- Definition: Acute flaccid paralysis (AFP) is defined as sudden onset of weakness and floppiness in any part of the body in a child <15 years of age or paralysis in a person of any age in whom polio is suspected.
- Differential diagnosis:
- Polio
- Vaccine associated paralytic polio (VAPP)
- Guillain-Barre syndrome
- Transverse myelitis
- Traumatic neuritis.
- Background rate of AFP:
- In India, where the incidence of conditions such as traumatic neuritis and AFP caused by other non-polio enteroviruses is very high, the background non-polio AFP rate is undoubtedly much higher.
- For this reason, the operational target of non-polio AFP case detection in India has been set to 2/1,00,000.
- Sample collection:
- Two stool specimens must be collected from every AFP case
- Stool specimens must be collected within 14 days of onset of paralysis to maximize the chances of isolating poliovirus
- In case samples cannot be collected within 14 days, the specimens should still be collected up to 60 days of onset of paralysis.
- Outbreak response immunization (ORI):
- After the AFP case investigation and stool specimen collection, ORI is organized in the community and performed as soon as possible
- Usually 500 children below 5 years of age from the locality/village of the AFP case are covered under ORI.