2. 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.
3. WHAT IS SURVEILLANCE ?
IT IS A CONTINOUS SCRUTINY
OF ALL ASPECTS OF OCCURRENCE & SPREAD
OF DISEASE
THAT ARE PERTINENT TO EFFECTIVE
CONTROL.
SURVEILLANCE INCLUDES
1. COLLECTION OF DATA
2. ANALYSIS OF DATA
3. INTERPRETATION OF DATA
4. DISTRIBUTION OF RELEVANT DATA SO THAT
NECESSARY ACTION CAN BE TAKEN
4. WHY POLIO IS A CANDIDATE FOR
ERADICATION ?
MAN IS THE ONLY RESERVIOR
NO LONG TERM CARRIER STATE
ROUTE OF TRANSMISSION IS FAECO-ORAL
HALF LIFE OF EXCRETED VIRUS IN SEWAGE
SAMPLE IN TROPICAL CLIMATE LIKE INDIA IS 48
HOURS.
POTENT AND EFFECTIVE VACCINE.
5. FOUR KEY STRATEGIES FOR POLIO
ERADICATION
RI-PROGRAMME [ UIP ] - 1985
MASS IMMUNIZATION(PPI) – 1995-96
CAMPAIGNS
APF SURVEILLANCE - 1997
MOPING UP IN FOCAL AREAS
6. AIM OF AFP
SURVEILLANCE
TO 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 ]
7. GOAL OF AFP SURVEILLANCE
IDENTIFICATION 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.
8. 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.-----
9. SURVEILLANCE OF
ACUTE FLACCID PARALYSIS
STARTED IN 1997 OCTOBER
ACHIEVED GLOBAL BENCHMARKS IN MAY
1998
MAPPING OF POLIO CASES MADE
POSSIBLE
LABS PROVIDING > 80% RESULTS ON TIME
GENETIC SEQUENCING CAPACITY
EXPANDED
10. The AFP Surveillance System
Hospitals
Clinics
Investigation
Non-Polio AFP Polio AFP
Community
11. When to report AFP case
Immediately ( Just one phone call)
9689931339 / 9822912062 /
24487700
12. WHAT TO REPORT
Any Case of Acute Flaccid Paralysis < 15 Yrs age
It May be
Monoplegia,Paraplegia,Hemiplegia,Facial
Palsy,or Any Trasient weakness.
Any case of Suspected Polio Clinically
Irrespective of any age
13. WHAT IS NOT AFP ?
TRAUMA
ISOLATED FACIAL NERVE PALSY
HYPOKALAEMIA
ACUTE RHEUMATIC FEVER
CONGENITAL FLACCID PARALYSIS
14. CONDITIONS SOMETIMES
PRESENTING WITH AFP
TUMOR
ENCEPHALITIS
HYPOKALEMIC PARALYSIS [ DUE TO LOW
SERUM POTASSIUM USUALLY REVERSIBLE ]
POTT’s DISEASE
TB MENINGITIS
OSTEOMYELITIS