Poliomyelitis (acute flaccid paralysis)

A80.3

*Notifiable condition

• Description
• Diagnostic criteria
• General and supportive measures
• Referral

Also see Inflammatory Polyneuropathy (Guillain-Barré Syndrome) .

DESCRIPTION

Poliomyelitis is eradicated in South Africa. Most cases of acute flaccid paralysis (AFP) are caused by Guillain-Barré Syndrome, but all cases of AFP must be notified as the clinical signs are indistinguishable.

DIAGNOSTIC CRITERIA

Clinical

• Suspect in all children with acute flaccid paralysis, often asymmetrical with intact sensation.

Investigations

• Send two stool specimens (on ice) taken 24–48 hours apart to the NICD via the local laboratory.

GENERAL AND SUPPORTIVE MEASURES

• Isolate patient to prevent faecal-oral spread.
• Rehabilitative measures:
  • Most patients need physiotherapy and occupational therapy.

REFERRAL

• Discuss all cases with a specialist.
• Children requiring intensive care if none is available on site.