The number of cases of acute flaccid paralysis (AFP) reported in the UK has increased to 57. The figure represents cases reported between 1 January 2018 and 24 September 2019. The majority of cases have been in children.
Increases in AFP have also been reported in Europe and the USA. It is not yet clear whether the increase in reports is a genuine increase in disease or because of improved detection and awareness.
In the past, AFP was commonly due to poliovirus infection. The success of the vaccination programme means that polio is now very rare internationally and has been eliminated in the UK. However, AFP may be linked with other viral infections including non-polio enteroviruses.
Updated national guidelines on the surveillance, investigation and management of suspected polio cases were published by Public Health England (PHE) this week. The document includes guidance on enhanced surveillance of enterovirus and suspected cases of AFP.
Advice is also given on the management of suspected cases and consideration of post-exposure prophylaxis, as well as appropriate sample collection for confirmation of infection and containment requirements for storage and usage of polio viruses for laboratory staff.
For patients with vaccine-related poliovirus 1 or 3, isolation is not required. However, for vaccine-related poliovirus 2 or potentially infectious materials containing vaccine-related poliovirus 2, patients should be isolated at home for a period of seven days if all testing is negative.
For wild-type polio or vaccine-derived polioviruses with confirmed virus/vaccine-derived poliovirus, isolation at home is sufficient provided compliance is good.
The full guidelines are available here.