Performance of acute flaccid paralysis surveillance compared with <scp>W</scp>orld <scp>H</scp>ealth <scp>O</scp>rganization standards

Desai, Shalini; Smith, Tiffany; Thorley, Bruce R; Grenier, Danielle; Dickson, Nigel; Altpeter, Ekkehardt; Sabbe, Martine; Elliott, Elizabeth J; Zurynski, Yvonne

doi:10.1111/jpc.12691

Cited by 9 publications

(14 citation statements)

References 14 publications

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“…27,28 Infectious symptoms (respiratory or gastrointestinal) often precede AFP cases, a feature similarly observed in Canada, the UK and the USA. 28 NPEV are amongst the most frequently isolated. NERL manages all samples collected from PAEDS-APSU AFP surveillance cases, testing stool for WPV and cVDPV as well as sub-typing NPEV species identified in stool, or where available, cerebral spinal fluid (CSF), blood or respiratory samples.…”

Section: Acute Flaccid Paralysis Surveillance: Australia and Abroadmentioning

confidence: 82%

“…27 To improve Australia's ability to meet surveillance benchmarks, the Paediatric Active Enhanced Disease Surveillance (PAEDS) Network was established in 2007 to complement APSU surveillance, among other activities. 28 PAEDS surveillance nurses at five paediatric tertiary hospitals nationwide actively identify admissions of possible AFP and collect demographic and clinical data. 21,26,27 A total of 718 cases were reported by the PAEDS arm between 2007 and 2015; Australia has met its WHO surveillance detection requirements in each year since PAEDS involvement, though stool collection rates remained below the 80% target.…”

Section: Acute Flaccid Paralysis Surveillance: Australia and Abroadmentioning

confidence: 99%

“…29,30 Respiratory PCR testing for EV-A71 is also often positive; however, CSF detection of the virus has been shown to be less sensitive despite the presence of CNS disease. 28 The utility of serological studies for EV-A71 decreases with age due to cross-reactive antibodies for various enterovirus serotypes, and the yield for serum viral PCR testing is also low. 29 When EV-A71 causes a polio-like AFP phenotype, an anterior myelitis pattern of inflammation is typically seen on magnetic resonance imaging (MRI) of the spine.…”

Section: New Enemies: Enterovirus Species a Serotype 71 (Ev-a71)mentioning

confidence: 99%

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Polio – The old foe and new challenges: An update for clinicians

Bao

Thorley

Isaacs

et al. 2020

J Paediatrics Child Health

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The Global Polio Eradication Initiative since 1988 has seen the impact of poliovirus decline from frequent global epidemics in the early 1900s to being now only endemic in two countries today. Global vaccination programmes and surveillance for the disease have resulted in the landmark eradication of two of the three poliovirus strains in the last 5 years. Australia continues to contribute to global surveillance efforts for the disease via the Australian Paediatric Surveillance Unit and the Paediatric Active Enhanced Disease Surveillance Network, which aim to detect cases of acute flaccid paralysis in children, the key clinical feature of poliomyelitis. Today, in the era of the polio 'endgame', there is growing recognition of non-polio enteroviruses causing paralytic diseases that are polio-like, particularly in children, with an increased need for awareness and vigilance by paediatric clinicians.

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Section: Acute Flaccid Paralysis Surveillance: Australia and Abroadmentioning

confidence: 82%

Section: Acute Flaccid Paralysis Surveillance: Australia and Abroadmentioning

confidence: 99%

Section: New Enemies: Enterovirus Species a Serotype 71 (Ev-a71)mentioning

confidence: 99%

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Polio – The old foe and new challenges: An update for clinicians

Bao

Thorley

Isaacs

et al. 2020

J Paediatrics Child Health

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“…Moreover, it's important to note that the prevalence of AFP was more common in the second half of the year, which can be due to the prevalence of respiratory infections and their role in the onset of the speci c diseases such as GBS [1][2] .…”

Section: Discussionmentioning

confidence: 99%

Acute Flaccid Paralysis: A Registry-based Study of Demographic, Clinical, and Diagnostic Characteristics of Children in a Referral Center in Iran

