15.21B: Poliomyelitis
- Describe poliomyelitis and its effect on motor neurons
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.
Although approximately 90% of polio infections cause no symptoms at all, affected individuals can exhibit a range of symptoms if the virus enters the blood stream. In about 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.
BACKGROUND
Poliomyelitis was first recognized as a distinct condition by Jakob Heine in 1840. Its causative agent, poliovirus, was identified in 1908 by Karl Landsteiner. Although major polio epidemics were unknown before the late 19 th century, polio was one of the most dreaded childhood diseases of the 20 th century. 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. By 1910, much of the world experienced a dramatic increase in polio cases and 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.
DEVELOPMENT OF A VACCINE
Developed in the 1950s, polio vaccines are credited with reducing the global number of polio cases per year from many hundreds of thousands to today under a thousand. Enhanced vaccination efforts led by the World Health Organization, UNICEF, and Rotary International could result in global eradication of the disease.
Key Points
- Spinal polio is the most common type of polio and results in asymmetric paralysis, usually involving the legs.
- Bulbar polio is infection of the cranial nerves and causes weakness and paralysis in muscles innervated by the cranial nerves, while bulbospinal polio occurs when both the cranial nerves and spinal nerves are affected.
- Although approximately 90% of polio infections cause no symptoms at all, affected individuals can exhibit a range of symptoms if the virus enters the blood stream.
Key Terms
- motor neuron : A neuron located in the central nervous system that projects its axon outside the CNS and directly or indirectly control muscles.
- spinal polio : Spinal polio is characterized by asymmetric paralysis that most often involves the legs.
- poliomyelitis : acute infection by the poliovirus, especially of the motor neurons in the spinal cord and brainstem, leading to muscle weakness, paralysis and sometimes deformity
- paralysis : The complete loss of voluntary control of part of person’s body, such as one or more limbs.