Rare Infections

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    Polio

    • Caused by Polio virus.
    • Often transmitted via fecal-oral or oral-oral route.
    • Generally a gastro-intestinal.  In ~90% of cases, people are asymptomatic.  In rare cases it can invade other tissues such as the CNS (~1%), causing asymmetric paralysis + atrophy.
    • Generally the virus starts with infecting GI cells, migrates to tonsils, then causes viremia, which can lead to many other manifestations depending on the type of tissue invaded.  In particular, it can invade the CNS system causing poliomyelitis.
    • Two types of paralytic poliomyelitis
      • Bulbar Polio (Cervical nerves - causes breathing/swallowing problems) - often deadly without ventilator support.
      • Spinal Polio - Often anterior horn cells - affects motor function.
      • Bulbospinal polio - both?
    • Symptoms often persist 2-10days.  Prognosis:
      • 1/2 of patients recover fully with no further symptoms.
      • 1/4 recover with mild symptoms
      • 1/4 have continuing severe neuro deficits.
    • Post-polio syndrome - progressive neuro symptoms such as new weakness or extreme fatigue, non-infective.
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