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- 1. Guidelines For Clinicians In Polio EradicationBy Dr. MAHASEN IBRAHIM ASSISSTENT PROFESSION FOR PUBLIC HEALTH
- Inspired by the success of global smallpox eradication and poliomyelitis control in the Americas, the World Health Assembly made a commitment in 1988 to eradicate polio by 2000 .
- Strategies for eradication:
- high infant immunization coveragewith four doses of oral poliovirus vaccine (OPV) in the first year of life & high quality SIA.
- surveillance for wild poliovirusthrough reporting all acute flaccid paralysis (AFP) cases among children under fifteen years of age, with laboratory testing of two stool samples from at least 80%of cases .
4. 5. 6. 7. 1- Efforts done to rise vaccination coverage and reach children in remote areas 8. 9. 10. 11.
- Surveillance For Wild Poliovirus Through:
- reporting all cases with acute flaccid paralysis in children up to 15 years of age, or any age when polio is suspected.
- reporting to the preventive health doctor must be within 24 hours of case detection.
- surveillance for wild poliovirus through:
- and laboratory testing of two stool samples
- (samples to becollected within the first 14 days of paralysis onset , 24 hours apart and the first sample must be collected within 48 hours of case detection)
- since The Global Polio Eradication Initiative launch in 1988, over 2 billion children have been immunized and a 99 percent reduction in polio has been achieved .
14. Polio endemic and importation countries in 2010 15. 16. Certification is conducted on a regional basis. Each region can consider certification only when all countries in the region demonstrate the absence of wild poliovirus transmission for at least three consecutive years. 17. In polio-free regions: What is required to achieve global certification? 18.
- Maintain certification-standard surveillancefor acute flaccid paralysis.
19. What iscertification standard surveillance ? 20.
- the ability to detect annually at least 2 cases of non-polio acute flaccid paralysis (AFP) for every 100 000 children under 15 years of age.
- two stool specimens (collected within the first 14 days of paralysis onset) must be collected from at least 80% of cases of acute flaccid paralysis and all specimens should be processed at a WHO accredited laboratory .
- Ensure highest possible immunity levels against wild poliovirus (maintenance of high vaccination coverage).
- Develop actionplans for responding rapidly to importationsof wild poliovirus.
- Any child under the age of fifteen years presenting with acute flaccid paralysis (including cases diagnosed as Guillian Barre Syndrome ) or any person of any age with paralytic illness if poliomyelitis is suspected .
25. Role Of Physicians In AFP Surveillance System 26. Notify immediately ( by phone within 24 hours ) to the preventive health sector any case presented with rapidly progressing weakness or flaccid paralysis including GBS in a child aging up to 15 years of age
- Notify preventive health doctor
27. Two stool samples with at least 24 hours in betweenmust be collected from the case within the first 14 days of paralysis onset = adequate samples.
- 2 stool samples in first 14 days
- It must be :
- within 48 hours of case detection
- clinical, neurological (with NCSEMG) and virological investigation ( including stool samples for virologic study)
- Why it is important to immediately investigate the reported case?
- Polio is a public health emergency---a highly communicable disease.
- Do not want to lose the case.
- Must start stool collection process.
- Weekly zero report
If you didn't see any case in a week please fulfill the weekly zero report for poliomyelitis and AFP cases by writing zero in each cell. 31. Neurological assessment of the case with EMG & NCS
- EMG & NCS
32. do follow up examinationto assess the presence of paralysis after 60 days of onset.
- Follow up at 60 days
33. Fulfill data of national case documentation forms.
- Case documentations
34. YOU THANK