scholarly journals Detection of Imported Wild Polioviruses and of Vaccine-Derived Polioviruses by Environmental Surveillance in Egypt

2012 ◽  
Vol 78 (15) ◽  
pp. 5406-5409 ◽  
Author(s):  
Soile Blomqvist ◽  
Laila El Bassioni ◽  
Eman M. El Maamoon Nasr ◽  
Anja Paananen ◽  
Svetlana Kaijalainen ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Polio Eradication ◽  
Flaccid Paralysis ◽  
Environmental Surveillance ◽  
Wild Type ◽  
Wild Poliovirus ◽  
Afp Surveillance

ABSTRACTSystematic environmental surveillance for poliovirus circulation has been conducted in Egypt since 2000. The surveillance has revealed three independent importations of wild-type poliovirus. In addition, several vaccine-derived polioviruses have been detected in various locations in Egypt. In addition to acute flaccid paralysis (AFP) surveillance, environmental surveillance can be used to monitor the wild poliovirus and vaccine-derived poliovirus circulation in populations in support of polio eradication initiatives.

scholarly journals Environmental Surveillance Complements Case-Based Surveillance of Acute Flaccid Paralysis in Polio Endgame Strategy 2019–2023

2020 ◽  
Vol 86 (15) ◽  
Author(s):  
Peng Chen ◽  
Yao Liu ◽  
Haiyan Wang ◽  
Guifang Liu ◽  
Xiaojuan Lin ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Polio Eradication ◽  
Flaccid Paralysis ◽  
World Health ◽  
Paralytic Poliomyelitis ◽  
Environmental Surveillance ◽  
Wild Poliovirus ◽  
The World ◽  
Afp Surveillance ◽  
Case Based

ABSTRACT The Polio Endgame Strategy 2019–2023 has been developed. However, more effective and efficient surveillance activities should be conducted with the preparedness of emergence for vaccine-derived poliovirus (VDPV) or wild poliovirus (WPV). We reviewed the impact of the case-based acute flaccid paralysis (AFP) surveillance (1991 to 2018) and environmental surveillance (2011 to 2018) in polio eradication in Shandong province of China. Clinical characteristics of AFP cases and enterovirus (EV) investigation of research samples were assessed. During the period, 10,224 AFP cases were investigated, and 352 sewage samples were collected. The nonpolio AFP rate sustained at over 2.0/100,000 since 1997. Of 10,224 cases, males and young children experienced a higher risk of severe diseases, and 68.5% suffered lower limb paralysis. We collected 1,707 EVs from AFP cases, including 763 polioviruses and 944 nonpolio enteroviruses (NPEVs). No WPV was isolated since 1992. The AFP surveillance showed high sensitivity in detecting 143 vaccine-associated paralytic poliomyelitis (VAPP) cases and 6 VDPVs. For environmental surveillance, 217 (61.6%) samples were positive for poliovirus, and altogether, 838 polioviruses and 2,988 NPEVs were isolated. No WPV was isolated in environmental surveillance, although one VDPV2 was identified. Phylogenetic analysis revealed environmental surveillance had the capacity to detect a large scope of NPEVs. The case-based AFP surveillance will be indispensable for detecting VAPP cases and VDPV circulation in countries using oral polio vaccine. Environmental surveillance is advantageous in identifying EV circulation and responding to ongoing circulating VDPV outbreaks and should be expanded to complement the AFP surveillance. IMPORTANCE Interrupting wild poliovirus transmission and stopping circulating vaccine-derived poliovirus (cVDPV) outbreaks have been proposed as two global goals by the World Health Organization in the Global Polio Eradication Initiative (GPEI). This analysis, based on the 28-year acute flaccid paralysis (AFP) surveillance and 8-year environmental surveillance, provides continued high-quality surveillance performance in achieving the GPEI and detecting the circulation of enterovirus. Given the ongoing cVDPV outbreaks in the world, we present the surveillance capacity of environmental surveillance in capturing enterovirus circulation. The final poliovirus (especially VDPV) elimination has become increasingly complex, and the case-based AFP surveillance alone will lead to difficulties in early detecting dynamics of poliovirus transmission and monitoring the extent of environmental circulation. This study goes beyond previous work to provide a detailed comprehensive evaluation of the enterovirus surveillance and can be used to formulate a set of implementation plan and performance indicators for environmental surveillance.

