L8: Acute Flaccid Paralysis (Polio) Flashcards
Epidemeology of AFP
- Only 1 in 200 polio infections leads to irreversible paralysis.
- Among those paralysed, 5 to 10% die from respiratory muscles paralysis.
International Epidemeology of Poliomyelitis
Since 1979, no cases of Polio in the U.S due to widespread polio vaccination.
Countries in which Poliomyelitis is endemic
Afghanistan - Pakistan - Nigeria
Countries in which Poliomyelitis causes epidemic outbreaks
- Democratic Republic of the Congo
- Syria
National epidemeology of Poliomyelitis
Epidemic threshold of Poliomyelitis
One confirmed case.
Suspected Case of Poliomyelitis
Any pathological condition associated with acute
flaccid paralysis that occurs in a child under 15 years suffering from acute flaccid paralysis .
Probable Case of Poliomyelitis
none
Confirmed Case of Poliomyelitis
- A case of acute flaccid paralysis confirmed by laboratory investigations (virulent polio virus isolated from a faecal sample),
OR
- epidemiologically liked to a confirmed polio case
Causative agent of Poliomyelitis
- Poliovirus; 3 types (Type I, II, III).
- there is no cross-immunity between the three viral types .
Types of Poliomyelitis
What age group is mostly affected by Poliomyelitis?
- mainly affects children < 5 years.
- Rarely, it can occur at older ages among those who are not immune
Reservoir of Poliomyelitis
- The human being is the only reservoir (case or carrier) & for every case of polio, it is estimated that 200 subclinical cases occur.
- The reservoir of infection is usually young children .
MOT of Poliomyelitis
IP of Poliomyelitis
From 3 to 35 days (usually 7-14 days).
Infectivity Period of Poliomyelitis
Infected persons are
❶ most infectious from 7−10 days before and after the onset of symptoms
❷ For 14 days after paralysis.
❸ However, poliovirus is excreted in the stools for up to 6 weeks .
Susceptibility of Poliomyelitis
- anyone who hasn’t been vaccinated is at risk of developing the disease .
- A person becomes immune after at least 3 valid doses of either Sabin or Salk vaccine.
General Prevention of Poliomyelitis
(refer to general epidemiology lectures).
Specific Prevention of Poliomyelitis
- Vx
- Seroprophylaxis
What is the most important preventive measure in Poliomyelitis?
Vx, Most important preventive measure and the main way to keep the zero-polio status
Types of Vx in Poliomyelitis
- Oral sabin
- Injectable salk
Compare between Salk & sabin in terms of:
- Nature
- Characters
- Control Epidemics
- Herd Immunity
- Doses
- Indication for Vx
Seroprophylaxis in Poliomyelitis
Immunoglobulins for contacts with immunodeficiency disease, cortisone therapy, etc
National Control Measure for Case in Poliomyelitis
Notification in Poliomyelitis
- to the WHO, from all health care facilities serving children <15 years (group A).
- Weekly zero reporting from all reporting sites nationwide upwards then to the Directorate then to the Expanded Program of Vaccinations.
Isolation in Poliomyelitis
At fever hospital
TTT in Poliomyelitis
no specific treatment but bed rest + analgesics + artificial respiration +physiotherapy
Contact Measures in Poliomyelitis
❶ Enlistment
❷ Surveillance
❸ Booster dose of vaccine Or immunoglobulin
Epidemic Measures in Poliomyelitis
❶ In countries with polio eradication, single case of poliomyelitis is considered public emergency
❷ MOH should determine whether disease represents an indigenous, imported or VAPP (vaccine acquired polio paralysis) case
❸ Case & contact control measures
International Measures in Poliomyelitis
Measures taken by MOH to eradicate poliomyelitis (Polio eradication programs applied by the year 2005)
