Poliomyelitis presentation

8/10/2019 Poliomyelitis presentation

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P O L I O M Y E L I T I SS H A U N B Y R N E , J O N A H G R A N T , A N D S A M K I P P E R M A N


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C O N G R AT U L AT I O N S I T S A E N T E R O V I R U

Enterovirus

Acute viral infection

Single stranded RNA and a protein capsid.

Three serotypes (PV1, PV2, and PV3)

Infection occurs via the fecaloral route TEM micrograpViron

http://www.ep


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S H O U L D I S E E A D O C T O R I F I H AV E P O L I O

Outcomes of poliovirus

No Symptoms. (9095%)

Minor Illness. (48%)

Non-paralytic aseptic meningitis. (12%)

Paralytic poliomyelitis. (0.10.5%)

Spinal polio. (79% of paralytic)

Bulbospinal polio. (79% of paralytic)

Bulbar polio(2% of paralytic)

http://www.polioeradica


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I N C R E A S E D R I S K F A C T O R S

HIV/AIDS

Malnutrition

Physical activity immediately

following the onset of paralysis

Anything that weakens the

immune systemhttp://www.rotary


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T H E I N T E S T I N A L T R A C T

Poliovirus begins infecting pharynx andintestinal mucosa cells

It binds to cell receptor known as CD115

The Poliovirus substitutes its RNA, into

the cells RNA and begins manufacturingduplicate virus

Moves to bloodstream after 7-10 days


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POL IOV IRUSHTTP: / /UPLOAD.WIK IMEDIA.ORG/WIK IPEDIA/COMMONS/8/8A/PR IMARY_CNS_LYMPH

PARA LYT I C P OL IO

Destroys neurons in central nervous

system

Inflammation and lack of movement

result from destruction of neurons

Nerve impulses return to the formerly

paralyzed muscle within a month
http://upload.wikimedia.org/wikipedia/commons/8/8a/Primary_CNS_lymphoma_-_very_high_mag.jpg


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B U L B A R P O L I O A N D B U L B O S P I N A L P O L

Bulbospinal polio destroys nerves in spinalcord (19% paralytic cases)

Affects thephrenic nerve which affects the

muscles in the diaphragm

Patient cannot breath without ventilator

Bubar polio destroys nerves in the brain

stem (2% of paralytic cases)

Affects all muscles in the body


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Spinal cordhttp://en.wikipedia.org


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Survives in highly acidic environments

Spreads through the lymphatic system

Replicates rapidly, overwhelms theprimary immune response

Different serotypes do not have crossimmunity

P O L I O V I R US I M M UN E AV O I D AN CE

HTTP : / /WWW.BORGENMA


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I M M U N E R E S P O N S E

Standard immune response involving

helper T cells, antibodies, and

phagocytes.

Antibodies, antibodies, antibodies


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What route(s) does poliovirus take to e

central nervous system?

Why lower motor neurons?

Why has type 2 poliovirus been eradic

types 1 and 3 have not?

W H AT W E D O N O T K N O W

HTTPS : /


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I N C R E A S E O F P R E VA L E N C E

Poor sanitation prior to the 20th century resulted in city dwellers

constantly exposed to the virus, enhancing a natural immunity

When public sanitation improved city dwellers gradually lost the

immunity to the virus and outbreaks became common

MID-1

HTTP : / /WWW.19THCENTURYBOTTLED IG
http://www.19thcenturybottlediggers.com/newyork.jpg


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I N C R E A S E O F P R E VA L E N C E

The polio epidemic reached critical proportions in 1952

58,000 cases

3,145 deaths

21,269 left with mild to severe paralysis

HTTP : / /THEGLYPTODON.WORDPRESS .COM/2012 /08 /21 /POL
http://theglyptodon.wordpress.com/2012/08/21/polio-caused-by-ice-cream/


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Its prevalence in mid-twentieth century society spurred grassroots

efforts that revolutionized medical philanthropy

Advanced the modern disability rights movement

Lessons learned from large-scale trials of the vaccine formed the bmodern clinical trials

One of the two diseases subject of a global eradication program

S O C I A L S I G N I F I C A N C E

HTTP : / /WWW.NORTHCOASTJOURNAL .COM/082
http://www.northcoastjournal.com/082103/cover0821-polio.jpg


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S E A R C H F O R A C U R E

With the rising prevalence of the disease,

researchers sought a vaccine to prevent

or mitigate the illness, most notably

Jonas Salk, Albert Sabin, Hilary

Koprowski, and Herald Cox.


