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IAP Recommendations
for AFP SURVEILLANCE
A non-Polio AFP rate of 1/100,000 should be
adopted as bench mark for adequacy of AFP surveillance in
India as per Kerala data, a State, which has been free of Polio for
more than three years.
Active community based surveillance should
be considered. Involvement of community should be solicited
by rewards for reporting a new unreported case of AFP.
State and Centre level Technical Expert Committee
be set up to oversee the process of AFP surveillance.
This committee should have a IAP representative on it.
Scope of AFP surveillance should be expanded
progressively to include contact surveys and environmental
surveys.
The IAP and IMA should be actively involved
in the process of AFP surveillance. The information regarding
what, where and to whom to report and what to expect after reporting
a case should be disseminated to all IAP and IMA
members.
Special efforts must be made to ensure coverage
of children between the age of 12 and 15 who may not
be reporting to the Department of Pediatrics of various reporting
units.
Intra-typing differentiation of all cases of
AFP must be provided to clinicians reporting the index cases.
Clinicians must follow all cases of AFP for
minimum of 60 days and correlate with virus intra-typing.
Every case or AFP-which do not have wild virus,
must be scrutinized by technical expert committee which
has an IAP representative on it to begin with such expert committees
may be constituted at State level, and gradually
such committees may be constituted in each district.
IAP Recommendations for Vaccine Associated Paralytic Polio
Discussion of VAPP should be restricted to
only academic circles.
Definition: - At present there is no accepted
definition - we will follow working definitions. Recipient VAPP -
Paralatic polio in which onset of illness occurs within 7-30 days
after administration of OPV. Contact VAPP - Paralytic polio which
has contact with a vaccinee and the onset of paralysis within 7-60
days after the vaccinee received the OPV or the patient lived in an
area where an OPV campaign were conducted within 7-60 days before
the illness started without a contact. In these patients following
data to be documented. History - OPV exposure evidence - Absence of
epidemiological links. Physical Exam. - Paralytic poliomyelitis Laboratory
- Stools negative for wild polio-virus.
In NPSP - AFP With Vaccine virus are discarded
as non-polio. Program should recognize VAPP and follow them up.
There must be a felt need to plan a new strategy,
which can minimize occurrence of VAPP. |
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