Presentation on the topic of polio prevention. Poliomyelitis and acute flaccid paralysis
Poliovirus Discovered by Enders, Weller and Robbins Discovered by Enders, Weller and Robbins Poliovirus, genus of enteroviruses Poliovirus, genus of enteroviruses RNA-containing RNA-containing 3 serotypes 3 serotypes Source of infection and reservoir of the virus - humans Source of infection and reservoir of the virus - humans Isolated from the nasopharynx ( 1-2 weeks) and intestines (several weeks) Isolated from the nasopharynx (1-2 weeks) and intestines (several weeks)
Epidemiology Airborne and alimentary routes of infection Airborne and alimentary routes of infection Resistance of the virus Resistance of the virus Summer, early autumn Summer, early autumn More often in southern countries More often in southern countries Children under 5 years old Children under 5 years old
Clinical forms Inapparent Inapparent Abortive (visceral) Abortive (visceral) Meningeal Meningeal Paralytic (“infantile spinal palsy”) Paralytic (“infantile spinal palsy”) spinal, pontine, bulbar, mixed spinal, pontine, bulbar, mixed
Course of paralytic forms Preparalytic period (1-2 days) Preparalytic period (1-2 days) Paralytic period (in the first hours after a decrease in temperature, morning paralysis) - up to 2 weeks Paralytic period (in the first hours after a decrease in temperature, morning paralysis ) - up to 2 weeks Recovery period Recovery period Period of residual effects Period of residual effects Mortality - 10%, disability - 40% (at the beginning of the 20th century).
Diagnostics Treatment Cellular-protein dissociation in the cerebrospinal fluid Cellular-protein dissociation in the cerebrospinal fluid Virological study (nasopharyngeal swabs, feces) Virological study (nasopharyngeal swabs, feces) Serological study in dynamics Serological study in dynamics Rest Rest Dehydration Dehydration Intensive therapy Intensive therapy Prevention of contractures Prevention of contractures Rehabilitation treatment Rehabilitation treatment
Isolation 3 weeks Isolation 3 weeks Observation of contacts Observation of contacts 3 weeks contacts 3 weeks Since 1959 - trivalent OPV vaccine at 1, 2 and 7 years Since 1959 - trivalent OPV vaccine at 1, 2 and 7 years creating herd immunity - 90% of the world's population needs to be vaccinated. creating herd immunity - it is necessary to vaccinate 90% of the world's population. Prevention
Every year, paralytic poliomyelitis in the countries of the WHO European Region fell ill. - 28.5 thousand children. – 7.7 thousand children – 7.7 thousand children 1975 – 1.1 thousand children 1975 – 1.1 thousand children 1979 – 0.2 thousand children 1979 – 0.2 thousand children
Sabin vaccine (OPV) - 1959 - oral pomyomyelitis vaccine - live attenuated polio virus (so-called vaccine strains). Administered through the mouth, drop by drop. Induces persistent powerful immunity, including in the intestines. Vaccine-associated polio is very rare - 1 in 5 million vaccinated people.
Salk vaccine (IPV), Denmark - inactivated, administered by injection, does not cause complications, induces good general immunity, but does not develop local protection in the intestine.
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Polio
Discipline: SP in pediatrics
Specialty: Nursing
Teacher: Kasatikova N.V.
GBPOU "Tolyatti Medical College"
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Lecture outline
Etiology, epidemiology
Clinic
Diagnostics
Treatment
Prevention
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Polio
An acute infectious disease characterized by general toxic symptoms and frequent damage to the nervous system
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Etiology
Enteroviruses, three serotypes.
They tolerate freezing well.
They die under the influence of ultraviolet radiation and disinfectants.
Pathogenesis
Portal of entry: mucous membrane of the oral cavity, pharynx and small intestine.
Viruses penetrate hematogenously into the central nervous system and infect the anterior (motor) horns of the spinal cord.
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Epidemiology
Source of infection: patient, virus carrier.
Mechanism of transmission: fecal-oral, airborne.
Seasonality: autumn-winter period.
Children under 3 years of age are most often affected.
Immunity is stable, but only to the transferred serotype.
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Periods of illness
Incubation: lasts 2-35 days, usually 5-14 days.
Preparalytic.
Paralytic.
Restorative.
Period of residual effects.
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Preparalytic period
It begins acutely, with a rise in temperature to 39°C, symptoms of intoxication.
Catarrhal phenomena: hyperemia of the mucous membranes of the oropharynx, runny nose, cough.
Damage to the gastrointestinal tract: vomiting, abdominal pain, sometimes diarrhea or constipation.
