Archive | July 2022

QUOTE FOR THE WEEKEND:

This could be due to a number of reasons, according to Dr. Judy Tung, section chief of Adult Internal Medicine at NewYork-Presbyterian/Weill Cornell Medical Center. Cold and flu viruses are continuing to circulate — in fact, in late April and early May, New York state saw an unusual spike in influenza — coinciding with summer allergies, not to mention an uptick in COVID-19 cases due to the rise of Omicron subvariants.

Dr. Judy Tung, expert on how to treat yourself at home for COVID-19 and colds

Dr. Judy Tung

“Summer cold symptoms are common and confusing this year not only because of COVID but also because of the late flu peak,” says Dr. Tung.

HealthMatters New York Presbyterian

Colds in the summer!

While people are accustomed to dealing with runny noses and scratchy throats in the fall and winter, many are experiencing the same symptoms this summer.

This could be due to a number of reasons, according to Dr. Judy Tung, section chief of Adult Internal Medicine at NewYork-Presbyterian/Weill Cornell Medical Center. Cold and flu viruses are continuing to circulate — in fact, in late April and early May, New York state saw an unusual spike in influenza — coinciding with summer allergies, not to mention an uptick in COVID-19 cases due to the rise of Omicron subvariants.

“Summer cold symptoms are common and confusing this year not only because of COVID but also because of the late flu peak,” says Dr. Tung.

To understand what viruses are circulating now and how to tell the difference between a summer cold, allergies, and COVID-19, Health Matters spoke with Dr. Tung, who is also associate dean for faculty development at Weill Cornell Medicine.

What have you seen this year with the flu and colds?

We started to see a resurgence of flu at the end of 2021, and then a big drop in cases at the beginning of 2022, during the initial Omicron surge. But with the relaxation of masking and distancing this spring, influenza experienced a late peak.

As for colds, this summer a lot more GI symptoms that accompany colds — vomiting and diarrhea in addition to fever, congestion and cough. This probably speaks to a dominance of enterovirus, a common summer cold virus that can produce more GI symptoms or pink eye symptoms than rhinovirus, which is more dominant in the winter. This can be confusing, because COVID also causes GI symptoms.

Why are we usually able to avoid bad colds in the summer? Why are colds lasting longer?One theory for why colds are lasting longer is that the immune system got a little forgetful, not having been exposed to the most current viral strains, and therefore is less prepared to fight them off. The immune system builds antibodies and other memory white blood cells to fight off pathogens after being exposed to them. When our immune systems are exposed to cold viruses all year long, they are “on the ready.” That didn’t happen last year because of all the precautions people took to protect themselves against COVID.

What are the biggest differences in symptoms between common colds, allergies, and COVID-19?
COVID is associated with loss of smell and taste, or unusual tastes that are not common in uncomplicated colds. Sinus infections can do this, but regular colds typically don’t affect smell or taste to the degree we see in COVID-19.

Allergies can really feel like a cold, down to the body aches when allergies are severe. Allergies do not produce fever and normally take many days of postnasal dripping to cause a cough, whereas colds and COVID can move to coughing swiftly.

What’s the best way to care for summer colds?
There is little difference in the way we care for summer and winter colds — drink fluids and get plenty of rest. One advantage of summer is that you can open windows to ensure that shared space is well ventilated, especially if there is a member in the household who is sick.

With the rise of the Omicron subvariants, what is important to keep in mind when you come down with what seems to be an ordinary cold or allergy symptoms?
It is important to get tested for COVID if you have cold symptoms — not because you are going to get gravely ill, but because you may inadvertently pass it along to someone who could get gravely ill.

Vaccination and boosting definitely protect people from severe COVID infection, preventing hospitalization and death. However, Omicron is highly infectious, and there is increasing evidence that while the vaccines are still proving to protect us against severe COVID, they are not as effective against stopping us from getting infected or reinfected.

Furthermore, there is some recent evidence that while Omicron is definitely milder than Delta, it is more contagious and may linger for longer, so people stay masked for 10 to 14 days and to use home antigen tests and look for a negative test to guide on when you can relax with masking again.

 

QUOTE FOR FRIDAY:

“As the weather gets warmer, we tend to spend more time outside under the hot sun. It’s important to know the difference between heat stroke and heat exhaustion.]

