Polio continues to be a global public health issue, and even though it has been eliminated from most of the republics of the world, some countries, threatens the dream of total elimination of polio from the surface of the world. The spreading of polio virus has never been eliminated in some countries, but even worse is the number of republics, both in Africa and all over the world that has been re-infected by polio virus. This report addresses the following, the causes, symptoms, and mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence) in regard to Polio. It focuses on the social determinants of health, the epidemiologic triangle as it relates polio, the role of the community health nurse, CDC as one of organization that addresses the polio epidemic and the global implication polio.
Polio, or poliomyelitis, is a crippling and potentially lethal communicable disease. It is instigated by the polio virus. The virus spreads from one individual to another and can strike an infected person’s brain and spinal cord, triggering paralysis. A virus is an infectious means that has the ability to increase only inside the living cells of a host and in contaminate them with the infection it carry's.
Polio is brought about by small RNA viruses. They are constituents of the retrovirus group of the Picornavirus family. There are three categories of polio infections they comprise of; Type 1, 2 and 3. Type 1 is the leading cause of around 85% of all paralytic infections. These types are antigenic ally different strains of infection and viruses or immunity to one type does not safeguard against the other two types, nevertheless, if immunity is created to one or all of the three strains, immunity is lifetime. The challenge that these viruses cause is the obliteration of spinal cord cells. The incubation period of polio is in between 3 and 35 days; as for paralytic cases, it is between 7–14 days.
Most people who get affected with poliovirus (around 72 out of 100) will not have any noticeable symptoms. Around 1 out of 4 individuals with poliovirus disease will have flu-like symptoms that may comprise—fever, sore throat, tiredness, headache, nausea and stomach pain. These symptoms typically last 2 to 5 days then they disappear on their own. A smaller percentage of people with poliovirus infection will acquire other more severe symptoms that affect the spinal cord and brain which include: meningitis (is the disease of the covering of the brain or spinal cord and it strikes in about 1 out of 25 individuals with poliovirus infection); paresthesia (is the abnormal sensation of the body, such as burning, tingling or numbness, these sensations may be felt in the hands, fingers, toes, or weakness in the arms, legs, or both, happens in about 1 out of 200 individuals with poliovirus infection); paralysis is the most critical symptom connected with polio because it can steer to death or permanent disability. Amid 2 and 10 out of 100 individuals who have paralysis from poliovirus infection pass on since the virus affects the muscles that assists them in breathing. Children who seem to fully recover can experience the post-polio syndrome which is characterized by development of new muscle pain, paralysis as adults or weakness.
Poliovirus only affects humans. It is very transmissible and spreads from one person to another through contact. The virus resides in an infected person’s intestines and throat. It comes into the body via the mouth and spreads by way of contact with the feces of an infected individual and, though not quite common, through drops from a cough or sneeze. One can get infested with poliovirus if they have feces on their hands and they touch their mouth. Also, one can get infected if they put in objects in their mouth like toys that are infected with feces (poop). An infected individual may spread the infection to others instantly and at about 1 to 2 weeks after symptoms emerge. The virus can survive in an infected person’s feces for several weeks. It can pollute water and food in unhygienic conditions. People who don’t have the symptoms can still surpass the virus to other people and make them ill.
When the virus that brings about polio has infected an individual, there is no cure that will treat polio. Early analysis and supportive treatments such as, pain control, bed rest, good nutrition, and physical rehabilitation to prevent deformities from happening over time can assist in reducing the lasting symptoms due to muscle damage. Polio vaccine protects the children by making their bodies ready to attack the polio virus. Almost all children who get all the proposed doses of vaccine will be protected from polio.
There are two categories of vaccine that can ward off polio: oral poliovirus vaccine (OPV) and inactivated poliovirus vaccine (IPV). The adults who are at risk for being infected with polio should receive a booster dosage these adults consists of: 1) those who are traveling to republics with high rates of the polio, such as Nigeria, India, Pakistan and Afghanistan; 2) health care workers who come into contact with patients who may have been infected by the polio virus; 3) laboratory workers dealing with the samples that may contain polio virus.
Reportable diseases are diseases thought to be of great importance to the public health. In the United States, local and national agencies necessitate that these diseases be conveyed when they are identified by doctors and laboratories. Polio is a reportable disease and it should be reported to the US Centers for Disease Control and Prevention (CDC). It is the obligation of the health care to report cases of the polio disease. Reporting assists researchers in identifying disease trends and track disease epidemics. This knowledge can assist in controlling future outbreaks. Poliomyelitis is a ‘crucial’ notifiable state and must be informed by medical physicians and pathology facilities with immediate effect by telephoning upon preliminary diagnosis (probable or confirmed). Pathology facilities must follow up with written statement within five days.
