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Poliovirus is primarily spread by fecal-hand-oral transmission from one host to another. The virus is shed in oral secretions for several weeks and in the feces for several months.

It destroys the anterior horn cells in the spinal cord. 

Poliovirus infections can be divided into minor and major forms:

  • The minor illnesses occur 1 to 3 days before the onset of paralysis, with gastrointestinal complaints of nausea and vomiting, abdominal cramps and pain, and diarrhea and the systemic manifestations of sore throat, fever, malaise, and headache.

  • The major illness includes all forms of central nervous system (CNS) disease caused by poliovirus, including aseptic meningitis or nonparalytic polio, polioencephalitis, bulbar polio, and paralytic poliomyelitis, alone or in combination

Clinical findings: 
  • there is fever, stiffness of the neck (nuchal rigidity), and a plecocytosis in cerebrospinal fluid
  • profound asymmetrical muscle weakness develops
  • initial phase is typically followed by some recovery of muscle strength, but permanent weakness results from necrosis of anterior horn cells
  • foot and ankle:
    1. calcaneocavus (hindfoot cavus) which occurs as a result of a weak gastrocnemius
    2. foot intrinsics are typically spared in polio
    3. claw toes: results from relative overactivity of the long toe flexors and extensors (to compensate for weakness of the triceps
  • Rarely, a transverse myelitis with paraparesis, urinary retention, sensory complaints and signs and autonomic dysfunction including hyperhidrosis or hypohidrosis, and decreased limb temperature may occur

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Orthopaedic infections in children
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