Poliomyelitis (Polio) and Tetanus
Poliomyelitis (Polio)
Poliomyelitis, or polio, is a paralysis or paralytic disease caused by a virus. Carriers of the disease agent, a virus called poliovirus (PV), enters the body through the mouth, intestinal tract infect. The virus can enter the bloodstream and flows into the central nervous system causing muscle weakness and sometimes paralysis (paralysis).
Etymology
The word polio comes from [Greek] or its more recently, of "gray" and "spotting".
History
Polio has been known since pre-historic times. Wall paintings in ancient Egyptian temples depict otherwise healthy people with withered legs who walks with a cane. Roman Emperor Claudius was stricken with polio as a child and a limp all his life.
Poliovirus to attack without warning, damaging the nervous system causing permanent paralysis, usually in the legs. A large number of patients died of respiratory muscles can not move. When polio struck America during the decades after World War II, the disease is called 'specter of all the parents', because it affects mainly children aged under five years old. There, the parents do not let their children out of the house, locked the movie theaters, swimming pools, schools and even churches closed.
Polio Virus
Poliovirus is a small RNA virus that consists of three different strains and highly infectious. The virus will attack the nervous system and paralysis can occur within hours. Polio attacks regardless of age, fifty percent of cases occur in children between the ages of 3 to 5 years. Polio incubation period of the first symptoms ranged from 3 to 35 days.
Polio is an infectious disease which is categorized as a disease of civilization. Polio is spread through human contact. Polio can spread silently because most patients infected with poliovirus have no symptoms, so do not know if they themselves are infected. The virus enters the body through the mouth when a person consuming food or beverages contaminated feces. After a person is exposed to infection, the virus will come out through the feces for several weeks and then that virus transmission can occur.
Types of Polio
Non-polio paralysis
Non-polio paralysis causes fever, vomiting, abdominal pain, lethargy, and sensitive. Muscle cramps occur in the neck and back, the muscles are soft to the touch.
Spinal polio paralysis
Strains of poliovirus attacks the spinal cord, destroying the anterior horn cells which control movement of the trunk and leg muscles. Although this strain can cause permanent paralysis, less than one in 200 sufferers will experience paralysis. Paralysis occurs most often found on the feet. Once the polio virus attacks the intestines, the virus will be absorbed by vessel capillary blood through the intestinal walls and transported throughout the body. Polio virus attacks the spinal cord and motor nerve - which controls physical movement. In this period of flu-like symptoms appear. However, in patients who have no immunity or have not been vaccinated, the virus usually will attack all parts of the trunk spinal cord and brain stem. These infections will affect the central nervous system - spreading along nerve fibers. Along with a proliferation of the virus in the central nervous system, the virus destroys motor neurons. Motor neurons do not have the ability and muscle regeneration associated with it will not react to commands from the central nervous system. Paralysis in the legs causes the legs to be weak - the condition is called acute flaccid paralysis (AFP). Severe infection of the central nervous system can cause paralysis of the trunk and muscles of the thorax (chest) and abdominal (stomach), is called quadriplegia.
Polio Pulbar
Polio is caused by the absence of natural immunity so that the affected part of the brain stem. The brain stem contains motor neurons that regulate breathing and cranial nerves, which send signals to various nerves that control eye movement; trigeminal nerve and facial nerve associated with the cheeks, tear glands, gums, and muscles of the face; auditory nerves that regulate hearing; glossofaringeal nerve that helps the process of swallowing and the various functions of the esophagus; movement of the tongue and taste, and the nerves that send signals to the heart, intestines, lungs, and additional nerve that regulates the movement of the neck.
Without the respirator, bulbar polio can cause death. Five to ten percent of patients who suffered from bulbar polio will die when their breathing muscles can not work. Death usually occurs after damage to the cranial nerves in charge send 'command breathe' into the lungs. Patients can also die from damage to the swallowing function; victim may 'drown' in their own secretions unless treated tracheostomy suctioning or to suck up the liquid that is secreted before entering into the lungs. However trakesotomi also difficult if the patient has used 'iron lung' (iron lung). This tool helps weak lungs by increasing and reducing the air pressure inside the tube. If the air pressure increased, the lung will deflate, if air pressure is reduced, the lung will expand. Thus, pumping air in and out of the lungs. A much more severe infection in the brain can lead to coma and death.
Bulbar polio death rate ranges from 25-75% depending on patient age. Until now, those who survive this type of polio have to live with an iron lung or respirator. Bulbar and spinal polio often attacked simultaneously and is a sub-class of polio paralysis. Polio paralysis is not permanent. Patients who recover may have a near normal body functions.
The children and polio
Young children are exposed to polio often experience only mild symptoms and become immune to polio. Therefore, residents in areas with good sanitation became more susceptible to polio because it does not suffer from polio as a child. Vaccination in infancy will help prevent polio in the future because of polio to become more dangerous if it affects adults. People who have had polio is not likely to experience additional symptoms in the future such as muscles wither; symptoms are called post-polio syndrome.
The first effective Vaccine
The first effective vaccine developed by Jonas Salk. Salk refused to patent the vaccine because he thinks the vaccine is owned by everyone as well as sunlight. But the vaccines used for mass inoculation was a vaccine developed by Albert Sabin. Prevention of child polio inoculations for the first time held in Pittsburgh, Pennsylvania on February 23, 1954. Polio disappeared in America in 1979.
