Poliomyelitis

__**Poliomyelitis **__


 * Root Cause: **

Infection with a member of the genus Enterovirus, which is known as the Poliovirus.


 * Affected cell types /tissues /organs /systems: **

The first infected cells are in the pharynx and the intestinal mucosa. So, the gastrointestinal cells are infected and then it spreads to the tonsils, intestinal lymphoid tissue, deep cervical and mesenteric lymph nodes. This is then absorbed by the blood and invades the central nervous system.




 * Historical Background: **

The work of Jakob Heine in 1840 and Karl Medin in 1890 led to the discovery of the disease as Heine-Medin disease. After this it was later known as the infantile paralysis because it had infected children much more than adults. Around 1900 is when small localized paralytic polio epidemics began to appear in Europe and the United States. This was mainly caused by the poor sanitation and close living corridors within all the towns where people lived. During the first half of the 20th century outbreaks in North America, Australia, and New Zealand reached pandemic proportions. 1952 is seen as the worst epidemic in United States history. There was a reported 58,000 cases of the disease, in which 3,145 people died, and 21,269 were left with mild to disabling paralysis (Pearce 2005). In 1957, fifteen scientists who made contributions to the treatment of poliomyelitis were honored by the Polio Hall of Fame. Found at Roosevelt Warmspring Institute for Rehabilitation in Warmsprings, Georgia. Franklin Roosevelt and Jack Nicklaus a very well-known professional golfer are famous victims of the disease.


 * Common Symptoms: **

High fever, headache, stiffness, muscle weakness, sensitive to touch, difficulty swallowing, muscle pain, loss of reflexes, irritability, constipation, inability to urinate, and paralysis usually develops before the fever breaks if it is going to develop.


 * Standard treatments: **

The standard prevention against obtaining the disease is a vaccination which exposes individuals to the virus and allows them to be immune to the virus. The IgA antibodies are present in the tonsils and the gastrointestinal tract to block virus replication. Also, antibodies IgG and IgM can prevent the spread of the virus to the central nervous system motor neurons (Kew et al., 2005). As for treating the disease when it is acquired antibiotics are used to prevent the infection in weakening muscle, physical therapy, and a nutritional diet are used to prevent implications from the disease. There is no known cure for the disease.


 * Current Research: **

One area of current research is in the area of post-poliomyelitis syndrome. This syndrome is the cause of life long muscle aches and pain due to poliomyelitis infection. There has been recent research to determine why this happens after the poliomyelitis infection. One experiment was done to determine if serum inflammatory markers TNF, IL-1, IL-6, and leptin are increased in PPS. The research found that serum TNF, IL-6, and leptin levels were much higher in PPS patients. They also determined that TNF levels seem to be correlated with muscle pain (Fordyce et al., 2008). This research allows for the further study and possibly even a treatment to reduce TNF levels, therefore reducing the muscle pain in the patients.

 Other current research strives to rid of the OPV (oral polio vaccination) because it has no effect on the development of paralytic poliomyelitis. The new vaccination that they are looking to put into use is the IPV (Inactive polio vaccination). The use of this vaccination would provide excellent protection among individuals as well as it has been shown to induce a high level of immunity in young infants. IPV is very expensive and can only be given to adults. And for the vaccination to be successful it needs to be given in two doses. So, the use of this vaccination does not seem to be ideal. This research article looks into the area of antiviral drugs for the treatment of polio. The article does not go very far in depth but it discusses the use of antiviral drugs to prevent the virus from entering the cells by not allowing them to bind to the needed receptors. The article also discusses how the antiviral drug is needed to free the world of the polio virus. The drug would be cheap and easy to provide for people in the undeveloped third world countries (Collett et al., 2008). So, this research article opened up a possibility for various research in the field of antiviral drugs to prevent poliomyelitis.


 * References: **

Collett, M., Neyts, J., & Modlin, J. (2008). A case for developing antiviral drugs against polio. Antiviral Research, 179-187. <span style="font-family: 'Times New Roman',Times,serif; font-size: 140%;">Fordyce, C., Gagne, D., Farzaneh, J., Sudabeh, A., Arnold, D., Costa, D.,. . . Lapierre, Y. (2008). Elevated serum inflammatory markers in post-poliomyelitis syndrome. Journal of the Neurological Sciences, 80-86. <span style="font-family: 'Times New Roman',Times,serif; font-size: 140%;">He Y, Mueller S, Chipman P, et al. (2003). "Complexes of Poliovirus Serotypes with Their Common Cellular Receptor, CD155". J Virol 77 (8): 4827–35. doi:10.1128/JVI.77.8.4827-4835.2003 <span style="font-family: 'Times New Roman',Times,serif; font-size: 140%;">Kew O, Sutter R, de Gourville E, Dowdle W, Pallansch M (2005). "Vaccine-derived polioviruses and the endgame strategy for global polio eradication". Annu Rev Microbiol 59: 587–635. doi:10.1146/annurev.micro.58.030603.123625 <span style="font-family: 'Times New Roman',Times,serif; font-size: 140%;">Pearce J (2005). "Poliomyelitis (Heine-Medin disease)". J Neurol Neurosurg Psychiatry 76 (1): 128. <span style="font-family: 'Times New Roman',Times,serif; font-size: 140%;">doi:10.1136/jnnp.2003.028548 <span style="font-family: 'Times New Roman',Times,serif; font-size: 140%;">Yin-Murphy M, Almond JW (1996). "Picornaviruses: The Enteroviruses: Polioviruses". Baron's Medical Microbiology (Baron S et al., eds.) (4th ed.). Univ of Texas Medical Branch