Non-paralytic polio has been classified as “Immediately notifiable, Urgent,” which requires that local and state health departments contact CDC within 24 hours.ĬDC (Emergency Operations Center, 77) will provide consultation regarding: Paralytic polio has been classified as “Immediately notifiable, Extremely Urgent,” which requires that local and state health departments contact CDC within 4 hours. For more information see CDC poliomyelitis guidelines for epidemiologic, clinical, and laboratory investigations of AFP to rule out poliovirus infection. The rapid investigation of suspected polio cases is critical to identifying possible poliovirus transmission and implementing proper control measures. For questions, contact the CDC Emergency Operations Center at 77.Store specimens at –20 degrees celsius and ship frozen.Collect appropriate stools (whole stool) and throat specimens (OP swab): 2 specimens of each taken at least 24 hours apart during the first 14 days after onset of paralytic disease.Work with the state and local health department to order poliovirus testing:.Contact the state or local health department immediately to report a patient with suspected poliomyelitis. Poliomyelitis has been classified as immediately notifiable, extremely urgent.Evaluate the patient for flaccid weakness and document tone, reflexes, and muscle strength.Practice good hand hygiene and contact precautions when interacting with the patient.Only healthcare workers with evidence of complete polio vaccination should attend to the patient. Detection of poliovirus in CSF from confirmed polio cases is uncommon, and a negative CSF test result cannot be used to rule out polio.Ĭonsider polio in patients with polio-like symptoms, especially if the person is unvaccinated, incompletely vaccinated, recently traveled abroad to a place where polio still occurs, or was exposed to a person who recently traveled to one of these areas. Many patients with AFP will have a lumbar puncture and analysis of cerebrospinal fluid (CSF) performed as part of their evaluation. This is described as descending paralysis. Paralysis usually begins in the arm or leg on one side of the body (asymmetric) and then moves towards the end of the arm or leg (progresses to involve distal muscle groups). Polio Case Definition and DiagnosisĪ probable case of polio is defined as an acute onset of flaccid paralysis of one or more limbs with decreased or absent tendon reflexes in the affected limbs, without other apparent cause, and without sensory or cognitive loss. A study examining AFP in 245 children younger than 15 years in California from 1992-1998 found the most common diagnoses were Guillain-Barré Syndrome (23%), unspecified AFP (21%), and botulism (12%). However, AFP caused by these agents is very uncommon in the United States. Known viral causes of AFP include enterovirus, adenovirus, and West Nile virus. It can result from a variety of infectious and noninfectious causes. Even in the absence of laboratory-documented poliovirus infection, AFP is expected to occur at a rate of at least 1 per 100,000 children annually. Worldwide, children younger than 15 years are the age group at highest risk of developing polio and some other forms of AFP. Acute flaccid paralysis (AFP) is a manifestation of a wide spectrum of clinical diseases.
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