iron%20Lungs.jpghttp://ccat.sas.upenn.edu/goldenage/wonder/Archive/Images/Iron%20Lungs.jpg

  28. Isolation of the Virus • From infected person’s… • Stool • Pharynx • Cerebrospinal fluid (CSF) http://www.proficientprocedures.com/images/lumbar_large.jpg

  29. Originally used to diagnose and try to find a cure… • Now, used for mapping genome to determine “wild-like” or “vaccine-like” http://www.sciencemag.org/feature/e-market/prodlink/qiarepg.jpg (http://pathmicro.med.sc.edu/misc/polio.pdf)

  30. Isolating the virus leads to… http://focus.hms.harvard.edu/2000/Jan28_2000/poliovirus.jpg

  31. Inactivated poliovirus vaccine (IPV) • Salk’s vaccine • Series of vaccinations (http://pathmicro.med.sc.edu/misc/polio.pdf)

  32. Three vaccinations After the first: still need more! http://boardingpasses.org/wp-content/uploads/2007/03/shots.jpg http://www.achievement.org/achievers/sal0/large/sal0-005.jpg (http://pathmicro.med.sc.edu/misc/polio.pdf) http://upload.wikimedia.org/wikipedia/commons/b/b8/Polio_vaccine_poster.jpg

  33. Second: 90% of people are immune • Third: 99% immune http://www.achievement.org/achievers/sal0/large/sal0-005.jpg (http://pathmicro.med.sc.edu/misc/polio.pdf) http://upload.wikimedia.org/wikipedia/commons/b/b8/Polio_vaccine_poster.jpg

  34. Advantage: Can be used in/around immunodefficient patients http://shop.usps.com/wcsstore/PostalStore/upload/images/600x600_salk.jpg • (http://pathmicro.med.sc.edu/misc/polio.pdf)

  35. Disadvantages Requires injection Unknown immunity period Less local immunity http://www.congressionalgoldmedal.com/images/JonasSalkTimeMag.jpg • (http://pathmicro.med.sc.edu/misc/polio.pdf)

  36. More research lead to another… http://www.umw.edu/hisa/resources/Student%20Projects/McCreedy/students.umw.edu/_lmccr9sd/poliovaccine/images/polio%20vial.jpg

  37. Oral Polio Vaccine (OPV) • Sabin’s vaccine • Primary vaccine in U.S. for many years http://www.jakarta.travel/wiki/images/5/5f/Polio_vaccine_in_Jakarta.jpg • (http://pathmicro.med.sc.edu/misc/polio.pdf)

  38. Series as well • First: 50% immune • Third: more than 95% immune http://spktruth2power.files.wordpress.com/2008/05/polio-61.jpg • (http://pathmicro.med.sc.edu/misc/polio.pdf)

  39. Advantages • Local immunity • Lifelong immunity • Spread to others • (http://pathmicro.med.sc.edu/misc/polio.pdf) http://upload.wikimedia.org/wikipedia/commons/b/b8/Polio_vaccine_poster.jpg

  40. Disadvantage • Paralytic disease caused by vaccine http://www.edsmart.com/stamps/images/06_sabin_500s.jpg • (http://pathmicro.med.sc.edu/misc/polio.pdf) http://upload.wikimedia.org/wikipedia/commons/b/b8/Polio_vaccine_poster.jpg

  41. Which is better? • Debatable! • Most commonly used in U.S.: IPV http://alignmap.com/wp-content/Graphics/immunization.jpg Resolution No. 6/08-4 ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES

  42. Effect of Vaccines – U.S. http://pathmicro.med.sc.edu/misc/polio.pdf

  43. Polio – Then • 1988 • endemic in 125 countries • Over 1000 children paralyzed a day http://www.humanillnesses.com/images/hdc_0001_0001_0_img0075.jpg • (http://www.polioeradication.org/history.asp)

  44. Treatment of Polio • Antibiotics • Moist heat • Pain killers http://www.southwestmedical.com/images/products/images/DUR4503.jpg (http://www.umm.edu/ency/article/001402.htm)

  45. Treatment of Polio • Physical therapy • Braces or corrective shoes • Orthopedic surgery http://upload.wikimedia.org/wikipedia/commons/thumb/f/f3/Polio_physical_therapy.jpg/180px-Polio_physical_therapy.jpg (http://www.umm.edu/ency/article/001402.htm)

  46. Polio - Now • 2006-present • Four countries with never interrupted endemic • Nigeria • India • Pakistan • Afghanistan http://www.sweetmarias.com/india.gif http://www.nipissingu.ca/department/history/MUHLBERGER/uploaded_images/pakistan-map-707286.gif http://students.umf.maine.edu/~olakpeok/Pictures/%257B8B0CD468-1115-4F28-8749-A742CD247152%257D_Nigeria.gif http://static.lonelyplanet.com/worldguide/maps/wg-afghanistan-1-400x300.gif • (http://www.polioeradication.org/history.asp)

  47. Polio Worldwide - 2005 http://images.google.com/imgres?imgurl=http://upload.wikimedia.org/wikipedia/commons/thumb/f/f5/Polio_worldwide_2005.svg/800px-Polio_worldwide_2005.svg.png&imgrefurl=http://commons.wikimedia.org/wiki/Image:Polio_worldwide_2005.svg&h=353&w=800&sz=77&hl=en&start=1&um=1&usg=__PDE0SQk6j8us7Mo986hX3yXrOew=&tbnid=Us56IBjwLFEdTM:&tbnh=63&tbnw=143&prev=/images%3Fq%3Dpolio%2Bworldwide%26um%3D1%26hl%3Den%26sa%3DN

  48. Polio Today http://www.polioeradication.org/casecount.asp

  49. http://www.polioeradication.org/content/general/casemap.shtmlhttp://www.polioeradication.org/content/general/casemap.shtml

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