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Acute Flaccid Paralysis Surveillance for General Practitioners
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Acute Flaccid Paralysis Surveillance for General Practitioners

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  • 1. Surveillance For ACUTE FLACCID PARALYSIS --Rtn. P.P.Dr.Avinash Bhondwe
  • 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