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Poliovirus
Published in Patricia G. Melloy, Viruses and Society, 2023
Some survivors recalled having a headache and a stiff neck in the evening, and then waking up the next day to partial paralysis. A few former polio patients indicated that they were initially misdiagnosed as having another illness as well (Gould 1995). Scientists know that poliovirus can induce an interferon response initially, which explains the febrile-like illness noted by these polio survivors (Yin-Murphy and Almond 1996). A spinal tap (to obtain cerebrospinal fluid) became the standard for correctly diagnosing polio in the early to mid-20th century (Wilson 2005). Currently, poliovirus can be detected from throat, feces, or cerebrospinal fluid samples that are then used to culture the virus in vitro in the laboratory or used in a polymerase chain reaction (PCR) test to detect the poliovirus genome. Sequencing can be used to determine the type of polio, and even the typical geographical location for that strain of the virus (CDC 2021a). People infected with poliovirus also make antibodies against the virus that can be detected in bodily secretions (Yin-Murphy and Almond 1996).
The Viruses
Published in Julius P. Kreier, Infection, Resistance, and Immunity, 2022
Polio was first described in the eighteenth century. Epidemics occurred frequently until about 1955 when attenuated and inactivated polio vaccines came into wide use. Poliovirus was one of the first viruses propagated in cell culture and its complete crystallographic structure is known today.
Polio
Published in Rae-Ellen W. Kavey, Allison B. Kavey, Viral Pandemics, 2020
Rae-Ellen W. Kavey, Allison B. Kavey
During the summer of 1911, three Rockefeller clinicians performed a classic clinical study of a polio outbreak in New York city, describing the natural history of the disease in 71 hospitalized children and 90 outpatient cases.14 Their findings in families indicated that polio was highly contagious and confirmed that a significant number of those infected with the poliovirus had few if any symptoms. Their series emphasized that paralysis was not the presenting symptom of polio, but instead followed an initial stage characterized by non-specific symptoms of fever, lethargy, muscle pain, and headache. They reviewed multiple laboratory results trying to identify a defining diagnostic pattern, without success. Thirty-four cases were described in great detail including the history of the illness, the physical findings on presentation and the hospital course, day by day. These case descriptions illuminated the variety of presentations of infection with the poliovirus. The histories of 12 infants and children who died are described in heart-rending detail as hour by hour, progressive paralysis of the intercostal muscles and the diaphragm led to respiratory failure and death.
Emerging trends and insights in acute flaccid myelitis: a comprehensive review of neurologic manifestations
Published in Infectious Diseases, 2023
Baljinder Singh, Sanchit Arora, Navjot Sandhu
The target is to treat the major neurologic damage which is seen when AFM is clinically presented. The treatment with various agents viz. antiviral drugs, glucocorticoids, intravenous immunoglobulins, plasma exchange, etc. has proven to be unsuccessful [1]. Surgical Nerve transfer to the region of the cord, which is not affected by AFM, has shown some improvement in the clinical status of the patients [66]. Besides this, physical therapy, which is widely used for polio, may give better outcomes to non-polio AFM patients. Polio therapy is aimed at all three stages viz. Acute, convalescent, and chronic polio paralysis [67]. Symptomatic treatment available for specific symptoms presented by an individual patient such as muscle power loss, flexibility loss, any residual deformity, reduced vital capacity, and any loss in functional stamina involves physical therapy which should be advised as soon as the patient is diagnosed with AFM [68].
Recent strategies driving oral biologic administration
Published in Expert Review of Vaccines, 2021
Badriyah Shadid Alotaibi, Manal Buabeid, Nihal Abdalla Ibrahim, Zelal Jaber Kharaba, Munazza Ijaz, Ghulam Murtaza
Oral drug administration is an ideal route of drug delivery. In contrast to injectables, oral drug delivery has several advantages, such as self-administration and noninvasiveness [1], resulting in better compliance and improved health outcomes. Gastrointestinal barriers hinder the efficient absorption of large therapeutic molecules, for instance, biologics [2]. The exemptional cases include some vaccines [3–5] and few combinations of biologics and permeation enhancers [6,7]. The first-ever oral vaccines targeted the polio virus in 1950 [8]. This successful demonstration led to adenovirus, rotavirus, cholera, and typhoid fever vaccines [3,4]. The mucosal surfaces of respiratory, gastrointestinal, and urogenital tracts are the primary homes of numerous pathogens [4]. Oral vaccine administration results in the elicitation of systemic immunity; rather, its main immunological advantage lies in its ability to provide mucosal immunity and protect mucosal membrane against infection. Alternatively, intramuscular vaccination induces a successful systemic immune response, but the resulting mucosal immunity is weak. Only trained personnel can correctly administer intramuscular vaccine [4,5]. These limitations restrict the use of the intramuscular vaccine in pandemics. Besides, intramuscular immunization could be unsuccessful in the complete eradication of mucosal infection [9,10]. As a result, the disease may affect unimmunized people. Despite these benefits, the proportion of oral vaccination is smaller compared to intramuscular administration of vaccines.
Cross-neutralization Capacity of Immune Serum from Different Dosage of Sabin Inactivated Poliovirus Vaccine Immunization against Multiple Individual Polioviruses
Published in Expert Review of Vaccines, 2021
Kai Chu, Weixiao Han, Deyu Jiang, Zhiwei Jiang, Taotao Zhu, Wenbo Xu, Yuemei Hu, Gang Zeng
Poliomyelitis is a paralytic disease caused by any of the three poliovirus types 1, 2, and 3, especially in children aged <5 years [1]. The vaccination era started in 1955 when the inactivated poliovirus vaccine (IPV) developed by Jonas Salk was licensed in the USA, followed by the oral polio vaccine (OPV) by Albert Sabin licensed in 1961 [2]. The widespread introduction of polio vaccines has prompted a rapid decline in cases with poliomyelitis worldwide. Furthermore, the World Health Organization (WHO) launched the Global Polio Eradication Initiative (GPEI) in 1988, which reduced the global incidence of polio by 99.9% [3,4]. The WHO currently recommends the need to not only rapidly eradicate wild polioviruses but also prevent the occurrence of vaccine-associated paralytic poliomyelitis (VAPP), recurrent circulating vaccine-derived poliovirus (cVDPV), and immunodeficient vaccine-derived poliovirus (iVDPV) [5–7]. The incidence of VAPP is estimated to be 2–4 cases/million birth cohort per year in countries using OPV [8], and the attenuated viruses in live OPV may re-acquire neurovirulence and transmissibility through prolonged replication in an individual or community and finally transform into cVDPVs [9–11].