It is an acute viral infection caused by an RNA virus belonging to Picornaviridae family under enterovirus genera.
It primarily infects human alimentary tract but may infect the CNS resulting in varying degrees of paralysis & possibly death.
It is discussed in the following headings:
1. Epidemiology of Poliomyelitis in children
2. Clinical spectrum of poliomyelitis
3. Clinical features/presentation of poliomyelitis in children
4. Treatment of Poliomyelitis in children
5. Prevention of Poliomyelitis in children
6. Eradication strategy of Poliomyelitis in children
Leptospirosis is a worldwide public health problem. In humid tropical and subtropical areas, where most developing
countries are found, it is a greater problem than in those with a temperate climate. The magnitude of the problem in
tropical and subtropical regions can be largely attributed to climatic and environmental conditions but also to the
great likelihood of contact with a Leptospira-contaminated environment caused by, for example, local agricultural
practices and poor housing and waste disposal, all of which give rise to many sources of infection. In countries with
temperate climates, in addition to locally acquired leptospirosis, the disease may also be acquired by travellers
abroad, and particularly by those visiting the tropics.
Leptospirosis is a potentially serious but treatable disease. Its symptoms may mimic those of a number of other
unrelated infections such as influenza, meningitis, hepatitis, dengue or viral haemorrhagic fevers. Some of these
infections, in particular dengue, may give rise to large epidemics, and cases of leptospirosis that occur during such
epidemics may be overlooked. For this reason, it is important to distinguish leptospirosis from dengue and viral
haemorrhagic fevers, etc. in patients acquiring infections in countries where these diseases are endemic. At present,
this is still difficult, but new developments may reduce the technical problems in the near future. It is necessary,
therefore, to increase awareness and knowledge of leptospirosis as a public health threat.
The lecture gives concise review about the main four groups of viruses causing hemorrhagic fever i.e. Flavivirues, Filoviruses, Arenaviruses and Bunyaviruses.
This presentation aims at helping the pediatric trainees and practitioners to brush up their knowledge in Immunization. The schedule is based on the Universal Immunisation Programme. I have tried to cover as much as possible in terms of individual vaccines and hope it is beneficial to the reader.
Rubella, also known as German measles or three-day measles, is an infection caused by the rubella virus. This disease is often mild with half of the people not realizing that they are infected. A rash may start around two weeks after exposure and last for three days.
Viral hepatitis, All types of Hepatitis virus RahulDoke4
Hepatitis refers to an inflammation of the liver cells and damage to the liver. There are different types and causes, but the symptoms can be similar.
The liver's functions include detoxifying the blood, storing vitamins, and producing hormones. Hepatitis can disrupt these processes and create severe health problems throughout the body.
Leptospirosis is a worldwide public health problem. In humid tropical and subtropical areas, where most developing
countries are found, it is a greater problem than in those with a temperate climate. The magnitude of the problem in
tropical and subtropical regions can be largely attributed to climatic and environmental conditions but also to the
great likelihood of contact with a Leptospira-contaminated environment caused by, for example, local agricultural
practices and poor housing and waste disposal, all of which give rise to many sources of infection. In countries with
temperate climates, in addition to locally acquired leptospirosis, the disease may also be acquired by travellers
abroad, and particularly by those visiting the tropics.
Leptospirosis is a potentially serious but treatable disease. Its symptoms may mimic those of a number of other
unrelated infections such as influenza, meningitis, hepatitis, dengue or viral haemorrhagic fevers. Some of these
infections, in particular dengue, may give rise to large epidemics, and cases of leptospirosis that occur during such
epidemics may be overlooked. For this reason, it is important to distinguish leptospirosis from dengue and viral
haemorrhagic fevers, etc. in patients acquiring infections in countries where these diseases are endemic. At present,
this is still difficult, but new developments may reduce the technical problems in the near future. It is necessary,
therefore, to increase awareness and knowledge of leptospirosis as a public health threat.
The lecture gives concise review about the main four groups of viruses causing hemorrhagic fever i.e. Flavivirues, Filoviruses, Arenaviruses and Bunyaviruses.
This presentation aims at helping the pediatric trainees and practitioners to brush up their knowledge in Immunization. The schedule is based on the Universal Immunisation Programme. I have tried to cover as much as possible in terms of individual vaccines and hope it is beneficial to the reader.
Rubella, also known as German measles or three-day measles, is an infection caused by the rubella virus. This disease is often mild with half of the people not realizing that they are infected. A rash may start around two weeks after exposure and last for three days.