Characteristic: hyperesthesia, adynamia, increased sweating (especially of the face), muscle spasms, tremors, pain in the muscles of the limbs, usually where paralysis later occurs.
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Preparalytic period
Due to pain, the child takes forced positions: forced lordosis, throwing back the head.
The tripod symptom is typical: when sitting down, the child leans on the bed with his arms laid back.
Positive meningeal symptoms are often detected: stiff neck, Kernig and Brudzinski signs.
At the end of the period, body temperature usually decreases and intoxication decreases.
Duration 2-5 days.
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Paralytic period
Paralysis appears suddenly or develops over several hours; The temperature is often normal, but sometimes paralysis occurs at the height of a repeated rise in temperature.
The muscles of the legs are most often affected, less often the muscles of the arms, neck, and torso.
In the affected area, muscle tone is reduced, reflexes are absent.
Affected extremities become cold, pale, or cyanotic.
Duration 8-10 days.
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Recovery period
It begins with the disappearance of symptoms of intoxication and pain.
Functional recovery is slow and uneven.
In the affected muscles, tone remains reduced for a long time, areflexia and atrophy persist.
Uneven recovery of functions leads to curvatures, deformities and contractures.
The growth of the affected limb lags behind, lameness occurs.
Lasts from 1-6 months. up to 3 years.
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Period of residual effects
Persistent flaccid paralysis, atrophy of the affected muscles, contractures, shortening of the limb, etc.
Depending on the severity, they can be minor or lead to severe disability.
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Clinic of atypical forms
Inapparent: without clinical manifestations (healthy virus carriers), specific immunity is formed.
Abortive: without damage to the nervous system; moderate symptoms of intoxication, catarrhal symptoms (cough, runny nose), hyperesthesia, sweating, abdominal pain, intestinal disorders. The current is favorable. Lasts 3-7 days.
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Clinic of typical forms
Non-paralytic poliomyelitis (meningeal form): symptoms are similar to abortive polio, but intoxication is more pronounced. On the 2-3rd day of illness, vomiting, headache, convulsions, and meningeal symptoms appear. The course is favorable, there is no paralysis.
Paralytic poliomyelitis (forms):
spinal - the most typical
bulbar
pontine
encephalic
mixed (combined)
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Spinal shape
Paresis, paralysis of the muscles of the arms, legs, neck, chest, torso; sensitivity preserved
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Bulbar form
The most severe form.
Hyperthermia, severe headache, vomiting.
Increased salivation, difficulty swallowing, choking, liquid food getting into the nose, aspiration is possible.
Impaired phonation due to damage to the laryngeal muscles and ligaments.
Speech disorders: it is slurred, the child speaks in a whisper or in a hoarse voice.
With paralysis of the diaphragm and intercostal muscles, shortness of breath, cyanosis, shallow breathing, and a silent cough appear.
Possible death from paralysis of the respiratory center.
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Pontine form
Damage to the facial nerve and paresis of facial muscles:
facial asymmetry
smoothness of the nasolabial fold
pulling the corner of the mouth to the healthy side
incomplete closure of eyelids
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Encephalic form
Loss of consciousness, convulsions, hand tremors, nystagmus.
Meningeal symptoms, focal symptoms.
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Diagnostics
Virological method: isolation of the virus from nasopharyngeal swabs, feces, cerebrospinal fluid
Serological method: increase in titer of specific antibodies
UAC: moderate leukocytosis
Lumbar puncture and cerebrospinal fluid analysis
Electromyography
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Principles of treatment
Hospitalization.
Therapeutic and protective regime: strict bed rest on a hard mattress in a physiological body position to prevent contractures; change position every 2 hours.
Reduction of parenteral manipulations to a minimum, peace in the ward, comfortable temperature.
For breathing disorders: elevated leg end, sanitation of the respiratory tract, if necessary, a tracheostomy; transfer to hardware mechanical ventilation.
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A room with “iron lung” devices, which house patients with respiratory paralysis, in one of the hospitals in California, California 1953
POLIO
Poliomyelitis –
(from the Greek polios - gray and myelos - bone or spinal cord) - an acute infectious disease (old name - “infantile paralysis”) caused by one of the smallest viruses - poliovirus from the family of picornaviruses, which do not have an envelope and contain RNA
POLIO
The duration of the incubation period is from 4 to 30 days
Polio is transmitted through contaminated hands, food, water
It is assumed that the infection can also be transmitted by airborne droplets
The virus affects the central nervous system, causing a degenerative-inflammatory process in the anterior horns of the spinal cord and the gray matter of the subcortex
POLIO
ICD CLASSIFICATION – 10
A.80. Acute polio
A.80.0. Acute paralytic poliomyelitis associated with vaccine virus.