scholarly journals Acute Flaccid Paralysis surveillance in Polio Eradication and Beyond: Learning from Bangladesh

2021 ◽  
Author(s):  
Humayra Binte Anwar ◽  
Yameen Mazumder ◽  
Sanjana Nujhat ◽  
Bushra Zarin Islam ◽  
Anna Kalbarczyk ◽  
...  
Keyword(s):  
Surveillance System ◽  
Disease Surveillance ◽  
Technical Assistance ◽  
Acute Flaccid Paralysis ◽  
Grey Literature ◽  
Polio Eradication ◽  
Flaccid Paralysis ◽  
Depth Information ◽  
Acute Flaccid Paralysis Surveillance ◽  
Afp Surveillance

Abstract IntroductionGlobal Polio Eradication Initiative, GPEI led by the World Health Organization (WHO), helped to develop standard acute flaccid paralysis surveillance (AFP) system worldwide, including Bangladesh, which comprises infrastructure, knowledge, expertise, funding, technical assistance, and trained personnel. AFP surveillance can complement any disease surveillance systems, and many countries are now utilizing these polio surveillance assets for monitoring other vaccine-preventable diseases. This paper outlines how AFP surveillance has evolved in Bangladesh over time, its success and challenging factors, and its potential to accomplish other health goals.MethodologyThis mixed-method study includes a grey literature review, a survey for quantitative and qualitative information on barriers and facilitators, and Key Informant Interviews (KIIs) to gather relevant in-depth information on AFP surveillance in Bangladesh. Grey literature was collected online and paper documentation from different stakeholders. Online and in-person surveys were conducted in six divisions of Bangladesh, including Dhaka, Rajshahi, Rangpur, Chittagong, Sylhet, and Khulna, to map tacit knowledge ideas, approaches, and experiences. KIIs were conducted at global, national, and sub-national levels. Data were then combined on focused emerging themes, including history, challenges, and successes of the AFP surveillance system in Bangladesh.ResultsAFP surveillance in Bangladesh was first introduced in 1990 at the district and Upazila level major hospitals. High population growth, low performance, hard-to-reach areas, and groups of people residing in risky zones were major challenges to implementing this surveillance system. Surveillance was gradually enriched by establishing certification standards and community-based AFP surveillance and improved Surveillance Immunization Medical Officer (SIMO) network activities, laboratory activities, and proper monitoring and evaluation. In Bangladesh, a national disease surveillance system and a laboratory are now being used for multiple diseases, including polio, measles, Japanese Encephalitis, Neonatal Tetanus etc.ConclusionIn Bangladesh, it is evident that the AFP surveillance system is supporting the health system more broadly by building knowledge, experience, and assets and forming a strong platform for other health programs. In addition, its strengths can be leveraged for combating new and emerging diseases like COVID-19. However, the sustainability of the AFP surveillance in Bangladesh still needs collaborative support from partners, mainly technical assistance.

scholarly journals Acute flaccid paralysis (AFP) surveillance: challenges and opportunities from 18 years’ experience, Spain, 1998 to 2015

2018 ◽  
Vol 23 (47) ◽  
Author(s):  
Josefa Masa-Calles ◽  
Nuria Torner ◽  
Noemí López-Perea ◽  
María de Viarce Torres de Mier ◽  
Beatriz Fernández-Martínez ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Polio Eradication ◽  
Case Definition ◽  
Flaccid Paralysis ◽  
Notification Rate ◽  
Surveillance Network ◽  
Challenges And Opportunities ◽  
Afp Surveillance ◽  
The Mean ◽  
Annual Proportion

