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India - Acute Flaccid Paralysis 2014

Ronan Kelly

Ronan Kelly

Retired 2020
Link to previous thread - Acute Flaccid Paralysis in India March 2012 - Dec 2013
****SEARO took over the publication of the Polio Bulletin in June 2014. Prior links may not work. Try this page - http://www.searo.who.int/india/topics/poliomyelitis/en/
India.webp

http://www.npspindia.org/bulletin.pdf
 
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Re: India - Acute Flaccid Paralysis 2014

google translated;

Symptoms of polio in Shillai
Paonta Sahib - the Gram Panchayat Development Block Shillai Ashyadi a seven- year-old children were found to have signs of the disease such as polio . After coming to the Department of Health of the matter is stirred . According to the Department by sending information relating to other children in the village departmental team Anderkhate process is under investigation . Ashyadi past the village's seven -year-old boy had fever . Kin took Nahan district hospital for treatment , where PGI Chandigarh lad was sent off after a few trials . At the moment the child is undergoing treatment at PGI Chandigarh and is said to be in a coma . According to information reaching the hospital after child Nahan district health Mukyayl Shillai Bimo affect the health of the children of the village were ordered to investigate . However, vigilance department in terms of the process is the process of being told . Hrmohindra Sirmour CMO Dr. Singh said the possibility of polio in children is 0.1 of a percentage . Such cases are called AFP case . After visiting such case the department is cautious . Check the health of the children of the village is under extreme vigilance processes . February 14th, 2014
http://www.divyahimachal.com/top-news-and-stories/शिलाई-में-पोलियो-के-लक्षण/

Comment - There are 50,000+ cases of AFP in India each year so this is probably not Polio. - Ro
 
Re: India - Acute Flaccid Paralysis 2014

Characterization of the Non-Polio Enterovirus Infections Associated with Acute Flaccid Paralysis in South-Western India
Rongala Laxmivandana,

Prasanna Yergolkar,

Varanasi Gopalkrishna,

Shobha D. Chitambar mail


Published: April 22, 2013DOI: 10.1371/journal.pone.0061650

Abstract

Non-polio enteroviruses (NPEVs) have been reported frequently in association with acute flaccid paralysis (AFP) cases during Polio Surveillance Programs (PSPs) worldwide. However, there is limited understanding on the attributes of their infections. This study reports characteristics of NPEVs isolated from AFP cases, investigated during PSPs held in 2009?2010, in Karnataka and Kerala states of south-western India having varied climatic conditions. NPEV cell culture isolates derived from stool specimens that were collected from 422 of 2186 AFP cases (<1?14 years age) and 17 of 41 asymptomatic contacts; and details of all AFP cases/contacts were obtained from National Polio Laboratory, Bangalore. The distribution of NPEV infections among AFP cases and circulation pattern of NPEV strains were determined by statistical analysis of the data. Genotyping of all NPEV isolates was carried out by partial VP1 gene sequencing and phylogenetic analysis. NPEV positive AFP cases were significantly higher in children aged <2 years; with residual paralysis; in summer months; and in regions with relatively hot climate. Genotyping of NPEVs identified predominance of human enteroviruses (HEV)-B species [81.9%?Echoviruses (E): 57.3%; coxsackieviruses (CV) B: 15%; numbered EVs: 8.9%; CVA9: 0.7%] and low levels of HEV-A [14.5%?CVA: 6%; numbered EVs: 8.5%] and HEV-C [3.6%?CVA: 2.6%; numbered EVs: 1%] species, encompassing 63 genotypes. EV76 (6.3%) and each of E3, CVB3 and E9 (4.97%) were found frequently during 2009 while E11 (6.7%), CVB1 (6.1%), E7 (5.1%) and E20 (5.1%) were detected commonly in 2010. A marked proportion of AFP cases from children aged <2 years; presenting with fever; and from north and south interior parts of Karnataka state was detected with E/numbered EVs than that found with CVA/CVB. This study highlights the extensive genetic diversity and diverse circulation patterns of NPEV strains in AFP cases from different populations and climatic conditions.
...
journal.pone.0061650.g003.webp
full open access paper at http://www.plosone.org/article/info:doi/10.1371/journal.pone.0061650
 
Re: India - Acute Flaccid Paralysis 2014

Antigenic Diversity of Enteroviruses Associated with Nonpolio Acute Flaccid Paralysis, India, 2007?2009


C. Durga Rao Comments to Author , Prasanna Yergolkar1, and K. Subbanna Shankarappa12
Author affiliations: Author affiliations: Indian Institute of Science, Bangalore, India (C.D. Rao, K.S. Shankarappa); National Institute of Virology?World Health Organization?South East Asia Region Polio Laboratory Network, Victoria Hospital, Bangalore (P. Yergolkar); National Institute of Virology, Bangalore (P. Yergolkar); Victoria Hospital, Bangalore (P. Yergolkar)

