INFANTILE PARALYSIS

Hokitika Guardian, 4 March 1932, Page 8

INFANTILE PARALYSIS

A SCOURGE OF CHILDHOOD. METHOD OF TREATMENT. ,:i , (Department of Health). Acute poliomyelitis is the scientific , name of the disease which is commonly* known as infantile paralysis, though l paralysi s actually occurs in a comparatively small proportion of those attacked. Throughout the world from 1880 to the pres'emt day over 160 outbreaks of. infantile paralysis have been recorded. In recent yeqrs there has been a marked, increase both- in the frequency of .the epidemics and in the average of cases recorded in each. This increase cannot be wholly accounted for by the fact that infantile paralysis is now better known, and is, therefore, more* readily recognised and diagnosed as such. A great deal, of research work has been undertaken in recent, years to establish the origin and nature of this disease, and as a result a considerate addition has been made to our knowledge of the subject, though much remains to be learned.

‘ CAUSE AND IMMUNITY. The disease hAs been definitely shown to be one of those produced by organisms so minute that they will pass through the pores of the finest laboratory filter and remain invisible undef the highest-powered microscope .available. In, .this respect it is on all-fours ■with smallpox, measles, mumps, rabies, 1 typhus, and yellow fever, which have been under, investigation, for many years. The disease .has been experi- : mentally conveyed to monkeys by innoculation from the spinal cord of the • child who had died of the disease. One attack of infantile paralysis confers a high degree of immunity. It has been shown that the blood serum of those who have recovered from the disease when mixed with the virus renders it harmless. It has also been shown recently that human blood serum from mild or abortive cases when mixed wiith the virus renders it inert just as does the, seijpm ,of typical oases in which paralyses has developed. Hence ’it was possible during the last epidemic of infantile paralysis in New Zealand, for those who had suffered previously, from infantile paralysis to donate blood serum for file treatment of active cases with marked beneficial result to the patients. >, Environment .and social conditions’ have little bearing upon tile appearance of the disease, .and it occurs a s commbnlv in I sparsely rural districts as in crowded cities. The victims of the disease are almost without exception robust children, and the children of wealthy parents ,are. equally prone tp an attack as, those,.,pf -the! poorer classes. It is a d'sease of early life, by far the greatest majority of cases occurring under the age of sixteen years.

MODES OF TRANSMISSION. The. modern explanation of recurrent epidemics of infantile paralysis and their .distinctive features, is that it is a.-readily communicable .disease, like measles, and is much more widespread in ..the .community than would be indicated .by the paralytic cases alone. Most cases are mild, escape -notice, and leave, .the individual protected against further attacks.. It is most infectious durjing. the early istage «i the disease. We are, therefore, dealing with a common infection, always present in the community, but which in recent years and particularly in the late summer and autumn seasons, is apt to gain an increased virulence. Persons of jjve years and under contribute approximately 70 per cent, of the cages and epidemics in any one country tend to recur every three to five years, seemingly when a fresh number of susceptible children is available. (Persons under sixteen years contribute over £0 per cent of the cases. There is much evidence to support the opinion that the disease both in its mild arid in its severe form is directly transmissible from person to person. In addition, healthy . carriers, persons who have been in contact with a case, can carry the virus jn the mucous membrane of their noses and throats without suffering any symptoms. . These carriers, even if the infection they carry comes from a mild unrecognised case may produce an tybtack of severe type if they chance to convey the infection to a sufficiently susceptible person. Exhaustive inquiries £n many outbreaks have sjiown evidence against the likelihood of transmission oi the d aease by insects,. or by animals. The data collected from many epidemics do rot support the idea that peculiar climatic conditions may predispose to the disease and determine an epidemic inasmuch as the disease appears to toliow the lines of transport rather than to correspond to any definite climatic factor.

The weight of present opinion, therefore, inclines to the view that infant,le paralysis i s exclusively a human disease, and is spread by personal contact, which includes all the .usual opportunities, direct or indirect, for the transference of body discharges from person to person, having in niiiul the possibility that the infection may occur, through contaminated food.

SYMPTOMS. Infantile paralysis in its mode ° f onset often imitates other diseases. The early symptoms may be suggestive oi either ‘influenza or .summer diarrhoea. An early diagnosis is a great aid to successful treatment parents should be their guard, more especially during the summer and autumn month, when any

of the following symptoms occur: in-fluenza-like onset, headache, general pain in joints and muscles, fever, cough, sneezing. Onset with symptoms referable to the Gastro-intestinal system, fever* nausea, vomiting, diarrhoea. {Later symptoms are referable to the ,Nervous System. Drowsiness, irritability, restlessness, .pain and rigidity in the back of the neck, retraction of the head, muscle tenderness, pain on being handled, loss of reflexes, u;eakness u. certain, v ,..groups of muscles and later paralysis. ~ a child wno is developing infantile, paralysis ha s what is apparently a slight feverish attack from which he recovers for a few days prior '.so having a relapse, subsequently developing the more characteristic symptoms outlined above. An onset vvi.h one or more remissions is very suggestive .of infantil.6' paralysis. When signs of involvement of . the Nervous System' are" apparent the diagnosis is neadily shade. -Paralysis of a group of muscles occurs when its control area in the, brain or spinal cord is injured or destroyed.

, TREATMENT,

First preventive treatment: General precautions include free ventilation oi the house; the elimination of flies or other insects, keeping the food covered, observing a high degree of domestic cleanliness. Garbage cans should be cleaned , out frequently And coverc-d. Common property should be avoided and care should be taken to avoid interchange of towels, handkerchiefs, pillow cases ; toothbrushes, etc. Dishes should be. well scoured with plenty of very hot water. Family pets should be kept clean and not handled too much. Hands should he kept scrupulously washed, especially before meals.

lit behoves all- who come in contact with ,ai .case of infantile paralysis to strictly carry out all instructions of the medical attendant and health authorities as to. isolation and the precautionary measures tp be observed. No personal precaution can be too great to prevent ilie spread to others. Do not let children become, over-fatigued, do not allow them to play long periods in hot sunshine and be .careful to keep the head of the. neck well protected by a 'shady hat. It is good for them to be out ‘df ' : doors but large gatherings of people-especially inside should be avoided. '

Regarding the treatment of individual cases, 'success largely depends upon early diagnosis, which permits prompt measures to be taken as the administration of protective serum of appropriate care for affected groups of muscles. Therefore when iri-doubt send for your medical adviser and take no chances. Prompt and expert treatment of affected groups of muscles may succeed in limiting the extent of paralysis and in bringing about satisfactory recovery. I Treatment' 'must be prolonged and is' tieceisiarily ‘tedious, .but.- often results in remarkable 1 improvement. The period of exclusion from school for children suffering from infantile paralyses is for at least!'-six weeks from the date of onset of the disease. Contacts are eluded' for a>t least two weeks from t6e date of-exposure to risk "of infection, and-in mil cases the Medical Officer 'of Health f ihas power to impose further should it be deemed U--. " necessaty.