6/10/2010

Global polio fight to get needed funds -Bill Gates


Global polio fight to get needed funds -Bill Gates

Posted at 06/08/2010 8:16 PM | Updated as of 06/08/2010 8:16 PM

ABUJA, Nigeria - Rich nations and global donors should be able to provide the $2.6 billion in aid needed to combat polio through 2012 despite the global credit crunch, multi-billionaire philanthropist Bill Gates said on Monday.
The World Health Organisation has suggested a budget of $2.6 billion for its polio eradication efforts in 2010-2012, but says it faces a shortfall of about half of funds for that period.
"We are going to the rich world donors at a time when their budgets are tight," Gates, the founder of software giant Microsoft, told reporters during a visit to Nigeria's capital Abuja.
"But between what our foundation will do, what the others will do, I feel quite sure that we will be able to fund that fight," he added.
The Bill & Melinda Gates Foundation, which has been active in fighting child and infectious diseases in poor countries, will commit more than $150 million of its $34 billion fund this year to mass polio immunisation and surveillance programmes.
The number of worldwide cases has declined this year, most significantly in Nigeria which has recorded its lowest level of infections ever with only three so far in 2010. That is down from a total of 288 cases last year.

Key to ending polio
Nigeria, one of four countries where polio is endemic, is considered key to wiping out the virus which spread out from the northern half of the country to 17 African nations in the last few years.
Dr Bruce Aylward, director of the polio eradication initiative of WHO, said there were still many children in Nigeria that are not receiving vaccines and a large outbreak could re-occur if governments and donors become complacent.
"The reality is that it can easily explode again, where you could have thousands of children paralyzed again every single year in this country," Aylward said.
For example, polio was recently found in Tajikistan for the first time in 10 years and quickly spread, paralyzing 152 children in a few months, WHO said.
Nigeria has struggled to contain polio since some northern states imposed a year-long vaccine ban in mid-2003. Some state governors and religious leaders in the predominately Muslim north claimed the vaccines were contaminated by Western powers to spread sterility and HIV/AIDS among Muslims.
Traditional leaders throughout the country pledged in January 2009 to support immunisation campaigns, however, and are pushing parents to have their children vaccinated.
Immunisations of children in Nigeria's north rose to 71 percent this year, up from 63 percent in 2009. WHO has set a goal of 80 percent in Africa's most populous nation.
Polio, which spreads in areas with poor sanitation, attacks the nervous system and can cause irreversible paralysis within hours of infection. Children under the age of 4 are the most vulnerable to the disease that until the 1950s crippled thousands of people every year in rich nations htp://www.abs-cbnnews.com/global-filipino/world/06/08/10/global-polio-fight-get-needed-funds-bill-gates

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

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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