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Social determinants of health are social and economic conditions that effect the health of people and the society. These conditions are formed by the amount of power, resources and money that people have, all of which are prejudiced by policy choices. Social determinants of health influence factors that are associated with health outcomes. The main social factor in polio is the way that individuals are handled while they have polio. This is majorly witnessed in Pakistan, Afghanistan and Nigeria. When people are affected with polio many are often afraid of associating with so as not to be infected so they end ups excluding the infected person from everyday life mainly due to fear. This generates a problem that influences the social aspects of people’s lives. This makes people socially secluded as well as creating a division in cultures that influences the way they live.
The economic determinant in polio is mainly about the financial status of those affected with polio. People with a low financial status would have a difficult time recuperating through any health problem particularly polio. Since polio cannot be cured it’s quite difficult to maintain the disease since it’s quite expensive. This makes the lives of those affected difficult.
The Epidemiologic Triangle is a paradigm that researchers have established for learning about health problems. It helps in understanding infectious diseases and how they spread. The Triangle has three vertices: agent, or microbe this is the causes the disease; host, are organisms, mostly humans or animals, which are subjected to and harbor an infection; environment, or those external factors that cause or allow disease transmission. An epidemic or an outbreak comes into existence when there are more instances of a particular infection than expected in that given region, or among a particular group of people, over a specific period of time. The task of an epidemiologist is to disrupt at least either of the sides of the Triangle, breaking the connection between the agent, the host, and the environment, and stopping the spreading of disease.
When it comes to the Epidemiologic Triangle of the polio, the contributing agent is the polio virus which has three serovar 1, 2, and 3. Most epidemics of paralytic polio are due to type 1 virus. The Host - human intestine and throat. Environment - crowded and unhygienic surroundings. Polio virus can thrive for long episodes in the external environment. In a cool environment, it can survive in water for up to 4 months and in faces for up to 6 months. The virus is well adapted for fecal oral route of transmission. Nevertheless the virus can be quickly inactivated by pasteurization and a diversity of physical and chemical means. Vector - the virus is located in the faces and oropharyngeal secretions of an infected individual.
The Community Health Nurse implements, surveillance, disease control and follow-up activities in relation to the polio diseases. They assist in the outbreak organization by offering communicable disease control advice, advice-giving service to other health professionals, educating members of the public, institutions, schools and child care centers. The community health nurse is also responsible with the follow up and improved surveillance of notifications connected to Polio.
Demographics consists of an array of socioeconomic data, comprising of the breakdown of a population by age, gender, income, ethnicity, employment status, internet access and home ownership. Demographics offer a simplification of a particular specific population, based on a sampling of individuals in that geography. The information that is collected on the patient demographic data such as: gender, age, race and cultural background becomes a part of the patient’s examination record. This demographic information assists the care team to interconnect efficiently with patients, as well as to comprehend a patient’s culture, which may influence their health.
One of the organization that deals with Polio is the Centers for Disease Control and Prevention (CDC). It is a tactical partner in the overall effort to eliminate polio worldwide. CDC offers scientific knowledge to many polio eradication activities and programs. CDC’s laboratories provide analytical diagnostic facilities and genomic sequencing of polioviruses to assist in guiding disease control efforts in many countries. In 2014, this comprised of support for application of improved laboratory processes that have improved sensitivity to notice and check new polio infection.
There are four regions of the world that are confirmed to be polio free: America, Western Pacific, Europe and South East Asia. Three polio-endemic countries are: Pakistan, Afghanistan and Nigeria. In 2016, only 37 cases of polio were found in those last pockets, the smallest number of new cases in history. In 1988, polio dispersed in more than 125 republics, where it paralyzed over 350,000 children. The plans for polio eradication function when they are fully executed. This is clearly shown by India’s achievement in preventing polio in January 2011, in debatably the most technically-challenging position, and polio-free accreditation of the whole South-East Asia Region of WHO happened in March 2014. Strategies for polio eradication in India comprises of: Conveyance of Pulse Polio Immunization periods every year until polio is eliminated, Withstand high levels of repetitive immunization, Monitoring OPV treatment at dist. level and below. Improved surveillance with the capability of detecting all instances of AFP due to polio and non-polio etiology. Arranging follow ups of all cases of AFP within 60 days to inspect the samples for virus seclusion, conducting epidemic control for cases established or believed to be polio infected so to stop the spreading of the virus. Other ways include: mopping up, line listing of cases, and execution of Pulse Polio Programme. Failure to apply tactical approaches, nevertheless, leads to ongoing spreading of the virus. Endemic transmission is ongoing in Pakistan, Afghanistan and Nigeria.
Failure to prevent polio in these last outstanding areas could bring about in as many as 200 000 new instances every year, in 10 years, worldwide.
References
- CDC Global Health: Polio. (2019). Retrieved from https://www.cdc.gov/polio/
- M, A. (2019). Poliovirus Studies during the Endgame of the Polio Eradication Program. - PubMed - NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/27795480
- Social Determinants of Health. (n.d.). Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health?topicid=39
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