Acute flaccid paralysis in Australian children

Authors

  • AMS Morris,

    1. 1 Australian Paediatric Surveillance Unit, The Children's Hospital at Westmead, 2 Department of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, 3 National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, 4 Australian National Polio Reference Laboratory, Melbourne, Victoria and 5School of Population Health, University of Queensland, Brisbane, Queensland, Australia
    Search for more papers by this author
  • 1 EJ Elliott,

    1. 1 Australian Paediatric Surveillance Unit, The Children's Hospital at Westmead, 2 Department of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, 3 National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, 4 Australian National Polio Reference Laboratory, Melbourne, Victoria and 5School of Population Health, University of Queensland, Brisbane, Queensland, Australia
    Search for more papers by this author
  • 2 RM D’Souza,

    1. 1 Australian Paediatric Surveillance Unit, The Children's Hospital at Westmead, 2 Department of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, 3 National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, 4 Australian National Polio Reference Laboratory, Melbourne, Victoria and 5School of Population Health, University of Queensland, Brisbane, Queensland, Australia
    Search for more papers by this author
  • 3 J Antony,

    1. 1 Australian Paediatric Surveillance Unit, The Children's Hospital at Westmead, 2 Department of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, 3 National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, 4 Australian National Polio Reference Laboratory, Melbourne, Victoria and 5School of Population Health, University of Queensland, Brisbane, Queensland, Australia
    Search for more papers by this author
  • 1 M Kennett,

    1. 1 Australian Paediatric Surveillance Unit, The Children's Hospital at Westmead, 2 Department of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, 3 National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, 4 Australian National Polio Reference Laboratory, Melbourne, Victoria and 5School of Population Health, University of Queensland, Brisbane, Queensland, Australia
    Search for more papers by this author
  • and 4 H Longbottom 5

    1. 1 Australian Paediatric Surveillance Unit, The Children's Hospital at Westmead, 2 Department of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, 3 National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, 4 Australian National Polio Reference Laboratory, Melbourne, Victoria and 5School of Population Health, University of Queensland, Brisbane, Queensland, Australia
    Search for more papers by this author

 Associate Professor EJ Elliott, Australian Paediatric Surveillance Unit, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia. Fax: +61 2 9845 3082; email: elizabe2@chw.edu.au

Abstract

Objectives:  To describe the epidemiology and causes of acute flaccid paralysis (AFP) in Australian children, and the clinical features of the two most common causes of AFP, Guillain−Barré syndrome and transverse myelitis.

Methods:  Monthly active surveillance for AFP was carried out through the Australian Paediatric Surveillance Unit, with AFP defined as ‘acute onset of flaccid paralysis in one or more limbs or of bulbar paralysis in any child less than 15 years of age’.

Results:  Between March 1995 and December 1999, 143 cases of AFP were reported (approximately 0.8 per 100 000 children < 15 years of age per annum). The age range was 2 months−14 years and 59% were boys. Out of these children, 137 (96%) were hospitalized and 47 required intensive care. No case of wild or vaccine-associated poliomyelitis was identified. The most common causes of AFP were Guillain−Barré syndrome in 67 (47%) and transverse myelitis in 27 (19%). Other diagnoses included acute disseminated encephalomyelitis, trauma, tick-bite paralysis and infantile botulism.

Conclusion:  The participation of paediatricians in AFP surveillance contributed to the accreditation of Australia (along with the other 36 countries of the western Pacific region) as ‘polio free’ by the World Health Organization in October 2000. The surveillance also provided data on the frequency of AFP and identified Guillain−Barré syndrome and transverse myelitis as the most common diagnoses. In this large national series, many other conditions that may present as non-polio AFP were identified.

Ancillary