Poliomyelitis or polio is a neurological disease that can cause permanent paralysis. This disease is caused by a viral infection and is highly contagious, but can be prevented by immunization against polio.
Most polio sufferers are toddlers, especially those who have not undergone polio immunization. However, polio can be experienced by anyone regardless of age. In addition to permanent paralysis, polio can also cause disorders of the respiratory nerves so that sufferers have difficulty breathing.
The polioviruses found can be in the form of vaccine/sabin poliovirus, wild poliovirus/WPV (Wild Poliovirus) and VDPV (Vaccine Derived Poliovirus). VDVP is a polio vaccine/sabin virus that mutates and can cause paralysis.
VDPV is classified into 3 categories namely 1). Immunodeficient-related VDPV (iVDPV) is derived from immunodeficient patients, 2). Circulating VDPV (cVDPV) when there is evidence of person-to-person transmission in the community, and 3). Ambiguous VDPV (aVDPV) if it cannot be classified as cVDPV or iVDPV. Determination of the type of virus in question, determined based on laboratory tests. Identification of VDPV based on the degree of difference of the OPV virus strain. Poliovirus is categorized as VDPV if there is a difference of more than 1% (>10 nucleotide changes) for poliovirus types 1 and 3, while for poliovirus type 2 if there is a difference of more than 0.6% (>6 nucleotide changes).
Polio can strike at any age, but polio mainly affects children under the age of five. In the early 20th century, polio was one of the most feared diseases in industrialized countries, crippling hundreds of thousands of children every year. In the 1950s and 1960s polio was controlled and practically eliminated as a public health problem in industrialized countries. This is after the introduction of an effective vaccine.
Symptoms, Signs and Incubation Period
The incubation period for poliovirus usually takes 3-6 days, and paralysis occurs within 7-21 days.
Most infected people (90%) have no symptoms or very mild symptoms and usually go unrecognized. In other conditions, the initial symptoms are fever, fatigue, headache, vomiting, stiffness in the neck and pain in the legs.
The symptoms of polio sufferers are divided into three groups, namely:
• Non-paralytic polio can cause vomiting, muscle weakness, fever, meningitis, fatigue, sore throat, headache and stiff and sore feet, hands, neck and back
• Paralytic polio causes headache, fever, muscle weakness, weakness in the legs and arms, and loss of body reflexes.
• Post-polio syndrome causes difficulty breathing or swallowing, difficulty concentrating, muscle weakness, depression, sleep disturbances with difficulty breathing, fatigue and decreased muscle mass.
Causes of Polio
Polio is caused by the polio virus. The virus enters through the oral cavity or nose, then spreads in the body through the bloodstream.
The spread of the polio virus can occur through direct contact with the feces of a polio patient, or through the consumption of food and drink that has been contaminated with the polio virus. This virus can also be spread through splashes of saliva when an infected person coughs or sneezes, but this is less common.
The polio virus is very easy to attack people who have not received the polio vaccine, especially in the following conditions:
• Living in an area with poor sanitation or limited access to clean water.
• Is pregnant.
• Have a weak immune system, for example people with AIDS.
• Caring for family members infected with the polio virus.
• Have had tonsil removal.
• Undergoing strenuous activities or experiencing stress after exposure to the polio virus.
• Work as a health worker who treats polio patients.
• Travel to areas that have experienced polio outbreaks.
When to go to the doctor
Polio immunization is given 4 times in the first 3 months since the child is born. Complete your child’s polio immunization according to the schedule recommended by the doctor. Apart from the mandatory schedule, there are additional immunizations carried out according to the policy of the Ministry of Health of the Republic of Indonesia. This additional immunization activity is called the National Polio Immunization Week (PIN Polio).
If there is a polio PIN activity and you have a toddler, visit the posyandu, puskesmas, or hospital where it is held, to get polio immunization, even if your child has received the complete polio vaccine.
Method of Transmission (Contagion)
Polio is spread through person-to-person contact. When a child is infected with wild poliovirus, the virus enters the body through the mouth and multiplies in the intestines. It is then discharged into the environment through faeces where it can spread rapidly through the community, especially in situations of poor hygiene and sanitation. The virus will not be susceptible to infection and die if a child is fully immunized against polio. Polio can spreads when food or drink is contaminated with faeces. There is also evidence that flies can passively transfer poliovirus from feces to food. Most people infected with the polio virus have no signs of illness and are never aware that they have been infected. These asymptomatic people carry the virus in their intestines and can “silently” spread the infection to thousands of other people.
Polio Treatment
The doctor will advise the patient to get more rest and increase fluid consumption to relieve symptoms that arise. Treatment aims to relieve symptoms, speed up the healing process, and prevent complications. The drugs commonly used are:
• Pain relievers
This medication is used to relieve pain, headache, and fever. An example of this drug is ibuprofen.
• Antibiotic drugs
Antibiotics are used to treat bacterial infections that can accompany polio, such as urinary tract infections. An example of an antibiotic that can be given is ceftriaxone.
• Muscle relaxants (antispasmodics)
This medication is used to relieve tension in the muscles. Examples of these drugs are tolterodine and scopolamine. In addition to medication, warm compresses can also be used to relieve muscle tension.
Doctors will put a breathing apparatus on the patient if polio causes respiratory problems. Sometimes, surgery will also be performed to correct the deformity of the arm or leg.
Polio Prevention
Polio prevention can be done by immunization against polio. The polio vaccine is able to provide immunity against polio disease and is safe to give to people with weakened immune systems. There are two forms of polio vaccine, namely injectable (IPV) and oral drops (OPV).
Polio in the form of oral drops (OPV-0) is given to the baby shortly after birth. Furthermore, the polio vaccine will be given in four doses, either in the form of injections (IPV) or oral drops (OPV). The following is the schedule for administering the four doses of the polio vaccine:
• The first dose (polio-1) is given at 2 months of age.
• The second dose (polio-2) is given at 3 months of age.
• The third dose (polio-3) is given at 4 months of age.
• The last dose is given at 18 months of age, as a booster dose.
In the first three doses (polio-1 to polio-3), an infant should receive at least one dose of injectable polio vaccine (IPV).
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