Poliomyelitis (polio for short) is an acute infectious disease caused by poliovirus. Clinical manifestations are mainly fever, upper respiratory symptoms, limb pain, some patients can occur flaccid nerve paralysis and leave paralysis sequelae, generally infected children under 5 years old, so commonly known as “polio”. According to epidemiological data, the disease is suspected to occur in the local area, and the disease is suspected to occur after contact with patients who have not taken the vaccine, such as excessive sweating, irritability, sensory allergy, neck and back pain, ankylosis, and loss of tendon reflexes. The presence of flaccid paralysis helps in the diagnosis. Virus isolation and serum-specific antibody testing can confirm the diagnosis. Differential diagnosis The prodromal phase must be differentiated from upper respiratory tract infections, influenza, and gastroenteritis. Pre-paralytic patients can be differentiated from various viral encephalitis, septic meningitis, tuberculous meningitis and epidemic B encephalitis. Patients with paralysis should also be differentiated from infectious polyneuritis (Guillain-Barré syndrome), periodic paralysis, and other lesions caused by osteoarthropathy. Treatment Prodromal phase and pre-paralysis: 1. General treatment: bed rest until the fever subsides for 1 week. Avoid all factors that cause paralysis, such as strenuous activities, intramuscular injections, surgery, etc. Ensure the supply of fluid and heat. 2, symptomatic treatment: if necessary, use antipyretic drugs, sedatives to relieve general muscle spasm discomfort and pain; appropriate amount of passive exercise can reduce muscle atrophy and deformity occurrence. Paralysis period: 1. Maintain functional position: The correct posture of the patient’s body should be in a straight line when lying in bed, with the knees slightly bent, the hips and spine can be made straight with a board or sandbag, and the ankles at 90°. Immediately after the pain disappears, make active and passive exercises to avoid bone deformation. 2, nutritional supplement: proper nutrition should be given nutritious diet and a lot of water, such as sweating caused by high ambient temperature or hot compress, then sodium salt should be supplemented. Gastric tube can be used to ensure food and water intake in case of anorexia. 3.Drugs to promote functional recovery: use nerve cell nutrition fecht such as vitamin B1, B12 and nerve conduction promoting drug dibazol; muscle tone enhancing drugs such as galantamine are generally used after the acute phase. 4, medullary paralysis: (1) Keep the airway unobstructed: adopt low head position (bed foot elevated to 20°~25°) to avoid misaspiration, avoid gastric tube feeding for the first few days, use intravenous route to supplement nutrition. If there are more secretions in the trachea, they should be aspirated in time to prevent airway obstruction; (2) Monitor blood gas, electrolytes, blood pressure, etc., and deal with problems promptly; (3) In cases of vocal cord paralysis and respiratory muscle paralysis, tracheotomy is required, and in cases of impaired ventilation, mechanically assisted breathing is required. Recovery period and sequelae: Active functional recovery treatment such as massage, acupuncture, active and passive exercise and other physiotherapy measures should be performed after the body temperature recedes to normal, muscle pain disappears and paralysis stops developing. If the deformity is more severe, surgical orthopedic treatment is feasible. Prevention Management of the source of infection: patients should be isolated for at least 40 days from the onset of the disease, close contacts should be medically observed for 20 days, and for virus carriers should be isolated according to the patient’s requirements. Cut off the route of transmission: in the acute stage, the patient’s feces should be soaked in 20% chlorinated lime emulsion for 1-2 hours or disinfected with chlorinated disinfectant before discharge; diapers and clothing soiled with feces should be disinfected by boiling, and clothing should be exposed to sunlight. The advantages of live attenuated vaccine (OPV) are that it is easy to use, more than 95% of the vaccinees have long-term immunity, and specific antibodies sIgA can be produced in the intestine, so that the contacted person can also obtain immunity; however, because it is a live virus, it is used for people with immune deficiency or those treated with immunotherapeutic agents. China began to produce its own polio attenuated virus in 1960, and is now generally using mixed multivalent sugar pills, generally the first immunization from 2 months of age, three times in a row, sound 4-6 weeks apart, and then a booster immunization at 4 years of age. The vaccine should be swallowed with cold boiled water, and it is not advisable to drink hot water half an hour after taking the vaccine. (2) Inactivated vaccine (IPV) has the advantages of being safe and is generally used for people with immune deficiency and their family members, and can also be used for people receiving immunosuppressive therapy; the disadvantages are that it is more expensive, the maintenance time of immunity is shorter, and repeated injections are required, and the intestine cannot produce local immunity. 2. Passive immunization: young children who have not taken the vaccine, pregnant women, medical personnel, immunocompromised persons, and local surgical hands such as tonsil removal should receive early intramuscular injection of gammaglobulin if they come into contact with patients.