3/17/2010

Children who suffer a permanent paralysis of the limbs due to Polio


Nigeria: The Fresh Offensive Against Polio Ruby Rabiu
Children who suffer a permanent paralysis of the limbs due to Polio require an extensive program of rehabilitation. This may include physiotherapy, braces, special shoes, calipers, and in many cases, orthopaedic surgery. A team effort from doctors, physiotherapists, occupational therapists, and psychologists is required to get each child through the ordeal. 

    

An ongoing healthy standard of living is very important to our children. A well-balanced diet, a thorough exercise regime, and appropriate healthcare can help manage the ongoing impact of Polio, as well as help in later life should the child be amongst the 25% of sufferers that will develop Post Polio Syndrome (PPS).PPS symptoms include fatigue, slow-progressive muscle weakness, muscle and joint pain, and muscular atrophy. PPS can strike polio survivors anywhere from 10 to 40 years after their recovery from polio. 
Fortunately, there is no effect of the Polio virus on the brain, so these children remain completely able to take part in a normal school curriculum and achieve highly in life. 
T
he SKSN Limb Workshop fits children with the appliances they require, whether it be braces or calipers, and the school provides funding to enable the children to visit specialist prosthetic units, should an artificial limb be required. 
8 March 2010
Beginning from Saturday March 6, Nigeria joined 19 countries in West and Central Africa in a campaign to immunize over 85 million children under five years old against polio. The four-day exercise ends today.
Nigeria's effort has been supported by the United Nations Children's Fund (UNICEF), World Health Organisation (WHO), and other international partners.
A schedule of the programme from the UNICEF office in Nigeria shows that staff at 19,112 fixed immunization posts will immunize babies and children while 32,172 house-to-house vaccination teams and 14,224 special teams carrying vaccine cool are travelling on foot or motorbikes and in cars and boats on the door-to-door vaccination drive.
The other countries involved in this special programme include Benin, Burkina Faso, Cameroon, Cape Verde, Central African Republic, Chad, Gambia, Ghana, Guinea, Liberia, Mali, Mauritania, Senegal and Sierra Leone. All these countries are in the March 6 to 9 immunization programme.
Cote d' Ivoire, Niger and Togo will join at a later date because of transition programmes currently taking place in the three countries.
The campaign is being spearheaded by the Global Polio Eradication Initiative, a network of partners including national governments, the Rotary International, the US Centres for Disease Control and Prevention, the International Federation of the Red Cross, as well as the UNICEF and WHO.
The aim is to reach every child under the age of five. It is considered significant because without a critical mass of children being immunized, the virus will rage on. More than 400,000 volunteers and health workers are involved in the aim to reach the targeted 85 million children.

Part of a statement from UNICEF which relates the incidence of polio in the two subcontinents, reads, "For children in West and Central Africa, the threat of the crippling disease, eradicated in much of the world, still looms. In Nigeria, the virulent polio virus is still endemic. In 2008, it spread from the north of the country to other nations in the region. Many of these countries were on the way to being declared polio-free and had successfully eradicated the virus. Yet with the movement of people across borders, and the inadequate level of routine immunization in many areas, the virus has quickly spread. Now, many of these areas are re-infected, threatening more children with paralysis and even death."
In the current logistical exercise, vaccination teams are crossing some of the toughest and most challenging terrain in Africa to reach children. The teams, equipped with special carriers that ensure the vaccine remains below the required 8 degrees Celsius, go from door to door in search of every child under five.
Experienced health workers are being deployed to locations known to be the most challenging. A special plan is in place to focus on the border areas between countries with an independent monitoring system developed to track progress. Count Down, an internet newsletter produced every two weeks by the World Health Organization in Nigeria, provides an update on the effect of polio in Nigeria within the last one year. According to the update which comes under the caption, "Total number of children paralysed by polio 26 February 2009 to 26 February 2010," Kano State presents the worst case of 70.
Kano is followed by other affected states in this order: Katsina (25), Bauchi (23), Borno (16), Kebbi (14), and Niger (13). Zamfara, Sokoto, and Kaduna states had 10 cases each, while Gombe and Yobe had nine and eight cases respectively. The states of Delta, Kogi, and Nasarawa suffered five polio paralysis each within the recorded year while Benue, Plateau and Bayelsa came down each with four. Three and two cases were recorded against Ogun and Ebonyi States respectively while Abia, Lagos, Edo and Kwara states had one each.