Both heat stroke and heat exhaustion are caused by your body’s inability to cool itself.

Sweat is your body’s natural tool for cooling you down. If you overexercise or work strenuously in hot weather or a heated room, your body may have difficulty producing enough sweat to keep you cool.

Heat exhaustion occurs when the body loses excess amounts of water and salt, typically from sweating. On the other hand, heat stroke is a serious medical emergency that occurs when your body is unable to control its internal temperature.”.

Healthline (healthline.com)

Heat Stroke

Heatstroke is a condition caused by your body overheating, usually as a result of prolonged exposure to or physical exertion in high temperatures. This most serious form of heat injury, heatstroke, can occur if your body temperature rises to 104 F (40 C) or higher. The condition is most common in the summer months.

Heatstroke requires emergency treatment. Untreated heatstroke can quickly damage your brain, heart, kidneys and muscles. The damage worsens the longer treatment is delayed, increasing your risk of serious complications or death.

Heatstroke can occur as a result of:

  • Exposure to a hot environment. In a type of heatstroke, called nonexertional (classic) heatstroke, being in a hot environment leads to a rise in core body temperature. This type of heatstroke typically occurs after exposure to hot, humid weather, especially for prolonged periods. It occurs most often in older adults and in people with chronic illness.
  • Strenuous activity. Exertional heatstroke is caused by an increase in core body temperature brought on by intense physical activity in hot weather. Anyone exercising or working in hot weather can get exertional heatstroke, but it’s most likely to occur if you’re not used to high temperatures.

In either type of heatstroke, your condition can be brought on by:

  • Wearing excess clothing that prevents sweat from evaporating easily and cooling your body
  • Drinking alcohol, which can affect your body’s ability to regulate your temperature
  • Becoming dehydrated by not drinking enough water to replenish fluids lost through sweating

Heatstroke signs and symptoms include:

  • High body temperature. A core body temperature of 104 F (40 C) or higher, obtained with a rectal thermometer, is the main sign of heatstroke.
  • Altered mental state or behavior. Confusion, agitation, slurred speech, irritability, delirium, seizures and coma can all result from heatstroke.
  • Alteration in sweating. In heatstroke brought on by hot weather, your skin will feel hot and dry to the touch. However, in heatstroke brought on by strenuous exercise, your skin may feel dry or slightly moist.
  • Nausea and vomiting. You may feel sick to your stomach or vomit.
  • Flushed skin. Your skin may turn red as your body temperature increases.
  • Rapid breathing. Your breathing may become rapid and shallow.
  • Racing heart rate. Your pulse may significantly increase because heat stress places a tremendous burden on your heart to help cool your body.
  • Headache. Your head may throb.

Risk factors

Anyone can develop heatstroke, but several factors increase your risk:

  • Age. Your ability to cope with extreme heat depends on the strength of your central nervous system. In the very young, the central nervous system is not fully developed, and in adults over 65, the central nervous system begins to deteriorate, which makes your body less able to cope with changes in body temperature. Both age groups usually have difficulty remaining hydrated, which also increases risk.
  • Exertion in hot weather. Military training and participating in sports, such as football or long-distance running events, in hot weather are among the situations that can lead to heatstroke.
  • Sudden exposure to hot weather. You may be more susceptible to heat-related illness if you’re exposed to a sudden increase in temperature, such as during an early-summer heat wave or travel to a hotter climate.Limit activity for at least several days to allow yourself to acclimate to the change. However, you may still have an increased risk of heatstroke until you’ve experienced several weeks of higher temperatures.
  • A lack of air conditioning. Fans may make you feel better, but during sustained hot weather, air conditioning is the most effective way to cool down and lower humidity.
  • Certain medications. Some medications affect your body’s ability to stay hydrated and respond to heat. Be especially careful in hot weather if you take medications that narrow your blood vessels (vasoconstrictors), regulate your blood pressure by blocking adrenaline (beta blockers), rid your body of sodium and water (diuretics), or reduce psychiatric symptoms (antidepressants or antipsychotics).Stimulants for attention-deficit/hyperactivity disorder (ADHD) and illegal stimulants such as amphetamines and cocaine also make you more vulnerable to heatstroke.
  • Certain health conditions. Certain chronic illnesses, such as heart or lung disease, might increase your risk of heatstroke. So can being obese, being sedentary and having a history of previous heatstroke.