Acute flaccid paralysis (AFP) surveillance is key for global polio eradication. It allows detecting poliovirus (PV) reintroductions from endemic countries. This study describes AFP surveillance in Spain from 1998 to 2015. During this time, 678 AFP cases were reported to the Spanish National Surveillance Network. The mean notification rate was 0.58 AFP cases/100,000 population under 15 years old (range: 0.45/100,000–0.78/100,000). Two periods (P) are described: P1 (1998–2006) with the AFP notification rate ranging from 0.66/100,000 to 0.78/100,000, peaking in 2001 (0.84/100,000); and P2 (2007–2015) when the AFP rate ranged from 0.43/100,000 to 0.57/100,000, with the lowest rate in 2009 (0.31/100,000). No poliomyelitis cases were caused by wild PV infections, although two Sabin-like PVs and one imported vaccine-derived PV-2 were detected. Overall, 23 (3.4%) cases met the hot case definition. Most cases were clinically diagnosed with Guillain–Barré syndrome (76.9%; 504/655). The adequate stool collection rate ranged from 33.3% (7/21) to 72.5% (29/40). The annual proportion of AFP cases with non-polio enterovirus findings varied widely across the study period. AFP surveillance with laboratory testing for non-polio enteroviruses must be maintained and enhanced both to monitor polio eradication and to establish sensitive surveillance for prompt detection of other enteroviruses causing serious symptoms.

scholarly journals Evaluation of Acute Flaccid Paralysis (AFP) surveillance system, Kebbi State, Nigeria, 2013-2018

2020 ◽  
Author(s):  
Hashim Abdulmumin Bala ◽  
Yahaya Mohammed ◽  
Nyampa Barau ◽  
Lukman Surajudeen ◽  
Polycarp Uche Ori
Keyword(s):  
Surveillance System ◽  
Acute Flaccid Paralysis ◽  
Performance Standards ◽  
Case Definition ◽  
Flaccid Paralysis ◽  
Suspected Case ◽  
Surveillance Systems ◽  
Case Definitions ◽  
Wild Poliovirus ◽  
Afp Surveillance

Abstract Background Since 1988, the incidence of polio has reduced by more than 99 percent, worldwide, according to the WHO. Each year, more than 350,000 children were paralyzed, in more than 125 endemic countries. Today, only two countries are still having transmission of polio: Pakistan and Afghanistan. No wild poliovirus has been reported anywhere in Africa since 2016. A good and effective Acute Flaccid Paralysis (AFP) surveillance system is necessary to detect any suspected case of polio to interrupt the transmission of polio within any country. We evaluated the AFP surveillance system to identify gaps in its operations. Methods We used the updated CDC guidelines for evaluating public health surveillance systems and the WHO performance standards to assess the system. We also interviewed stakeholders using an adapted questionnaire, and a key informant interview. We also reviewed AFP surveillance data from 2013–2018. We summarized data using means, frequencies, and proportion. Results We interviewed a total of 49 respondents. Of these, 47 (98%) reported case definitions as being easy to use, and case investigation forms as being easy to fill, 46 (97%) reported data tools could easily accommodate changes, and all the surveillance officers understand the case definition of AFP. All respondents were willing to continue with the system. The non-polio AFP rate (24.6–55.2), stool adequacy (95-99.7%), timeliness, and completeness of reporting were found to be consistently above the WHO minimum standard. Conclusion The AFP surveillance system in Kebbi State was found to be useful, simple, flexible, acceptable, sensitive, representative, timely, and stable, though donor-driven. Absence of data on 60-day follow up and feedback from the laboratory was a major problem with the system.

scholarly journals Evaluation of Acute Flaccid Paralysis (AFP) surveillance system, Kebbi State, Nigeria, 2013-2018

2020 ◽  
Author(s):  
Hashim Abdulmumin Bala ◽  
Yahaya Mohammed ◽  
Nyampa Barau ◽  
Lukman Surajudeen ◽  
Polycarp Uche Ori
Keyword(s):  
Surveillance System ◽  
Acute Flaccid Paralysis ◽  
Performance Standards ◽  
Case Definition ◽  
Flaccid Paralysis ◽  
Suspected Case ◽  
Surveillance Systems ◽  
Case Definitions ◽  
Wild Poliovirus ◽  
Afp Surveillance

