Related Experiment Videos
Poliomyelitis: 20 years--the Pondicherry experience
S Mahadevan1, S Ananthakrishnan, S Srinivasan
1Department of Pediatrics, Fawaharlal Institute of Post-Graduate Medical Education and Research, Pondicherry, India.
Insights
Lack of polio immunization and intramuscular injections in young children are key risk factors for acute poliomyelitis. Early oral polio vaccine (OPV) administration and avoiding unnecessary injections can help control this disease.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Poliomyelitis remains a significant public health concern in Southern India.
- A 20-year study period (1968-1987) observed 12,830 pediatric cases of acute poliomyelitis.
Purpose of the Study:
- To analyze trends, risk factors, and outcomes of acute poliomyelitis in children.
- To identify key preventive measures for poliomyelitis control.
Main Methods:
- Retrospective analysis of 12,830 pediatric poliomyelitis cases.
- Evaluation of vaccination status, age at onset, and clinical outcomes.
- Identification of risk factors including immunization status and injection history.
Main Results:
- The median age of onset decreased significantly over the study period.
- A high percentage of cases (66.3%) were unvaccinated, and 14.7% were vaccine failures.
- Intramuscular injections preceded poliomyelitis in 66% of cases, often linked to fever treatment.
- Mortality was 2.13%, primarily due to respiratory failure.
Conclusions:
- Lack of immunization and intramuscular injections during the pre-paralytic phase are critical risk factors.
- Timely oral polio vaccine (OPV) administration and avoidance of unnecessary injections in febrile children are essential for disease control.
Abstract:
During a 20-year period, 12,830 cases of acute poliomyelitis in children (aged 1 month-12 years) were seen in a South Indian teaching hospital (Pondicherry). Almost three-quarters (72.4%) of children were below the age of 2 years. The median age at onset of poliomyelitis shifted from 19.5 months (in the period 1968-1977) to 11 months (in the years 1978-1987). After 1981, epidemic peaks were noted every third year. 66.3% of cases had not received even a single dose of oral polio vaccine and 14.7% cases were vaccine failures (in the years 1983-1987). Provocation of poliomyelitis occurred in 66% of children and usually followed intragluteal injections associated with treatment of non-specific fevers. The overall mortality was 2.13%, the major cause of death being respiratory failure (60%). Polio virus type 1 was the major isolate among selected cases studied during 1983-1987. The risk factors identified in our study are lack of immunization and administration of intramuscular injections during the pre-paralytic phase. Ensuring early administration of multiple doses of oral polio vaccine to infants and avoiding intramuscular injections in young febrile children are important measures for the control of poliomyelitis--a continuing problem in Southern India.