Poliomyelitis incubation period in children. Symptoms of polio in children: how to recognize polio in a child in time? Symptoms of the abortive form of poliomyelitis

What is Poliomyelitis in Children -

(Heine-Medin's disease, or epidemic infantile paralysis) is an infectious disease caused with the localization of the pathological process in the anterior horns of the spinal cord.

Poliomyelitis is: acute unspecified, acute non-paralytic, acute paralytic poliomyelitis other and unspecified; acute paralytic, caused by a wild natural virus; acute paralytic, caused by a wild introduced virus; acute paralytic associated with the vaccine; acute poliomyelitis.

Until recently, this disease was spread throughout the planet. Both isolated, unrelated cases and epidemics have been recorded. Polio was a serious threat - primarily to children.

After World War II, the incidence increased: 71% in Sweden and 37.2% in the United States. In Russia, the rise was not so high, but still significant: in 1940 to 0.67% and in 1958 to 10.7%. In the fight against this serious disease, the Salk vaccine and the live Sabin vaccine (abbreviated as ZhVS), which appeared in the late 50s and early 60s of the last century, made it possible to achieve.

After the vaccination of ZhVS began in Russia, the incidence rate fell by more than 100 times. Since 1997, cases of poliomyelitis caused by wild strains have not been recorded in Russia. Thanks to universal vaccination, the disease was defeated.

The source and carrier of polio infection is man. The virus is isolated from the nasopharynx and intestines, therefore it can be transmitted by airborne or alimentary routes. Despite the fact that the wild polio virus has been overcome, vaccine strains are still active, which are associated with 10-15 cases of polio throughout Russia every year.

Dangerous in terms of infecting others are those with erased or undeveloped forms of the disease. The virus is excreted with feces not only during the course of the disease, but also after recovery - several weeks or months. It can be detected in the nasopharynx after the onset of the disease (within 1-2 weeks), especially the first 3, 4 or 5 days. In the last days of the incubation period, patients are also "contagious". The infection can be picked up through toys, unwashed hands, contaminated products.

Despite the fact that anyone can get polio, children under 7 years of age are most susceptible to the disease. In the first 2-3 months of life, children practically do not get this infection. After a person has had the disease, stable humoral immunity appears and the resistance of the cells of the intestinal mucosa to the homologous type of virus is noted. Relapses almost never occur.

What provokes / Causes of Polio in children:

Three types of viruses have been identified: Brünnhilde, Lansing, Leon, which differ in antigenic properties. belong to the picornavirus family, a genus of enteroviruses containing RNA.

The source of the spread of infection are sick and healthy carriers of the virus, excreting the infection with nasopharyngeal and intestinal contents. The latter determines the possibility of alimentary and airborne ways of spreading the infection. In the first 7-10 days of illness, the virus can be isolated from the pharyngeal lavage. Over a longer period (6 weeks, sometimes several months), the virus is shed from the feces. The disease can be transmitted through dirty hands, food, toys. There is evidence of a wide spread of enteroviruses, including poliomyelitis, in the environment and food.

Poliomyelitis belongs to seasonal infections, most often occurring in the summer-autumn period. Acute poliomyelitis is characterized by a high level of contagiousness (contagiousness), can cover all segments of the population, but children under 7 years old suffer the most (70-90%). The paralytic form of poliomyelitis is rare.

Enteroviruses cannot be destroyed with the help of zimic-therapeutic drugs and antibiotics. The virus is inactivated by formaldehyde or free residual chlorine (the required concentration is 0.3–0.5 mg/l). Also helps to kill the infection ultraviolet irradiation, drying, heating to a temperature of 50 ˚С. The virus can be stored frozen for many years. For example, in an ordinary household refrigerator, he can live 2-3 weeks or more. At room temperature, the virus remains active for several days.

Pathogenesis (what happens?) during Polio in children:

The entry gates of the virus are the upper respiratory tract and the gastrointestinal tract. The reproduction of the virus occurs in the lymphatic structures of the back wall of the pharynx and intestines, then viremia occurs (the spread of the virus throughout the body through the bloodstream). During this period, the virus can be isolated from the patient's blood.