Abstract Background: Since 1988, the incidence of polio has reduced by more than 99 percent, worldwide, according to the WHO. Each year, more than 350,000 children were paralyzed, in more than 125 endemic countries. Today, only two countries are still having transmission of polio: Pakistan and Afghanistan. No wild poliovirus has been reported anywhere in Africa since 2016. A good and effective Acute Flaccid Paralysis (AFP) surveillance system is necessary to detect any suspected case of polio to interrupt the transmission of polio within any country. We evaluated the AFP surveillance system to identify gaps in its operations.Methods: We used the updated CDC guidelines for evaluating public health surveillance systems and the WHO performance standards to assess the system. We also interviewed stakeholders using an adapted questionnaire, and a key informant interview. We also reviewed AFP surveillance data from 2013-2018. We summarized data using means, frequencies, and proportion. Results: A total of 49 respondents were interviewed. Of these, 47 (98%) reported case definitions as being easy to use, and case investigation forms as being easy to fill, 46 (97%) reported data tools could easily accommodate changes, and all the surveillance officers understand the case definition of AFP. All respondents were willing to continue with the system. The non-polio AFP rate (24.6-55.2), stool adequacy (95-99.7%), timeliness, and completeness of reporting were found to be consistently above the WHO minimum standard.Conclusion: The AFP surveillance system in Kebbi State was found to be useful, simple, flexible, acceptable, sensitive, representative, timely, and stable, though donor-driven. The absence of data on 60-day follow up and feedback from the laboratory was a major problem with the system.

scholarly journals Protocol for the investigation of acute flaccid paralysis and suspected paralytic poliomyelitis

1997 ◽  
Vol 2 (6) ◽  
pp. 409-412 ◽  
Author(s):  
Adwoa Bentsi-Enchill ◽  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Clinical Symptoms ◽  
Incidental Finding ◽  
Wild Strain ◽  
Clinical Specimen ◽  
Polio Eradication ◽  
Flaccid Paralysis ◽  
Paralytic Poliomyelitis ◽  
Surveillance Program ◽  
Wild Poliovirus

Abstract Despite the elimination of indigenous wild poliovirus in Canada, ongoing surveillance for poliomyelitis is important because of the risk of wild virus importation from endemic regions. Most recently, importation of wild poliovirus into Canada occurred in 1993 and 1996,inboth instances with no associated clinical illness. Since 1991, the active surveillance of acute flaccid paralysis (AFP) in children less than 15 years old has been carried out in Canada to monitor for suspected cases of paralytic poliomyelitis. AFP surveillance is currently implemented through the Canadian Paediatric Surveillance Program. All suspected cases of paralytic poliomyelitis reported to the Laboratory Centre for Disease Control are evaluated by the national Working Group on Polio Eradication. The proper laboratory and neurological investigation of all AFP cases younger than 15 years old and suspected cases of poliomyelitis of any age is essential for the rapid detection of paralytic poliomyelitis, the most important clinical specimen for laboratory investigation being a stool sample collected within two weeks after the onset of paralysis for viral studies. This paper provides guidelines for investigating all suspected cases of paralytic poliomyelitis, including AFP cases less than 15 years old. Guidelines are also provided for reporting confirmed or suspected cases of paralytic poliomyelitis as well as the incidental finding of wild strain poliovirus, with or without any clinical symptoms.

scholarly journals Clinico-Epidemiological Study of Acute Flaccid Paralysis at a Tertiary Centre

2014 ◽  
Vol 34 (2) ◽  
pp. 104-110
Author(s):  
Shipra Chaudhary ◽  
Nisha Keshary Bhatta ◽  
Basudha Khanal ◽  
Rabin Bhandari ◽  
Rupa Rajbhandari Singh
Keyword(s):  
Respiratory Failure ◽  
Acute Flaccid Paralysis ◽  
Autonomic Failure ◽  
Polio Eradication ◽  
Case Definition ◽  
Flaccid Paralysis ◽  
Eastern Region ◽  
Tertiary Centre ◽  
Significant Difference ◽  
Afp Surveillance

