Paralytic poliomyelitis in vaccinated children

Abstract

Although the oral poliovaccine has been effective in the control of poliomyelitis, there are many observations of its failure. To ascertain clinical picture of the disease in vaccinated children and probable causative factors, this study was undertaken. Out of 125 children with Ac. poliomyelitis presented over a period of two years, 16 had received three or more doses of Trivalent-oral poliovaccine. Parents of these children were interviewed to find out possible cause of vaccine failure. All 16 children were below five years, male-female ratio was 9∶7. Twelve received three doses of polio vaccine and four had more doses. Intervals between the last dose of vaccine received and the onset of the disease in all were less than two years. Two had less than one week. Muscle powers in all children at the time of admission were in the range of grade 0/6 to grade 3/6. Poor maintenance of cold chain is probably the only identifiable cause of vaccine failure in 11 children. DPT inoculation along with poliovaccine might be the precipitating factor for paralysis in two children. To overcome these problems there is an urgent need of community involvement in health programmes, reorientation of health workers, a close supervision and steps to improve cold chain. The possibility of using killed poliovaccine should also be explored.