When the virus interacts with the cells of the nervous system, the most intense changes occur in motor neurons, in which the process of neuronophagy (destruction and removal of damaged or degeneratively altered nerve cells) is significantly expressed already at an early stage of the disease.

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Other diseases from the group Diseases of the child (pediatrics):

Poliomyelitis is a disease that affects the gray matter of the spinal cord. It is often confused with SARS. First, the temperature rises, followed by stiffness and pain in the joints. Later, paralysis develops. Prevention of poliomyelitis in children is successfully carried out with the help of vaccines. Seeing a doctor will help your child fight off the virus and stay healthy.

Acute infectious disease poliomyelitis has severe complications, including disability and even death.

Poliomyelitis is a serious disease that has severe complications, including disability and death.. Most often, children of preschool age are affected. The polio virus enters the intestines of a child through unwashed hands. After that, it multiplies and attacks. It is found in soil, food and water. The modes of transmission of the virus are diverse.

Treatment for polio involves only supportive procedures designed to repair damaged muscles and joints. The main method of combating the disease is prevention. Developed vaccinations prevent the development of the disease. At an early age, children are vaccinated with weakened and killed bacteria.

In the 1950s, many children had polio. The mortality rate was high. Those who recovered remained disabled. None of the patients survived the disease without consequences. Often, polio in children is diagnosed between 2 and 3 years of age. For decades, doctors considered the disease to be childish. Later, after several cases of illness in children of primary school age and adolescents, this theory was abandoned.

Today, advances in medicine can protect children from polio at an early age. Mandatory vaccination can protect children by forming lifelong immunity in them. The treatment is carried out with the help of supportive procedures.

Polio virus and modes of transmission

The polio virus is resistant to physical and chemical influences. It survives at a temperature of 4 degrees for several months. With a thermometer value of 37 degrees, the virus can survive for 50-60 days. Enterovirus often lives on feces, food, milk and soil. Ways of transmission - from the use of common toys to playing in the same sandbox with the patient.

Polioviruses are killed when objects are treated with disinfectants and high temperatures. They also cannot develop in the body of vaccinated children. Treatment after polio is aimed at restoring the affected limbs rather than eliminating the virus.

You can succumb to the attack of the virus even in adulthood. It is impossible to get infected from vaccinated babies. Only vaccine viruses are released from his body. The course of the disease in adulthood is more severe than in childhood. You can become infected when traveling to other countries where vaccination against polio is not carried out. Ways of transmission of viruses are very diverse.

The causative agents of the disease are intestinal viruses (enteroviruses). With sewage, the virus will enter the soil, and then on the hands of the child. It is also transmitted by a carrier or a sick person. The viability of the virus allows it to survive for a long time on food and in water. For vaccinated babies, it does not pose a danger.

Thanks to vaccination in Russia, poliomyelitis in children is not as common as, for example, in Central Asia. Treatment after poliomyelitis today is not able to eliminate the cause of the disease, it is more focused on restoring the lost functions of the body.

The disease can also be caused by vaccination. It's called vaccine-associated poliomyelitis. Signs may appear in the baby only a few months after the vaccination is carried out.

Symptoms

Once in the intestines of a child, the virus is carried by the blood throughout the body, including to the spinal cord and brain. During the first week, signs of polio in children do not appear. At this time, the enterovirus actively multiplies in the intestine.

The incubation period lasts from a week to two. Polio types:

• Paralytic is divided into bulbar, encephalitic, spinal, pontine. All of them have different symptoms from each other.
• Non-paralytic includes asymptomatic, meningeal, and visceral. The modes of transmission for all these forms are practically the same.

preparalytic stage

The course of the disease varies from severe to mild forms. At the initial stage - preparalytic, the following symptoms sharply worsen:

• Digestive disorders;
• Temperature rise;
• Inflammation of the mucous membrane of the upper respiratory tract;
• Headache;
• severe fatigue;
• apathy;
• Insomnia, replaced by drowsiness;
• Pain in the legs and arms, spine.