Abstract
Because of the broadened acute flacid paralysis (AFP) definition and enhanced surveillance, many nonpolio AFP (NP-AFP) cases have been reported in India since 2005. To determine the spectrum of nonpolio enterovirus (NPEV) serotypes associated with NP-AFP from polio-endemic and -free regions, we studied antigenic diversity of AFP-associated NPEVs. Of fecal specimens from 2,786 children with NP-AFP in 1 polio-endemic and 2 polio-free states, 823 (29.5%) were positive for NPEVs in RD cells, of which 532 (64.6%) were positive by viral protein 1 reverse transcription PCR. We identified 66 serotypes among 581 isolates, with enterovirus 71 most frequently (8.43%) detected, followed by enterovirus 13 (7.1%) and coxsackievirus B5 (5.0%). Most strains within a serotype represented new genogropups or subgenogroups. Agents for ≈35.0% and 70.0% of culture-positive and -negative cases, respectively, need to be identified. Association of human enterovirus with NP-AFP requires better assessment and understanding of health risks of NPEV infections after polio elimination.
...
http://wwwnc.cdc.gov/eid/article/18/11/11-1457_article.htm
 
Re: India - Acute Flaccid Paralysis 2014

Source: http://timesofindia.indiatimes.com/...to-Kolhapur-hospital/articleshow/34844520.cms

Suspected polio patient shifted to Kolhapur hospital
Nikhil Deshmukh,TNN | May 9, 2014, 12.35 AM IST

KOLHAPUR: A 12-year-boy from Aanur village in Kagal tehsil of Kolhapur district has been found with polio-like symptoms, reported the primary health centre. The PHC located in Chikhali village of Kagal tehsil has reported the case to its senior officers.

The boy complained of pain in his legs on April 29 and was taken to the Chikhali-based PHC. After check up, the local medical officers asked the parents to shift him to a city-based hospital with better facilities. The family took him to a private hospital in Nipani on April 30. The local medical officers asked the family to shift the boy to Kolhapur for further treatment and he was shifted to a Kolhapur private hospital the next day.

The district health officer, after receiving a report from the PHC, sent a team to the private hospital and collected the samples of the boy on May 3. The samples were sent to the Haffkin Institute in Mumbai on May 4 and the report is expected within 15 days...
 
Re: India - Acute Flaccid Paralysis 2014

Got a case of polio vaccine
Published: Tue, 03 Jun two thousand and fourteen 12:30 AM (IST) | Updated: Tue, 03 Jun 2 014 12:30 AM (IST)By: Editorial Team

In the case of polio vaccine came Bastar. India has been declared polio-free country, in which case it is questioning this claim. The polio virus medical authorities are not saying this environment.

The Health Department is claiming that Chhaprbanpuri gram block of the district's four-year-old Bharat father Tokapal stocking during the campaign was given frequent doses of polio vaccine. Meanwhile, the boy suddenly fell two months ago and his extremities were numb.

After admission to Mecoj doctors expressed fears of polio in India stool (feces) and other regional polio lab samples were sent for testing in Kolkata.

The report from the Veedeepivi (Deraiwhd poliovirus vaccine) was confirmed by the treatment of the child, and he is now healthy.

The possibility of an episode in a million

According to experts in child Bharat caused by viruses that are found in the area but did not show signs of polio polio vaccine (live virus) because it happened. The polio vaccine is administered to children in a million of them so that the possibility of being called Veedeepivi. According to Dr. C. Matriy Dhamtari and Mahasamund district in the year 2013 has seen the episode.

Be re-vaccination

The highlight of the episode after the Department of Health during the pulse polio campaign cent - per claim in question are supplying vaccine to children. While in office Chhaprbanpuri Mapap round (More) polio vaccination campaign. Children aged zero to five years on the pattern of PPI drug is given in two cycles. Not only informed of such cases against polio and all segments of the district medical officer, doctors have been given special training.

When the body vulnerable to attack

Such cases are very rare.

Wild polio virus is not it. The polio vaccine is given to a child and the child is not immune to the disease, then such a situation arise. The polio virus is not related to the issue of child Bastar.

- Dr. Subhash Pandey, state immunization officer Raipur

Two months ago a tad Tokapal block district of Kolkata Regional Lab Veedeepivi polio was confirmed. Subsequently, the child was provided with treatment in Mapap vaccination rounds. Bharat child is now fully healthy after treatment.

- Dr. C. Matriy, District Immunization Officer

- See more at: http://naidunia.jagran.com/chhattisgarh/jagdalpur-jagdalpur-news-104827#sthash.4WyZRK13.dpuf
 
Re: India - Acute Flaccid Paralysis 2014

Mosquito-borne virus shows polio-like symptoms
Umesh Isalkar,TNN | Jun 14, 2014, 05.31 AM IST

PUNE: Two months after the country earned its polio-free tag, a mosquito has emerged as a fresh concern. Mosquito-borne West Nile virus has been found to be causing acute flaccid paralysis (AFP), the main symptom of poliomyelitis, for the first time in India. The symptom is the most common sign of acute polio and is used for surveillance during polio outbreaks.

