Acute flaccid paralysis is only a possible symptom of polio and not a conclusive trait, says health administrator
Less than 24 hours after a prominent national newspaper sparked off worldwide concern by reporting that polio had reappeared in India just a fortnight after it had been reported as eradicated, a top health administrator has lashed out at the media for misreporting the issue.
“Incorrect and unsubstantiated information can be a major setback for any programme,” said Anuradha Gupta, Additional Secretary, Ministry of Health and Family Welfare, who is in charge of polio eradication. “These reports are not only inaccurate, but also misleading and de-motivating for the polio workforce, who are working extremely hard to make India polio-free,” she said.
The Hindustan Times on Tuesday reported that an 18-month-old girl had been admitted to a government-run hospital in Kolkata with suspected polio. The child, hailing from South 24 Parganas district in West Bengal, showed symptoms of partial paralysis with movement disability, known in medical parlance as acute flaccid paralysis, or AFP — a possible symptom of polio.
Ms. Gupta's said the child's case was one of over 8,000 AFP cases to have been investigated by the National Polio Surveillance Project (NPSP) with the support of local health authorities since January 1 this year. Every one of these AFP cases had tested negative for polio.
“It is important to understand that polio is one of the several causes of AFP and not the only cause for AFP. It is incorrect to call an AFP case a polio case until confirmed by laboratory test,” she said. Over 35,000 reporting units across the country reported 60,782 children with AFP cases, which were followed up and investigated by the laboratories in the year 2011. Only one tested positive for polio, in Howrah district of West Bengal in January, 2011.
The child's stool samples were sent to the National Institute of Virology, Pune, and the School of Tropical Medicine, Kolkata; the test results are expected next week.
Media frenzy
International media, among them The Guardian and The Wall Street Journal, had been quick to pick up the story and splash it across the globe. “Child's paralysis sparks fears that India will fail in mission to be declared free of polio following removal from ‘endemic' list,” The Guardian wrote.
However, the report — like others in the international media — made no reference to the nature of AFP, or the context of the case. The next day, The Guardian ran a fresh story incorporating a rebuttal issued by the Ministry of Health.
Continued threat
Ms. Gupta said, however, that there were continued threats to India's polio-free status. Since Pakistan is yet to eradicate the disease, India has a serious threat of importing polio cases from across the border. Five booths have been set up along the India-Pakistan border for continuous vaccination of children up to 5 years who were crossing into India.
“We need to continue our efforts to eradicate polio. We need to ensure that all children up to the age of five are protected against polio until the disease is eradicated completely,” Ms. Gupta said.
India has a highly sensitive surveillance system that is capable of rapidly picking up cases of polio anywhere in the country. As part of surveillance, any child under 15 who suddenly develops floppiness or weakness or paralysis in any part of the body is investigated. AFP cases have to be tested to rule out polio as a cause of the illness.
The environmental surveillance of sewage samples is being tested for detection of the polio virus in Mumbai, Delhi, Patna and Kolkata.
Keywords: Polio, polio immunisation drive, polio-endemic country, Global Polio Eradication Initiative, National Polio Surveillance Project, acute flaccid paralysis



I'm super puzzled. There are over 60,000 cases of AFP, this means that a huge number of children are paralyzed or partially paralyzed and will be struggling for the rest of their lives. And this is okay? As long as the paralysis is caused by something else and not polio? Do these kids get treatment? Is anyone trying to figure out what is causing all this AFP? Is anyone trying to prevent future cases of AFP? Bizarre situation. Makes no sense at all.
It is heartening that India has remained polio-free since Jan 2011. Ms Anuradha Gupta, Additional Secretary, Ministry of Health and Family Welfare, in charge of polio eradication has repeatedly stressed the measures initiated by India to prevent entry of WPV from Pakistan. We have to potect all fronts; however,historically WPV from Pakistan has never crossed the border (and vice versa. It is African WPV that has higher potential to enter our country, and cause an outbreak. International airports are weak spots, and enforcement of OPV(with associated risk of VAPP/VDPV) at international airports has diplomatic implications. India should ensure that all children less than 5 years enetering India are imminised against polio. We should also provide facilities for Injectable Polio vaccine (IPV) (OPV may not be acceptable to visitors from developed nations that have swithed to IPV for routine immunzation) to those reporting without a valid proof of immunization.
Media should be more circumspect while reporoting any news especially those that have far-reaching importance. The HT did a signal disservice by reporting unconfirmed news abbout polio. In my opinion The Press Council should pull-up the HT.
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