These symptoms continue to appear for 5 days. If previously vaccinated, the disease remains at this stage. For the child, this means a speedy recovery. Treatment at this stage is carried out with the help of sedatives and painkillers. Later, physiotherapy and orthopedic treatment is carried out. In unvaccinated children, the disease is much more severe and has serious consequences.

Paralytic

At the next stage - paralytic, the child loses symptoms such as fever and muscle pain. Paresis (weakening of certain muscle groups) begins to appear, and then paralysis. The latter are characterized by the complete absence of voluntary movements in the child. The legs are more susceptible to injury.

The deltoid muscle is immobilized, sometimes the respiratory muscles, abs, neck and torso.

The stem form affects the muscles of the face, tongue, larynx and pharynx. Asymmetry and lethargy of paralysis are the main features of the stem form of poliomyelitis. There is a noticeable decrease in overall muscle tone, the appearance of dislocations and rapidly progressive atrophy.

recovery stage

At the recovery stage, which lasts from 4 months to six months, there are some improvements in the child's condition. After six months, the pace of recovery slows down. Residual effects include curvature of the spine, shortening of the limbs, muscle atrophy, restrictions in the movement of various joints. An important step in the fight against the disease is timely diagnosis. Unvaccinated children are more likely to experience severe consequences of the disease.

Effects

After suffering from polio, children may experience symptoms such as muscle atrophy, deformity and thinning of the limbs. They can be shortened, and the spinal column can be curved. After 20 years in the body of an adult who has previously had polio, post-polio syndrome may develop.

It is characterized by the following symptoms:

• Increased fatigue;
• Pain in muscles and joints;
• Impaired swallowing.

Diagnosis allows you to identify the disease at an early stage. Mortality from poliomyelitis ranges from 5 to 25%. One of the main disorders is the defeat of the respiratory muscles. It often leads to death from lack of oxygen. . Deformation of the spine and limbs often causes disability. Symptoms of polio at the initial stage are not easy to recognize, so at the first suspicions, the baby should be taken to the hospital.

Diagnostics

Special diagnostics helps to identify poliomyelitis in children. It is carried out in the laboratory. Main methods:

• Modified neutralization reaction - on infected samples, due to a change in the pH of the medium, the culture liquid changes color;
• RSK - complement fixation reaction.

The virus is isolated from feces, as well as by studying nasopharyngeal swabs. Such diagnostics provides reliable information about the virus in the baby's body.

Treatment

An antiviral agent that would be treated, modern medicine has not yet developed. The main course of recovery is carried out in a hospital. The child is isolated for 40 days. Particular attention is paid to the care of atrophied limbs. During the recovery period, massage, physiotherapy, physiotherapy exercises are carried out. Recovery is possible when orthopedic treatment is carried out after an illness. It focuses on the correction of deformed limbs. The identification of the disease, as well as the determination of therapeutic measures, is carried out by a neurologist. Vaccinations are the main way to avoid illness.

Preventive measures

Prevention of poliomyelitis is carried out in early childhood - 3 months. are given to the baby using a live Sebin vaccine. Droplets of the solution are instilled into the oral cavity. The procedure is carried out three times with a frequency of a month.

Intramuscularly, a vaccine is made with killed viruses. Revaccination is carried out at 18 and 20 months. The next period of vaccine administration is 14 years.

A weakened or killed virus, when it enters the body, causes a powerful response. There is an intensive production of antibodies that form lifelong immunity. The chance of encountering the disease in vaccinated children is extremely small. It occurs when the immune system is severely weakened.

Complications that the vaccine can cause are a mild skin reaction. In such cases, you should immediately consult a doctor. There are no complications from vaccination. Their chance is very small. In vaccinated children, the risk of infection is minimized. Before vaccination, a pediatrician is consulted.

Poliomyelitis in children in our time, as mass immunization is widely practiced, is not as widespread as it was in the years when the vaccine was not invented. Remember at least the cult picture of Andrew Wyeth "Christina's World", which depicts a girl with this terrible disease. This canvas became a symbol of America in the 50s of the last century and symbolized how a teenager with polio, despite paralysis, reaches out for life.

