Lessons from diagnostic investigations of patients with poliomyelitis and their direct contacts for the present surveillance of acute flaccid paralysis

Clin Infect Dis. 1999 Oct;29(4):849-54. doi: 10.1086/520448.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Antibodies, Viral / blood
  • Child
  • Child, Preschool
  • Enzyme-Linked Immunosorbent Assay
  • Feces / virology
  • Humans
  • Immunoglobulin A / blood
  • Immunoglobulin M / blood
  • Infant
  • Infant, Newborn
  • Middle Aged
  • Muscle Hypotonia / etiology
  • Paralysis / etiology*
  • Poliomyelitis / diagnosis*
  • Poliovirus / isolation & purification

Substances

  • Antibodies, Viral
  • Immunoglobulin A
  • Immunoglobulin M