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Rates and Standardization
Published in Marcello Pagano, Kimberlee Gauvreau, Heather Mattie, Principles of Biostatistics, 2022
Marcello Pagano, Kimberlee Gauvreau, Heather Mattie
In 1954, a study tested the effectiveness of the poliomyelitis vaccine developed by Dr. Jonas Salk [108]. Poliomyelitis is a communicable illness caused by the poliovirus; it ranges in severity from a mild infection to fatal paralytic disease. First, second, and third graders in the United States and Canada were randomly assigned to one of two treatment groups. Members of one group received the Salk vaccine, while those in the other group were given a placebo, an inert substance which was physically indistinguishable from the true vaccine. A total of 401,974 children received either the vaccine or the placebo. Listed below are the numbers of reported cases of disease for each of the two groups. The reported cases are divided into true instances of polio and incorrect diagnoses. The true cases are further stratified by whether the disease was paralytic or nonparalytic.
The Neurologic Disorders in Film
Published in Eelco F. M. Wijdicks, Neurocinema—The Sequel, 2022
What can be said about poliomyelitis to understand the portrayal? In the overwhelming proportion of cases, poliomyelitis is a viral infection by an enterovirus that causes a non-distinctive viral illness and, in some, a devastating paralysis from the involvement of the anterior horn of the spinal cord. When the brainstem becomes involved, patients develop oropharyngeal weakness, which causes difficulty in clearing secretions and compromises respiration. Many patients in the past had back stiffness and severe pain from hypertonicity. Many patients developed intercostal paralysis and severe weakness of the diaphragm, an early paralytic stage of anterior poliomyelitis. Other patients were able to create sufficient respiratory movements using the accessory muscles and the diaphragm. Over a few days, the paralyzed intercostal muscles improved, and the patient went on to almost complete recovery.
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
The diagnosis of poliomyelitis relies on a high clinical suspicion. It is based on the clinical presentation of acute, asymmetric, flaccid paralysis, and early CSF findings consistent with aseptic meningitis.
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].
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
How does diagnostic technology today compare with the historical experience with polio? Polioviruses likely infected human populations for centuries [31], but the recognition of poliomyelitis as a distinct disease traces back to 1840 when Joseph Heine synthesized various clinical accounts of this paralytic disease as manifestations of one and the same disease [32]. Anecdotal evidence of other disease clusters soon followed, and in 1890 Medin presented the first known ‘epidemic’ of 44 cases of infantile paralysis, including various forms of poliomyelitis [33]. Medin characterized polio as an acute infection, although he found no evidence of ‘contagion’ in families of affected patients. These and subsequent studies culminated in the seminal work of Wickman who provided an analysis of >1,000 cases of acute poliomyelitis based on a 1905 Scandinavian epidemic [34]. Wickman’s studies led to demonstration of person-to-person transmission of the disease, and to recognition of ‘abortive’ (mild or asymptomatic) infections without paralysis. Definitive evidence for transmissibility came from studies that demonstrated transmission from humans to monkeys by injection of spinal cord material from a patient with severe poliomyelitis into the intraperitoneal space of two old-world monkeys, one of whom developed flaccid paralysis [35]. This work and multiple additional lines of evidence (reviewed in [36]), identified the etiological agent as a ‘filterable’ virus and named the poliovirus.
Lower-limb muscle strength, static and dynamic postural stabilities, risk of falling and fear of falling in polio survivors and healthy subjects
Published in Physiotherapy Theory and Practice, 2020
Thaiana Santos Galvão, Egídio Sabino Magalhães Júnior, Marco Antonio Orsini Neves, Arthur de Sá Ferreira
Acute anterior poliomyelitis, an inflammatory disease caused by poliovirus infection, is characterized by motor neuron loss in the spinal cord, resulting in asymmetric muscle weakness. Most cases of poliomyelitis occur in pediatric populations, but disability may remain throughout adulthood (Boyer et al. 2010; Gonzalez et al. 2010; Tiffreau et al. 2010). Worldwide, acute anterior poliomyelitis is being eradicated, and the incidence has declined from approximately 350,000 to 37 cases between 1988 and 2016 (World Health Organization 2017). In Brazil, the incidence decreased from 1,290 to 11 between 1980 and 1991 and has been eradicated since that time (Ministério da Saúde 2018). In late adulthood, up to 70% of polio survivors develop postpolio syndrome, which is characterized by a new set of symptoms, such as additional muscle weakness, muscle pain, and excessive central and peripheral fatigue (Boyer et al. 2010; Gonzalez et al. 2010; Tiffreau et al. 2010). Therefore, the clinical management of polio survivors is currently the main challenge facing multidisciplinary rehabilitation teams (Gonzalez et al. 2010) in developing countries (Cousins 2017).