How polio is transmitted and photos of sick children

Acute epidemic poliomyelitis is an infectious disease of a viral nature. Mostly children under the age of 4 suffer from poliomyelitis; but the disease is dangerous for both older children and adults. In children with poliomyelitis, the central nervous system is predominantly affected - in the gray matter of the spinal cord, the cell bodies that are responsible for controlling movement die.

The causative agent of the disease is a filterable virus, which belongs to the family of enteroviruses. The virus has good resistance to environmental factors: it does not die when dried or under the influence of cold, it is not destroyed by digestive juices, it is not affected by antibiotics.

How is polio transmitted to children and from whom can you get infected? The source of infection is a sick person. Especially dangerous as a source of infection is one who carries the disease in an erased or atypical form. You can also get infected from a healthy virus carrier. The patient is most contagious in the acute period of the disease.

Polio in children can be caused by eating contaminated food or water; in addition, the causative agent of the disease can be transmitted through contact of a healthy person with a sick person; an airborne route of infection is also possible, although it is of secondary importance.

The human body has a low susceptibility to poliomyelitis. So, of all those infected with the virus of this disease, only up to 1% of people fall ill. Children of the first 4 years of life are most susceptible to poliomyelitis. If a child does not receive enough vitamins, if the child suffers from excessive physical and mental stress, his susceptibility to polio increases. Often polio is preceded by other infectious diseases -,. These diseases weaken the body's resistance, and the latter is unable to give a fitting rebuff to the polio virus. After the disease remains stable immunity.

The entrance gate for infection is the pharyngeal lymphatic ring and the digestive tract. If the body does not have a sufficiently good resistance, the virus enters the bloodstream and already with it reaches the nerve cells that it infects; the virus can also penetrate nerve cells through the nerve conductors. The clinic largely depends on the number of dying nerve cells. The consequence of poliomyelitis in children, if a third (and even a quarter) of nerve cells die in the thickenings of the spinal cord, may be paresis.

Look at the photo - with polio in children, if three-quarters of nerve cells die under the influence of the virus, complete paralysis occurs:

How poliomyelitis manifests itself in children: the first signs

The duration of the incubation period for poliomyelitis can be on average about 2 weeks.

There are 4 stages during poliomyelitis: initial, paralytic, recovery and stage of residual phenomena. How does polio manifest in children at each of these stages?

The disease begins acutely. In most cases, the onset of the disease is similar to. The first sign of poliomyelitis in a child is catarrhal changes in the upper respiratory tract - there may be a runny nose, sore throat, cough, and body temperature rises significantly. There is increased sweating. Some children with poliomyelitis have disorders of the gastrointestinal tract - or diarrhea. A sick child may complain of general weakness, headache; he is lethargic, drowsy, but sleeps badly at night. Nausea and vomiting are noted. Sometimes a child can observe a darkened consciousness and delirium. Also, a symptom of polio in a child may be characteristic twitches and. Most often, seizures can be seen in children of the first year of life. When bending the neck and back, the child feels pain in the spine; he also notes pain when pressing on the spine. Disturbed by pain in the limbs. With an increase in the severity of the disease, severe pain in the shoulders and back appears; when moving, these pains increase sharply. Sometimes a sign of polio in a child is a stiff neck (the child is unable to bend his head). The described clinical picture can be observed within a few days.

The body temperature decreases at the end of the initial stage, and the patient has paresis and paralysis. This is how the paralytic stage begins. Most often, paresis and paralysis affect the muscle groups of the lower extremities and the deltoid muscle.

As you can see in the photo, sometimes the symptoms of polio in children can be lesions of the muscles of the neck, trunk, abdomen (abdominal pressure), as well as the muscles of the chest:

If paralysis of the diaphragm and intercostal muscles develops, breathing suffers. The paralytic stage of poliomyelitis continues for 1-2 weeks, sometimes more.

Already at the beginning of the recovery stage of the disease, the signs of poliomyelitis in children disappear: headache and excessive sweating disappear; as a rule, pain in the spine and limbs stops. Movement is restored in certain muscle groups. At first, the recovery process is fast, but then it slows down. The duration of the recovery period is up to 3 years. If in some muscles the function is not restored, then atrophy of these muscles develops.