Complications

Heatstroke can result in a number of complications, depending on how long the body temperature is high. Severe complications include:

  • Vital organ damage. Without a quick response to lower body temperature, heatstroke can cause your brain or other vital organs to swell, possibly resulting in permanent damage.
  • Death. Without prompt and adequate treatment, heatstroke can be fatal.

When to go to the doctor or call 911:

If you think a person may be experiencing heatstroke, seek immediate medical help. Call 911 or your local emergency services number.

Take immediate action to cool the overheated person while waiting for emergency treatment.

  • Get the person into shade or indoors.
  • Remove excess clothing.
  • Cool the person with whatever means available — put in a cool tub of water or a cool shower, spray with a garden hose, sponge with cool water, fan while misting with cool water, or place ice packs or cold, wet towels on the person’s head, neck, armpits and groin.
  • Without prompt and adequate treatment, heatstroke can be fatal.

Prevention

Heatstroke is predictable and preventable. Take these steps to prevent heatstroke during hot weather:

  • Wear loosefitting, lightweight clothing. Wearing excess clothing or clothing that fits tightly won’t allow your body to cool properly.
  • Protect against sunburn. Sunburn affects your body’s ability to cool itself, so protect yourself outdoors with a wide-brimmed hat and sunglasses and use a broad-spectrum sunscreen with an SPF of at least 15. Apply sunscreen generously, and reapply every two hours — or more often if you’re swimming or sweating.
  • Drink plenty of fluids. Staying hydrated will help your body sweat and maintain a normal body temperature
  • Never leave anyone in a parked car. This is a common cause of heat-related deaths in children. When parked in the sun, the temperature in your car can rise 20 degrees F (more than 11 C) in 10 minutes.It’s not safe to leave a person in a parked car in warm or hot weather, even if the windows are cracked or the car is in shade. When your car is parked, keep it locked to prevent a child from getting inside.
  • Take it easy during the hottest parts of the day. If you can’t avoid strenuous activity in hot weather, drink fluids and rest frequently in a cool spot. Try to schedule exercise or physical labor for cooler parts of the day, such as early morning or evening.
  • Get acclimated. Limit time spent working or exercising in heat until you’re conditioned to it. People who are not used to hot weather are especially susceptible to heat-related illness. It can take several weeks for your body to adjust to hot weather.
  • Be cautious if you’re at increased risk. If you take medications or have a condition that increases your risk of heat-related problems, avoid the heat and act quickly if you notice symptoms of overheating. If you participate in a strenuous sporting event or activity in hot weather, make sure there are medical services available in case of a heat emergency.

QUOTE FOR THURSDAY:

“Poliomyelitis (polio) is a highly infectious viral disease that largely affects children under 5 years of age. The virus is transmitted by person-to-person spread mainly through the faecal-oral route or, less frequently, by a common vehicle (e.g. contaminated water or food) and multiplies in the intestine, from where it can invade the nervous system and cause paralysis.

In 1988, the World Health Assembly adopted a resolution for the worldwide eradication of polio, marking the launch of the Global Polio Eradication Initiative, spearheaded by national governments, WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC), UNICEF, and later joined by the Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance. Wild poliovirus cases have decreased by over 99% since 1988, from an estimated 350 000 cases in more than 125 endemic countries then to 175reported cases in 2019.

Of the 3 strains of wild poliovirus (type 1, type 2 and type 3), wild poliovirus type 2 was eradicated in 1999 and no case of wild poliovirus type 3 has been found since the last reported case in Nigeria in November 2012. Both strains have officially been certified as globally eradicated. As at 2020, wild poliovirus type 1 affects two countries: Pakistan and Afghanistan.”

WHO World Health Organization

Part II Polio what are the causes, symptoms, how its diagnosed & treated with how to prevent it”.

        PPS2  PPS  PPS3

The answer is even with a name; it is called Post-polio syndrome.

Around 40% of people who survive paralytic polio may develop additional symptoms 15–40 years after the original illness. These symptoms – called post-polio syndrome – include new progressive muscle weakness, severe fatigue and pain in the muscles and joints.

This is how it works:

What is post-polio syndrome?

