Disease Description
Causes
Polio is caused by a Poliovirus, which is isolated by three serotypes: PV1, PV2, and PV3. Now, only the first type is found in nature. It is highly contagious and can cause paralytic polio. The virus reaches 15-30 nm in diameter and multiplies in the cytoplasm of affected cells (Chumakov et al., 2021). Poliovirus contains ribonucleic acid, which transmits infected genetic information from the virus nucleus to the protein-synthesizing particles.
Symptoms
Most often, polio is asymptomatic. A clinically pronounced picture occurs in about a quarter of cases (Chumakov et al., 2021). In this case, intoxication syndrome and meningeal or gastrointestinal syndromes are possible.
Mode of Transmission
The source of infection is only a person, and the mechanism of transmission of infection is fecal-oral. It is realized through water, food and household transmission routes, that is, through contaminated hands, food and water.
Complications
Complications are formed in the severe course of the disease. Most often they occur when the spinal cord, the innervating muscles of the diaphragm and intercostal muscles are affected (Fischer et al., 2021). With paralysis of the diaphragm muscles, the movement of the chest during breathing is disrupted, which is complicated by the development of pneumonia.
Treatment
Antiviral therapy has not yet been developed, so treatment is aimed at eliminating the symptoms and preventing the development of complications. To strengthen the immune system, drugs based on interferon alpha are prescribed (Fischer et al., 2021). In the case of swallowing disorders, nutrition is administered through a probe.
Demographic of Interest
Mortality
Polio mainly affects children under the age of 5 (Chumakov et al., 2021). In one out of 200 cases of infection, irreversible paralysis develops (Chumakov et al., 2021). 5-10% of such paralyzed children die due to the onset of paralysis of the respiratory muscles (Chumakov et al., 2021).
Morbidity
Recently, the incidence has begun to increase again: in 2018, 177 cases of polio have already been detected in the world (Fischer et al., 2021).
Incidence
In 2020, the disease was detected not only in Afghanistan and Pakistan but also in African countries (Fischer et al., 2021).
Prevalence
Due to mass immunization, the number of endemic countries in 2015 decreased to two — Afghanistan and Pakistan (Chumakov et al., 2021). Several cases of polio vaccine have been reported in Africa, the Eastern Mediterranean, Southeast Asia, and the western Pacific.
Reportable Disease
Reasoning
Polio is a reportable disease because it is epidemiologically significant (Chumakov et al., 2021). As a result of its cases, there is a critical level of social and economic consequences that society bears as a result of morbidity and preventive measures.
Reporting Criteria
When registering cases of polio, it is necessary to take into account the definitions of cases in accordance with the international classification of diseases (Fischer et al., 2021). This is acute flaccid paralysis, or any paralytic disease, regardless of age, with suspected polio. In addition, acute paralytic polio caused by wild polio virus associated with the vaccine in the recipient or with the vaccine in the contact should be registered.
Social Determinants of Health
The social determinants of health include spending people’s time in groups, living together, and performing activities related to eating together. In addition, the social determinants of health include bodily contact, such as, for example, handshakes (Fischer et al., 2021). These factors contribute to the development of the chosen communicable disease. Polio is transmitted through water and food and sometimes by airborne droplets, so all of these social interactions contribute to infection.
Epidemiologic Triangle
Host Factors
A child under 5 years of age acts as a host (Fischer et al., 2021). The factors influencing the development of the disease on the host are age, the presence or absence of vaccination, the level of immunity, and the presence of contact with the patient at the host.
Agent Factors
The polio virus acts as an agent. Factors affecting the activity of the agent is the type of virus, that is, whether it is wild or caused by vaccination.
Environmental Factors
The environmental factor is temperature: in a warm climate, the virus multiplies faster. In addition, the purity of the water affects – in an already polluted source, the polio virus multiplies faster and has wider access to potential hosts.
Special Considerations for Epidemiologic Triangle
For the epidemiological triangle, there are special considerations for the general population of parents. Since most often, children under 5 years old become hosts, it is necessary to closely monitor the child’s health and vaccinate them in time (Fischer et al., 2021). In addition, there are special notifications for communities that do not have access to clean water and live in hot climates. In such an environment, the agent will develop and spread very quickly.
Importance of Demographic Data
The importance of demographic data to community health allows to track the foci of infection in time and introduce quarantine and apply appropriate measures to prevent the spread of the disease.
Role of Community Health
Primary Prevention
The primary prevention of the community health nurse is case finding, when cases of polio are detected according to reporting criteria. Further, timely urgent and detailed reporting of these cases is carried out by the community health nurse.
Secondary Prevention
At the secondary prevention stage, data collection is carried out by the community health nurse. Polio cases are collected and grouped (Fischer et al., 2021). Then the community health nurse performs the analysis of the received symptoms and locations for the source of ignition of the polio epidemic.
Tertiary Prevention
Follow-up measures are carried out by the community health nurse within the framework of tertial prevention. They are aimed at stopping the spread of polio and reducing the number of cases to zero.
Integrating Christian Worldview
A community health nurse can incorporate a Christian worldview when dealing with a population affected by the chosen communicable disease. For example, they may remind patients that a Christian is supposed to take their meals seriously (Souisa, 2019). To do this, they should sit down at the table clean, washing one’s hands thoroughly. Such actions will be effective in preventing the spread of the epidemic.
National Agency
National agency that addresses the communicable disease chosen is Centers for Disease Control and Prevention (CDC). The organizations contribute to resolving and reducing the impact of disease by spreading awareness about it. They post information about symptoms and methods of distribution (CDC, 2023). In addition, the CDC provides a clear algorithm of actions during polio epidemics and in case of suspicion of this disease.
Global Implication of Disease
A global implication of the disease is increased infant mortality. This is addressed in other countries by using a mopping-up campaign with a monovalent oral polio vaccine in infected areas. This disease is not endemic to a particular area and can occur in any country in the world. But Pakistan and Afghanistan are where it is most common (Souisa, 2019). There are polio outbreaks that are imported from these countries in other countries, such as Cameroon (Souisa, 2019).
References
Centers for Disease Control and Prevention. (2023). CDC 24/7: Saving lives, protecting people. Web.
Chumakov, K, Ehrenfeld, E., Agol, V., & Wimmer, E. (2021). Polio eradication at the crossroads. The Lancet, 9(8), 1172-1175. Web.
Fischer, T. K., Simmonds, P., & Harvala, H. (2021). The importance of enterovirus surveillance in a post-polio world. The Lancet, 22(1), 35-40. Web.
Souisa, N. N. (2019). Sharing meal, sharing life together: An anthropological perspective on the significance of sharing meal ritual based on the religious life. Advances in Social Science, Education and Humanities Research, 187(6), 7-10. Web.