The stage of residual effects is characterized by persistent flaccid paralysis, atrophy of some muscle groups, and the development of contractures. Various deformations take place.

These photos show photos of the signs of polio in children at each stage:

Among the complications of poliomyelitis in children, pneumonia should be called,. Often, it is precisely because of the addition of one or another complication after poliomyelitis that children die.

How to treat polio in children and prevent the disease

At the slightest suspicion of symptoms of poliomyelitis in children, the patient must be hospitalized in the infectious diseases department for treatment. From the first days of illness, the child must observe strict bed rest. The duration of bed rest is at least 2 weeks. The doctor prescribes a diet. To improve the quality of sleep in the treatment of polio, children are given sleeping pills. Thermal procedures are shown - wet hot wraps, treatment with paraffin, ozocerite, light baths. Thanks to this therapy, the likelihood of complications is significantly reduced.

There is no specific treatment for poliomyelitis. Antibiotics and sulfa drugs are prescribed only in cases of complications due to the addition of a secondary infection to the painful process. Treatment is aimed at increasing the body's resistance, at creating the so-called passive immunity. To effectively treat polio in a child, vitamin therapy is indicated. Especially important is the additional introduction of vitamins C and group B into the body of a sick child. In case of severe pain, thermal procedures are prescribed - heating pads, hot wraps, warm and hot general baths. The doctor prescribes various stimulants for interneural and myoneural conduction. Amino acids are shown. In the recovery period, an important place is given to physiotherapy procedures.

As can be seen in the photo, children with polio are shown physiotherapy exercises and massage:

Gymnastic exercises should be performed by the child as soon as possible - the pain will barely disappear. Good results are achieved with post-treatment of patients in sanatoriums or resorts.

• the child must strictly observe the rules of personal hygiene;
• it is necessary to create all conditions for the complete physical and mental rest of a sick child; obligatory observance of bed rest; long sleep is important;
• the patient's dishes are to be boiled;
• all secretions of a sick child, namely sputum, mucus from the nasal cavity, urine, feces, are disinfected;
• the child should receive high-calorie food with a sufficient content of vitamins; the diet of a child suffering from poliomyelitis should be diversified with products with which ascorbic acid and B vitamins enter the body;
• in the initial period of the disease, when the child is concerned about catarrhal phenomena from the upper respiratory tract, make sure that the child breathes through the nose (if necessary, use vasoconstrictors); in case of tonsillitis, gargle the child's throat as often as possible with solutions of antiseptics - furacilin, baking soda, table salt, natural sea salt, as well as infusions and decoctions of various medicinal plants that have antiseptic and anti-inflammatory effects;
• give the child a light massage daily; the main massage technique used is stroking.

• regularly take freshly squeezed juice of lettuce; children under 10 years of age drink 50-100 ml of juice 2-3 times a day; older children can also drink 150-200 ml of juice; 1-2 tablespoons of honey should be added to the juice each time;
• with severe catarrhal symptoms from the upper respiratory tract, with sore throat, use a warm decoction of sage herb for gargling; preparing a decoction: 1 tablespoon of dried herbs, crushed to a powder state, pour 200 ml of water and cook at a low boil for 10-12 minutes, after which the product cools quickly, strain through 1-2 layers of gauze, squeeze out the rest of the raw material; gargle the child's throat several times a day; after each rinse, do not eat or drink for half an hour;
• to improve sleep, take a warm infusion of oregano herb; preparation of infusion: pour 1 teaspoon of dried, carefully chopped raw materials into 200 ml of boiling water and leave in a sealed container at room temperature for about half an hour, strain through a fine strainer or 1 layer of gauze; children under 10 years old take 1 tablespoon of infusion 6-8 times a day; a child over 10 years old drink this infusion warm in 6-8 doses during the day;
• with severe pain in the shoulders and back, with headaches, take a hot bath for a child; the procedure is performed as follows: the child sits in a bath at a water temperature of 37 ° C, then the water temperature is gradually increased to 41 ᵒС, and for older children it can even be up to 43 ° С; the water temperature should rise within 15 minutes; you can take a bath at a water temperature of 41-43 ° C for up to 5 minutes; after the end of the procedure, you need to wrap yourself in a sheet and cover yourself with a woolen blanket, sweat for at least 30 minutes; you can further increase sweating by drinking a cup of hot tea (black long leaf or tea with the addition of lime blossom); after intense sweating stops, the child should stay in bed for another 2 hours; the described procedure is very effective, but it should be used only with the consent of the attending physician and under his control;
• every evening before going to bed, the child is recommended to take a warm general bath or half bath with the addition of a decoction of pine needles to the water; preparation of a decoction: cut 200-300 g of dried pine needles with a knife as finely as possible, pour 1-2 liters of water and cook at a low boil for 12-15 minutes, after which the product should be infused at room temperature for at least 45 minutes, strain through 1 layer of gauze, pour the finished broth into bath water and mix; the procedure should be taken at a water temperature of 36-38 ° C; the duration of the procedure is from 5 to 15 minutes.

