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Poliomyelitis was first recognized as a distinct condition by [[Jakob Heine]] in 1840.<ref name=Paul_1971>{{cite book| author = Paul JR| title=A History of Poliomyelitis| publisher=Yale University Press| location= New Haven, Conn| year=1971| pages=16–18| isbn= 0-300-01324-8| series= Yale studies in the history of science and medicine}}</ref> Its causative agent, [[poliovirus]], was identified in 1908 by [[Karl Landsteiner]].<ref name=Paul_1971/> Although major polio [[epidemic]]s were unknown before the 20th century, polio was one of the most dreaded childhood diseases of the 20th century in the United States. Polio epidemics have crippled thousands of people, mostly young children; the disease has caused paralysis and death for much of human history. Polio had existed for thousands of years quietly as an [[endemic (epidemiology)|endemic]] pathogen until the 1880s, when major epidemics began to occur in Europe; soon after, widespread epidemics appeared in the United States.<ref name = Trevelyan/> By 1910, much of the world experienced a dramatic increase in polio cases and frequent epidemics became regular events, primarily in cities during the summer months. These epidemics—which left thousands of children and adults paralyzed—provided the impetus for a "Great Race" towards the development of a [[vaccine]]. The [[polio vaccine]]s developed by [[Jonas Salk]] in 1952 and [[Albert Sabin]] in 1962 are credited with reducing the annual number of polio cases from many hundreds of thousands to around a thousand.<ref name=Aylward_2006>{{cite journal |author=Aylward R |title=Eradicating polio: today's challenges and tomorrow's legacy |journal=Ann Trop Med Parasitol |volume=100 |issue=5–6 |pages=401–13 |year=2006 |pmid=16899145}}</ref> Enhanced [[vaccination]] efforts led by the [[World Health Organization]], UNICEF and Rotary International could result in global eradication of the disease.<ref>{{cite journal |author=Heymann D |title=Global polio eradication initiative | url=http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862006000800006&lng=en&nrm=iso&tlng=en |journal=Bull. World Health Organ. |volume=84 |issue=8 |pages=595 |year=2006 |pmid=16917643 |doi=}}</ref>
Poliomyelitis was first recognized as a distinct condition by [[Jakob Heine]] in 1840.<ref name=Paul_1971>{{cite book| author = Paul JR| title=A History of Poliomyelitis| publisher=Yale University Press| location= New Haven, Conn| year=1971| pages=16–18| isbn= 0-300-01324-8| series= Yale studies in the history of science and medicine}}</ref> Its causative agent, [[poliovirus]], was identified in 1908 by [[Karl Landsteiner]].<ref name=Paul_1971/> Although major polio [[epidemic]]s were unknown before the 20th century, polio was one of the most dreaded childhood diseases of the 20th century in the United States. Polio epidemics have crippled thousands of people, mostly young children; the disease has caused paralysis and death for much of human history. Polio had existed for thousands of years quietly as an [[endemic (epidemiology)|endemic]] pathogen until the 1880s, when major epidemics began to occur in Europe; soon after, widespread epidemics appeared in the United States.<ref name = Trevelyan/> By 1910, much of the world experienced a dramatic increase in polio cases and frequent epidemics became regular events, primarily in cities during the summer months. These epidemics—which left thousands of children and adults paralyzed—provided the impetus for a "Great Race" towards the development of a [[vaccine]]. The [[polio vaccine]]s developed by [[Jonas Salk]] in 1952 and [[Albert Sabin]] in 1962 are credited with reducing the annual number of polio cases from many hundreds of thousands to around a thousand.<ref name=Aylward_2006>{{cite journal |author=Aylward R |title=Eradicating polio: today's challenges and tomorrow's legacy |journal=Ann Trop Med Parasitol |volume=100 |issue=5–6 |pages=401–13 |year=2006 |pmid=16899145}}</ref> Enhanced [[vaccination]] efforts led by the [[World Health Organization]], UNICEF and Rotary International could result in global eradication of the disease.<ref>{{cite journal |author=Heymann D |title=Global polio eradication initiative | url=http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862006000800006&lng=en&nrm=iso&tlng=en |journal=Bull. World Health Organ. |volume=84 |issue=8 |pages=595 |year=2006 |pmid=16917643 |doi=}}</ref>
==Laboratory Findings==
A laboratory diagnosis of poliomyelitis is usually made based on recovery of poliovirus from the stool or pharynx. Neutralizing antibodies to poliovirus can be diagnostic and are generally detected in the blood of infected patients early in the course of infection. Analysis of the patient's cerebrospinal fluid (CSF), which is collected by a lumbar puncture ("spinal tap") reveals an increased number of white blood cells (primarily lymphocytes) and a mildly elevated protein level. Detection of virus from the CSF is diagnostic of paralytic polio, but rarely occurs.


