Acute anterior poliomyelitis

Acute anterior poliomyelitis (AAP) is a form of poliomyelitis, a highly infectious viral disease that primarily affects children. The disease is caused by the poliovirus, a member of the Enterovirus genus. AAP is characterized by the inflammation and destruction of the motor neurons in the anterior horn of the spinal cord, leading to muscle weakness and paralysis.

Etiology

The causative agent of AAP is the poliovirus, a small, single-stranded RNA virus that belongs to the Enterovirus genus of the Picornaviridae family. There are three serotypes of poliovirus: PV1, PV2, and PV3, all of which can cause AAP.

Pathogenesis

The poliovirus is primarily transmitted through the fecal-oral route. After ingestion, the virus multiplies in the oropharynx and the intestinal tract, followed by viremia, which leads to the spread of the virus to the central nervous system. In the anterior horn of the spinal cord, the virus causes inflammation and destruction of the motor neurons, leading to the clinical manifestations of AAP.

Clinical Manifestations

The clinical manifestations of AAP can range from asymptomatic infection to severe paralysis. The most common symptoms include fever, fatigue, headache, vomiting, stiffness in the neck, and pain in the limbs. In severe cases, the disease can cause irreversible paralysis, usually in the legs.

Diagnosis

The diagnosis of AAP is primarily based on clinical symptoms. Laboratory confirmation can be obtained by isolating the poliovirus from the patient's stool or throat swab. Cerebrospinal fluid examination can also be helpful in the diagnosis.

Treatment and Prevention

There is no specific treatment for AAP. Management is primarily supportive, including pain relief, physiotherapy for muscle weakness, and ventilatory support in case of respiratory failure. Prevention of AAP is through immunization with either inactivated poliovirus vaccine (IPV) or oral poliovirus vaccine (OPV).

See Also

• Poliomyelitis
• Poliovirus
• Enterovirus
• Picornaviridae
• Anterior horn
• RNA virus