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Poliovirus
Published in Patricia G. Melloy, Viruses and Society, 2023
The recovery and chronic phases of the illness for a polio survivor varied tremendously depending on the individual and the kind of treatment accessible to them. Personal accounts by survivors sometimes mention the discrimination that they faced because of their new disability, while others did not have the same experience. In many instances, survivors of paralytic polio were able to go back to their lives and finish school, get a job, and start a family (Wilson 2005). As Wilson states in his book Living with Polio (p. 169), “Here, one of the biggest hurdles was to learn to deal with the stigma of being a cripple.” Polio survivors, especially children, just wanted to “fit in” with their old neighborhood and community, and typically did not have contact with other polio survivors after leaving the hospital. At the same time, there were estimated to be over a million polio survivors in the United States in the late 20th century (Wilson 2005).
Neuroinfectious Diseases
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Jeremy D. Young, Jesica A. Herrick, Scott Borgetti
Classic paralytic polio often begins with severe muscle pain and spasms. This is followed by fasciculations and weakness of the lower limbs, more than upper limbs, and proximal muscles more than distal muscles. Progression of the patient's weakness peaks in 48 hours, halting after 5–7 days.
Polio
Published in Rae-Ellen W. Kavey, Allison B. Kavey, Viral Pandemics, 2020
Rae-Ellen W. Kavey, Allison B. Kavey
In terms of residual paralysis, 10–40% of patients with paralytic polio reportedly recovered full muscle strength but 60–90% were left with variable paralysis, ranging from near total paralysis to isolated paralysis of individual muscles. Early muscle recovery reflected reduced inflammation of infected gray matter with improved function within weeks. Over time, remaining brainstem and spinal cord motor neurons developed new branches called axonal sprouts which could re-innervate orphaned muscle fibers, denervated by the acute infection, restoring the capacity to contract. Terminal sprouting could generate enlarged motor neuron units doing the work of multiple units: a single motor neuron that once controlled 200 muscle cells might control more than 800 cells. Finally, remaining muscle fibers with retained innervation hypertrophied and weaker muscles functioned at a higher than usual intensity, improving strength and function.34
Adolf Kussmaul (1822–1902), and the naming of “poliomyelitis”
Published in Journal of the History of the Neurosciences, 2022
Nadeem Toodayan, Eric Matteson
Although some features of the illness might certainly be accounted for by an attack of paralytic polio, the symptom complex of progressive but self-limiting paraparesis with peripheral sensory and autonomic symptoms in the absence of a distinct central sensory level (which could indicate transverse myelitis) may be better explained by an acute inflammatory demyelinating polyradiculoneuropathy, or Guillain-Barre syndrome.1It was not until 1875 that Wilhelm Erb (1840–1921) and Carl Westphal (1833–1890) first indicated the clinical importance of deep tendon reflexes (Louis and Louis 2002), and this is why Kussmaul did not comment on such findings in his own case. We would expect the reflexes to be diminished in this instance. Kussmaul himself had originally described such a syndrome in the same year Octave Landry (1826–1865) coined the term “acute ascending paralysis” (Landry 1859), but he could not identify an anatomical or toxic cause for the disease (vide infra). Indeed, the term “Kussmaul-Landry paralysis” was in use before the name Guillain-Barre syndrome was popularized (Fischer 1931, 87), and was apparently the first of a number of eponymous clinical entities to be later linked to Kussmaul’s name (see Table 1).
Hypothetical emergence of poliovirus in 2020: part 1. Consequences of policy decisions to respond using nonpharmaceutical interventions
Published in Expert Review of Vaccines, 2021
Kimberly M. Thompson, Dominika A. Kalkowska, Kamran Badizadegan
In Figure 5, the initial rise of the disease in 2020 shown in Figure 2 has been intentionally truncated by limiting the vertical axis to 100,000 cases per year to demonstrate dynamics beginning 1 year after the emergence. In addition, Figure 5 includes an expected incidence line (bold black line) superimposed on the individual runs to show the expected level and periodicity of endemic disease in the absence of eradication. Importantly, while the initial emergence affects individuals of all ages (because no one has immunity), after the initial burn through the population, most of the disease incidence would appear in children who have no immunity. (This is essentially why and how an established infectious disease such as polio comes to be known as a ‘childhood disease.’). Flattening the curve shows a slower accumulation of cases over time and thus a less rapid decline of the average age of infection. The endemic equilibrium in 2030 for the expected birth cohort of approximately 136 million surviving infants [54] would lead to 680,000, 68,000, or 136,000 expected paralytic polio cases in 2030 for nWPV1, nWPV2, or nWPV3, respectively.838384858687888990919293949596979899100101102
Quality of life for post-polio syndrome: a patient derived, Rasch standard scale
Published in Disability and Rehabilitation, 2018
Carolyn A. Young, Anne-Marie C. Quincey, Samantha M. Wong, Alan Tennant
The disease-specific nature of the PP-QoL is also of importance. In addition to the obvious targeting of items to the consequences or impact of the condition, reflecting improved face validity, there is evidence that disease-specific instruments have better psychometric qualities such as discrimination, than their generic counterparts.[37] With respect to face validity, and particularly the derivation of items from the patient experience, it would appear that generic instruments can be ill-targeted for older subjects, which would be common for those with PPS in western countries where the last major outbreaks were in the 1950s.[38] Also, some of the issues expressed by our patients took unexpected forms, which would not be captured by generic measures. As our participants usually had experience of paralytic polio, their increasing disability lead to a specific fear about slipping backwards to a previous state of disability, which related to loss of ability to sustain independence, freedom, competence, usefulness to others, respect and status. This led in many cases to a high level of frustration that the disease might be “re-appearing”, and all the fears associated with that experience. It was noted that depression was also common among respondents (which may, or may not be associated with this experience) and these levels are consistent to those found elsewhere.[39]