International Organisations
The Count Down newsletter, known fully as Count Down to Polio Eradication in Nigeria, also reports, however, that a more portent vaccine, the bivalent Oral Polio Vaccine (bOPV)), which was administered for the first time in Africa in Nigeria during the January National Immunization Plus Days (IPDs) would speed up the interruption of the polio viruses troubling Nigeria and neighbouring countries.
It explains in its report that the bOPV "simultaneously targets type 1 and 3 polio viruses and is at least 30 percent more effective than the traditional trivalent polio vaccine, according to a clinical field trial conducted in India."
The success of the polio eradication exercise will be significant. It will mean the prevention of a life of disability and physical hardship in communities already facing countless threats to survival.

Nigeria:The Nation Records 90 Percent Reduction in Polio:Cases
Akor Sylvester
16 March 2010
           


Abuja — Efforts to meet the health-related Millennium Development Goals (MDGs) in the country last weekend received a boost, as the Minister of Health, Prof. Babatunde Osotimehin said that Nigeria has recorded about 90 per cent reduction in wide polio virus infection in the past one year.
He said this last Saturday Polio" campaign organized by the National Primary Health Care Development Agency (NPHCDA) in Abuja.
"That is why we are staging this 'Walk Against Polio' campaign, to involve all Nigerian in the fight against polio. This is the time to double our efforts. This is also the time expected of our friends all over the world to support us in the struggle," he said.
He said that the success so far recorded could not have been possible without the support of the development partners, traditional and religious leaders, as well as the political commitment of the present administration.
Flagging off the campaign at the Old Parade ground Abuja, Minister for the Federal Capital Territory (FCT), Senator Adamu Alairo, said the FCT administration, having understood that polio could be transmitted by poor environment through contaminated food and water, laid more emphasis on clean and healthy environment.
"The polio walk is a social mobilisation strategy that seeks to create and heighten awareness about polio, and enhance community acceptance and ownership of polio eradication activities and other health services. This is expected to ensure improved quality and effectiveness in primary health care programme. This will also serve and sustain political commitment at all levels," he said.
He said the government was not only optimistic that it could totally eradicate polio, but also reduced the prevalence of other child killer disease, such as measles, diphtheria and yellow fever. He added that the involvement of traditional and religious leaders was making positive "in-road in the fight against polio."
While calling on relevant stakeholders to assist government in its resolve to free the country from polio diseases, the minister said his would continue to collaborate with the health ministry in ensuring that the country wins the battle against polio infection. 
 Nigeria: The Fresh Offensive Against Polio
Ruby Rabiu
8 March 2010
Beginning from Saturday March 6, Nigeria joined 19 countries in West and Central Africa in a campaign to immunize over 85 million children under five years old against polio. The four-day exercise ends today.
Nigeria's effort has been supported by the United Nations Children's Fund (UNICEF), World Health Organisation (WHO), and other international partners.
A schedule of the programme from the UNICEF office in Nigeria shows that staff at 19,112 fixed immunization posts will immunize babies and children while 32,172 house-to-house vaccination teams and 14,224 special teams carrying vaccine cool are travelling on foot or motorbikes and in cars and boats on the door-to-door vaccination drive.
The other countries involved in this special programme include Benin, Burkina Faso, Cameroon, Cape Verde, Central African Republic, Chad, Gambia, Ghana, Guinea, Liberia, Mali, Mauritania, Senegal and Sierra Leone. All these countries are in the March 6 to 9 immunization programme.
Cote d' Ivoire, Niger and Togo will join at a later date because of transition programmes currently taking place in the three countries.
The campaign is being spearheaded by the Global Polio Eradication Initiative, a network of partners including national governments, the Rotary International, the US Centres for Disease Control and Prevention, the International Federation of the Red Cross, as well as the UNICEF and WHO.
The aim is to reach every child under the age of five. It is considered significant because without a critical mass of children being immunized, the virus will rage on. More than 400,000 volunteers and health workers are involved in the aim to reach the targeted 85 million children.