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J O N A S S A L KV I R O L O G I S T, U N I V E R S I T Y O F P I T T S B U R G H

Asked to join the fight against polio by the director of

the National Foundation for Infantile Paralysis

First to develop and distribute a successful polio

vaccine

Executed the greatest public health experiment in

history


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A L B E RT S A B I NP O L I S H M E D I C A L R E S E A R C H E R

Developed the oral polio vaccine containing anattenuated form of the virus

Due to success of Salk vaccine in US, Sabin vaccine

was/is used more common internationally

"You don't need to have an expert doctor or nurse to give the

vaccine. Sabin's vaccine was the vaccine to bring polio to the edge

of eradication.

- Daniel Wilson, Muhlenberg College


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Jonas Salk first researched vaccination with influenza

Began researching poliovirus at University of Pittsburgh

Sorted 125 strains of poliovirus

Identified three basic types of the virus

HeLa cells

1948 - Harvard research

D E V E L O P M E N T O F V AC C I N E

HTTP : / /D IRECTORSBLOG.N IH .GOV/2013 /08 /07 /HELA -CELLS -A -NEW-CHAPTE
http://directorsblog.nih.gov/2013/08/07/hela-cells-a-new-chapter-in-an-enduring-story/


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D E V E L O P M E N T O F V AC C I N E

Formaldehyde

Trial runs:

Recovered victims

Patients who have never contracted polio

HTTP : / /WWW.V I ROLOGY.WI SC . EDU/V I RUSWORLD/
http://www.virology.wisc.edu/virusworld/PS10/p1m_poliovirus.jpg


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RESULTS

First trials increased antibody count

Second trials increased antibody count and no contracted virus

American Medical Association

Initial results suggested about 60-70% prevention

Manufacturing error

1955: 18,985 cases ------ 1957: 5,894 cases


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HTTP : / /AMER ICANTH INGS . F I LES .WORDPRESS .COM/2009 /10 /ME I SENPRODUCT IONSDOTCOM
http://americanthings.files.wordpress.com/2009/10/meisenproductionsdotcom.jpg


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S AB I N V AC C I N E

Sabin thought Salks vaccine wasnt strong

enough

Oral instead of injection

Effective and efficientHTTP : / /WWW.UNICEF .ORG

POL IO -VAC


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PRESENT STATE

Cases are very rare in the United States today

Virus mutation


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E F F E C T I V E N E S S

HTTP : / /WWW.CDC .GOV/POL IO /PROGRESS /
http://www.cdc.gov/polio/progress/


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H I S T O R I C A L S I G N I F I C A N C E

One of the oldest-known diseases

Egyptian paintings depict healthy people with deformed limbs

Has caused paralysis in millions over the course of history

First medical description given in 1789 (a debility of the lower e

HTTP : / /UPLOAD .WIK IMED IA .ORG/WIK I PED IA /COMMONS/5 /5C /P

HTTP : / /UPLOAD .WIK IMED IA .ORG/WIK I PED IA /COMMONS/5 /5C /P
http://upload.wikimedia.org/wikipedia/commons/5/5c/Polio_Egyptian_Stele.jpghttp://upload.wikimedia.org/wikipedia/commons/5/5c/Polio_Egyptian_Stele.jpg


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J A K O B H E I N EG E R M A N O R T H O P E D I S T

First recognized polio as a distinct condition in 1840 in

a report of the disease

First to identify the illness as a clinical entity

HTTP : / /UPLOAD .WIK IMED IA .ORG/WIK I PED IA /COMMONS/2 /2E / JAKOBHE INE . JPG
http://upload.wikimedia.org/wikipedia/commons/2/2e/Jakobheine.jpg


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K A R L L A N D S T E I N E RA U S T R A L I A N B I O L O G I S T A N D P H Y S I C I A N