Tavasoli¹,

Pazouki²,

Hosseinpour³

et al. 2020

Preprint

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Background: Acute Flaccid Paralysis(AFP) is a clinical syndrome characterized by acute progressive weakness in limbs and respiratory and swallowing muscles. Etiologies of AFP mostly include infections in anterior horn cells of the spinal cord, Guillain-Barre syndrome(GBS), transverse myelitis, viral myositis, myasthenia gravis and botulism. An accurate and early diagnosis of AFP is crucial. The aims of this study were to determine the main etiologies and characteristics of AFP in children and also design a diagnostic approach for AFP based on a hospital-based registry system.Method: This retrospective, cross-sectional study is a five-years survey, from 2011 to 2016 in Children’s Medical Center as the main children referral hospital in Iran. Totally 118 patients who had met AFP ICD-10- CM and inclusion criteria were included. All clinical and Paracinical data were collected based on a prepared questionnaire for the study.Result: The mean age of the patients was 6.09 ± 3.60 years old. The most frequent underlying etiologies were GBS, viral myositis and Vaccine-Associated Paralytic Poliomyelitis(VAPP) accounting for 67.8%, 15.3% and 5% of the patients, respectively. In terms of preceding clinical symptoms coryza, fever and gastrointestinal symptoms were more common. The most common neurologic presenting symptom was motor dysfunction. Cerebrospinal fluid analysis mainly indicated increase level of protein in favor of GBS. Elevated Creatine kinase level with the mean of 2184 IU/L has been reported in patients with viral myositis. Brain imaging principally revealed normal results and spinal MRI findings were compatible with the diagnoses of GBS and transvers myelitis. All stool sample results for polio virus detection were negative.Conclusion: In this study, we determined the etiologies of AFP in Iranian children referred to Children’s Medical Center. Guillain-Barre syndrome, viral myositis, transverse myelitis and VAPP were the most common etiologies. We also recommended a diagnostic approach for AFP in pediatric population regards to main etiologies in emergency room of a children referral hospital.

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“…In a non-endemic country such as Iran, the incidence of at least one case of non-polio AFP per 100,000 children under the age of fifteen is expected. 15,16 During the past few years, Poliovirus transmission has been reported at its lowest levels; however, the virus continues to spread from endemic countries, and the high level of immigration across countries creates an environment for Polio Virus reintroduction. 17 Despite the overall success of GPEI in Iran, as well as the absence of confirmed polio cases in the country since 2001 11 , Iranian authorities remain concerned regarding the possibility of transmission from two polio-endemic neighboring countries of Afghanistan and Pakistan, which are both at a high risk of wild poliovirus.…”

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confidence: 99%

Eleven-year surveillance of acute flaccid paralysis in southwestern Iran

2019

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Momen AA, Shakurnia A, Momen M. Eleven-year surveillance of acute flaccid paralysis in southwestern Iran. Turk J Pediatr 2019; 61: 544-551. The purpose of the study was to report the results of acute flaccid paralysis (AFP) surveillance in the southwestern Iran in the 11 years' period. This is a retrospective descriptive study based on WHO guidelines. The collected data includes all pediatric AFP cases reported between of January 2006 to December 2016 by all health centers of Khuzestan province in Southwest of Iran.During an eleven-year period, 274 cases of AFP were reported in Khuzestan Province. Among them, 56.9% were younger than five years of age, and 55.9% were male. None of these cases was confirmed as poliomyelitis. The annual incidence of non-polio AFP ranged from 1.46/100,000 to 3.11/100,000 (Mean: 2.04 cases/100,000). The incidence rate of AFP in children under five years of age was significantly higher compared to older children (p=0.001), and the most common cause of paralysis (74.5%) was Guillain-Barre syndrome. All performance indicators met the WHO-specified targets. The follow-up of patients with AFP is essential to the eradication of poliomyelitis.

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Performance of acute flaccid paralysis surveillance compared with World Health Organization standards

Cited by 9 publications

References 14 publications

Polio – The old foe and new challenges: An update for clinicians

Polio – The old foe and new challenges: An update for clinicians

Acute Flaccid Paralysis: A Registry-based Study of Demographic, Clinical, and Diagnostic Characteristics of Children in a Referral Center in Iran

Eleven-year surveillance of acute flaccid paralysis in southwestern Iran

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