Acute Flaccid Paralysis case investigation, Butaw District, Sinoe County, Liberia, August 2016
Thomas Paasawe1, Maame Amo-Addae1, Joseph Asamoah Frimpong1,&, Lily Sanvee Blebo1, Faith Kamara1
1Liberia Field Epidemiology Training Program, Monrovia, Liberia
Joseph Asamoah Frimpong, Liberia Field Epidemiology Training Program, Monrovia, Liberia
Acute Flaccid Paralysis (AFP) is characterized by sudden onset of weakness in one or more limbs. It is a common sign of acute poliomyelitis which is targeted for eradication by World Health Organization. AFP is used for surveillance of poliomyelitis but is also associated with a number of other pathogenic agents including enteroviruses, echoviruses, West Nile virus, and adenoviruses, among others. AFP is among the 14 priority conditions requiring immediate reporting in Liberia. On 28 September, 2016 a community health volunteer informed the Butaw District Health Team about a case of AFP. An investigation was conducted to verify the report, determine the cause and extent of the disease and take response actions or make recommendations.
we conducted physical assessment of the suspected case, collected two stool samples 24 hours apart for lab investigation, reviewed hospital records, interviewed parents and conducted active case search with the case definition: any child less than 15 years with sudden weakness in the leg or arm in Butaw District. We took actions and made recommendations based on findings.
the reported patient was a one year, two-month old female who developed sudden
weakness in both legs after she had walked at age 1 year. She was partially
vaccinated against poliomyelitis (received OPV 0, 1 and 2), with no history
of travel or contact with similar case. No other cases were identified in the
community or among the child’s contacts. Stool specimen tested negative for
polio but positive for non-polio enterovirus. At 60-day follow-up, paralysis
one case of AFP was verified in Butaw District, caused by non-polio enterovirus. Public education was conducted in the community on AFP, its causes and prevention. The need for proper fecal waste disposal and hand-washing was stressed. Child is being managed by clinicians and AFP surveillance on-going.
1st Ghana Field Epidemiology and Laboratory Training Programme Scientific conference (Accra)
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