UP case is TB meningitis, not polio

Aditi Tandon

Tribune News Service

New Delhi, July 23

India continues to be polio-free with the recent suspected case from Uttar Pradesh turning out to be negative for the debilitating wild polio virus.

The Health Ministry today said the reported case of Acute Flaccid Paralysis (AFP), detected in Balrampur on June 18, was not polio. Advanced tests of the stool samples from the affected six-year-old patient have shown the case was TB meningitis.

“We have received the reports for stool sample. It is not polio. It is TB meningitis. We pick up non polio Acute Flaccid Paralysis cases to the extent of 50,000 on an average annually. As per WHO protocol, we have to investigate each such case to rule out polio because polio is one of the many causes of AFP just like TB meningitis is,” Pradeep Haldar, Deputy Commissioner, Immunization, in the Health Ministry told The Tribune today.

The results of UP case come as a relief for India which is sincerely guarding WHO polio free certification since 2014. India has remained free of the circulation of wild polio virus (a condition for polio-free status) since January 2011 when the last case was detected in West Bengal’s Howrah. India was the last among WHO South East Asian Region countries to be declared polio-free.

Since WHO grants only region-wise polio-free certification, the entire region comprising 11 nations was declared polio-free after India got rid of the virus in 2014 (after three successful years of zero virus circulation since 2011).

One of the necessities to remain wild polio-free is regular surveillance of AFP cases to rule out the disease. AFP is an acute onset of a flaccid paralysis of one or more limbs with decreased or absent tendon reflexes in the affected limbs, without other apparent cause, and without sensory or cognitive loss and is symptomatic of polio though it has other infectious and non infectious causes.

In India, the last time bulk AFP cases were found polio related was in 2009 when out of 50405 annual cases of AFP, 741 were wild polio virus cases. Since then India has seen around 55000 AFP cases annually but none polio related.

The WHO recommended protocols and its Global Polio Eradication Programme requires nations to probe every AFP to rule out polio. Highly sensitive surveillance for AFP including immediate case investigation and specimen collection is be to detection of wild poliovirus circulation with the ultimate objective of polio eradication in the world.