Contents
What is polio
Poliomyelitis in children (or infantile spinal paralysis, spinal paralysis of children) is an acute viral disease that affects the nervous system, and also causes inflammation of the nasopharyngeal and intestinal mucosa. The causative agent is a tiny virus from the picornavirus family.
Mostly polio occurs in childhood, but it can also occur in unvaccinated adults, although much less frequently.
Poliomyelitis is dangerous because it causes paralysis and paresis, and subsequently the child may become disabled or even die.
There are two forms of polio in children: paralytic and non-paralytic.
Non-paralytic form. It does not affect the nervous system, the child can be a carrier of the virus, while he has no symptoms of the disease. In the meningeal form, the membranes of the brain and spinal cord are affected, but the nervous system is not affected.
paralytic form. It has several varieties:
- spinal – accompanied by paralysis of the arms and legs, neck and torso;
- bulbar – respiratory and cardiac functions are disturbed, the child cannot swallow, speak;
- pontine – facial muscles lose sensitivity;
- encephalitic – the brain is affected;
- mixed
Causes of polio in children
– The source of infection is a patient or a virus carrier that excretes pathogens with the secretion of the upper respiratory tract (the entire incubation period and the first week of the disease, less often up to 1,5 months) and with feces (within 1-6 months). The infection is transmitted to the child by airborne droplets (when talking, sneezing, coughing) or fecal-oral (through dirty hands), or by contact-household mechanism (through contaminated water, food). Susceptibility to the polio virus is universal, but children under 7 years of age, and especially under 1 year of age, are most susceptible. The disease occurs only in the unvaccinated. Children of the first 2 – 3 months of life, thanks to the immunity received from the mother, practically do not get polio, – explains pediatrician, infectious disease specialist Nadezhda Knyazhskaya.
Symptoms of polio in children
The symptoms of poliomyelitis in children are quite extensive and depend on the form of the disease.
Non-paralytic poliomyelitis begins with fever up to 38 ° C, headache, weakness and malaise. The child may complain of cough and sore throat, as well as abdominal pain, nausea and vomiting, and sometimes loose stools. The non-paralytic form of meningitis in children is usually mild and does not cause serious consequences.
With the meningeal form, the disease begins acutely. First, the temperature jumps sharply to 39 ° C (after which it falls, but then returns again and is already badly knocked off), cold symptoms appear, on the 2nd – 3rd day the child becomes drowsy, lethargic, capricious. The doctor will note positive meningeal symptoms: high stiffness (tension) of the occipital muscles, Kerning’s symptom (if the patient, who is lying on his back, bends the leg at the knee by 90 degrees, then it will not be possible to straighten it back).
In the paralytic form of poliomyelitis in children, there are several stages of the disease.
During the preparalytic period of the disease, the child has a high fever, he complains of headache, weakness, malaise, runny nose and sore throat. After 2 to 3 days, the symptoms subside, but soon increase again. The child already complains not only of a severe headache, but also of pain in the back and legs, confusion.
After that comes a paralytic period, during which paralysis of the legs, neck, torso may occur, the muscles of the diaphragm and respiratory muscles may also be affected, due to which suffocation and respiratory arrest may develop.
After 1 – 2 weeks, a recovery period begins, during which paralyzed muscles are restored – it can last up to 1 – 3 years.
In the residual period, joint contractures (limitation of mobility), muscle atrophy and limb deformities can form, which can eventually lead to disability.
Treatment of polio in children
Poliomyelitis is a dangerous disease that can lead to serious consequences, so it is important to see a doctor in time.
Diagnostics
— Diagnosis of poliomyelitis includes several stages. The preliminary diagnosis is established on the basis of epidemiological, clinical data. Especially the doctor should be alerted by paralysis (mainly of the lower extremities), which develop immediately after a febrile period. The final diagnosis is made after virological and ENMG confirmation (signs of anterior horn lesions). The final diagnosis – after the results of laboratory examination and clinical and instrumental examination of patients after 60 days. The main method of laboratory diagnosis of meningeal and paralytic forms of poliomyelitis is the study of cerebrospinal fluid, which is carried out for all patients, explains infectious disease doctor Nadezhda Knyazhskaya.
Additional methods for diagnosing poliomyelitis in children:
- serological with the determination of antibodies in neutralization reactions;
- determination of the antigen of the poliomyelitis virus by the MRSK method;
- molecular biological (real time PCR);
- molecular genetic (sequencing);
- cultural with the detection of polioviruses in tissue culture and biological samples in the neutralization reaction.
Biological fluids are examined:
- faeces (positive for up to 6 months may be obtained);
- blood (rarely has a positive result in the detection of the virus);
- cerebrospinal fluid (rarely has a positive result in the detection of the virus);
- discharge from the oropharynx (within 1 – 7 days from the onset of the disease).
Modern treatments
– Treatment of polio in children is symptomatic and depends on the form and severity of the disease; unfortunately, there is no specific effective antiviral drug. Absolutely all patients, regardless of form and severity, are subject to hospitalization in an infectious diseases hospital, the infectious disease doctor clarifies.
It is very important to ensure complete physical rest during treatment (strict bed rest is prescribed), if necessary, painkillers and diuretics are prescribed, if the child’s breathing is disturbed, he is connected to artificial lung ventilation, and if swallowing is disturbed, he is fed through a tube. During the recovery period, physiotherapy exercises, massage, physiotherapy (paraffin, UHF) are held and spa treatment is prescribed.
Polio prevention in children at home
Almost one hundred percent and the only prevention of polio in children is one – vaccination. The first vaccination is carried out at 3 months with an inactivated vaccine, the second – at 4,5 months. At 6 months, the third vaccination with a live vaccine is carried out (in case of disorders of the immune system and chronic diseases of the gastrointestinal tract, an inactivated vaccine is used). Then, at 18 months, the first revaccination is carried out, at 20 months – the second revaccination. At the age of 14, the third and last revaccination with a live vaccine is carried out.