Poliomyelitis in Oman: acute flaccid paralysis surveillance leading to early detection and rapid response to a type 3 outbreak

Countries are increasingly requesting guidance on carrying out acute flaccid paralysis (AFP) surveillance, aimed at detecting and confirming all cases of acute paralytic poliomyelitis. The experience of Oman provides many lessons in this respect. AFP surveillance in Oman was established systematical...

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Bibliographic Details
Published in:Bulletin of the World Health Organization 1994-11, Vol.72 (6), p.907-914
Main Authors: ROBERTSON, S. E, SULEIMAN, A. J. M, MEHTA, F. R, AL-DHAHRY, S. H. S, EL-BUALY, M. S
Format: Article
Language:English
Subjects:
Adolescent
Biological and medical sciences
Care and treatment
Child
Child, Preschool
Complications and side effects
Disease Outbreaks
Health aspects
Human viral diseases
Humans
Infant
Infant, Newborn
Infectious diseases
Medical sciences
Muscle Hypotonia
Oman - epidemiology
Paralysis
Paralysis - epidemiology
Paralysis - etiology
Poliomyelitis
Poliomyelitis - epidemiology
Poliomyelitis - prevention & control
Poliomyelitis - virology
Poliovirus - isolation & purification
Poliovirus Vaccine, Oral
Population Surveillance
Tropical medicine
Viral diseases
Viral diseases of the nervous system
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Summary:Countries are increasingly requesting guidance on carrying out acute flaccid paralysis (AFP) surveillance, aimed at detecting and confirming all cases of acute paralytic poliomyelitis. The experience of Oman provides many lessons in this respect. AFP surveillance in Oman was established systematically. First, an epidemiologist was assigned to coordinate surveillance, and a laboratory for performing polio-virus isolation was identified. Next, operational guidelines for AFP surveillance were developed and widely promoted among health staff. The quality of the system has been monitored for more than 3 years with selected performance indicators. From January 1990 to April 1993, 49 AFP cases were reported, corresponding to an average annual rate of 2.1 AFP cases per 100,000 children aged less than 15 years. A total of 98% of the AFP cases were investigated within 48 hours of being reported; two stool samples were obtained from 94% of the cases. Following complete investigation, nearly a third of the reported AFP cases were classified as being clinically compatible with Guillain-Barré syndrome. Four AFP cases, all reported in 1991, were confirmed to be due to wild type 3 poliovirus. Because AFP surveillance detected these cases rapidly, Oman was able to carry out outbreak control measures promptly and more than 350,000 extra doses of oral poliovirus vaccine were delivered to children under 6 years of age.
ISSN:0042-9686
1564-0604