Post-polio syndrome is an illness of the nervous system that can appear 15 to 50 years after you had polio. It affects your muscles and nerves, and it causes you to have weakness, fatigue, and muscle or joint pain.

Although post-polio syndrome can make some day-to-day activities more difficult, treatment can help control symptoms and help you stay active. Your symptoms may not get worse for many years. Post-polio syndrome usually progresses very slowly.

Only people who have had polio can get post-polio syndrome. But having post-polio syndrome doesn’t mean that you have polio again. Unlike polio, post-polio syndrome doesn’t spread from person to person.

What causes post-polio syndrome?

Post-polio syndrome most likely arises from the damage left over from having the polio viruse in the body still.

The polio virus harms the nerves that control muscles, and it makes the muscles weak. If you had polio, you may have gained back the use of your muscles. But the nerves that connect to the muscles could be damaged without your knowing it. The nerves may break down over time and cause you to have weak muscles again.

Researchers are studying other possible causes of post-polio syndrome. One theory is that the immune system plays a role.

What are the symptoms?

Symptoms of post-polio syndrome tend to show up very slowly. The main symptoms are:

  • New muscle weakness. This is most common in the muscles that had nerve damage from polio. You may also have weakness in muscles that you didn’t realize had been affected by polio. Overuse or underuse of the muscles can lead to weakness.
  • Fatigue. You may find that the activities you used to do without getting tired are now causing fatigue. You may often feel tired, have a heavy feeling in your muscles, or feel sleepy. At times you may have trouble thinking clearly.
  • Muscle or joint pain. Muscles affected by polio tend to be weaker than normal. To make up for this weakness, other muscles have to work harder. This puts extra wear and tear on muscles, joints, and tendons, sometimes leading to aches, cramping, and pain.

Depending on which muscles are affected, this trio of muscle weakness, fatigue, and pain can make daily activities more difficult. For example, people with shoulder or arm weakness may have trouble getting dressed. People who have weakness in their legs may have trouble walking or climbing stairs.

Post-polio syndrome is rarely life-threatening, but the symptoms can significantly interfere with an individual’s ability to function independently. Respiratory muscle weakness, for instance, can result in trouble with proper breathing, affecting daytime functions and sleep.  Weakness in swallowing muscles can result in aspiration of food and liquids into the lungs and lead to pneumonia.

Only a polio survivor can develop PPS.

The severity of weakness and disability after recovery from poliomyelitis tends to predict the relative risk of developing PPS.  Individuals who had minimal symptoms from the original illness are more likely to experience only mild PPS symptoms.  A person who was more acutely affected by the polio virus and who attained a greater recovery may experience a more severe case of PPS, with greater loss of muscle function and more severe fatigue.

The exact incidence and prevalence of PPS is unknown.  The U.S. National Health Interview Survey in 1987 contained specific questions for persons given the diagnosis of poliomyelitis with or without paralysis.  No survey since then has addressed the question.  Results published in 1994-1995 estimated there were about 1 million polio survivors in the U.S., with 443,000 reporting to have had paralytic polio.  Accurate statistics do not exist today, as a percentage of polio survivors have died and new cases have been diagnosed.  Researchers estimate that the condition affects 25 to 40 percent of polio survivors.

What causes PPS?

The cause of PPS is unknown but experts have offered several theories to explain the phenomenon—ranging from the fatigue of overworked nerve cells to possible brain damage from a viral infection to a combination of mechanisms.  The new weakness of PPS appears to be related to the degeneration of individual nerve terminals in the motor units.   A motor unit is formed by a nerve cell (or motor neuron) in the spinal cord or brain stem and the muscle fibers it activates.  The polio virus attacks specific neurons in the brain stem and spinal cord.  In an effort to compensate for the loss of these motor neurons, surviving cells sprout new nerve-end terminals and connect with other muscle fibers.  These new connections may result in recovery of movement and gradual gain in power in the affected limbs.

Years of high use of these recovered but overly extended motor units adds stress to the motor neurons, which over time lose the ability to maintain the increased work demands.  This results in the slow deterioration of the neurons, which leads to loss of muscle strength.  Restoration of nerve function may occur in some fibers a second time, but eventually nerve terminals malfunction and permanent weakness occurs.  This hypothesis explains why PPS occurs after a delay and has a slow and progressive course.