A.80.1. Acute paralytic poliomyelitis caused by wild imported poliovirus (types 1, 2 or 3).
A.80.2. Acute paralytic poliomyelitis caused by wild local (endemic) poliovirus (types 1, 2 or 3).
A.80.3. Acute paralytic poliomyelitis, other and unspecified etiology.
A.80.4. Acute non-paralytic poliomyelitis
POLIO
Clinical forms of paralytic poliomyelitis
2. Bulbar
3.Pontina
4.Mixed
(bulbospinal,
pontospinal)
Motor nuclei of the cranial nerves of the brainstem
Isolated lesion
nuclei of the facial nerve in the area of the Varoliev bridge
Damage to the nuclei of the cranial nerves and spinal cord
POLIO
The most common form.
In the pre-vaccination period it was 46-54%
POLIO
Spinal form of acute polio
Preparalytic period
The onset is acute, with high T° and intoxication
Catarrhal phenomena, loose stools
Children are lethargic, moody, have poor sleep and appetite
Headaches, pain in the back, neck, limbs
On examination, meningeal signs and tension symptoms
Pain when sitting up in bed with legs extended
Myoclonus of muscles or muscle groups in areas of future paresis
POLIO
Spinal form of acute polio
Paralytic period
The lower extremities are most often affected
Paralysis is flaccid in nature
Severely limited range of motion
Low tone
SR low or absent
POLIO
Spinal form of acute polio
Features of paralysis:
short rise time
the proximal parts are more often affected
asymmetrical, “mosaic” arrangement
sensory, pelvic disorders and pyramidal symptoms are absent
GLOBAL POLIO ERADICATION INITIATIVE
In 1988, the Forty-First World Health Assembly, then composed of delegates from 166 Member States, adopted a resolution to eradicate polio from the world
This marked the beginning of the Global Polio Eradication Initiative, led by the World Health Organization, Rotary International, the US Center for Disease Control (CDC) and the United Nations Children's Fund UNICEF
The Initiative was adopted following the confirmation of smallpox eradication in 1980 and built on the progress made in eradicating poliovirus in the Americas in the 1980s
Abstract for the presentation
Presentation for schoolchildren on the topic “Polio” in medicine. pptCloud.ru is a convenient catalog with the ability to download powerpoint presentations for free.
Polio
Polio virus
Discovered by Enders, Weller and Robbins Poliovirus, a genus of enteroviruses RNA containing 3 serotypes The source of infection and reservoir of the virus is humans Isolated from the nasopharynx (1-2 weeks) and intestines (several weeks)
Epidemiology
Airborne and nutritional routes of infection Virus resistance Summer, early autumn More often in southern countries Children under 5 years of age
Pathogenesis of polio
Virus Oropharyngeal mucosa, gastrointestinal tract Lymphatic system Circulatory system Nervous system Extraneural tissues
Clinical forms
Inapparent Abortive (visceral) Meningeal Paralytic (“infantile spinal palsy”) spinal, pontine, bulbar, mixed
Course of paralytic forms
Pre-paralytic period (1-2 days) Paralytic period (in the first hours after a decrease in temperature, morning paralysis) - up to 2 weeks Recovery period Period of residual effects Mortality - 10%, disability - 40% (at the beginning of the 20th century).
Diagnostics Treatment
Cellular-protein dissociation in the cerebrospinal fluid Virological study (nasopharyngeal swabs, feces) Serological study over time Rest Dehydration Intensive therapy Prevention of contractures Rehabilitation treatment
Isolation 3 weeks Observation of contacts 3 weeks Since 1959 - trivalent OPV vaccine at 1, 2 and 7 years to create herd immunity - it is necessary to vaccinate 90% of the world's population. Prevention
Every year, paralytic poliomyelitis occurred in the countries of the WHO European Region.
1951-1955 — 28.5 thousand children 1961-1965. – 7.7 thousand children 1975 – 1.1 thousand children 1979 – 0.2 thousand children
Sabin vaccine (OPV)
– 1959 - oral pomyomyelitis vaccine - live attenuated polio virus (so-called vaccine strains). Administered through the mouth, drop by drop. Induces persistent powerful immunity, including in the intestines. Vaccine-associated polio is very rare - 1 in 5 million vaccinated people.
Salk vaccine (IPV)
- 1955, Denmark - inactivated, administered by injection, does not cause complications, induces good general immunity, but does not develop local protection in the intestine.