Early detection of patients is very important. Patients and persons with suspected poliomyelitis should be isolated from others as soon as possible. The duration of isolation is 21 days from the onset of the disease. In the room in which the patient was before hospitalization, final disinfection is carried out. For the prevention of poliomyelitis in children, timely is of great importance.

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The content of the article

Etiology of poliomyelitis in children

Epidemiology of poliomyelitis in children

Pathogenesis and pathological anatomy of poliomyelitis in children

Clinic of poliomyelitis in children

Diagnosis, differential diagnosis of poliomyelitis in children

Prognosis of polio in children

Treatment of polio in children

Prevention of polio in children

Poliomyelitis has been stopped by the efforts of the governments of many countries of the world. But it is not yet possible to completely exclude the disease from the list of existing serious diseases. In this article, we will talk about what this dangerous disease is, how to recognize it and how to treat it.

What it is?

Poliomyelitis is a viral inflammation of the gray matter cells of the spinal cord. The disease is most often childhood and is highly contagious. Spinal cells are affected by poliovirus, which leads to their paralysis. As a result, the nervous system ceases to function normally.

Usually there are no visible symptoms with polio, only when the virus enters the central nervous system, it causes paralysis and paresis.

The study of the disease began in the 19th century, and in the middle of the 20th century, poliomyelitis acquired the scale of a national disaster in many countries, including European ones. The polio vaccine was developed independently by American and Soviet scientists. In recent years, countries have declared themselves polio free. Outbreaks of the disease are observed from time to time only in three states - Nigeria, Afghanistan and Pakistan.

In 2015, two cases were recorded in Ukraine. Doctors have every reason to believe that polio can spread in this country due to the fact that, according to statistics, only half of Ukrainian children received the vaccine against the disease. In Russia, the situation is under control, but it tends to worsen. This is primarily due to the influx of migrants, including from neighboring Ukraine.

Causes

Poliomyelitis is caused by a picornovirus from the enterovirus family. The virus is quite stable, for example, in the aquatic environment it can live up to 100 days without loss of its properties, and in human feces - up to six months. The virus is not afraid of low temperatures, and also perfectly repels the attacks of gastric juice, passing through the human food tract. Boiling water, sunlight, chlorine can destroy the virus.

A child can become infected from a sick person or a carrier who has no visible symptoms.

Through the mouth, the virus is released into the environment within a few days, and with feces - for weeks and even months. Thus, two ways of infection are possible - airborne and alimentary (through dirty hands, with contaminated food). A significant contribution to the spread of this virus is made by the ubiquitous flies.

After entering the body of a child, the poliovirus begins to multiply in the lymphoid tissue of the tonsils, in the intestines and lymph nodes. Gradually, it penetrates into the blood, and from there - into the spinal cord and central nervous system.

The incubation period is from 3 days to one month, most often from 9 to 11 days. At the end of the period, the first signs of the disease may appear, or they may not appear, and then it will be possible to recognize poliomyelitis only by the results of laboratory tests.

Most often, cases of polio are recorded in summer and autumn. At risk are children from six months to seven years. In the first few months of a child's life, polio does not threaten at all, since maternal innate immunity reliably protects the baby from this type of enterovirus.

After an illness, lifelong immunity is developed to the polyvirus.