Polio eradication effort
In 1938, President Roosevelt established the National Foundation for Paralysis of the Child, which aims to find a polio prevention, and treat those already infected. The foundation was established the March of Dimes. Mothers visiting from house to house, the children help do things for other people, cinema advertising, all aimed enlist the help of a dime, or ten cents. Funds that go when it is used to fund research that Dr. Jonas Salk produced the first effective vaccine. In 1952, in America there are 58 thousand cases of polio. In 1955 the Salk vaccine came into use. In 1963, after tens of millions of children vaccinated, in America there were only 396 cases of polio.
In 1955, President Dwight Eisenhower announced that the U.S. will teach other countries how to make a polio vaccine. This information is provided free of charge, to 75 countries, including the Soviet Union.
In 1988, the World Health Organization or WHO adopted a resolution to eliminate polio by the year 2000. At the moment there are about 350 thousand cases of polio worldwide. Although in 2000, polio has not been eradicated, but the number of cases has been reduced to below 500. Polio no longer exists in East Asia, Latin America, the Middle East or Europe, but still found in Nigeria, and a small amount in India and Pakistan. India has made polio eradication efforts are quite successful. While in Nigeria, the disease is still contagious because the ruling government to suspect that given polio vaccine can reduce fertility and the spread of HIV. In 2004, the Nigerian government asked WHO to vaccinate again after polio re-spread throughout Nigeria and 10 neighbors. Internal conflicts and civil wars in Sudan and Ivory Coast also complicate the administration of polio vaccine.
Although many attempts have been made, in 2004, polio infection rates increased to 1185 in 17 countries from 784 in 15 countries in 2003. Some people are in Asia and 1037 in Africa. Nigeria has 763 patients, 129 India, and Sudan 112.
On May 5, 2005, reported an explosion of polio infection in Sukabumi due to strains of the virus that causes outbreaks in Nigeria. The virus is expected to carry over from Nigeria to the Arab and came to Indonesia through the Indonesian workers who work in the Arab or a person who travels to Arabia for Hajj or anything else.
Tetanus
Tetanus, also known as lockjaw , is a disease that caused by tetanospasmin, a type of neurotoxin produced by Clostridium tetani which infects the nervous system and muscles so that the nerves and muscles to become stiff (rigid). Kitasato was the first to succeeded in isolating the organism from the human victims are exposed to tetanus and also reported that the toxins can be neutralized by specific antibodies. The word tetanus is derived from the Greek meaning teinein tetanos of tightening. This disease is an infectious disease when muscle spasm tonic and hiperrefleksia cause trismus (lockjaw), generalized muscle spasm, curved backs (opisthotonos), glottal spasm, convulsions, and respiratory paralysis.
Characteristics of Clostridium tetani
C. tetani bacteria including Gram-positive, obligate anaerobic, can form spores, and drumstick-shaped. Spores are formed by C. tetani is highly resistant to heat and antiseptics. He can hold even been autoclaved (1210C, 10-15 minutes) and also resistant to phenol and other chemical agents. Clostridium tetani bacteria are commonly found in soil, human feces and pets and in agricultural areas. Generally, bacterial spores are distributed in soil and digestion tract and feces of horses, sheep, dogs, cats, rats, pigs, and chickens. When the bacteria are in the body, it will produce a neurotoxin (a protein that acts as a poison that attacks the nervous system). C. tetani exotoxin produced two pieces, namely tetanolysin and tetanospasmin. The function of tetanoysin not known with certainty, but also can affect the tetanus. tetanospasmin is a toxin that is strong enough.
Pathogenesis and Pathophysiology
Tetanus is caused by neurotoxins (tetanospasmin) from Gram-positive anaerobic bacterium, Clostridium tetani, the first 1 to 2 weeks after inoculation of spores into the body's blood to the injured (incubation period). This disease is one of 4 important clinical manifestations of disease is primarily the result of the power influences exotoxin (tetanus, gas gangrene, diphtheria, botulism). The entry of these germs can be wound in dealing with local tissue damage, embedded foreign objects or sepsis with contamination of soil, shallow and small abrasions or wounds contaminated with soil shear, trauma to the fingers or toes associated with finger fractures and injuries to the surgery.
In anaerobic conditions, spores of these bacteria will germination into vegetative cells. Furthermore, the toxin will be produced and spread throughout the body via the circulatory and lymphatic systems. The toxin will be active in certain places such as central nervous system including the brain. Symptoms klonis that evoked from the toxin is to block the release of neurotransmitters, causing uncontrolled muscle contractions. As a result of tetanus is a rigid paralysis (loss of ability to move) on the voluntary muscles (which motion can be controlled), commonly called lockjaw because it usually first appears on the jaw and facial muscles. Death is usually caused by respiratory failure and mortality is extremely high ratio.
Treatment
To neutralize the poison, administered tetanus immunoglobulin. tetracycline and penicillin antibiotics given to prevent further formation of toxins, so that existing raccun dead.
Other drugs may be given to calm patients, to control spasms and relax muscles. Patients are usually hospitalized and placed in a quiet room. For moderate to severe infections, may need a ventilator to assist breathing.
Food is given through an IV or nasogastric tube. To remove dirt, installed a catheter. The patient should lie alternately tilted to the left or right and was forced to cough to prevent pneumonia.
To reduce the pain given codeine. Other drugs can be administered to control blood pressure and heart rate. After recovering, should be given full vaccination for tetanus infection does not confer immunity against subsequent infection.
Prognosis
Tetanus has a mortality rate of up to 50%. Death usually occurs in people who are very young, very old and injecting drug users. If symptoms worsen with immediate or delayed treatment if the prognosis would be worse.
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