Through years of studies, scientists at the National Institute of Neurological Disorders and Stroke (NINDS) and at other institutions have shown that the weakness of PPS progresses very slowly.  It is marked by periods of relative stability, interspersed with periods of decline.

How is PPS diagnosed?

The diagnosis of PPS relies nearly entirely on clinical information.  There are no laboratory tests specific for this condition and symptoms vary greatly among individuals.  Physicians diagnose PPS after completing a comprehensive medical history and physical examination, and by excluding other disorders that could explain the symptoms.

Physicians look for the following criteria when diagnosing PPS:

  • Prior paralytic poliomyelitis with evidence of motor neuron loss.  This is confirmed by history of the acute paralytic illness, signs of residual weakness and atrophy of muscles on neuromuscular examination, and signs of motor neuron loss on electromyography (EMG).  Rarely, people had subtle paralytic polio where there was no obvious deficit.  In such cases, prior polio should be confirmed with an EMG study rather than a reported history of non-paralytic polio.
  • A period of partial or complete functional recovery after acute paralytic poliomyelitis, followed by an interval (usually 15 years or more) of stable neuromuscular function.
  • Slowly progressive and persistent new muscle weakness or decreased endurance, with or without generalized fatigue, muscle atrophy, or muscle and joint pain.  Onset may at times follow trauma, surgery, or a period of inactivity, and can appear to be sudden.  Less commonly, symptoms attributed to PPS include new problems with breathing or swallowing.
  • Symptoms that persist for at least a year.
  • Exclusion of other neuromuscular, medical, and skeletal abnormalities as causes of symptoms.

PPS may be difficult to diagnose in some people because other medical conditions can complicate the evaluation.  Depression, for example, is associated with fatigue and can be misinterpreted as PPS.   A number of conditions may cause problems in persons with polio that are not due to additional loss of motor neuron function.  For example, shoulder osteoarthritis from walking with crutches, a chronic rotator cuff tear leading to pain and disuse weakness, or progressive scoliosis causing breathing insufficiency can occur years after polio but are not indicators of PPS.

Polio survivors with new symptoms resembling PPS should consider seeking treatment from a physician trained in neuromuscular disorders.  It is important to clearly establish the origin and potential causes for declining strength and to assess progression of weakness not explained by other health problems.   Magnetic resonance imaging (MRI) and computed tomography (CT) of the spinal cord, electrophysiological studies, and other tests are frequently used to investigate the course of decline in muscle strength and exclude other diseases that could be causing or contributing to the new progressive symptoms.  A muscle biopsy or a spinal fluid analysis can be used to exclude other, possibly treatable, conditions that mimic PPS.  Polio survivors may acquire other illnesses and should always have regular check-ups and preventive diagnostic tests.   However, there is no diagnostic test for PPS, nor is there one that can identify which polio survivors are at greatest risk.

Is there a treatment for PPS?

There are currently no effective pharmaceutical treatments that can stop deterioration or reverse the deficits caused by the syndrome itself.  However, a number of controlled studies have demonstrated that non-fatiguing exercises may improve muscle strength and reduce tiredness.   Most of the clinical trials in PPS have focused on finding safe therapies that could reduce symptoms and improve quality of life.

Researchers at the National Institutes of Health (NIH) have tried treating persons having PPS with high doses of the steroid prednisone and demonstrated a mild improvement in their condition, but the results were not statistically significant.  Also, the side effects from the treatment outweighed benefits, leading researchers to conclude that prednisone should not be used to treat PPS.

Preliminary studies indicate that intravenous immunoglobulin may reduce pain and increase quality of life in post-polio survivors.

A small trial to treat fatigue using lamotrigine (an anticonvulsant drug) showed modest effect but this study was limited and larger, more controlled studies with the drug were not conducted to validate the findings.

Although there are no effective treatments, there are recommended management strategies.  Patients should consider seeking medical advice from a physician experienced in treating neuromuscular disorders.  Patients should also consider judicious use of exercise, preferably under the supervision of an experienced health professional.  Physicians often advise patients on the use of mobility aids, ventilation equipment, revising activities of daily living activities to avoid rapid muscle tiring and total body exhaustion, and avoiding activities that cause pain or fatigue lasting more than 10 minutes.  Most importantly, patients should avoid the temptation to attribute all signs and symptoms to prior polio, thereby missing out on important treatments for concurrent conditions.   Always go to your physician for advisement before starting any exercise regimen to make sure your M.D. clears the activity first, for your safety!