Symptoms and signs by form

Most children do not develop poliomyelitis even after the end of the incubation period. Symptoms will depend on the form of the disease and the state of immunity of the child.

Hardware

There are no symptoms. Paralysis does not develop. It is found only in blood tests. The markers are antibodies to poliovirus.

Visceral

The most common form. At the end of the incubation period, at the very beginning of the disease, there may be symptoms of the most common viral infection - sore throat, headache, fever, sometimes diarrhea and nausea.

The pain subsides in about a week. Paralysis does not develop.

Non-paralytic

With it, all the symptoms of a viral infection appear (sore throat, fever, abdominal pain), but more pronounced than with the visceral form.

There is a tension of the occipital muscles, neurological manifestations. The disease is accompanied by a severe headache, but does not cause paralysis.

The child recovers in 3-4 weeks.

Paralytic

If a child runs his fingers along the spine, he will experience severe pain. If you ask a child to touch his own knees with his lips, he will not succeed. The baby with this form of the disease sits with the torso tilted forward and with an emphasis on both hands, in the so-called tripod position. This form can cause paralysis. Paralysis usually occurs when one-fourth of the nerve cells die.

Complete paralysis is quite rare, it occurs only in 1% of cases. But partial paresis of individual muscles is more common. Paralytic manifestations do not occur immediately, but as the temperature decreases, closer to recovery. The muscles of the legs most often atrophy, less often the respiratory system or trunk.

Diagnostics

The symptoms of poliomyelitis are very similar to the clinical manifestations of many diseases caused by enteroviruses and herpetic viruses. That is why, when symptoms of SARS appear, it is important to call a doctor so as not to miss the time and detect the disease, if any. This will help the methods of laboratory diagnostics.

Blood, a swab from the nasopharynx and a sample of stool will be sent to the laboratory. It is in them that the virus can be detected.

First of all, the doctor will need to distinguish polio from similar traumatic neuritis, Guillain-Barré syndrome, transverse myelitis. Poliomyelitis is characterized by a high temperature at the onset of the disease, descending paralysis, and reduced tendon reflexes.

If poliomyelitis is suspected, the child must be hospitalized in an infectious diseases hospital.

Consequences and complications

The dead cells of the spinal cord are gradually replaced, scarred, therefore, the functions of the part of the body for which they were responsible are partially lost. The spinal form of paralysis, in which the thoracic, cervical and lumbar regions are affected, threatens with flaccid paralysis of the limbs.

With bulbar poliomyelitis, cranial nerves are affected, so complications will be localized higher - basically, the process of swallowing, the reproduction of sounds by the vocal apparatus is disturbed. The most dangerous is paralysis of the respiratory muscles, this can lead to death.

Both the facial nerves and the brain can be affected if the virus reaches the central nervous system. The latter is fraught with the development of lifelong persistent paralysis.

The prognosis for non-paralytic poliomyelitis is favorable.

With paralytic pathology, to one degree or another, they remain with the child for life. However, a competent and responsible approach to rehabilitation makes it possible to avoid disability in case of mild injuries and restore motor functions in full or almost in full.

Treatment

Despite the fact that humanity has worked hard to create a vaccine against polio, no drugs have been developed against this disease. The virus is completely insensitive to antibiotics, and antiviral drugs are not able to slow down its progress.

The only protector of the child at this moment is his own immunity. Only he is able to develop antibodies that can deal with the virus before it infects the brain and kills a large number of spinal cord cells.

All therapy boils down to the fact that the child is symptomatic care. When the temperature rises, they give antipyretics, with muscle pain they give painkillers and anti-inflammatory drugs.

The occurrence of paralysis is closely monitored by doctors in the hospital, with the appearance of neurological disorders and seizures, the child is prescribed muscle relaxants - drugs that relax muscles, an anticonvulsant treatment regimen.

In case of damage to the respiratory function, they provide resuscitation assistance with connecting the child to a ventilator.

In the process of treatment, the child is shown abundant warm drink, bed rest and complete rest.

The recovery period deserves more attention. It is in it that it will be decided whether the paralysis will remain or pass, whether the child will receive a disability or not. Rehabilitation after poliomyelitis begins with the restriction of physical activity and physical activity of the child. It is impossible to strain the muscles in order to limit the paralyzed zones.

