Historically, polio regularly circulated in communities the world over. With the advent of improved sanitation and hygiene in the 20th century, outbreaks in North America and Europe most commonly occurred in the summer and fall. The polio virus generally follows the fecal-oral transmission route, meaning that a victim likely ingested water contaminated by feces from another polio carrier. And this most commonly was associated with swimming. Most people contracted the polio virus as children, had a minor cold-like illness with fever, muscle pain, diarrhea, and abdominal pain. And then it went away. However, the virus entered the central nervous system of 1% of patients. Half of these developed non-paralytic CNS polio with a headache, neck, back, and limb pain and severe gastrointestinal symptoms, which eventually resolved on their own. In the other half (5 out of 1000 patients who contract polio) the patient is paralyzed.[1]
There are two types of paralytic polio:
Bulbar polio occurs when the infection invades the brainstem and hinders breathing and swallowing. In most patients these symptoms last 10-14 days before the patient can resume breathing and swallowing on his own. In an austere environment, the patient would have to be mechanically ventilated for this period and still may not recover.
Spinal polio afflicts and permanently damages the spinal cord resulting in weakness or paralysis. Any limb or combination of limbs may be affected.
Polio will often be fatal when there is no higher medical care.[2]
The following information comes directly from The Ship’s Medicine Chest and Medical Aid at Sea:
Incubation Period: Commonly 7 to 12 days, with a range from 3 to 21 days.
Isolation Period: Isolation precautions not more than 7 days in hospital management. Of little value in home or ship conditions because the spread of infection is greatest when symptoms first appear.
Poliomyelitis is an acute viral disease that occurs chiefly in children with most of the cases occurring in the first three years of life. Adults usually are immune. Today polio is wholly preventable with two types of vaccine available: the injectable Salk vaccine and the newer Sabin oral vaccine.
Polio may start with no recognizable symptoms or it may resemble a head cold with fever, vomiting, and irritability. The symptoms last about three days and the temperature may rise to 104°F (40°C). From the fourth to the tenth day the condition will seem to be clearing. However, the symptoms return with a feeling of apprehension, headache, stiff neck and back, and deep muscle pains. Varying degrees of paralysis follow. Thereafter improvement is gradual either with complete recovery or paralysis to some degree.
Treatment
No specific treatment is effective. When poliomyelitis is suspected, medical advice by radio should be obtained. The patient should be put to bed and isolation nursing technique observed. For paralysis of body parts, hot moist heat may be applied coupled with gentle, active or passive, motion as soon as the patient can tolerate it.
If urine is retained, a catheter should be inserted (see p. 325). All stools and urine are infectious, so bedpans and urinals should be disinfected (see p. 318).
This concludes the information from The Ship's Medicine Chest.
Notes from other sources: In unvaccinated children, if muscle loss or weakness is uneven or worse on one side, polio may be suspected. In adults, such symptoms are more likely attributed to stroke or a back or head injury.[3]
Usually children recover completely within a few days. However, sometimes part of the body becomes paralyzed, most often one or both legs. Over time, the weak limb thins and does not grow as fast as the normal one. There is no medicine to correct the paralysis, but sometimes part or all of the strength lost will slowly return.[4]
Calm the pain with acetaminophen or aspirin. Position the patient to be comfortable and avoid contracting the muscles. Gently straighten the limbs so that the patient lies as straight as possible. Arrange cushions under the knees if necessary to relieve pain, but try to keep the legs straight.[5]
Do not give injections of any medicine to a child with signs of a cold, fever, or other signs that may be caused by the polio virus. The irritation caused by an injection may turn a mild case of polio without paralysis into a severe case with paralysis.[6]
Herbs that may be effective against polio virus:
Chinese skullcap[7]
Elder[8]
Ginger[9]
Licorice[10]
References:
The Ship’s Medicine Chest and Medical Aid at Sea, 1978, 184-185.
[1] Survival and Austere Medicine, 3rd Edition, 295.
[2] Ibid, 296.
[3] David Werner, Where There Is No Doctor, 37.
[4] Ibid, 314.
[5] Ibid.
[6] Ibid.
[7] Stephen Buhner, Herbal Antivirals, 134.
[8] Ibid, 160.
[9] Ibid, 172.
[10] Ibid, 218.
11.11.20
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