Viral hepatitis, All types of Hepatitis virus RahulDoke4
Hepatitis refers to an inflammation of the liver cells and damage to the liver. There are different types and causes, but the symptoms can be similar.
The liver's functions include detoxifying the blood, storing vitamins, and producing hormones. Hepatitis can disrupt these processes and create severe health problems throughout the body.
Poliovirus is a picornaviridae. it has 3 wildtypes, Wildtype 2 has been eradicated from the world. All countries have been declared polio free except Pakistan, Afghanistan and Nigeria. Global Polio Eradication Initiative has been discussed.
Polio viruses and polio immunisation ppt by Dr Prince C PDR.PRINCE C P
The causative agent of poliomyelitis (commonly known as polio), is a human Enterovirus and member of the family of Picornaviridae.
Poliovirus was first isolated in 1909 by Karl Landsteiner and Erwin Popper.
Poliovirus is one of the most well-characterized viruses, and has become a useful model system for understanding the biology of RNA viruses.
A breakthrough came in 1948 when the virus was successfully cultivated in human tissue in the laboratory by John Enders.
Enders, Weller and Robins, passaged the same strain in non neuronal cell culture.
Vaccines against poliomyelitis: the formalin-inactivated vaccine (IPV) by Jonas Salk(1953) and the live-attenuated vaccines (OPV) by Albert Sabin (1956)
Expanded Program of Immunization.
Objectives are:
To learn about EPI and the current situation of EPI in Pakistan
To understand the mechanism of the Cold Chain and the maintenance of vaccines
Polio is a viral disease that destroys the nerve cells present in the spinal cord causing paralysis or muscle weakness to some part of the body.
Pulse Polio Programme was launched in 1995 after a resolution for a global initiative of polio eradication was adopted by World Health Assembly (WHA) in 1988.
Epidemiological Exercise for Undergraduate Medical Students. The exercise is based on Cohort Study, Case control study, Horrock's apparatus, Vital Indices.
A study design is a specific plan or protocol for conducting the study, which allows the investigator to translate the conceptual hypothesis into an operational one
Obesity is defined as an abnormal growth of the adipose tissue and or enlargement of fat cell size (hypertrophic obesity) or increase in fat cell number (hyperplastic obesity).
Obesity is often expressed in terms of body mass index (BMI)
Dengue is a self limited acute febrile condition and sometimes
haemorrhagic, primarily transmitted to the humans from
infected Aedes species ( Ae. aegypti or Ae. albopictus ).
Dengue Syndrome will be discussed in following headings
1.Epidemiology
2. Manifestation
3. Clinical presentation,
4. Diagnosis
5. Treatment
6. Prevention & Control
Infection caused by three closely related nematodes (W. bancrofti, B. malayi & B. timori) & transmitted to man by bite of infective mosquitos & clinically characterized by-
Lymphangitis, lymphadenitis, elephantiasis of genitals, legs & arms or
Pulmonary esonophilia or Filaria arthritis
CLINIC PRESENTATION
MANAGEMENT
PREVENTIVE MEASURES
FILARIALSURVEY
Malaria epidemiology, clinical features & treatmentDr. Animesh Gupta
Malaria is a protozoal disease caused by infection with
parasites of the genus Plasmodium and transmitted by
certain species of infected female Anopheles mosquito.
Experimental Epidemiology
1st Clinical trial
Basic steps in RCT
Randomization & its method
Manipulation/ Intervention
Types of RCT
Phases in Clinical trial
Hierarchy of epidemiological study
Concept of Association, Causation and Correlation
Association - Spurious, Indirect & Direct
Multi-factorial causation
Guidelines for Judging causality
Additional Criteria for Judging causality
What is Cohort?
Indication and Elements of Cohort Study.
What is Relative risk and Attributable risk, and its interpretation?
Advantages & disadvantages of Cohort study.
Difference between Case control & Cohort study.
Different types of epidemiological methods
Salient features of case control study
Steps for conducting case control study
Matching
Odds ratio
Bias in case control study
Advantages & disadvantages in case control study
Descriptive Epidemiology (including Measurement in epidemiology)Dr. Animesh Gupta
Basic measurement in epidemiology
Incidence & Prevalence
Tools of measurement in epidemiology
Epidemiological methods
Descriptive epidemiology.
Distribution of disease in term of Time, Place and Person
Epidemiology - Definition, History, Aims, Approach, Uses/Purpose.
"The study of the distribution and determinants of
health related states in specified populations , and
the application of this study to control of health
problems."
