AFP Surveillance to End Polio

Surveillance ForACUTE FLACCID PARALYSIS --Rtn. P.P.Dr.Avinash Bhondwe

DEFINITION :Sudden onset of weakness of a limb or paralysis over a period of 15 days in a patient less 15 years of age .

A.F.P.

WHAT IS SURVEILLANCE ? IT IS A CONTINOUS SCRUTINY OF ALL ASPECTS OF OCCURRENCE &

SPREAD OF DISEASE THAT ARE PERTINENT TO EFFECTIVE

CONTROL.

SURVEILLANCE INCLUDES1. COLLECTION OF DATA2. ANALYSIS OF DATA3. INTERPRETATION OF DATA4. DISTRIBUTION OF RELEVANT DATA SO

THAT NECESSARY ACTION CAN BE TAKEN

WHY POLIO IS A CANDIDATE FOR ERADICATION ?MAN IS THE ONLY RESERVIORNO LONG TERM CARRIER STATEROUTE OF TRANSMISSION IS FAECO-

ORALHALF LIFE OF EXCRETED VIRUS IN

SEWAGE SAMPLE IN TROPICAL CLIMATE LIKE INDIA IS 48 HOURS.

POTENT AND EFFECTIVE VACCINE.

FOUR KEY STRATEGIES FOR POLIO ERADICATIONRI-PROGRAMME [ UIP ] - 1985MASS IMMUNIZATION(PPI) – 1995-96 CAMPAIGNS

APF SURVEILLANCE - 1997MOPING UP IN FOCAL AREAS

AIM OF AFP SURVEILLANCETO DETECT POLIO TRANSMISSION &

INTERRUPTION OF TRANSMISSION AFP CASE

POLIO CASE

RESERVOIR OF INFECTION [ 100 TO 1000 SUB CLINICAL CASES ]

CONTAINMENT MEASURES [ O.R.I. / MOP UP ]

GOAL OF AFP SURVEILLANCEIDENTIFICATION OF ALL RESERVOIRS

OF CIRCULATING WILD POLIO VIRUS( THAT COULD BE POLIO ) BY

DOCUMENTING ALL SUCH CASES,IT IS POSSIBLE TO SHOW THAT NONE OF THESE “POLIO-LIKE” CASES WERE CAUSED BY THE POLIO VIRUS,AND THAT POLIO IS NO LONGER PRESENT OR EXISTING.

WHY AFP SURVEILLANCE INSTEAD OF POLIO SURVEILLANCE ?SURVEILLANCE OF A POLIO CASE

ALONE IS NOT SUFFICIENT BECAUSE IT IS IMPOSSIBLEE TO PRECISELY IDENTIFY ALL CASES OF POLIO CLINICALLY DUE TO CONFUSING AND AMBIGUOUS CLINICAL SIGNS AND VARIABLE CLINICAL KNOWLEDGE & SKILLS OF DOCTOR.

CLINICALLY POLIO IN ACUTE STAGE, IS DIFFICULT TO DISTINGUISH FROM OTHER CAUSES OF ACUTE ONSET OF FLACCID PARALYSIS.-----

SURVEILLANCE OF ACUTE FLACCID PARALYSIS

STARTED IN 1997 OCTOBERACHIEVED GLOBAL BENCHMARKS IN

MAY 1998MAPPING OF POLIO CASES MADE

POSSIBLELABS PROVIDING > 80% RESULTS ON

TIMEGENETIC SEQUENCING CAPACITY

EXPANDED

The AFP Surveillance System

Hospitals Clinics

Investigation

Non-Polio AFP Polio AFP

Community

When to report AFP case

Immediately ( Just one phone call)

9689931339 / 9822912062 /

24487700

WHAT TO REPORTAny Case of Acute Flaccid Paralysis < 15

Yrs ageIt May be

Monoplegia,Paraplegia,Hemiplegia,Facial Palsy,or Any Trasient weakness.

Any case of Suspected Polio Clinically Irrespective of any age

WHAT IS NOT AFP ?TRAUMAISOLATED FACIAL NERVE PALSYHYPOKALAEMIAACUTE RHEUMATIC FEVERCONGENITAL FLACCID PARALYSIS

CONDITIONS SOMETIMES PRESENTING WITH AFP

TUMORENCEPHALITISHYPOKALEMIC PARALYSIS [ DUE TO

LOW SERUM POTASSIUM USUALLY REVERSIBLE ]

POTT’s DISEASETB MENINGITISOSTEOMYELITIS