Introduction
Poliomyelitis, caused by the infection of Polio virus, is a severely debilitating disease. This virus that causes this disease spreads from human to human by the feco-oral route. Polio virus infection even symptomatic cause sore throat, nausea, vomiting, diarrhoea and abdominal pain. If and when the virus invades the central nervous system, headache, neck ache, non-paralytic aseptic meningitis along with irritability and lethargy develops. Sometimes, there is progression to the paralytic type and that is when infection of the brain and spinal cord happens. This usually happens infants. It is characterized by fever, headaches, changes in mental status, confusion, seizures and spastic paralysis. Plus Polio Syndrome, better and more correctly known as Post Polio Syndrome (PPS) is a condition seen in individuals who have a past history of polio. Plus Polio Syndrome develops around 15-30 years after the very first paralytic polio attack, that means a person who has been infected by polio virus may develop PPS between ages 35 and 60 years.Such an individual will complain of an increase in muscular pain, muscular weakness, and fatigue.
History
Polio dates back to prehistory and Egyptian art work includes paintings and carving of people with withered limbs and otherwise healthy bodies. Since polio affected children more than it affected adults, and caused children to walk with the help of canes, this disease acquired the name, infantile paralysis. Polio mainly spread due to poor hygiene and sanitation and in the late 19th and early 20th centuries efforts were made to better the sewage system and provision of clean water. Polio victims were left immobilized and disabled and this sad phenomenon brought about campaigns against polio epidemics. Even though the West managed to get rid of polio completely, the endemic still exists in some parts of South Asia and Nigeria and consequently so does Plus Polio Syndrome
Features
Individuals who have recovered from polio and have been stable for a long time may begin to experience suddenly new symptoms characterized by muscular pain, weakness and fatigue. This is due to the fact that their muscles are going into a process called atrophy that is responsible for the rapidly decreasing muscle mass. Both the upper and lower limbs begin to get affected, even if they were spared in the first attack. Daily activities become difficult to perform and periods of stability are followed by periods of disability. Lung capability is affected and respirator problems including sleep apnoea ensue. Cold temperatures become intolerable. Plus Polio syndrome is more disabling in people who acquired the original polio infection at a younger age.
Tips and comments
The diagnosis of Plus Polio Syndrome is established by exclusion of other diseases and is aided by neurological examination, muscle biopsy, magnetic resonance imagining and spinal fluid analysis. There is no way to prevent or cure Plus Polio syndrome and the management is palliative, which includes bed rest and pain killers. Analgesics are taken for pain relief and wheel chairs can be used to improve the quality of life. Smoking should be quit. Tracheotomy tubes help in case of breathing difficulty and persons with PPS should be given influenza vaccines.