Screening is defined as the search for unrecognized disease or defect by means of rapidly applied tests , examinations or other procedures in apparently healthy individuals
Rheumatic Heart Disease (RHD) is one of the major causes of cardiovascular disease, accounting for nearly 25-45% of the acquired heart disease.
Rheumatic Fever (RF) is a febrile disease affecting connective tissue (heart) & joints. It is caused due to infection of the throat by group-A beta hemolytic streptococci.
It is NOT a communicable disease but results from communicable disease(streptococcal pharyngitis).
RF is the common cause of acquired heart disease in childhood and adolescence.
IMNCI (Integrated Management of Neonatal and Childhood illness) is an integrated approach to child health that focuses on the well-being of the whole child.
IMNCI strategy is one of the main interventions under RCH-II/NRHM, that focuses on Preventive, Promotive and Curative aspects of program.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
2. POLIOMYELITIS
Dr. Animesh Gupta
M.B.B.S., M.D., F.D.M.,
F.A.G.E.
Associate Professor
Dept. of Community
Medicine
Narayan Medical College &
Hospital, Jamuhar, Bihar
Monday, August 8, 2022 2
3. SLO
At the end of this class, the student must be able to
o Describe the epidemiology of Poliomyelitis in children
o Classify clinical spectrum of poliomyelitis
o Enumerate clinical features/presentation of poliomyelitis in children
o Describe the treatment of Poliomyelitis in children
o Describe the Prevention of Poliomyelitis in children
oDescribe the eradication strategy of Poliomyelitis in children
Monday, August 8, 2022 3
4. INTRODUCTION
oPolio – grey matter, myelitis – inflammation
of the spinal cord
oIt is an acute viral infection caused by an
RNA virus belonging to Picornaviridae
family under enterovirus genera.
oIt primarily infects human alimentary tract
but may infect the CNS resulting in varying
degrees of paralysis & possibly death
Monday, August 8, 2022 4
5. HISTORY
o1580-1350 BC an Egyptian tablet
portrays a priest with a withered leg,
indicating that the disease dates backs to
ancient times.
o1789 – First recognized by Dr Micheal
Underwood.
o1835 – Badam described acute paralysis
in 4 children suggestive of paralysis
o1875 – Erb introduced the term acute
anterior poliomyelitis.
o1909 – Causative virus was recognised by
Karl Landsteiner and Erwin Popper.
Monday, August 8, 2022 5
7. India has not
reported any polio
cases since
January 2011.
India was declared
Polio free since
27th March 2014.
Monday, August 8, 2022 7
8. 15 June 2016 – Global
emergency after an active
strain of wild polio virus
was detected in a water
sample collected from a
drain.
Vaccine derived polio
virus was detected in this
water sample after 5 years
of polio free status in
India.
3.5 lakh children aged
between 6 weeks to 3
years from Hyderabad and
Ranga Reddy district were
vaccinated.
Monday, August 8, 2022 8
9. EPIDEMIOLOGY
AGENT FACTOR
oAgent – Poliovirus
o Serotype
oType 1 - (Brunhilde/Mahoney): mostly causes outbreaks
oType 2 - (Lansing): easiest to eradicate
oType 3 - (Leon): often last to be eradicated
VAPP (Vaccine Associated Paralytic Polio)- Type- 2 & 3
Virus remain alive in water for 4 months & in faeces for 6
months
Pasteurization, physical and chemical agents – inactivation of
the virus
Group
:
Group IV
((+)ssRNA)
Family
:
Picornaviridae
Genus
:
Enterovirus
Specie
s:
Poliovirus
Monday, August 8, 2022 9
10. AGENT FACTOR….
oReservoir of infection-
Man is only reservoir
No chronic carrier
Most infectious are sub-clinical & mild cases
oSource of infection
Faeces & Oropharyngeal secretions of infected persons
oIncubation period: 7 to 14 days( 3- 35 days)
oCommunicability
Cases are most infectious 7-10 days before & after onset of symptoms
Monday, August 8, 2022 10
11. HOST FACTOR
oAge – 6 months to 3 yrs.
oSex – M:F is 3:1
oRisk factors – Trauma, operative procedures such as
tonsillectomy, administration of immunizing agents such as
alum-containing DPT
oImmunity-
oMaternal Ab disappears during first 6 months
oReinfection can occur since infection with one type does not
protect completely against the other two types of viruses.
