Gastrointestinal Infectious Disease-Related Central Nervous System Infections (Poliomyelitis)

Abstract

Poliomyelitis is an acute infectious disease caused by infections of poliovirus, with humans as the only natural host, and mostly occurs in children. The incidence rate gradually increases over 6 months of age and decreases after 5 years of age, and rare in adults. Poliomyelitis is a contact infectious disease that is highly contagious and is transmitted mainly through fecal-oral infection from patients in the acute phase and asymptomatic poliovirus carriers, with an incubation period of 3–35 days, mostly 5–14 days [1]. After poliovirus infection, most people are asymptomatic or have nonspecific symptoms, including mild fever, malaise, headache, sore throat, and gastrointestinal discomfort. Of patients with nonspecific disease symptoms, 1–2% may develop paralytic disease. Paralysis progresses rapidly with fever, often resulting in asymmetric muscle atrophy, but there is no impairment of sensation and bladder or rectal function. Poliomyelitis is also known as “poliomyelitis” or “infantile paralysis” because of the clinical manifestations of decreased muscle tone and asymmetric flaccid paralysis [2]. Patients with poliomyelitis are more commonly seen with occult infection and non-paralytic cases, most of which can be cured, with a few patients left with paralytic sequelae. With the extent of vaccination and improved immunity in the population, the incidence has decreased significantly, and the disease is almost exclusively seen in vaccine-associated cases, namely, vaccine-associated paralytic poliomyelitis (VAPP). WHO defines VAPP as acute flaccid paralysis occurring in 4–40 days after oral administration of live-attenuated polio vaccine, in which vaccine-like poliovirus is isolated from fecal samples of patients and the virus is identified as the cause. In addition, polio-associated neurological sequelae must occur at least 60 days after the onset of paralysis [3]. The incidence of VAPP neonates in the country is 1–2.4/1 million [4].