==References==
==References==

Revision as of 20:54, 7 December 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Poliomyelitis, often called polio or infantile paralysis, is an acute viral infectious disease spread from person to person, primarily via the fecal-oral route.[1] The term derives from the Greek polio (πολίός), meaning "grey", myelon (µυελός), referring to the "spinal cord", and -itis, which denotes inflammation.[2] Although around 90% of polio infections have no symptoms at all, effected individuals can exhibit a range of symptoms if the virus enters the blood stream.[3] In fewer than 1% of cases the virus enters the central nervous system, preferentially infecting and destroying motor neurons, leading to muscle weakness and acute flaccid paralysis. Different types of paralysis may occur, depending on the nerves involved. Spinal polio is the most common form, characterized by asymmetric paralysis that most often involves the legs. Bulbar polio leads to weakness of muscles innervated by cranial nerves. Bulbospinal polio is a combination of bulbar and spinal paralysis.[4]

Historical Perspective

Poliomyelitis was first recognized as a distinct condition by Jakob Heine in 1840.[5] Its causative agent, poliovirus, was identified in 1908 by Karl Landsteiner.[5] Although major polio epidemics were unknown before the 20th century, polio was one of the most dreaded childhood diseases of the 20th century in the United States. Polio epidemics have crippled thousands of people, mostly young children; the disease has caused paralysis and death for much of human history. Polio had existed for thousands of years quietly as an endemic pathogen until the 1880s, when major epidemics began to occur in Europe; soon after, widespread epidemics appeared in the United States.[6] By 1910, much of the world experienced a dramatic increase in polio cases and frequent epidemics became regular events, primarily in cities during the summer months. These epidemics—which left thousands of children and adults paralyzed—provided the impetus for a "Great Race" towards the development of a vaccine. The polio vaccines developed by Jonas Salk in 1952 and Albert Sabin in 1962 are credited with reducing the annual number of polio cases from many hundreds of thousands to around a thousand.[7] Enhanced vaccination efforts led by the World Health Organization, UNICEF and Rotary International could result in global eradication of the disease.[8]

Laboratory Findings

A laboratory diagnosis of poliomyelitis is usually made based on recovery of poliovirus from the stool or pharynx. Neutralizing antibodies to poliovirus can be diagnostic and are generally detected in the blood of infected patients early in the course of infection. Analysis of the patient's cerebrospinal fluid (CSF), which is collected by a lumbar puncture ("spinal tap") reveals an increased number of white blood cells (primarily lymphocytes) and a mildly elevated protein level. Detection of virus from the CSF is diagnostic of paralytic polio, but rarely occurs.

References

  1. Cohen JI (2004). "Chapter 175: Enteroviruses and Reoviruses". In Kasper DL, Braunwald E, Fauci AS, et al (eds.). Harrison's Principles of Internal Medicine (16th ed. ed.). McGraw-Hill Professional. p. 1144. ISBN 0071402357.
  2. Chamberlin SL, Narins B (eds.) (2005). The Gale Encyclopedia of Neurological Disorders. Detroit: Thomson Gale. pp. 1859–70. ISBN 0-7876-9150-X.
  3. Ryan KJ, Ray CG (eds.) (2004). "Enteroviruses". Sherris Medical Microbiology (4th ed. ed.). McGraw Hill. pp. 535–7. ISBN 0-8385-8529-9.
  4. Atkinson W, Hamborsky J, McIntyre L, Wolfe S (eds.) (2007). "Poliomyelitis". Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book) (PDF) (10th ed. ed.). Washington DC: Public Health Foundation. pp. 101–14.
  5. 5.0 5.1 Paul JR (1971). A History of Poliomyelitis. Yale studies in the history of science and medicine. New Haven, Conn: Yale University Press. pp. 16–18. ISBN 0-300-01324-8.
  6. Aylward R (2006). "Eradicating polio: today's challenges and tomorrow's legacy". Ann Trop Med Parasitol. 100 (5–6): 401–13. PMID 16899145.
  7. Heymann D (2006). "Global polio eradication initiative". Bull. World Health Organ. 84 (8): 595. PMID 16917643.