There is no cure for polio, only treatment to alleviate the symptoms.  Heat and physical therapy is used to stimulate the muscles and antispasmodic drugs are given to relax the muscles. While this can improve mobility, it cannot unfortunately reverse permanent polio paralysis.

How Polio can be PREVENTED:

Polio can be prevented through immunization. Polio vaccine, given multiple times, almost always protects a child for life.

 

 

QUOTE FOR WEDNESDAY:

“Polio, or poliomyelitis, is a disabling and life-threatening disease caused by the poliovirus.  The virus spreads from per son to person and can infect a person’s spinal cord, causing paralysis (can’t move parts of the body). Most people who get infected with poliovirus (about 72 out of 100) will not have any visible symptoms.  About 1 out of 4 people (or 25 out of 100) with poliovirus infection will have flu-like symptoms.  A smaller proportion of people (much less than one out of 100, or 1-5 out of 1000) with poliovirus infection will develop other, more serious symptoms that affect the brain and spinal cord.  This would include Paresthesia (feeling of pins and needles in the legs), others with Meningitis (infection of the covering of the spinal cord and/or brain) occurs in about 1 out of 25 people with poliovirus infection to Paralysis=the worst symptom (can’t move parts of the body) or weakness in the arms, legs, or both, occurs in about 1 out of 200 people with poliovirus infectionl.”

CDC Centers for Disease Control and Prevention

 

Part I Polio – What is this disease, types of Polio, and risk factors to Polio!

Polio I  

  

A virus is a small, infectious agent that is made up of a core of genetic material surrounded by a shell of protein. The genetic material (which is responsible for carrying forward hereditary traits from parent cells to offspring) may be either deoxyribonucleic acid (DNA) or ribonucleic acid (RNA). Viruses are at the borderline between living and nonliving matter. When they infect a host cell, they are able to carry on many life functions, such as metabolism and reproduction. But outside a host cell, they are as inactive as a grain of sand.

Viruses cause disease by infecting a host cell and taking over its biochemical functions. In order to produce new copies of itself, a virus must use the host cell’s reproductive “machinery.” The newly made viruses then leave the host cell, sometimes killing it in the process, and proceed to infect other cells within the organism.

Viruses can infect plants, bacteria, and animals. The tobacco mosaic virus, one of the most studied of all viruses, infects tobacco plants. Animal viruses cause a variety of diseases, including AIDS (acquired immuno deficiency syndrome), hepatitis, chicken pox, smallpox, polio, measles, rabies, the common cold, and some forms of cancer.

Viruses that affect bacteria are called bacterio-phages, or simply phages (pronounced FAY-jez). Phages are of special importance due to the susceptibility of the virus transmission. The disease Polio (poliomyelitis) in time will be transmitted throughout the bloodstream and the highly viral infectious disease is now spreading in the body.

Poliomyelitis (POLIO) is a viral disease. There are three types of polio0-virus and many strains of each type. The virus enters through the mouth and multiplies in the throat and gastrointestinal tract, then moves into the bloodstream and is carried to the central nervous system where it replicates and destroys the motor neuron cells. Motor neurons control the muscles for swallowing, circulation, respiration, and the trunk, arms, and legs.

Human nerve cells have a protruding protein structure on their surface whose precise function is unknown. When polio-virus encounters the nerve cells, the protruding receptors attach to the virus particle, and infection begins. Once inside the cell, the virus hijacks the cell’s assembly process, and makes thousands of copies of itself in hours. The virus kills the cell and then spreads to infect other cells.

A virus is a small, infectious agent that is made up of a core of genetic material surrounded by a shell of protein. The genetic material (which is responsible for carrying forward hereditary traits from parent cells to offspring) may be either deoxyribonucleic acid (DNA) or ribonucleic acid (RNA). Viruses are at the borderline between living and nonliving matter. When they infect a host cell, they are able to carry on many life functions, such as metabolism and reproduction. But outside a host cell, they are as inactive as a grain of sand.

