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Acute Flaccid Paralysis
Acute Flaccid Paralysis
ACUTE FLACID
PARALYSIS
PRESENTED
BY
OJAN RONALD
IYETE HC III
INTERNATIONAL RESCUE COMMITTEE
AFP Surveillance at Iyete HC III
Definition
• What is Acute Flaccid Paralysis?
• Acute Flaccid Paralysis or AFP is a clinical syndrome,
which refers to a collection of signs and symptoms,
instead of a diagnosis.
• AFP is defined by the acute onset of weakness or
paralysis with reduced muscle tone in children.
• There are many infectious and non-infectious
causes of AFP.
AFP Surveillance at Iyete HC III
• Of the 3 strains of wild poliovirus (type 1, type 2, and type 3), wild
poliovirus type 2 was eradicated in 1999 and no case of wild poliovirus
type 3 has been found since the last reported case in Nigeria in
November 2012.
• For example, after >2 years without detection of wild polio in Nigeria, the
3 laboratory confirmed WPV1 cases in children between 2 and 5 years
of age with onset between July and August 2016 were confirmed
• These detected viruses were closely linked to WPV1 last detected in the
Nigerian state of Borno in 2011, an indication that this strain had been
circulating without detection since that time
Sources: http://www.who.int/news-room/detail/13-02-2018-statement-of-the-sixteenth-ihr-emergency-committee-regarding-the-international-
spread-of-poliovirus; http://www.who.int/csr/don/06-october-2016-polio-nigeria/en/
AFP Surveillance at Iyete HC III
• The genetic analysis of the isolated strain indicates that also this
cVDPV2 strain has been circulating in the area for at least two years.
Source: http://www.who.int/csr/don/06-october-2016-polio-nigeria/en/
AFP Surveillance at Iyete HC III
• In February 2018
– states infected with WPV1, cVDPV1 or cVDPV3 include Afghanistan, Pakistan
and Nigeria
– states infected with cVDPV2s include Democratic Republic of the Congo,
Nigeria and Syrian Arab Republic
– States no longer infected by WPV1 or cVDPV, but which remain vulnerable to
re-infection include Cameroon, Central African Republic, Chad and Niger
Source: http://www.who.int/news-room/detail/13-02-2018-statement-of-the-sixteenth-ihr-emergency-committee-regarding-the-international-spread-
of-poliovirus
AFP Surveillance at Iyete HC III
Source: http://www.euro.who.int/__data/assets/pdf_file/0005/276485/Factsheet-Polio-en.pdf?ua=1;
http://www.euro.who.int/en/health-topics/communicable-diseases/poliomyelitis/maintaining-polio-free-status-of-european-region-as-part-of-the-
global-polio-endgame-strategy
AFP Surveillance at Iyete HC III
Source: http://www.euro.who.int/en/health-topics/communicable-diseases/poliomyelitis/maintaining-polio-free-status-of-european-region-as-part-
of-the-global-polio-endgame-strategy
AFP Surveillance at Iyete HC III
Definition of AFP
• Acute flaccid Paralysis (AFP) is a clinical syndrome
characterised by rapid onset of weakness, including
(less frequently) weakness of respiratory and
swallowing, progressing to maximum severity within
several days to weeks.
Acute Flaccid
Paralysiss
AFP SURVEILLANCE
STEP 1: Detect all AFP cases using the Standard case definition
• Conduct daily/weekly active search at health facilities (Remember to include all causes
that may present with AFP)
• Sensitize communities to report all cases suspected
TYPES OF AFP SURVEILLANCE
a) ACTIVE SURVEILLANCE FOR AFP
• A designated person Visiting Health facilities, rehabilitation centers and highly
populated areas
b) ACTIVE AFP CASE FINDING
• Community case finding( VHTs, CHEWs) or HWs visiting traditional Birth attendants and
traditional healers in search for AFP
c) ROUTINE SURVEILLANCE FOR AFP (ZERO REPORTING)
• Immediate notification of AFP in children <15 years of age is required.
AFP Surveillance at Iyete HC III
STEP 2: CONT
• Fill the AFP case investigation form for suspected
cases detected after 60 days from onset of paralysis
and submit to the district/HSD.
TASKS
Contacts of AFP
creteria (eligibility) for sampling contact of AFP cases
1. AFP case with inadequate stool (stool specimen collected
beyond 14 days of onset of paralysis and not exceeding 60
days of onset of paralysis)
2. “Hot” or highly suspected AFP cases
3. AFP cases from areas within limited accessibility or hard to
reach district even without reported Virus isolation
4. When there is any suspicion by the program regarding
quality of the collection process or handling of the index
AFP stool specimens.
AFP Surveillance at Iyete HC III
Cont
• Step 3:
• Collect samples from at least 3 contacts (1 stool sample per contact)
• Collection, storage and transportation of stool specimen are the same as for
AFP cases
• Fill in a specific form “contact stool collection form” for each contact selected.
• Label each specimen clearly as a contact of the specific case; include the
specific ID code of the case followed by number, e.g C1, C2 or C3
• Label the specimen with the name, date, and contact number (e.g C1, C2 or
C3
AFP Surveillance at Iyete HC III
AFP Surveillance at Iyete HC III
AFP Surveillance at Iyete HC III
AFP Surveillance at Iyete HC III
OJAN RONALD BOLD
AFP Surveillance at Iyete HC III