Part of a statement from UNICEF which relates the incidence of polio in the two subcontinents, reads, "For children in West and Central Africa, the threat of the crippling disease, eradicated in much of the world, still looms. In Nigeria, the virulent polio virus is still endemic. In 2008, it spread from the north of the country to other nations in the region. Many of these countries were on the way to being declared polio-free and had successfully eradicated the virus. Yet with the movement of people across borders, and the inadequate level of routine immunization in many areas, the virus has quickly spread. Now, many of these areas are re-infected, threatening more children with paralysis and even death."
In the current logistical exercise, vaccination teams are crossing some of the toughest and most challenging terrain in Africa to reach children. The teams, equipped with special carriers that ensure the vaccine remains below the required 8 degrees Celsius, go from door to door in search of every child under five.
Experienced health workers are being deployed to locations known to be the most challenging. A special plan is in place to focus on the border areas between countries with an independent monitoring system developed to track progress. Count Down, an internet newsletter produced every two weeks by the World Health Organization in Nigeria, provides an update on the effect of polio in Nigeria within the last one year. According to the update which comes under the caption, "Total number of children paralysed by polio 26 February 2009 to 26 February 2010," Kano State presents the worst case of 70.
Kano is followed by other affected states in this order: Katsina (25), Bauchi (23), Borno (16), Kebbi (14), and Niger (13). Zamfara, Sokoto, and Kaduna states had 10 cases each, while Gombe and Yobe had nine and eight cases respectively. The states of Delta, Kogi, and Nasarawa suffered five polio paralysis each within the recorded year while Benue, Plateau and Bayelsa came down each with four. Three and two cases were recorded against Ogun and Ebonyi States respectively while Abia, Lagos, Edo and Kwara states had one each.

The Count Down newsletter, known fully as Count Down to Polio Eradication in Nigeria, also reports, however, that a more portent vaccine, the bivalent Oral Polio Vaccine (bOPV)), which was administered for the first time in Africa in Nigeria during the January National Immunization Plus Days (IPDs) would speed up the interruption of the polio viruses troubling Nigeria and neighbouring countries.
It explains in its report that the bOPV "simultaneously targets type 1 and 3 polio viruses and is at least 30 percent more effective than the traditional trivalent polio vaccine, according to a clinical field trial conducted in India."
The success of the polio eradication exercise will be significant. It will mean the prevention of a life of disability and physical hardship in communities already facing countless threats to survival

Nigeria: The Nation Records 90 Percent Reduction in Polio Cases
Akor Sylvester
16 March 2010

             
Abuja — Efforts to meet the health-related Millennium Development Goals (MDGs) in the country last weekend received a boost, as the Minister of Health, Prof. Babatunde Osotimehin said that Nigeria has recorded about 90 per cent reduction in wide polio virus infection in the past one year.
He said this last Saturday Polio" campaign organized by the National Primary Health Care Development Agency (NPHCDA) in Abuja.
"That is why we are staging this 'Walk Against Polio' campaign, to involve all Nigerian in the fight against polio. This is the time to double our efforts. This is also the time expected of our friends all over the world to support us in the struggle," he said.
He said that the success so far recorded could not have been possible without the support of the development partners, traditional and religious leaders, as well as the political commitment of the present administration.
Flagging off the campaign at the Old Parade ground Abuja, Minister for the Federal Capital Territory (FCT), Senator Adamu Alairo, said the FCT administration, having understood that polio could be transmitted by poor environment through contaminated food and water, laid more emphasis on clean and healthy environment.
"The polio walk is a social mobilisation strategy that seeks to create and heighten awareness about polio, and enhance community acceptance and ownership of polio eradication activities and other health services. This is expected to ensure improved quality and effectiveness in primary health care programme. This will also serve and sustain political commitment at all levels," he said.
He said the government was not only optimistic that it could totally eradicate polio, but also reduced the prevalence of other child killer disease, such as measles, diphtheria and yellow fever. He added that the involvement of traditional and religious leaders was making positive "in-road in the fight against polio."
While calling on relevant stakeholders to assist government in its resolve to free the country from polio diseases, the minister said his would continue to collaborate with the health ministry in ensuring that the country wins the battle against polio infection.
















