HEALTH NOTES.

Taranaki Daily News, 18 December 1926, Page 8

HEALTH NOTES.

ACUTE POLIOMYELITOS.

DISEASE OF EARLY LIFE

INFANTILE PARALYSIS.

(Contributed by Department of Health)

Acute poliomyelitis is the scientific name of the disease which is commonly knowu as infantile paralysis, though paralysis actually occurs in a comparatively small proportion of those attacked. Throughout the world from 1880 to the present day over 150 outbreaks of infantile paralysis have been recorded. In recent years there has been a marked increase both in the frequency of the epidemics and in the average of eases recorded in each. Over a period of live years the number of eases per epidemic now average from 300 to 600, and as au exceptional instance New York City reported 8928 cases in 1916 with 2407 deaths. This increase cannot be wholly accounted for by the fact that infantile paralysis is now readily recognised and diagnosed as better known and is therefore more such. A great deaj of research work has been undertaken in recent ypars to establish the origin and nature of thia disease, and as a result a considerable 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 under the highest-powered microscope available. In this respect it Is on all-fours with smallpox, measles, mumps, rabies, typhus, and yellow fever, which have heeu under investigation for many years. The disease has been experimentally conveyed, to monkeys by inoculation from, the spinal cord of a 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 with the virus renders it inert, just as does the serum of typical cases in which paralysis has developed. Hence it was possible during the last epidemic of infantile paralysis in New Zealand for those who had Buffered previously, from infantile paralysis to donate blood serum for the treatment of active cases with markedly beneficial result to th<? patients. Environment and social conditions have little bearing upon the appearance of the disease, and it occurs as commonly in sparsely settled rural districts as in crowded cities. Ihe victims of the disease are almost without exception robust children, and the children of wealthy parents are equally prone to an attack as those of the poorer classes. It is a disease 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 very 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. There is thus a high degree of acquired immunity except in the young. Only the occasional severe cases-with paralysis is recognised and diagnosed aS infantile paralysis. It is most infectious during the early stage of 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 five years and under contribute approximately 70 per cent, of the cases, 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 90 per cent, of the cases. There is much evidence to support the opinion that the disease both in its mild and 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 in the mucous membrane of their noses and throats without suffering any symptoms. Tiiese carriers, even if the infection they carry germs from a mild unrecognised case, may produce an attack of severe type if they chance to convey the infection to a. sufficiently susceptible person. Exhaustive inquiries in . many outbreaks have shown evidence against the likelihood of the transmission of the disease by insects, or by animals. The data collected from many epidemics do not support the idea that peculiar climatic conditions may predispose to the disease and determine an epidemic in as much as the disease appears to follow lines of transport rather than to correspond to any definite climatic factor. The weight c. present opinion, therefore, inclines to the view that infantile paralysis is exclusively a human disease, and is spread by personal contact, whicli includes all the usual opportunities, direct or indirect, for the transference of body discharges fromperson to person, having in mind the possibility that the infection may occur through contaminated food.

SY MPTOMS.

The symptoms may stimulate any o> the indefinite illnesses of childhood, and in the presence of an epidemic it is well for parents and physicians to treat sick children Having fever without a definite proven diagnosis as possible eases of poliomyelitis. Still there is a grouping of symptoms which is very suggestive, tne combination of fever, vomiting, constipation, drowsiness, and irritability*, especially when combined with headache, a transient flushing of the face, abnormal sweating or retention of urine is, enough to make tentative diagnosis of poliomyelitis, if defined cases are occurring in the vicinity. An onset with one or more remissions is very suggestive of poliomyelitis. When signs Of involvment of the nervous system

supervene the diagnosis is readily made. Paralysis of a group of muscles occurs when its controlling area in the brain or spinal cord is injured, or destroyed.

TREATMENT.

It behoves all who come in contact with a case of poliomyelitis to strictly carry out all instructions of the medical attendant and health authorities as to isolation and the precautionary measures to be observed. As this is a disease which often brings disaster in its train, no personal precaution can be too great to prevent its spread to others. Regarding the treatment of individual eases, the importance of securing medical advice at the earliest opportunity cannot be too greatly stressed. Prompt and expert treatment of affected groups of muscles is often efficacious in limiting the extent of paralysis and in bringing about satisfactory recovery. The best chances of recovery from the paralysis sometimes associated with poliomyelitis is skilful after care under the direction of a physician. Treatment must be prolonged, and is necessarily tedious but often results in remarkable improvement. The benefit of expert treatment has been repeatedly demonstrated at our largr public hospitals and at King Georg V. Hospital, Rotorua, where special facilities exist for dealing with such eases.