Objectives: To study the clinico-epidemiological profile of different causes of Acute Flaccid Paralysis (AFP) including Acute Encephalitis Syndrome (AES) and their associated co-morbidities. Methodology: A prospective hospital-based study was carried out including all cases fulfilling AFP case definition. History, clinical examination, necessary investigations were performed and required treatment given. Regular follow-ups were done and final classification made alongwith AFP surveillance team. Results: Out of 43 children included in the study, 18 expired and 25 completed follow-up. Final classification showed 53.5% AES, 9.3% Guillain Barre Syndrome (GBS), 9.3% dyselectrolytemia, 9.3%, peripheral neuritis, 7% Non-Polio Entero Virus (NPEV) and 11.6% others. Fever, altered sensorium and convulsions were present in 79.1%, 65.1% and 58.1% respectively. Eighty-four percent had asymmetrical paralysis with quadriparesis in 72%. Cerebrospinal fluid was abnormal in 34.9%. Japanese encephalitis serology was positive in 4.7%.  The mean GCS was 9.53±4.27 with a significant difference between survivors and non-survivors (p=0.02). Almost half (52.2%) required ICU care, of which 14 expired (p=0.005). Seventeen children needed mechanical ventilation, of which 13 died (p<0.001). Requirement of inotropes and complications like respiratory failure and autonomic failure were significantly related to death. Conclusion: AES, being one of the commonest causes of AFP, should be included in AFP surveillance. Poor GCS, requirement of inotropes, complications like respiratory failure and autonomic failure are related with poor prognosis. This study also helped in national surveillance of AFP cases in the eastern region and the target to achieve polio eradication in our country.doi: http://dx.doi.org/10.3126/jnps.v34i2.9794J Nepal Paediatr Soc 2014;34(2):104-110 

scholarly journals Laboratory-based Acute Flaccid Paralysis surveillance pre-polio free certification: Indonesia experience, 2003-2013

2019 ◽  
Vol 10 (1) ◽  
pp. 8-14
Author(s):  
Nike Susanti ◽  
Herna Herna
Keyword(s):  
Acute Flaccid Paralysis ◽  
Virus Transmission ◽  
Flaccid Paralysis ◽  
Microsoft Excel ◽  
Wild Poliovirus ◽  
Acute Flaccid Paralysis Surveillance ◽  
Directorate General ◽  
Good Laboratory ◽  
Afp Surveillance

