Poliomyelitis

1. COMMUNITY HEALTH NURSING-1
Guided by, Presented by,
Ms. Kinjal Jadav Kenil Chauhan

2. PRESENTATION ON
COMMON
COMMUNICABLE
DISEASE

4. INTRODUCTION
Polio can occur sporadically, endemically
or epidemically. Poliomyelitis was found
worldwide before the development of vaccine.
After the development of vaccine, It has been
eliminated from developed countries.
In india, this is a still problem. The
government is taking all efforts to eradicate
this disease by pulse polio compaigns.

5. EPIDEMIOLOGICAL TRIAD
Agent
(PolioVirus)
Host Environment
(Infant & children under (contaminated water and
3 years males>females) food overcrowding,rainy
season)

6. AGENT
• The causative agent of poliomyelitis is
POLIOVIRUS. It has three types of sero-types 1,2
and 3. mostly the polio occurs due to type-1 polio
virus.
• The virus is found in the oropharyngeal secretions
of a patients infected with polio virus.
• The cases of polio are infective 7-10 days before
and after the onset of symptoms i.e. The period
of communicability is 7-10 days before and after
the onset of symptoms.

7. HOST FACTOR
• Polio is a disease of infancy and childhood. It
means most vulnerable age is between 6
months and 3 years.
• It occurs three times more than female i.e.
occurrence of disease is 3:1 in males &
females.

8. ENVIRONMENTAL FACTORS
• It is more likely to occur in rainy season.
• Contaminated water,food, flies are the
environmental factors which can cause the
poliomyelitis.
• Polio virus is excreated in the faeces for 2-3
week, sometimes 3-4 months in polio case.
• Other causes of environment include
overcrowding, poor santitation etc.

9. MODE OF TRANSMISSION
• Faeco-oral route
Directly spread through fingers which are
contaminated with polio virus or indirectly
milk, water, food, flies and articles.
• Droplet Infection
Droplet infection is the mode of transmission of
infection. Personal contact with an infected
person with facilitate the spread of infection.

10. • Incubation period : 7 to 35 days
• CLINICAL MANIFESTATION:
 Asymmetrical flaccid paralysis
 Fever at the onset of paralysis which is suggestive of
polio.
 Anorexia
 Vomiting
 Nausea
 Malaise
 Headache
 Sore throat
 Abdominal pain
 Constipation

11. Stiffness of neck and back muscles.
Difficulty in swallowing
Weak or diminished deep tendon reflaxes
before the onset of paralysis.
– The paralysis in a case of polio reaches to its
maximum in less than 4 days. Paralysis occurs in
descending way i.e. starting at hip and then
moving down to distal parts of the extremity.
– In case of bulbar and bulbospinal form paralytic
poliomyelitis, cranial nerve involvement can cause
facial asymmetry, difficulty in swallowing. Death
can also occur due to respiratory insufficiency.

12. PREVENTION AND CONTROL
(1) Immunisation :
it is one of the effective means to achieve
prevention of poliomyelitis.
The vaccine used for immunisation is of two
types.
 Inactivated polio vaccine(IPV)
 Oral polio vaccine(OPV)

13. Inactivated Polio Vaccine :
It is the salk vaccine. It contains all the three
types of virus of polio which are inactivated by
formalin. The main advantage of giving advantage
of giving this vaccine is that it does not contain
live virus so it can be administered safely to
patients with immune deficiency, on radiation
therapy and on corticosteroids.
Oral Polio Vaccine :
The oral polio vaccine is sabin vaccine and contain
live virus according to National Immunisation
Schedule in india and WHO programme on EPI
recommend the administration of three polio
doses at an interval of 1 month.