Legal basis for prevention and anti-epidemic measures
Law is a set of generally binding norms (rules) of behavior established by the state. Compliance with legal norms is ensured by the coercive force of the state.
The state, in the rules of law, guarantees, stimulates and protects behavior that corresponds to these standards and provides for preventive measures, as well as punishment in the form of certain legal consequences for illegal behavior.
Levels of legal support for anti-epidemic practice in the Russian Federation
Constitution of the Russian Federation 1993 (vv. 1, 2,17,55 (part 3)
Laws of the Russian Federation
(6 basic laws)
Decrees of the Government of the Russian Federation
Orders of the Ministry of Health and Social Development of Russia
Resolutions of the Chief State Sanitary Doctor of the Russian Federation (37) (for 5 years)
Legal acts (laws) of territories, regions, districts, subjects of the Federation
Legal acts (Resolutions) of cities, districts (indirect advisory acts)
Sanitary rules and regulations (27) for 5 years
International Health Regulations
5 laws for the Voronezh region
Legal basis of anti-epidemic practice in Russia:
Constitution of the Russian Federation (1993)
“Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens”, adopted by the Supreme Council of the RSFSR on July 22, 1993.
Law of the Russian Federation No. 2300-1 “On the protection of consumer rights” dated February 7, 1992
Law of the Russian Federation No. 4866-1 “On appealing to court actions and decisions that violate the rights and freedoms of citizens” dated April 27, 1993.
Law of the Russian Federation No. 38-FZ “On preventing the spread in the Russian Federation of the disease caused by the human immunodeficiency virus (HIV infection)” dated March 30, 1995.
Law of the Russian Federation No. 157-FZ “On immunoprophylaxis of infectious diseases” dated September 17, 1998
Law of the Russian Federation No. 52-FZ “On the sanitary and epidemiological welfare of the population” dated March 30, 1999
Law of the Russian Federation No. 134-FZ “On the protection of the rights of legal entities and individual entrepreneurs during state control (supervision)” dated 08.08.2001
Regulatory documents regulating the tasks and functions of the Federal Supervision Service
— Regulations on the Ministry of Health and Social Development of the Russian Federation, approved by Decree of the Government of the Russian Federation dated June 30, 2004 No. 321
Regulations on the Federal Service for Supervision of Consumer Rights Protection and Human Welfare, approved by Decree of the Government of the Russian Federation of June 30, 2004 No. 322
Regulations on the implementation of state sanitary and epidemiological supervision in the Russian Federation, approved by Decree of the Government of the Russian Federation of September 15, 2005 No. 569
List of sanitary and epidemiological rules regulating
requirements for the prevention of infectious diseases
Sanitary protection of the territory of the Russian Federation (SP 3.4.1328-03).
Conditions for transportation and storage of medical immunobiological preparations
Sanitary and epidemiological requirements for conditions of transportation, storage and
dispensing to citizens of medical immunobiological preparations used
for immunoprophylaxis, pharmacies and healthcare institutions
5. Sanitary and epidemiological requirements for the organization and implementation of disinfection activities (SP 3.5.1378-03).
6. Hygienic requirements for the placement, arrangement of equipment and operation of hospitals, maternity hospitals and other medical institutions (SP 2.1.3.1375-03).
7. Prevention of diphtheria (SP 3.1.2.1108-02).
8. Prevention of polio (SP 3.1.2.1118-02).
9. Prevention of influenza (SP 3.1.2.1319-03).
10. Additions and changes to SP 3.1.2.1319-03 Prevention of influenza (SP 3.1.2.1382-03).
11. Prevention of measles, rubella, mumps (SP 3.1.2.1176-02).
12. Prevention of pertussis infection (SP 3.1.2.1320-03).
List of sanitary and epidemiological rules regulating requirements for the prevention of infectious diseases
13. Prevention of meningococcal infection (SP 3.1.2.1321-03).
14. Prevention of tuberculosis (SP 3.1.1295-03).
15. Prevention of tetanus (SP 3.1.1381-03).
16. Prevention of cholera. General requirements for epidemiological surveillance of cholera (SP 3.1.1086-02).
17. Prevention of plague (SP 3.1.7.1380-03).
18. Good practice for the production of medical immunobiological preparations (SP 3.3.2.1288-03).
20. Prevention of acute intestinal infections (SP 3.1.1.1117-02).
21. Prevention of streptococcal (group A) infections (SP 3.1.2.1203-03).
22. Prevention of infectious diseases during endoscopic manipulations (SP 3.1.127503).
23. Prevention of enterobiasis (SP 3.2.1317-03).
24. Safety of working with microorganisms of pathogenicity (hazard) groups 1-11 (SP 1.3.1285-03).
25. Safety of working with materials infected or potentially infected with wild poliovirus (SP 1.3.1325-03).
26. Sanitary and epidemiological requirements for deratization (SP 3.5.1.1129-02).
27. Sanitary and epidemiological requirements for the organization and implementation of disinfestation measures against synanthropic arthropods (SaNPiN 3.5.2.1376-03).