Latar belakang: Virus Polio Liar dapat menyebabkan kelumpuhan dan dapat dicegah dengan imunisasi. Untuk memonitor transmisi virus polio liar dilakukan surveilans Acute Flaccid Paralysis (AFP) dan investigasi laboratorium yang telah dimulai sejak tahun 1995 di Indonesia. Virus polio liar Indigenous terakhir ditemukan di Indonesia tahun 1995. Indonesia masih memiliki ancaman importasi virus polio liar dari negara endemis dan mutasi virus polio dari vaksin yang menyebakan kelumpuhan yang sama seperti virus polio liar. Artikel ini bertujuan untuk memberikan gambaran mengenai surveilans AFP berbasis laboratorium di Indonesia pada tahun 2003-2013 sehingga mengantarkan Indonesia sebagai negara bebas polio pada tahun 2014. Metode: Data yang dianalisis adalah data kasus AFP seluruh Indonesia periode tahun 2003-2013. Data didapat dari laboratorium jejaring laboratorium Polio di Jakarta, Bandung, Surabaya dan Sub Direktorat Surveilans, Direktorat Surveilans dan Karantina Kesehatan, Direktorat Jenderal Pencegahan dan Pengendalian Penyakit. Data di analisis menggunakan program Microsoft Excel. Hasil: Sebanyak 305 kasus AFP yang disebabkan oleh infeksi virus polio liar tipe 1 impor ditemukan pada tahun 2005 dan 2006. Terdapat 39 kasus AFP yang disebabkan cVDPV tipe 1 ditemukan di Pulau Madura pada tahun 2005. Virus polio liar tipe 1 hanya ditemukan di pulau Sumatera dan Jawa. Penyebaran Virus polio berhasil dihentikan pada tahun 2006 dan sudah tidak ditemukan lagi hingga tahun 2013. Kesimpulan: Surveilans AFP berbasis laboratorium yang baik berhasil memantau dan mendeteksi sirkulasi virus polio. Peningkatan kinerja surveillance AFP diperlukan untuk membuktikan terhentinya transmisi virus polio sehingga eradikasi polio secara global dapat diraih.  Kata kunci: surveilans, laboratorium polio, Acute Flaccid Paralysis   Abstract Background: Wild Poliovirus can cause flaccid paralysis and can be prevented by immunization. To monitor wild polio virus transmission, Acute Flaccid Paralysis (AFP) surveillance and laboratory investigations was initiated in 1995 in Indonesia. The last indigenous wild poliovirus found at 1995 in Indonesia. Indonesia still has the threat of imported wild polio viruses from endemic countries and poliovirus mutation from vaccine that can cause paralytic as well as wild poliovirus. The aim of this article is to describe the laboratory-based AFP surveillance in Indonesia from 2003-2013 so that it had led the Indonesia certified for polio free in 2014. Methods: Data analysis performed on AFP cases data from all provinces in Indonesia period of 2013-2014. Data were collected from polio laboratories network in Jakarta, Bandung, Surabaya and the Sub Directorate of Surveillance, Directorate of Surveillance and Health Quarantine, Directorate General of Disease Prevention and Control. Data were analyzed using Microsoft Excel program. Results: 305 paralysis cases were caused by imported type 1 wild poliovirus infection were found in 2005 and 2006. 39 paralysis cases caused by type 1 cVDPV infection were also found on Madura Island in 2005. Type 1 wild polioviruses only found on the Sumatra and Java island. The wild poliovirus transmission was stopped in 2006 and was no longer found until 2013. Conclusion: Good laboratory-based AFP surveillance has been successfully monitoring and detecting the circulation of the poliovirus. Improved AFP surveillance performance is needed to prove cessation of poliovirus transmission so that eradication of poliovirus can be achieved globally. Keywords: surveillance, polio laboratory, Acute Flaccid Paralysis

scholarly journals Cases of Acute Flaccid Paralysis Associated with Coxsackievirus A2: Findings of a 20-Year Surveillance in the Russian Federation

2022 ◽  
Vol 10 (1) ◽  
pp. 112
Author(s):  
Olga E. Ivanova ◽  
Armen K. Shakaryan ◽  
Nadezhda S. Morozova ◽  
Yulia A. Vakulenko ◽  
Tatyana P. Eremeeva ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Laboratory Data ◽  
Foot And Mouth Disease ◽  
Polio Eradication ◽  
Vaccination Schedule ◽  
Flaccid Paralysis ◽  
Global Polio Eradication Initiative ◽  
Afp Surveillance ◽  
Stool Samples ◽  
The Russian Federation

Surveillance for acute flaccid paralysis syndrome (AFP) in children under 15 is the backbone of the Global Polio Eradication Initiative. Laboratory examination of stool samples from AFP cases allows the detection of, along with polioviruses, a variety of non-polio enteroviruses (NPEV). The etiological significance of these viruses in the occurrence of AFP cases has been definitively established only for enteroviruses A71 and D68. Enterovirus Coxsackie A2 (CVA2) is most often associated with vesicular pharyngitis and hand, foot and mouth disease. Among 7280 AFP cases registered in Russia over 20 years (2001–2020), CVA2 was isolated only from five cases. However, these included three children aged 3 to 4 years, without overt immune deficiency, immunized with 4–5 doses of poliovirus vaccine in accordance with the National Vaccination Schedule. The disease resulted in persistent residual paralysis. Clinical and laboratory data corresponded to poliomyelitis developing during poliovirus infection. These findings are compatible with CVA2 being the cause of AFP. Molecular analysis of CVA2 from these patients and a number of AFP cases in other countries did not reveal association with a specific phylogenetic group, suggesting that virus genetics is unlikely to explain the pathogenic profile. The overall results highlight the value of AFP surveillance not just for polio control but for studies of uncommon AFP agents.

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