Polio classification

Jump to navigation Jump to search

Polio Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Poliovirus

Differentiating Polio from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Treatment

Medical Therapy

Prevention

Future or Investigational Therapies

Case Studies

Case #1

Polio classification On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Polio classification

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Polio classification

CDC on Polio classification

Polio classification in the news

Blogs on Polio classification

Directions to Hospitals Treating Polio

Risk calculators and risk factors for Polio classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]

Overview

The term poliomyelitis is used to identify the disease caused by any of the three serotypes of poliovirus. Two basic patterns of polio infection are described: a minor illness which does not involve the central nervous system (CNS), sometimes called abortive poliomyelitis, and a major illness involving the CNS, which may be paralytic or non-paralytic.[1]

Classification

In most people with a normal immune system, a poliovirus infection is asymptomatic.

Abortive Poliomyelitis

Rarely the infection produces minor symptoms; these may include upper respiratory tract infection (sore throat and fever), gastrointestinal disturbances (nausea, vomiting, abdominal pain, constipation or, rarely, diarrhea), and influenza-like illnesses.

CNS Involvement

The virus enters the central nervous system in about 3% of infections.

Non-Paralytic Poliomyelitis

Most patients with CNS involvement develop non-paralytic aseptic meningitis, with symptoms of headache, neck, back, abdominal and extremity pain, fever, vomiting, lethargy and irritability.[2]

Paralytic Poliomyelitis

Approximately 1 in 200 to 1 in 1000 cases progress to paralytic disease, in which the muscles become weak, floppy and poorly-controlled, and finally completely paralyzed; this condition is known as acute flaccid paralysis.[3] Depending on the site of paralysis, paralytic poliomyelitis is classified as spinal, bulbar, or bulbospinal. Encephalitis, an infection of the brain tissue itself, can occur in rare cases and is usually restricted to infants. It is characterized by confusion, changes in mental status, headaches, fever, and less commonly seizures and spastic paralysis.[4]

ECPPC and ELCPPC Classifications

Until 1976, paralytic poliomyelitis was classified according only to epidemiological data. The ECPPC, or Epidemiologic Classication of Paralytic Poliomyelitis Cases, distributed these cases into 1 of 4 categories:[5]

In 1985, a new classification was proposed, in order to incorporate not only epidemiological information but also viral isolation, and characterization of the viral strain. This new classification was named ELCPPC, or Epidemiologic and Laboratory Classification of Paralytic Poliomyelitis Cases, and it classifies paralytic poliomyelitis according to the following classes:[5]

Sporadic

Any case of poliomyelitis that is not epidemiological related to another, and that may be caused by either the wild form of the virus, or by the virus in the vaccine.

Epidemic

When a case of the disease is epidemiologically linked to a similar case. It may, or may not be related to the virus in the vaccine.

Immunologically abnormal

Any presumed or confirmed case of poliomyelitis that may be caused by either the wild form of the virus, or by the virus in the vaccine, irrespectively to the origin of the host's immunological deficiency.

Imported

Any new case of poliomyelitis in a person who has entered the US (either foreign or US resident), and that has been symptomatic for the previous 30 days of entrance, or that develops symptoms during the initial 30 days in the country.

References

  1. Falconer M, Bollenbach E (2000). "Late functional loss in nonparalytic polio". American journal of physical medicine & rehabilitation / Association of Academic Physiatrists. 79 (1): 19–23. PMID 10678598.
  2. name=Late>Leboeuf C (1992). The late effects of Polio: Information For Health Care Providers (PDF). Commonwealth Department of Community Services and Health. ISBN 1-875412-05-0. Retrieved 2007-11-10.
  3. Frauenthal HWA, Manning JVV (1914). Manual of infantile paralysis, with modern methods of treatment.. Philadelphia Davis, 79–101. OCLC 2078290
  4. Wood, Lawrence D. H.; Hall, Jesse B.; Schmidt, Gregory D. (2005). Principles of Critical Care, Third Edition. McGraw-Hill Professional. p. 870. ISBN 0-07-141640-4.
  5. 5.0 5.1 Sutter RW, Brink EW, Cochi SL, Kew OM, Orenstein WA, Biellik RJ; et al. (1989). "A new epidemiologic and laboratory classification system for paralytic poliomyelitis cases". Am J Public Health. 79 (4): 495–8. PMC 1349984. PMID 2929811.

Template:WH Template:WS