Then gradually increase the load. The child is assigned:

therapeutic exercises (LFK);

hydrotherapy;

electrical stimulation of paralyzed or atrophied muscles;

massotherapy.

All these measures are needed exclusively in combination, and the rehabilitation period promises to be slow. The task of this stage is not even to restore the functions of dead brain cells, but to stimulate compensatory mechanisms - healthy cells should take over part of the functions of their dead counterparts. If this can be achieved, then the forecasts are more favorable.

During this period, hormonal drugs, enzymes, vitamins, calcium and magnesium preparations can be prescribed, since these substances provide faster contact when conducting nerve impulses between the brain, nerve cells and muscles.

Can adults get sick?

Despite the fact that polio is already commonly considered a disease of children, adults can also become infected with this disease. In them, the disease is more severe, and the consequences are always more pronounced and dangerous than in children. Adults are also more likely to die.

Prevention

Non-specific disease prevention includes standard hygiene requirements - the child should wash their hands after returning from a walk and before eating, adults must deal with the flies as they are carriers of the poliovirus.

Babies suspected of having this disease are isolated in special hospitals, and the kindergarten or school they attend is quarantined for 21 days. During these three weeks, medical workers closely monitor the slightest changes in the state of health and the condition of other children, measure the temperature daily, and examine the tonsils.

Vaccination and the consequences of vaccinations

The most effective prevention against this disease is vaccination. Today, two types of vaccine are used in Russia: one contains live, but strongly weakened polioviruses, the second contains completely inactivated viruses killed by formalin.

The polio vaccination is included in the list of mandatory in the Russian Federation, it is included in the National calendar of preventive vaccinations and is free.

The first wave of vaccination begins at a very early age. The vaccine in the form of drops for oral administration is given to the child at 3 months, at 4.5 months and at 5 months. Then the drops will be given to the child at a year and a half, at 6 years and at 14 years.

Very often, pediatricians combine polio vaccination with DTP vaccination (against whooping cough, diphtheria and tetanus), however, provided that the child is over 2 years old at that time.

Vaccination can be not only in the form of drops, but also in the form of an injection solution, but such vaccines are produced only abroad (in France, Belgium) and are purchased by the Russian Ministry of Health annually.

Multi-component vaccines that immediately combine components against whooping cough, tetanus, diphtheria and poliomyelitis are also produced by foreign pharmaceutical companies.

Domestic vaccines are offered free of charge in the children's polyclinic. If parents have a desire to vaccinate a baby with an imported drug, then they will have to pay for it.

Before vaccinating a child, it is not recommended to feed abundantly, it is important that on the eve of a visit to the clinic, he empties his intestines. At the time of vaccination, the baby must be healthy, he should not have fever and other symptoms of possible diseases.

After vaccination, the child is not fed or watered for an hour.

Vaccination is not dangerous for children's health, although sometimes it can cause certain unpleasant consequences, in particular, diarrhea. It is temporary and does not pose a danger to the child.

In one case per million, the introduction of a live vaccine causes the disease of poliomyelitis. If a vaccinated child falls ill, then the probability of paralysis is estimated at only 1%.

Sometimes a child may react to the vaccine with a small allergic reaction like hives. The vaccine usually does not cause fever.

After vaccination, you can walk, swim, and lead the most ordinary lifestyle. That's just with the introduction of new products in the child's diet after vaccination, it is better to abstain for at least a week.

Contraindications to vaccination

Children who reacted to the previous vaccination with violent manifestations of the nervous system, who had neurological disorders after vaccination, are exempted from vaccination. Children with HIV infection and other causes of immunodeficiency are also not vaccinated.

If the child is ill or has had any viral infection not so long ago, the vaccination is temporarily postponed. At the same time, other diseases not caused by viruses are not grounds for canceling the next vaccination.

It is not worth refusing this vaccination, since polio is a dangerous disease that can make a child disabled, despite the level of development of modern medicine, its capabilities and the timely provision of qualified assistance.

For more information about poliomyelitis, see the next program of Dr. Komarovsky.