POLIO+RABIES

An acute viral disease that usually affects children and young adults.

What is the definition of Poliomyelitis?

Poliovirus.

What is the causative agent of Poliomyelitis?

Motor neurons of the brainstem and spinal cord.

What part of the nervous system is primarily affected in Poliomyelitis?

Motor paralysis, muscular atrophy, and sometimes permanent disability.

What results from inflammation of motor neurons in Poliomyelitis?

Gray – referring to gray matter of the nervous system.

What does the term 'Polios' mean?

Marrow – referring to the myelin sheath covering nerve fibers.

What does the term 'Myelos' mean?

Humans (only known host).

What is the host for Poliovirus?

Three: Brunhilde, Lansing, and Leon.

How many immunological types of Poliovirus exist?

In a rhesus monkey.

Where was the Brunhilde strain first identified?

From bulbar polio in Lansing, Michigan, USA.

Where was the Lansing strain isolated?

From a child named Leon during the Los Angeles epidemic.

Where was the Leon strain isolated?

Fecal-oral route.

What is the main mode of transmission of Poliomyelitis?

Contact with infected secretions/feces, contaminated food/water/utensils, flies, person-to-person.

What are other transmission routes for Poliomyelitis?

From the first 3 days up to 3 months of illness.

What is the period of communicability of Poliomyelitis?

During the first 2–3 days of acute illness.\

When is Poliomyelitis most contagious?

60% of patients are under 10 years old.

What age group is most affected by Poliomyelitis?

Males (ratio 3:2); mortality higher in males.

Which sex is more commonly affected by Poliomyelitis?

Better sanitation reduces incidence; poor sanitation increases it.

How does sanitation affect the incidence of Poliomyelitis?

Poliomyelitis triggered by excessive work, strain, or overexertion.

What is provocation poliomyelitis?

Abortive (non-paralytic), Non-paralytic, and Paralytic.

How is Poliomyelitis classified by severity?

4–8%.

What percentage of Poliomyelitis cases are Abortive?

Headache, sore throat, slight to moderate fever, vomiting, abdominal discomfort, and lumbar pain.

What are the general symptoms of Abortive Poliomyelitis?

No paralysis occurs.

Is paralysis present in Abortive Poliomyelitis?

Virus reaches CNS but does not cause paralysis.

What defines Non-Paralytic Poliomyelitis?

Neck, back, and limb pain; stiffness; reflex changes; transient paresis; positive Pandy’s test.

What are symptoms of Non-Paralytic Poliomyelitis?

About 50%.

What percentage of Non-Paralytic Poliomyelitis patients fully recover?

Destruction of motor neurons leading to paralysis of muscles.

What defines Paralytic Poliomyelitis?

Lower extremities, arms, and respiratory muscles.

What muscles can be affected in Paralytic Poliomyelitis?

Bulbar, Spinal, and Bulbospinal.

What are the subtypes of Paralytic Poliomyelitis?

The medullary region (cranial nerves IX and X).

Which area does Bulbar Polio affect?

Difficulty speaking/swallowing, facial and pharyngeal paralysis, temperature regulation issues.

What are symptoms of Bulbar Polio?

Head lag when raised supine – seen in bulbar polio.

What is Hoyne’s sign and what does it indicate?

Aspiration pneumonia due to food regurgitation through the nose.

What complications can result from Bulbar Polio?

Develops rapidly; serious prognosis.

What is the prognosis for Bulbar Polio?

Motor neurons of the spinal cord.

Which neurons are affected in Spinal Paralytic Poliomyelitis?

Higher spinal (respiratory involvement) and lower spinal (leg paralysis).

What are the forms of Spinal Paralytic Poliomyelitis?

Involvement of both brainstem and spinal cord.

What defines Bulbospinal Poliomyelitis?

Asymmetrical flaccid paralysis, decreased reflexes, hypersensitivity, sweating, urinary retention, constipation.

What are signs of Bulbospinal Polio?

Enters GI tract → multiplies → lymph nodes → blood → CNS.

What is the path of Poliovirus infection in the body?

Spinal cord, medulla, cerebellum, midbrain gray matter, and motor cortex.

What areas of the CNS are affected by Poliomyelitis?

Virus isolation from throat or stool; CSF culture.

What diagnostic tests are used for Poliomyelitis?

Respiratory failure, pneumonia, gastric dilation, cardiac irregularities, seizures, electrolyte imbalance.

What complications can occur in Poliomyelitis?

Urinary retention and bladder paralysis.

What urinary issues can occur in Poliomyelitis?

Symptomatic—bedrest, analgesics, moist heat, physical therapy, orthopedic surgery as needed.

What is the treatment for Poliomyelitis?

It can suppress respiration.

Why should morphine be avoided in Polio?

By immunization with oral polio vaccine (OPV).

How can Poliomyelitis be prevented?

