Journal Article

Lessons from Diagnostic Investigations of Patients with Poliomyelitis and Their Direct Contacts for the Present Surveillance of Acute Flaccid Paralysis

Tineke Herremans, Marion P. G. Koopmans, Harrie G. A. M. van der Avoort and Anton M. van Loon

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 29, issue 4, pages 849-854
Published in print August 1999 | ISSN: 1058-4838
Published online August 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/520448
Lessons from Diagnostic Investigations of Patients with Poliomyelitis and Their Direct Contacts for the Present Surveillance of Acute Flaccid Paralysis

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One of the key strategies for the global eradication of poliomyelitis is the virological investigation of stool samples in cases of acute flaccid paralysis (AFP) to exclude poliovirus as a possible cause. Clinical specimens from a serotype 3 outbreak provided an opportunity to examine the potential of newly developed methods for the diagnosis of poliomyelitis. The virus isolation rate was maximal (89.6%) during the first 2 weeks after the onset of paralysis and then dropped sharply to 18.6%. In contrast, a high percentage of patients tested positive for poliovirus-specific IgM (93.9%) in the early phase of the infection and remained positive for up to 8 weeks. Virus isolation would have correctly identified only 54.9% of the AFP cases. This rate would have been increased to 92% through the use of the poliovirus-specific IgM ELISA. The IgM ELISA could serve as an important additional tool for the rapid diagnosis of poliomyelitis.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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