First isolated and identified the poliovirus in 1908 with

peer physicians Constantin Levaditi and Erwin Popper

HTTP : / / IMAGES . F INEARTAMER ICA .COM/ IMAGES -MED IUM-LARGE/KARL -

LANDSTE INER - 1868 - 1943 -AUSTR IAN -EVERETT . JPG

W O R K S C I T E D
http://images.fineartamerica.com/images-medium-large/karl-landsteiner-1868-1943-austrian-everett.jpg


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Albert B. Sabin Archives [Internet]. Cincinatti(OH):University of Cincinatti; [cited 2014 Dec 2] . Available from: http://sabin.uc.edu/

Bankston JB. 2002. Jonas Salk and the Polio Vaccine [Internet]. Bear, (Delaware):Mitchell Lane Publishers; [cited 2014 Dec 2]

BOKHARI FB. 2014 May 6. Pakistan launches new polio vaccination efforts [Internet].CBS News; [cited 2014 Dec 2] . Available from: http://www.cbsnenew-polio-vaccination-efforts/

Bridges J. 2003. Post-polio syndrome. Journal of Consumer Health on the Internet (7.3) [Internet]. [2003, cited 2014 Sept 21] Volume 7:41-49. Availab

docview/57622734/C50AA1172AE4526PQ/2?accountid=14503 Center for Disease Control and Prevention . Polio Eradication [Internet]. Edition 1. Atlanta(GA):Disease Control and Prevnetion; [2014 September 4, c

from: http://www.cdc.gov/polio/

Center for Disease Control and Prevention . 2012. Poliomyelitis [Internet]. 12. St. Louis (MO):Global Polio Eradication Initiative ; cited 2014 Septembewww.cdc.gov/vaccines/pubs/pinkbook/downloads/polio.pdf

Christine Weiler . **Date of Publication**. Acute Poliomyelitis [Internet]. 1. Denver(CO):University of Colorado Health Sciences Center ; [2014 Sep 3, chttp://emedicine.medscape.com/article/306440-medication

Flanick L. 2014. Cell Biology: From HeLa Cells to the Polio Vaccine. Yale-New HavenTeachers Institute [Internet]. [cited November 20, 2014] 13.04.03. Available from: http://www.yale.edu/ynhti/curriculum/units/2013/4/13.04.03.x.html

GOAD M. 2005. IN POLIO'S AFTERMATH. Portland Press Herald (final edition) [Internet]. [2005 June 5, cited Sept 21] Final. Available from: http://sea

277242490/B6652721799A4D6BPQ/17?accountid=14503

Inactivated Polio Vaccine [Internet]. London:UK Health Centre; [cited 2014 Dec 2] . Available from: http://www.healthcentre.org.uk/vaccine/what-is-ipv-

JP. 1984. Modes of action of poliovirus vaccines and relation to resulting immunity.. Rev Infect Dis. [Internet]. cited 2014 Dec 2] . Available from: http://6740072

Neal Nathanson . 2008. The Pathogenesis of Poliomyelitis: What We Dont Know [Internet]. 71. Philadelphia(PN):Science Direct; [cited 2014] Availablepubmed/18585526

Thompson . 2014 Dec 2. The Salk polio vaccine: "Greatest public health experiment in history" [Internet]. CBS News; [cited 2014 Dec 2] . Available frothe-salk-polio-vaccine-greatest-public-health-experiment-in-history/

Wellner K. 2005. Polio and Historical Inquiry. OAH Magazine of History (19) [Internet]. [2005, cited 2014 Sept 21] Vol(19):54-58. Available from: http://w

W O R K S C I T E D
http://www.jstor.org/stable/25161982http://search.proquest.com/docview/277242490/B6652721799A4D6BPQ/17?accountid=14503http://www.yale.edu/ynhti/curriculum/units/2013/4/13.04.03.x.htmlhttp://www.cdc.gov/vaccines/pubs/pinkbook/downloads/polio.pdfhttp://www.cdc.gov/polio/http://search.proquest.com/docview/57622734/C50AA1172AE4526PQ/2?accountid=14503

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Poliomyelitis presentation