with infectious diseases
1. From 07.17.02. No. 228 “On the procedure for carrying out control measures during the implementation of state sanitary and epidemiological supervision.”
2. From 07.20.02. No. 259 “On coordination of measles surveillance activities.”
3. From 08/19/02 No. 270 “On approval of the measles elimination program in the Russian Federation by 2010.”
From 03/21/03 No. 117 “On implementation
measles elimination program in the Russian Federation to
From 12/19/03 No. 606 “On approval of instructions for preventing the transmission of HIV infection from
mother to child and a sample of informed consent for HIV chemoprophylaxis.”
From 07/09/03, No. 235 “On the creation
Coordination Council for the Prevention of HIV Transmission
infections from mother to child."
From 05/26/03 No. 210 “On the creation of an advisory council on HIV/AIDS issues of the Russian Ministry of Health.”
From 5.02.04 No. 37 “On interaction on issues of ensuring sanitary protection of the territory
Russian Federation and carrying out measures to prevent quarantine and other
especially dangerous infections."
9. From 01/17/06 No. 27 “On amendments to Appendix No. 1 to the order of the Ministry of Health of Russia dated June 27, 2001 No. 229 “On the national calendar of preventive vaccinations and the calendar of preventive vaccinations for epidemic indications.”
10. From December 28, 2004. No. 40 “On the creation of a coordinating council to prepare for an influenza pandemic.”
11. From 03/31/2005 No. 373 “On improving the system of epidemiological surveillance and control of influenza and acute respiratory viral infections.”
Orders of the Ministry of Health and Social Development of Russia in the field of control
with infectious diseases
12. From November 17, 2005 No. 774 “On the organization and implementation of measures for the prevention of plague.”
13. From 05/31/2005 No. 376 “On the submission of extraordinary reports on emergency situations of a sanitary and epidemiological nature.”
14. From 07.07.2005 No. 7 “On intra-laboratory contamination with wild poliovirus in
virological laboratory of the State Sanitary and Epidemiological Surveillance Center in the Republic of Mordovia.”
15. From 03.03.2005 No. 243 “On licensing by territorial departments of activities related to the use of infectious disease agents.”
16. From 03/21/2005 No. 364 “On approval of the regulations on the analytical group for monitoring and evaluating the effectiveness of projects and programs to combat the HIV/AIDS epidemic.”
17. From 09/06/2005 No. 713 “On the creation of a commission for the safe laboratory storage of wild polioviruses.”
18. From 09.11.2005 No. 764 “On the Laboratory Council of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare.”
19. From 07/08/2005 No. 633 “On the commission for the diagnosis of polio and acute flaccid paralysis.”
20. From 04/21/2006 No. 105 “On the commission for certification of polio eradication.”
Articles of the Criminal Code of the Russian Federation providing for penalties for violating the sanitary and epidemiological well-being of the population or attacks on their rights and freedoms in this area
Section VII “Crimes against the person”, including Chapter 16 “Crimes against life and health” (Article 121 “Infection with venereal disease” and Article 122 “Infection with HIV”), Chapter 19 “Crimes against the constitutional rights and freedoms of man and citizen” (Article 140 “Refusal to provide information to citizens”)
Section IX “Crimes against public safety and public order”, which includes Chapter 25 “Crimes against public health and public morality” (Article 236 “Violations of sanitary and epidemiological rules”, Article 237 “Concealment of information about circumstances that pose a danger to life”
and human health”, Article 238 “Release or sale of goods, performance of work or provision of services that do not meet safety requirements”) and Chapter 26 “Environmental violations” (Article 246 “Violations of environmental protection rules during the production of work”, Article 248 “ Violation of safety rules when handling microbiological or other biological agents or toxins”, Article 249 “Violation of veterinary rules and rules established for the control of diseases
and plant pests”, Article 250 “Water Pollution”, Article 251 “Atmospheric Pollution”, Article 252 “Marine Pollution”, Article 254 “Damage of Land”)
pneumopodveska
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