India Polio-free, but NPAFP looms

Though the World Health Organisation (WHO) has declared India a polio-free country, a similar condition termed “Non Polio Acute Flaccid Paralysis” or “NPAFP” continues to be a cause for concern among the medical fraternity.

Cases of NPAFP are still being reported across the country with Maharashtra having the third highest number of NPAFP cases in India (865 were recorded in 2015). NPAFP causes polio-like residual paralysis and inflammation of brain, and any child up to five years of age can fall prey to it. However, in Maharashtra, the number of cases has seen a steep fall in 2015 as compared to previous years. In 2012, 3,053 NPAFP cases were recorded in the state which fell to 2,862 cases in 2013 and 2,647 cases in 2014. According to medical experts, any sudden muscle paralysis is termed as Acute Flaccid Paralysis. Stool samples are then sent for analysis to identify if it is polio. If it is not polio, it is termed NPAFP. “It is twice as deadly as polio. In many cases, children suffering from NPAFP also die because of it,” said Dr Radha Krishnan, a paediatrician from the city.

A study by Dr Jacob Puliyel, a Delhi-based paediatrician, shows that in places like Uttar Pradesh, Bihar and Maharashtra, where overdose of polio vaccines is given, there are higher number of NPAFP cases reported. “The overuse of polio vaccination might have contributed to the rise of NPAFP cases. It is directly proportional to the amount of doses to the number of NPAFP cases,” said Dr Puliyel.

However, India still lacks infrastructure to find out various types of viruses that lead to such cases. An official from the state immunisation programme said, “When we get any stool sample of Acute Flaccid Paralysis, we just analyse it as polio positive. We don’t probe further to find out the other possible causes of paralysis.”

Dr Puliyel said there were several viruses that could cause paralysis, so, it was not possible for a single lab to conduct tests related to all types of viruses.