How polio gets into the human body:

Poliomyelitis (POLIO) is a viral disease. There are three types of polio virus and many strains of each type. The virus enters through the mouth and multiplies in the throat and gastrointestinal tract, then moves into the bloodstream and is carried to the central nervous system where it replicates and destroys the motor neuron cells. Motor neurons control the muscles for swallowing, circulation, respiration, and the trunk, arms, and legs.

Human nerve cells have a protruding protein structure on their surface whose precise function is unknown. When polio virus encounters the nerve cells, the protruding receptors attach to the virus particle, and infection begins. Once inside the cell, the virus hijacks the cell’s assembly process, and makes thousands of copies of itself in hours. The virus kills the cell and then spreads to infect other cells.

Polio is spread through person-to-person contact. When a child is infected with wild polio virus, the virus enters the body through the mouth and multiplies in the intestine. It is then shed into the environment through the faces where it can spread rapidly through a community, especially in situations of poor hygiene and sanitation. If a sufficient number of children are fully immunized against polio, the virus is unable to find susceptible children to infect, and dies out. Young children who are not yet toilet-trained are a ready source of transmission, regardless of their environment. Polio can be spread when food or drink is contaminated by feces. There is also evidence that flies can passively transfer polio virus from faces to food. Most people infected with the polio virus have no signs of illness and are never aware they have been infected. These symptom can be carried from person to person by the virus that’s in their intestines and can “silently” spread the infection to thousands of others before the first case of polio paralysis emerges. For this reason, WHO considers a single confirmed case of polio paralysis to be evidence of an epidemic – particularly in countries where very few cases occur.

Most infected people (90%) have no symptoms or very mild symptoms and usually go unrecognized. In others, initial symptoms include fever, fatigue, headache, vomiting, stiffness in the neck and pain in the limbs.

TYPES OF Polio:

1.) Acute flaccid paralysis (AFP)

One in 200 infections leads to irreversible paralysis, usually in the legs. This is caused by the virus entering the blood stream and invading the central nervous system. As it multiplies, the virus destroys the nerve cells that activate muscles. The affected muscles are no longer functional and the limb becomes floppy and lifeless – a condition known AFP = Acute Flaccid Paralysis.

Know all cases of AFP among children under fifteen years old are reported and tested for polio virus within 48 hours of onset.

All cases of acute flaccid paralysis (AFP) among children under fifteen years of age are reported and tested for poliovirus within 48 hours of onset.

2.) Bulbar polio

More extensive paralysis, involving the trunk and muscles of the thorax and abdomen, can result in quadriplegia. In the most severe cases (bulbar polio), polio virus attacks the nerve cells of the brain stem, reducing breathing capacity and causing difficulty in swallowing and speaking. Among those paralyzed, 5% to 10% die when their breathing muscles become immobilized.

Risk factors for paralysis

No one knows why only a small percentage of infections lead to paralysis. Several key risk factors have been identified as increasing the likelihood of paralysis in a person infected with polio. These include:

  • immune deficiency
  • pregnancy
  • removal of the tonsils (tonsillectomy)
  • intramuscular injections, e.g. medications
  • strenuous exercise
  • injury.

 

 

 

QUOTE FOR TUESDAY:

‘What is Meningitis? Meningitis is an infection of the tissues covering the brain and spinal cord (meninges). Viral meningitis is an infection caused by viruses and bacterial meningitis is an infection caused by bacteria.

Viral meningitis is usually less serious and goes away without treatment. Many different viruses can cause viral meningitis. Most of the viruses are common during the summer and fall months.

Bacterial meningitis is extremely serious. Brain damage, hearing loss or learning disability may happen after having bacterial meningitis. It is important to know what bacteria are causing bacterial meningitis so that the correct medicine can be used to prevent others from getting sick. The earlier the medicine is given the more successful it is. Streptococcus pneumonia and Neisseria meningitidis are two kinds of bacteria that cause bacterial meningitis. Haemophilus influenzae type b bacteria mostly attacks the very young but with the vaccination program in infants, meningitis in children happens less frequently.

Many of the viruses that cause viral meningitis can be spread through saliva or stool. Bacteria that cause bacterial meningitis can spread person-to-person through contact with fluids from the mouth or nose of a sick person. Most people already have natural protection against many of these germs.”.

John Hopkins Medicine

 

Bacterial versus Viral Infections.

As you might think, bacterial infections are caused by bacteria, and viral infections are caused by viruses. Perhaps the most important distinction between bacteria and viruses is that antibiotic drugs usually kill bacteria, but they aren’t effective against viruses.