Proper disposal of waste, isolation, sanitation, and fly control.

What other preventive measures are essential for Polio?

Enteric isolation.

What nursing isolation is required for Polio?

Neurologic status and vital signs.

What should nurses monitor daily in Polio patients?

Vigorous activity.

What is important to avoid during acute Polio?

For signs of autonomic dysfunction.

Why monitor blood pressure in Bulbar Polio?

Ensure adequate hydration, repositioning, and regular elimination.

What should be done to prevent fecal impaction in Polio?

Apply moist hot packs.

How can muscle pain be relieved in Polio?

Proper disposal of excreta, handwashing, and good skin/oral care.

What are important hygiene measures for Polio care?

To reduce anxiety and support rehabilitation.

Why is emotional support important for Polio patients?

Recurrence of symptoms 15–40 years after recovery.

What is Post-Polio Syndrome (PPS)?

Muscle weakness, fatigue, atrophy, difficulty breathing/swallowing, depression.

What are symptoms of Post-Polio Syndrome?

Imbalanced nutrition, ineffective thermoregulation, ineffective airway clearance, impaired mobility, pain, anxiety.

What are common nursing diagnoses for Polio?

An acute, zoonotic, and fatal viral infection transmitted through saliva of infected animals.

What is Rabies?

Dogs.

What is the reservoir of Rabies?

Rhabdovirus.

What virus causes Rabies?

Bullet-shaped.

What is the shape of the Rabies virus?

Central nervous system.

What system does the Rabies virus target?

Sunlight, UV light, ether, formalin, mercury, nitric acid.

The Rabies virus is sensitive to what agents?

Phenol, merthiolate, antibacterial agents.

The Rabies virus is resistant to what agents?

1 week to 7–12 months.

What is the incubation period of Rabies in dogs?

10 days to 15 years.

What is the incubation period in humans?

Bite distance from brain, severity, species, blood/nerves at site, host resistance.

What factors influence Rabies incubation?

Furious (classic) and Paralytic (dumb).

What are the forms of Rabies?

Hyperactivity, hydrophobia, photophobia, aerophobia, excitability.

What are signs of Furious Rabies?

Cardiorespiratory arrest.

What causes death in Furious Rabies?

Progressive paralysis, coma, eventual death.

What are signs of Paralytic Rabies?

Mainly via bite or saliva of infected animal.

How is Rabies transmitted?

Aerosols or organ transplants.

What are rare modes of Rabies transmission?

3–5 days before symptom onset until death.

When is a Rabies patient infectious?

Negri bodies in neurons.

What is the hallmark lesion of Rabies?

Hippocampus, basal ganglia, pons, medulla, salivary glands.

Where are Negri bodies found?

Virus replicates in muscle → travels via nerves → CNS → salivary glands.

What is the pathogenesis of Rabies?

Vaccine only works before virus enters nerves.

Why is early post-exposure prophylaxis critical in Rabies?

Lungs, adrenals, kidneys, bladder, and testicles.

What organs can be secondarily affected by Rabies virus?

Fever, malaise, irritability, pain at bite site, paresthesia, mild dysphagia.

What happens in the prodromal phase of Rabies?

Agitation, confusion, hydrophobia, aerophobia, photophobia, seizures, spasms.

What are symptoms of the neurologic phase of Rabies?

Painful spasms of pharyngeal muscles on attempting to swallow liquids.

What causes hydrophobia in Rabies?

Fear of air movement or drafts due to painful spasms.

What is aerophobia?

Hyperptyalism, priapism, spontaneous ejaculation, dilated pupils.

What are other neurologic symptoms of Rabies?

Quietness, paralysis, loss of control, coma, and respiratory failure.

What occurs in the terminal (paralytic) phase of Rabies?

Virus isolation, fluorescent antibody test (FAT), detection of Negri bodies.

What diagnostic tests confirm Rabies?

Immediate wound washing, vaccination, rabies immunoglobulin, and tetanus prophylaxis.

What is Post-Exposure Prophylaxis (PEP) for Rabies?

All Category II & III exposures or if animal is unvaccinated/sick.

When is PEP indicated?

Dog vaccination, bite prevention, affordable intradermal PEP.

What are WHO strategies for Rabies elimination?

Dog vaccination, stray control, 10–14 day confinement after bite.

What are animal-focused control measures for Rabies?

Education, reporting bites, avoiding stray animals.

What are public-focused control measures for Rabies?

The Anti-Rabies Act of 2007 (responsibilities of pet owners).

What is Republic Act 9482?

The Animal Welfare Act of 1998.

What is Republic Act 8485?

Provide quiet dark room, avoid water/air stimuli, emotional support.

What are key nursing interventions for Rabies patients?

Secure IV lines due to restlessness.

What fluid management precaution is necessary in Rabies?

Concurrent and terminal disinfection.

What type of disinfection is required after Rabies death?