REPORTABLE DISEASES TOOLKITInformation for Health Care Professionals

Reporting Obligations

REPORTING FORM

Epidemiology

Risk Factors/Susceptibility

Diagnosis & Laboratory Testing

TESTING INFORMATION & REQUISITION

Treatment & Case Management

Back to REPORTABLE DISEASES

Additional ResourcesReferences

Acute Flaccid Paralysis (AFP)

Confi rmed and suspected cases shall be reported to local Health Unit.

Aetiologic Agent: Acute Flaccid Paralysis (AFP) is the clinical presentation of a set of symptoms, and is not a fi nal diagnosis. Surveillance is conducted in an attempt to identify cases of AFP and to investigate all reported cases for evidence to rule out poliomyelitis (polio), which is essential for polio eradication. AFP may be caused by a number of agents. The immune-mediated condition Guillain-Barr Syndrome (GBS) is the most common cause of AFP in Canada. The causes of AFP, some of which lead to GBS, include, but are not limited to, enteroviruses (including poliovirus), echoviruses, adenoviruses, acute West Nile virus infection, campylobacter spp., transverse myelitis, peripheral neuropathy, acute non-bacterial meningitis, brain abscess, China syndrome, post-polio sequelae, tick paralysis, myasthenia gravis, porphyria and botulism. Poliomyelitis must be distinguished from other paralytic conditions by isolation of poliovirus from stool.

Clinical Presentation: Acute onset of focal weakness or paralysis, characterized as fl accid without other obvious cases (e.g., trauma), in children less than 15 years old.

The most characteristic feature of AFP associated with paralytic polio is its asymmetric distribution (not aff ecting both sides equally), which aff ects some muscle groups while sparing others, with fever present at onset. The most typical pattern is involvement of one leg only, or on arm, although this occurs less often. It is less common for both legs or both arms to be aff ected.

AFP due to Guillain-Barr Syndrome (GBS) may present as symmetrical paralysis and may progress for up to 10 days.

Modes of transmission: Depends on causative agent.

Incubation Period: Depends on the causative agent.

Period of Communicability: Varies, depending on causative agent.

1. PHAC. Poliomyelitis (Polio) Vaccine- Preventable Diseases, December 4, 2013.

2. PHAC. Acute fl accid paralysis surveillance: a global platform for detecting and responding to priority infectious disease, 2004.

3. Pan American Health Organization. Acute fl accid paralysis case investigation form, 2012.

4. Heymann, D.L. Control of Communicable Disease Manual (19th Ed.). Washington, American Public Health Association, 2008.

1. Ministry of Health and Long Term Care, Infectious Diseases Protocol, 2013.

Depends on causative agent.

Clinically confi rmed case: Acute onset of focal weakness or paralysis characterized as fl accid (reduced tone) without other obvious cause (e.g. trauma) in children