Epidemiology of Poliomyelitis
Dr. Rasha Salama
PhD Community Medicine and Public Health
Suez Canal University
Egypt
Poliomyelitis
First described by Michael Underwood in 1789
First outbreak described in U.S.
in 1843
21,000 paralytic cases reported in the U. S. in 1952
Global eradication in near future
Introduction
A viral infection most often recognized by acute onset of flaccid paralysis.
Infection with poliovirus results in a spectrum of clinical manifestations from inapparent infection to non-specific febrile illness, aseptic meningitis, paralytic disease, and death.
Poliomyelitis is a highly infectious disease caused by three serotypes of poliovirus.
Two phases of acute poliomyelitis can be distinguished: a non-specific febrile illness (minor illness) followed, in a small proportion of patients, by aseptic meningitis and/or paralytic disease (major illness).
The ratio of cases of inapparent infection to paralytic disease ranges from 100:1 to 1000:1.
Outcomes of poliovirus infection
Epidemiological pattern
The epidemiological pattern of polio depends upon the degree of the socioeconomic development and health care services of a country.
The pattern of the disease has been considerably modified by widespread immunization.
According to the WHO; Three epidemiological patterns have now been delineated:
Countries with no immunization: the virus infects all children, and by age 5 years almost all children develop antibodies to at least one of the 3 types of polio virus. In that pattern paralytic polio cases are frequent in infants.
Countries with partial immunization: In these countries, wild polio virus is largely replaced by vaccine virus in the environment.
Countries with almost total immunization coverage: in these countries polio is becoming rare, however, sporadic cases do occur rarely.
Poliomyelitis—United States, 1950-2005*
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