oNo cross immunity
Monday, August 8, 2022 11
12. ENVIRONMENTAL FACTOR
oRainy season i.e. June to September - 60% cases occur
oContaminated water, food & flies
oOvercrowding & poor sanitation
Monday, August 8, 2022 12
16. CLINICAL
PRESENTAT
ION
Inapparent infection:
- No presenting symptoms
- Recognised by virus isolation or raise in
antibody titre
Abortive polio or Minor Illness:
- Mild or self-limiting illness due to
viraemia
- Recognised by viral isolation or raise in
antibody titre
Non paralytic polio:
- Presenting with stiffness and pain in
the neck
- Synonymous with aseptic meningitis
16
Monday, August 8, 2022
17. CLINICAL
PRESENTAT
ION
Paralytic Polio
•Predominant sign is asymmetrical
flaccid paralysis
• History of fever at the onset of
paralysis is suggestive of polio
•Associated symptoms – malaise,
anorexia, nausea vomiting, headache,
sore throat, constipation, abdominal
pain, stiffness of neck and back muscles
• Tripod signs is present
Monday, August 8, 2022 17
19. CHARACTERISTICS OF PARALYSIS
oSudden paralysis, temporary or permanent
oProgression of paralysis reaches its maximum in less than 4
days ( 4 - 7 days)
oDescending in character i.e. starting at the hip and moving
down to the distal parts of the extremity.
oAs it is patchy paralysis muscle strength varies in different
muscles group of different limbs.
oProximal muscle group are more involved as compared to the
distal ones.
oDeep tendon reflexes are diminished before the onset of
paralysis. No sensory loss.
Monday, August 8, 2022 19
21. PARALYTIC
POLIO…
oCranial nerve involvement is seen in
bulbar and bulbospinal forms of
paralytic poliomyelitis.
oThere may be facial asymmetry,
difficulty in swallowing, weakness or
loss of voice.
oRespiratory insufficiency may be life
threatening and is usual cause of
death.
oAfter the acute phase, atrophy of the
affected muscles lead to a life with
residual paralysis
21
Monday, August 8, 2022
24. Despite the progress achieved since 1988, as long as a single child
remain infected with virus, children in all countries are at risk of
contracting the disease.
The polio virus can easily be imported to a polio free country and can
be spread rapidly.
Failure to eradicate could result in as many as 2,00,000 every year.
Polio vaccine given multiple times, can protect a child for life.
24
There is no cure for polio; it can only be prevented
Monday, August 8, 2022
29. PREVENTION & CONTROL
Primary
Health education
Improving sanitation & Personal hygiene
Immunization (OPV & IPV)
Secondary
Symptomatic treatment
Physiotherapy
Tertiary – Rehabilitation
DR. ANIMESH GUPTA 29
30. OPV
(LIVE ATTENUATED
VACCINE)
oDescribed by Albert Sabin in
1957
o Live attenuated virus (3
types) grown in primarily
monkey kidney or human
diploid cell cultures
o Schedule
oAt birth- Zero dose of polio
o6, 10 & 14 weeks –1st, 2nd & 3rd
doses
o12 to 18 months – one booster
dose
oDose & route of
administration -
o2 drops given orally
oInduces both humoral &
DR. ANIMESH GUPTA 30
31. OPV…
Heat sensitive – 80 C rapidly reduce potency
Not used in immunocompromised person and
corticosteroid therapy
DR. ANIMESH GUPTA 31
32. IPV
(INACTIVATED POLIO
VACCINE)
oDescribed by Jonas Salk in 1955
oContains all 3 types of poliovirus
inactivated by formalin
oSchedule- 4 doses
o1st dose – 6 weeks
o 2nd & 3rd doses at an interval of
1-2 months and 4th dose 6-12
months after 3rd dose
oAdditional doses at school entry
& every 5 years until the age of
18 years
oDose & route of administration –
0.5ml IM/SC
o Immunity- Induces humoral
antibodies but not intestinal or
local immunity
DR. ANIMESH GUPTA 32
33. IPV…
• Heat stable
• Can be used in immuno-compromised patient
• Used in the country where polio is eliminated
• Can not be used during epidemic of polio
DR. ANIMESH GUPTA 33
35. INDIA TO INTRODUCE
INJECTABLE INACTIVATED
POLIOVIRUS VACCINE (IPV)
In May 2012, the World Health Assembly endorsed
the Polio Eradication & Endgame Strategic Plan 2013-
2018
India joins 125 other countries to introduce
Inactivated Poliovirus Vaccine (IPV) into routine
immunization as part of Polio Eradication and
Endgame Strategic plan in 2015.