14. At birth, OPV-Odose is given, then 1st
dose of OPV is given at age of 6 weeks.
Booster dose of OPV is given at an age of 16-
24 months.
Vaccine Dose Route Age
Oral polio
vaccine
3 drops doses
+
Oral At birth- 0 Dose
2 booster doses 6 weeks – 1st dose
10 weeks – 2nd dose
14 weeks – 3rd dose
16-24 months – Booster dose

15. • Oral polio vaccine induces humoral and
intestinal immunity. It should not be
administrated in cases such as:
Fever
Diarrhoea
Dysentry
Acute infectious disease
Leukemias
Malignancy
Taking corticosteroids

16. • Note :
Oral polio vaccine should be kept at 4 degree celcius if
the vaccine is stabilised vaccine.
Non-stabilised vaccine should be kept at -20 degree
celcius in a deep freeze.
Vaccine should not be frozen and thawed repeatedly,
as this can have deleterious effects on the potency of
live vaccine.
 Passive Immnunisation :
Human normal Ig is used as a passive immunisation.
But the use of passive immunisation is eliminated due
to active immunisation with oral polio vaccine.the
dose of normal human Ig is 0.25- 0.3 ml per kg of body
weight.after a few weeks, the active immunisation
should be started.

17. (2)Early Diagnosis And Treatment of Cases :
The polio cases should be detected as early as
possible and appropriately treated in order to
prevent the spread of infection as well as to
control the disease.
(3) Surveillance :
Surveillance is one of the way to achieve, control
and prevention by identifying the rise, stability
or decreasing in number of cases.

18. (4) Isolation :
The polio cases should be isolated during the
period of communicability i.e. 7-10 days
before and after the onset of symptoms.
(5) Environmental sanitation :
As polio occur due to certain environmetal
condition such as contaminated water, food
etc. it also occurs due to poor sanitation and
overcrowding. Appropriate sanitary measures
should be adpoted to decrease the incidence
of polio. The over crowding should be
avoided.

19. (6) Handwashing :
Handwashing is one of the effective way to achieve
prevention. As a polio virus is excreated in faeces
and it can go into GI tract through fingers, if
hands are not washed after defaecation. So, it is
important to wash the hands.
(7) Pulse Polio Compaign/Immunisation :
In pulse polio immunisation, oral polio vaccine is
given to all children 0-5 years of age regardless of
previous immunisations. It includes 3 rounds for
3 days. On 1st day, polio drops are administrated
at booth. On 2nd day, homes are visited to
administer.

20. • Polio drops to children under 5 years of age.
To those who did not come to booth on first
day. On third day the children left without
polio drops,are administered polio drops by
visiting the homes.

21. Thank You

22. DRACUNCULIASIS
(GUINEA WORM DISEASE)
Dracunculiasis cases reported during 2003
were 32193 world-wide. Out of these 63%
were reported from sudan, nigeria and ghana.
According to WHO, weekly epidemiological
record NO. 13,2004, india is declared free of
guinea worm disease.

23. EPIDEMIOLOGICAL TRIAD
Agent
(dracunculus medinensis)
Host Environment
(all ages, both sexes) (water contaminated with
cyclops)

24. Agent
• Dracunculiasis is caused by dracunculus
medinesis which is a vector borne parasitic
disease .
• The female dracunculus makes her way to the
limbs near skin surface in an infected person.
• Blisters are formed due to inflammatory response
& these break on contact with water and release
a number of parasites into water , which are
taken by cyclops and develpoment of parasites
inside the cyclop takes 15 days.

25. • Cyclops are present in water and when the
human beings drink water contaminated with
cyclops , it goes into G.I. tract.
• In the G.I. tract with digested by gastric juice,
parasites are released and penetrate the
duodenal wall.
• Form here the agent moves to the subcutaneous
tissue of various parts of the body and takes 9-12
month to become an adult.
• The reservoir of infection is a person who
harbours the gravid female dracunculus
medinesis.

26. • HOST
• It can occur among all ages, both sexes .
• Multiple & repeated infections can occur in
the same person.

27. ENVIRONMENTAL FACTOR
• Contaminated water with cyclops.
• Dry season(March- May)

28. MODE OF TRANSMISSION
• Water –borne route.
Under Eradication
• Guinea-worm disease has been eradicated.
The eradicated strategies used were :-
• Diagnosis and treatment of cases. The drug
used were mebendazole, metronidazole etc.
• Surveillance for reserch of new cases .
• Control of cyclops.