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AFP Surveillance to End Polio

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Information about Acute Flaccid Paralysis surveillance for Polio Control in India

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AFP Surveillance to End Polio

  1. 1. Surveillance For ACUTE FLACCID PARALYSIS --Rtn. P.P.Dr.Avinash Bhondwe
  2. 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. 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. 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. 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. 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. 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. 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. 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. 10. The AFP Surveillance System Hospitals Clinics Investigation Non-Polio AFP Polio AFP Community
  11. 11. When to report AFP case  Immediately ( Just one phone call) 9689931339 / 9822912062 / 24487700
  12. 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. 13. WHAT IS NOT AFP ?  TRAUMA  ISOLATED FACIAL NERVE PALSY  HYPOKALAEMIA  ACUTE RHEUMATIC FEVER  CONGENITAL FLACCID PARALYSIS
  14. 14. CONDITIONS SOMETIMES PRESENTING WITH AFP  TUMOR  ENCEPHALITIS  HYPOKALEMIC PARALYSIS [ DUE TO LOW SERUM POTASSIUM USUALLY REVERSIBLE ]  POTT’s DISEASE  TB MENINGITIS  OSTEOMYELITIS

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