        




















        






























        

























The Polio Crusade

THE POLIO CRUSADE IN AMERICAN EXPERIENCE A GOOD VIDEO THE STORY OF THE POLIO CRUSADE pays tribute to a time when Americans banded together to conquer a terrible disease. The medical breakthrough saved countless lives and had a pervasive impact on American philanthropy that ... Continue reading..http://www.pbs.org/wgbh/americanexperience/polio/

Erradicación de La poliomielitis

Polio Tricisilla Adaptada

March Of Dimes Polio History

Dr. Bruno

video

movie

movie2

A 41-year-old man developed an acute illness at the age of 9 months during which, following a viral illness with headache, he developed severe weakness and wasting of the limbs of the left side. After several months he began to recover, such that he was able to walk at the age of 2 years and later was able to run, although he was never very good at sports. He had stable function until the age of 18 when he began to notice greater than usual difficulty lifting heavy objects. By the age of 25 he was noticing progressive difficulty walking due to weakness of both legs, and he noticed that the right calf had become larger. The symptoms became more noticeable over the course of the next 10 years and ultimately both upper as well as both lower limbs had become noticeably weaker.

On examination there was wasting of the muscles of upper and lower limbs on the left, and massively hypertrophied gastrocnemius, soleus and tensor fascia late on the right. The calf circumference on the right exceeded that on the left by 10 cm (figure1). The right shoulder girdle, triceps, thenar eminence and small muscles of the hand were wasted and there was winging of both scapulae. The right quadriceps was also wasted. The wasted muscles were also weak but the hypertrophied right ankle plantar flexors had normal power. The tendon reflexes were absent in the lower limbs and present in the upper limbs, although the right triceps was reduced. The remainder of the examination was normal.

Figure 1

The patient's legs, showing massive enlargement of the right calf and wasting on the left

Questions

1
What is that nature of the acute illness in infancy?
2
What is the nature of the subsequent deterioration?
3
What investigations should be performed?
4
What is the differential diagnosis of the cause of the progressive calf hypertrophy?

Answers

QUESTION 1

An acute paralytic illness which follows symptoms of a viral infection with or without signs of meningitis is typical of poliomyelitis. Usually caused by one of the three polio viruses, it may also occur following vaccination and following infections with other enteroviruses.1 Other disorders which would cause a similar syndrome but with upper motor neurone signs would include acute vascular lesions, meningoencephalitis and acute disseminated encephalomyelitis.

QUESTION 2

A progressive functional deterioration many years after paralytic poliomyelitis is well known, although its pathogenesis is not fully understood.2 It is a diagnosis of exclusion; a careful search for alternative causes, for example, orthopaedic deformities such as osteoarthritis or worsening scoliosis, superimposed neurological disorders such as entrapment neuropathies or coincidental muscle disease or neuropathy, and general medical causes such as respiratory complications and endocrinopathies.3

QUESTION 3

Investigations revealed normal blood count and erythrocyte sedimentation rate and normal biochemistry apart from a raised creatine kinase at 330 IU/l (normal range 60–120 IU/l), which is commonly seen in cases of ongoing denervation. Electromyography showed evidence of denervation in the right APB and FDI with polyphasic motor units and complex repetitive discharges, no spontaneous activity in the left calf and large polyphasic units in the right calf consistent with chronic partial denervation. Motor and sensory conduction velocities were normal. A lumbar myelogram was normal. Magnetic resonance imaging (MRI) scan of the calves is shown in figure2.

Figure 2

Axial T1 weighted MRI scan (TR 588 ms, TE 15 ms) of the calves, showing gross muscle atrophy and replacement by adipose tissue on the left, and hypertrophy of the muscles on the right, with only minor adipose tissue deposition

QUESTION 4

The differential diagnosis of the progressive calf hypertrophy is given in the box.

Causes of calf muscle hypertrophy

Chronic partial denervation

  • radiculopathy

  • peripheral neuropathy

  • hereditary motor and sensory neuropathy

  • spinal muscular atrophy

  • following paralytic poliomyelitis

    Neuromyotonia and myokymia

  • Isaac's syndrome

  • generalised myokymia

  • neurotonia

  • continuous muscle fibre activity due to: chronic inflammatory demyelinating polyradiculopathy, Guillain Barre syndrome, myasthenia gravis, thymoma, thyrotoxicosis, thyroiditis

    Muscular dystrophies

    Myositis

    Infiltration

  • tumours

  • amyloidosis

  • cysticercosis

    Link here