Bacteria

Bacteria are single-celled microorganisms that thrive in many different types of environments. Some varieties live in extremes of cold or heat. Others make their home in people’s intestines, where they help digest food. Most bacteria cause no harm to people, but there are exceptions.

Infections caused by bacteria include:

  • Strep throat
  • Tuberculosis
  • Urinary tract infections

Inappropriate use of antibiotics has helped create bacterial diseases that are resistant to treatment with different types of antibiotic medications.

Viruses

Viruses are even smaller than bacteria and require living hosts — such as people, plants or animals — to multiply. Otherwise, they can’t survive. When a virus enters your body, it invades some of your cells and takes over the cell machinery, redirecting it to produce the virus.

Diseases caused by viruses include:

  • Chickenpox
  • AIDS
  • Common colds

In some cases, it may be difficult to determine whether a bacterium or a virus is causing your symptoms. Many ailments — such as pneumonia, meningitis and diarrhea — can be caused by either bacteria or viruses.

Bacterial and viral infections have many things in common. Both types of infections are caused by microbes — bacteria and viruses, respectively — and spread by things such as:

  • Coughing and sneezing.
  • Contact with infected people, especially through kissing and sex.
  • Contact with contaminated surfaces, food, and water.
  • Contact with infected creatures, including pets, livestock, and insects such as fleas and ticks.

Microbes can also cause:

  • Acute infections, which are short-lived.
  • Chronic infections, which can last for weeks, months, or a lifetime.
  • Latent infections, which may not cause symptoms at first but can reactivate over a period of months and years.

Most importantly, bacterial and viral infections, can cause mild, moderate, and severe diseases.

Throughout history, millions of people have died of diseases such as bubonic plague or the Black Death, which is caused by Yersinia pestis bacteria, and smallpox, which is caused by the variola virus. In recent times, viral infections have been responsible for two major pandemics: the 1918-1919 “Spanish flu” epidemic that killed 20-40 million people, and the ongoing HIV/AIDS epidemic that killed an estimated 1.5 million people worldwide in 2013 alone.Bacterial and viral infections can cause similar symptoms such as coughing and sneezing, fever, inflammation, vomiting, diarrhea, fatigue, and cramping — all of which are ways the immune system tries to rid the body of infectious organisms. But bacterial and viral infections are dissimilar in many other important respects, most of them due to the organisms’ structural differences and the way they respond to medications.

The Differences Between Bacteria and Viruses

Although bacteria and viruses are both too small to be seen without a microscope, they’re as different as giraffes and goldfish.Bacteria are relatively complex, single-celled creatures with a rigid wall and a thin, rubbery membrane surrounding the fluid inside the cell. They can reproduce on their own. Fossilized records show that bacteria have existed for about 3.5 billion years, and bacteria can survive in different environments, including extreme heat and cold, radioactive waste, and the human body.

Most bacteria are harmless, and some actually help by digesting food, destroying disease-causing microbes, fighting cancer cells, and providing essential nutrients. Fewer than 1% of bacteria cause diseases in people.

Viruses are tinier: the largest of them are smaller than the smallest bacteria. All they have is a protein coat and a core of genetic material, either RNA or DNA. Unlike bacteria, viruses can’t survive without a host. They can only reproduce by attaching themselves to cells. In most cases, they reprogram the cells to make new viruses until the cells burst and die. In other cases, they turn normal cells into malignant or cancerous cells.

Also unlike bacteria, most viruses do cause disease, and they’re quite specific about the cells they attack. For example, certain viruses attack cells in the liver, respiratory system, or blood. In some cases, viruses target bacteria.

Diagnosis of Bacterial and Viral Infections

You should consult your doctor if you think you have a bacterial or viral infection. Exceptions include the common cold, which is usually not life-threatening.

In some cases, it’s difficult to determine the origin of an infection because many ailments — including pneumonia, meningitis, and diarrhea — can be caused by either bacteria or viruses. But your doctor often can pinpoint the cause by listening to your medical history and doing a physical exam.

If necessary, he or she also can order a blood or urine test to help confirm a diagnosis, or a “culture test” of tissue to identify bacteria or viruses. Occasionally, a biopsy of affected tissue may be required.