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8. Viral diseases
Patients with acute flaccid paralysis (AFP)
– C o nsid er all p atients with A F P as susp ected cases o f p o lio m y elitis.
– C o nfirm the d iagno sis by iso lating the virus: send the 2 sto o l sam p les to a reference
labo rato ry , with a clinical d escrip tio n o f the p atient. The sto o l sam p les m ust be sto red
and transp o rted between 0 °C and 8 °C .
– W hile waiting fo r labo rato ry co nfirm atio n, vaccinate all child ren und er 5 y ears o f age
living in the area (fro m the sam e village o r neighbo uring villages) , irresp ective o f
their vaccinatio n status.
– O nce the case is co nfirm ed , o rganiz e a m ass vaccinatio n cam p aign: the area and the
age gro up are d eterm ined as a functio n o f ep id em io lo gical d ata.
– S urveillance: fo r each case o f A F P there are between 1 0 0 and 2 0 0 subclinical cases.
Therefo re, active surveillance to d etect new cases is essential fo r ep id em ic co ntro l.
Prevention
– 2 ty p es o f vaccines exist:
• an injectable inactivated p o lio virus vaccine (I P V )
• a trivalent o ral attenuated p o lio virus vaccine (O P V )
In d evelo p ing co untries and d uring p o lio m y elitis erad icatio n cam p aigns, the O P V is
reco m m end ed fo r eco no m ic reaso ns, ease o f ad m inistratio n and p articularly fo r
ep id em io lo gical reaso ns: it ind uces a rap id intestinal im m unity (ep id em ic) and gro up
p ro tectio n d ue to its seco nd ary d iffusio n into the natural enviro nm ent
– V accinatio n sched ule with O P V
The W H O reco m m end s 4 d o ses befo re 1 y ear o f age:
Primary vaccination Booster doses
B irth O P V -0 * 8
6 week s O P V -1
1 0 week s O P V -2 O ne y ear after the last d o se
1 4 week s O P V -3 and at the age o f 6 y ears
* I f the first d o se (O P V -0 ) is no t ad m inistered at birth, giveth the 4 d o se a m inim um o
1 m o nth after therd3 d o se, fo r exam p le at the sam e tim e as m easles vaccinatio n.
193
Patients with acute flaccid paralysis (AFP)
– C o nsid er all p atients with A F P as susp ected cases o f p o lio m y elitis.
– C o nfirm the d iagno sis by iso lating the virus: send the 2 sto o l sam p les to a reference
labo rato ry , with a clinical d escrip tio n o f the p atient. The sto o l sam p les m ust be sto red
and transp o rted between 0 °C and 8 °C .
– W hile waiting fo r labo rato ry co nfirm atio n, vaccinate all child ren und er 5 y ears o f age
living in the area (fro m the sam e village o r neighbo uring villages) , irresp ective o f
their vaccinatio n status.
– O nce the case is co nfirm ed , o rganiz e a m ass vaccinatio n cam p aign: the area and the
age gro up are d eterm ined as a functio n o f ep id em io lo gical d ata.
– S urveillance: fo r each case o f A F P there are between 1 0 0 and 2 0 0 subclinical cases.
Therefo re, active surveillance to d etect new cases is essential fo r ep id em ic co ntro l.
Prevention
– 2 ty p es o f vaccines exist:
• an injectable inactivated p o lio virus vaccine (I P V )
• a trivalent o ral attenuated p o lio virus vaccine (O P V )
In d evelo p ing co untries and d uring p o lio m y elitis erad icatio n cam p aigns, the O P V is
reco m m end ed fo r eco no m ic reaso ns, ease o f ad m inistratio n and p articularly fo r
ep id em io lo gical reaso ns: it ind uces a rap id intestinal im m unity (ep id em ic) and gro up
p ro tectio n d ue to its seco nd ary d iffusio n into the natural enviro nm ent
– V accinatio n sched ule with O P V
The W H O reco m m end s 4 d o ses befo re 1 y ear o f age:
Primary vaccination Booster doses
B irth O P V -0 * 8
6 week s O P V -1
1 0 week s O P V -2 O ne y ear after the last d o se
1 4 week s O P V -3 and at the age o f 6 y ears
* I f the first d o se (O P V -0 ) is no t ad m inistered at birth, giveth the 4 d o se a m inim um o
1 m o nth after therd3 d o se, fo r exam p le at the sam e tim e as m easles vaccinatio n.
193
