The document discusses surveillance for acute flaccid paralysis (AFP). It defines AFP as the sudden onset of weakness or paralysis of a limb over 15 days in patients under 15 years old. Surveillance involves collecting, analyzing, interpreting, and distributing data to take necessary action. AFP surveillance aims to detect polio transmission and interrupt its spread by identifying all potential reservoirs of the virus. The goal is to show that no AFP cases were caused by polio virus, proving it is no longer present. The AFP Surveillance System involves hospitals, clinics, community investigation of non-polio and polio AFP cases.

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