However, unlike polio which is a childhood disease, West Nile induced AFP is seen in adults. So, the finding is not going to undermine the success of polio-free certification, say researchers, but is still reason for concern. Nationwide AFP surveillance is the gold standard to detect polio cases.
...
The case reports of three patients, all in the age bracket of 42 to 55 years, have the doctors flummoxed. The three patients were suffering from extreme muscle weakness of limbs, reduced muscle tone, impaired breathing and fever which are primarily the characteristics of polio.

Only after running blood tests and performing a battery of radiology tests that record activity in nerves and in spinal cord cells, did the doctor reach their diagnosis: AFP caused by West Nile virus.

"Previously, severe cases of West Nile had been characterised by meningitis and encephalitis, the brain swelling that is regarded as the most serious consequence of the virus. But the muscle weakness and other problems associated with AFP were not evident," said Arunkumar.
...
http://timesofindia.indiatimes.com/...-polio-like-symptoms/articleshow/36517803.cms

CASE REPORT
Year : 2014 | Volume : 17 | Issue : 1 | Page : 85-88

Acute flaccid paralysis due to West nile virus infection in adults: A paradigm shift entity

Boby Varkey Maramattom1, Geetha Philips2, Nittur Sudheesh3, Govindakarnavar Arunkumar3
1 Department of Neurology, Lourdes Hospital, Kochi, Kerala, India
2 Department of Internal Medicine, Lourdes Hospital, Kochi, Kerala, India
3 Manipal Centre for Virus Research (ICMR Virus Diagnostic Laboratory-Grade-I), Manipal University, Madhavnagar, Manipal, Karnataka, India

Date of Submission 22-Jun-2013
Date of Decision 03-Aug-2013
Date of Acceptance 12-Aug-2013
Date of Web Publication 12-Mar-2014
Correspondence Address:
Boby Varkey Maramattom
Department of Neurology, Lourdes Hospital, Kochi, Kerala- 682 006
India
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DOI: 10.4103/0972-2327.128561

PMID: 24753667

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Abstract
Three cases of acute flaccid paralysis (AFP) with preceding fever are described. One patient had a quadriparesis with a florid meningoencephalitic picture and the other two had asymmetric flaccid paralysis with fasciculations at the onset of illness. Magnetic resonance imaging in two cases showed prominent hyperintensitities in the spinal cord and brainstem with prominent involvement of the grey horn (polio-myelitis). Cerebrospinal fluid (CSF) polymerase chain reaction was positive for West Nile virus (WNV) in the index patient. All three cases had a positive WNV immunoglobulin M antibody in serum/CSF and significantly high titer of WNV neutralizing antibody in serum, clearly distinguishing the infection from other Flaviviridae such as Japanese encephalitis. WNV has been recognized in India for many decades; however, AFP has not been adequately described. WNV is a flavivirus that is spread by Culex mosquitoes while they take blood meals from humans and lineage 1 is capable of causing a devastating neuro-invasive disease with fatal consequences or severe morbidity. We describe the first three laboratory confirmed cases of WNV induced AFP from Kerala and briefly enumerate the salient features of this emerging threat.
...
Maramattom BV, Philips G, Sudheesh N, Arunkumar G. Acute flaccid paralysis due to West nile virus infection in adults: A paradigm shift entity. Ann Indian Acad Neurol [serial online] 2014 [cited 2014 Jun 14];17:85-8. Available from: http://www.annalsofian.org/text.asp?2014/17/1/85/128561
 
Re: India - Acute Flaccid Paralysis 2014

week 24 report; http://www.searo.who.int/india/topics/poliomyelitis/afpsurveillancebulletin_20june2014.pdf?ua=1

India.webp

West Nile Virus and Polio-like Syndromes: An Emerging Threat
Posted by Pranab Chatterjee on June 21, 2014 in Public Health
ResearchBlogging.org
While the whole nation has been gripped by a media-induced frenzy about the fatal effects of the so-called ?litchi virus? (do not get me started on this! This issue deserves a whole post of its own!), another virus-related news has quietly slipped beneath the radars of the cumulative hysteria. This article in the Times of India has implicated the West Nile Virus as the causative agent of acute flaccid paralysis which has historically been associated with the polio virus. India has earned the polio-eradicated status a couple months ago and now is under a new threat from another virus that causes similar issues.

Notably, the three patients who have been diagnosed to have been afflicted with WNV-associated poliomyelitis-like syndrome are all adults, aged between 42 and 55 years. In India, polio coverage was targeted at children only, and surveillance included adolescents aged up to 15 years. In this connection, if I can recollect correctly, Namibia is the only country that has previously faced the threat of adult poliomyelitis with patients in their 50s being struck down by the polio virus. Anyways. Coming back to this issue. If the newspaper article is to be believed, then the leading neurologists seem to have been flummoxed by this change in pathological behaviour of the WNV. While this is a rare presentation, it is not entirely unheard of. In 2002, there were letters published in the NEJM (1,2) that clearly spoke of a poliomyelitis-like condition arising from a WNV infection.
...
http://scepticemia.com/2014/06/21/west-nile-virus-and-polio-like-syndromes-an-emerging-threat/
 
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