IPV would be given along with third dose of oral polio
vaccine (OPV) at 14 weeks of age for children under
one year of age.
DR. ANIMESH GUPTA 35
37. STRATEGY FOR ERADICATION
oSustain high level of routine immunization
oConduct Pulse polio immunization
oMonitor Polio Surveillance (AFP)
oEmergency Preparedness & Response Plan (EPRP) –
Polio case detection
oInternational polio certification for travelers
DR. ANIMESH GUPTA 37
38. PULSE POLIO
IMMUNIZATION (PPI)
oLaunched in India in 1995.
oTarget to Children in the age group
of 0-5 years
o Administered polio drops during
National immunization days every
year.
o2 doses of OPV vaccines are given
at an interval of 4 to 6 weeks during
National immunization day (Nov. to
Feb.)
oThe dose of OPV during PPI are
extra doses which supplement & do
not replace the doses received
during routine immunization.
Pulse- Sudden, mass
administration of OPV on a single
days to all children 0-5 years of age
irrespective of their previous polio
DR. ANIMESH GUPTA 38
39. INTENSIFIED PULSE POLIO
IMMUNIZATION (IPPI)
oBooth activity – on Sunday
oSuccessive Monday, Tuesday & Wednesday – house to
house search to vaccinate children who have not received
vaccine on Sunday.
MOPPING UP
oAfter the detection of case in an area, Immunization to all
children under 5 years of age in the block /district
DR. ANIMESH GUPTA 39
40. POLIO
SURVEILLANCE
oAFP Surveillance
Finding and reporting
children with acute flaccid
paralysis (AFP)
Transporting stool
samples for analysis
Isolating poliovirus
Mapping the virus
oEnvironmental
Surveillance
DR. ANIMESH GUPTA 40
41. AFP SURVEILLANCE….
Case definition: Any child < 15 years who has acute
onset of flaccid paralysis for which no obvious cause
(such as severe trauma or electrolyte imbalance) is
found, or paralytic illness in a person of any age in
which polio is suspected.
DR. ANIMESH GUPTA 41
42. AFP SURVEILLANCE….
STOOL SAMPLE
oNumber -Two stool samples, with a gap of at least 24 - 48
hours between two samples
oTime- First within 14 days of onset of paralysis
oQuantity – Thumb sized
Storage – sealed in container and stored immediately inside
a refrigerator or packed between ice packs at 4-8°C in a cold
box
Transport – National Laboratory* within 72 hours of
collection with Maintenance of cold chain
*BJMC Ahmedabad, NIV Bangalore, ERC Mumbai, IoS Kolkata,
NCDC Delhi, CRI Kasauli, KIPM Chennai, SGPGI Lucknow
DR. ANIMESH GUPTA 42
43. AFP SURVEILLANCE….
Isolating polio virus
Isolation of polio virus from stool sample
Distinguishing between wild polio virus and vaccine related
polio virus
Mapping the virus
Once wild poliovirus has been identified, further tests are
carried out to determine where the strain may have originated.
By determining the exact genetic make-up of the virus, wild
viruses can be compared to others and classified into genetic
families, which cluster in defined geographical areas.
DR. ANIMESH GUPTA 43
46. Onset of paralysis
Investigation of suspected
case (≤48 hours of report)
2 stool specimens
collected 24 hours
apart
Outbreak response
immunization,
additional case finding
60-day follow-up exam
Specime
ns arrive
at
national
laborator
y
Results
reported
from
national
laboratory
Poliovirus isolates send
to regional reference
laboratory for intratypic
differentiation
Final classification of the case by the
expert committee (≤ 12 weeks since
onset of paralysis)
Flow diagram of case
investigation,
stool specimen collection and
outbreak response immunization
≤ 3
Days
≤ 24
Days
≤ 7 Days
DR. ANIMESH GUPTA 46
47. INTERNATIONAL
CERTIFICATE OF
VACCINATION
oYellow card or Carte Jaune is
an international certificate of
vaccination (ICV), issued by
WHO
oPakistan, Afghanistan, Nigeria,
Democratic Republic of the
Congo, Papua New Guinea,
Kenya, Somalia and Syria.
oTravelers must take bivalent
OPV or IPV at least a month
before departure or arrival
oThe certificate is valid for one
year
DR. ANIMESH GUPTA 47
48. 48
As long as a single child remains infected,
children in all countries are at risk of contracting
polio.
“END POLIO NOW: COUNTDOWN TO
HISTORY”
DR. ANIMESH GUPTA