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Suspected cases or outbreak of polio - guidance for management

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Management of suspected cases and outbreaks of polio

Since polio is increasingly rare and difficult to differentiate clinically from other diseases, cases of suspected paralytic illness, including other forms of acute flaccid paralysis such as Guillain-Barré syndrome and transverse myelitis, should be fully investigated as per the UK Standards for Microbiology Investigations (SMI) (http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/
1317133980627).

  • this should include two faecal samples for virology taken in the first week of illness, 24 to 48 hours apart. Ideally, faecal samples should also be obtained from household and other close contacts.
  • advice on the investigation and management of suspected cases is available from the Health Protection Agency Colindale (or Health Protection Scotland (HPS) in Scotland).

Suspected cases should be reported immediately to a consultant in communicable disease control (or consultant of public health medicine (CPHM) in Scotland) and should not await culture or other virological confirmation (1).

To prevent ongoing transmission,

  • IPV-containing vaccine should be administered to household contacts of people with suspected polio immediately (after stool samples have been obtained). A stock of IPV-containing vaccine is retained centrally for this purpose, and will be issued on the advice of the Health Protection Agency (HPA) or HPS.
  • IPV-containing vaccine may also need to be given immediately, after a case of paralytic poliomyelitis from wild virus, to other individuals in the neighbourhood of the case, regardless of a previous history of immunisation against poliomyelitis
  • in the event of a larger outbreak, it may be necessary to consider the use of the appropriate monovalent-OPV (m-OPV).
  • urgent advice should be sought from the HPA (Colindale) who may be able to access a supply of appropriate m-OPV. Other appropriate control measures should be instituted in discussion with HPA Colindale (HPS in Scotland) and will depend upon the nature of the case and the likely vaccine coverage in the affected group or locality

Reference:

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