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Poliomyelitis

Category: Illness or disabilities

Type

Involuntary

Introduction and description

Poliomyelitis often called polio, is an acute, viral, infectious disease.  The World Health Organization estimates that there are 10 to 20 million polio survivors worldwide.  Many notable individuals have survived polio including Franklin D Roosevelt.

Small localized paralytic polio epidemics began to appear in Europe and the United States around 1900. Outbreaks reached pandemic proportions in Europe, North America, Australia, and New Zealand during the first half of the 20th century.  In the United States, the 1952 polio epidemic became the worst outbreak in the nation's history. Of nearly 58,000 cases reported that year 3,145 died and 21,269 were left with mild to disabling paralysis. 

Developed in the 1950s, polio vaccines are credited with reducing the global number of polio cases per year from many hundreds of thousands to around a thousand.  Enhanced vaccination efforts led by the World Health Organization, UNICEF, and Rotary International 'could result in global eradication of the disease'.

Symptoms

Although approximately 90% of polio infections cause no symptoms at all, affected individuals can exhibit a range of symptoms if the virus enters the blood stream.  There are two basic patterns of polio infection

  • a minor illness which does not involve the central nervous system (CNS), sometimes called ‘abortive poliomyelitis’
  • a major illness involving the CNS

Abortive poliomyelitis - produces minor symptoms that include upper respiratory tract infection (sore throat and fever), gastrointestinal disturbances (nausea, vomiting, abdominal pain, constipation or, rarely, diarrhoea), and an influenza-like illness.

CNS polio - In about 3% of cases, the polio infection spreads and becomes CNS polio.  This  produces early symptoms that include high fever, headache, stiffness in the back and neck, asymmetrical weakness of various muscles, sensitivity to touch, difficulty swallowing, muscle pain, loss of superficial and deep reflexes, paresthesia (pins and needles), irritability, constipation, or difficulty urinating.

In about 1% of cases, the virus infects and destroys motor neurons, leading to muscle weakness and acute flaccid paralysis. Paralysis generally develops one to ten days after early symptoms begin.  Different types of paralysis may occur, depending on the nerves involved: 

  • Spinal polio is the most common form, characterized by asymmetric paralysis that most often involves the legs
  • Bulbar polio leads to weakness of muscles innervated by cranial nerves
  • Bulbospinal polio is a combination of bulbar and spinal paralysis.

In spinal polio, with the destruction of nerve cells, the muscles no longer receive signals from the brain or spinal cord; without nerve stimulation, the muscles atrophy, becoming weak, floppy and poorly controlled, and finally completely paralyzed. Progression to maximum paralysis is rapid (two to four days), and is usually associated with fever and muscle pain.

   

The likelihood of developing paralytic polio increases with age, as does the extent of paralysis. In children, paralysis occurs in only one in 1000 cases. In adults, paralysis occurs in one in 75 cases. 

In children under five years of age, paralysis of one leg is most common; in adults, extensive paralysis of the chest and abdomen also affecting all four limbs—quadriplegia—is more likely.  In these extreme cases it then becomes impossible for the person to breathe and an ‘iron-lung’ is needed to ‘breathe’ for them.

Cause

Poliomyelitis is caused by infection with a member of the genus Enterovirus known as poliovirus (PV). This group of RNA viruses colonize the gastrointestinal tract. The incubation time (to the first signs and symptoms) ranges from three to 35 days, with a more common span of six to 20 days. PV infects and causes disease in humans alone.

It is spread via two main routes - the oral-oral and fecal-oral routes. The disease is transmitted primarily via the fecal-oral route, by ingesting contaminated food or water. It is transmitted less via the oral-oral route, this mode is especially visible in areas with good sanitation and hygiene.

In one of the more ironic aspects of this disease, before the 20th century, polio infections were not as frequent.  Poorer sanitation of the time resulted in a constant exposure to the virus, which enhanced a natural immunity within the population. As improvements were made in community sanitation, including better sewage disposal and clean water supplies, the changes increased the proportion of children and adults at risk of polio infection, by reducing childhood exposure and immunity to the disease.

How it works

Why should polio give us hallucinations, visions or out of body experiences?

Non paralytic polio

Poliovirus enters the body through the mouth, infecting the first cells with which it comes in contact—the  pharynx and intestinal mucosa. The virus then begins to replicate. Poliovirus divides within gastrointestinal cells for about a week, from where it spreads to the tonsils, the intestinal lymphoid tissue and the deep cervical and mesenteric lymph nodes, where it multiplies abundantly.

The virus is subsequently absorbed into the bloodstream.

In a small percentage of cases, it can spread and replicate in other sites, such as brown fat, the reticuloendothelial tissues, and muscle. This sustained replication leads to the development of influenza-like symptoms. Rarely, this may progress and may cause a self-limiting inflammation of the meninges, the layers of tissue surrounding the brain.

Thus here we have the first route by which polio may give someone an involuntary experience as meningitis can give you an experience via 

Paralytic polio

In around 1% of infections, poliovirus spreads along certain nerve fiber pathways, replicating in and destroying motor neurons within the spinal cord, brain stem, and motor cortex.  This leads to the development of paralytic poliomyelitis, the various forms of which (spinal, bulbar, and bulbospinal) vary only with the amount of neuronal damage and inflammation that occurs, and the region of the CNS affected. On the right we see the bulbar region, an area key to spiritual experience

  • Bulbar polio -  Making up about 2% of cases of paralytic polio, bulbar polio occurs when poliovirus invades and destroys nerves within the bulbar region of the brain stem. The destruction of these nerves weakens the muscles supplied by the cranial nerves and causes difficulty breathing, speaking and swallowing.  Due to the effect on swallowing, secretions of mucus may build up in the airway, causing suffocation.  Thus hypoxia may also play a part in spiritual experience in this type of polio. 
  • Bulbo spinal polio - Approximately 19% of all paralytic polio cases have both bulbar and spinal symptoms; this subtype is called respiratory or bulbospinal polio. Here, the virus affects the upper part of the cervical spinal cord and paralysis of the diaphragm occurs. The critical nerves affected are the phrenic nerve, which drives the diaphragm to inflate the lungs, and those that drive the muscles needed for swallowing. By destroying these nerves, this form of polio affects breathing, making it difficult or impossible for the patient to breathe without the support of a ventilator. Here hypoxia may again be a mechanism of spiritual experience.

The destruction of neuronal cells produces lesions within the spinal ganglia; these may also occur in the reticular formation, vestibular nuclei, cerebellar vermis, and deep cerebellar nuclei.  Other destructive changes associated with paralytic disease occur in the forebrain region, specifically the hypothalamus and thalamus.

Thus depending on the disruption caused to the brain, this is another route by which spiritual experience can be obtained – see Brain damage.

Where the person is in a ventilator, the experience may be caused by nervous sensation deprivation and sensory deprivation.

  

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