Paper II
Question
Prophylaxis of poliomyelitis.
Answer
Prophylaxis of poliomyelitis relies primarily on active immunization:
- Oral Polio Vaccine (OPV) — live attenuated, given orally; induces both systemic (IgG) and local intestinal mucosal (secretory IgA) immunity, important for interrupting faecal-oral transmission and achieving community immunity; the mainstay of global eradication campaigns.
- Inactivated Polio Vaccine (IPV) — killed vaccine, given by injection; induces systemic immunity without any risk of vaccine-associated paralytic poliomyelitis (a very rare complication of OPV).
- Schedule: multiple doses in infancy as part of the routine schedule, supplemented in endemic/high-risk countries by mass Supplementary Immunization Activities (“Pulse Polio” campaigns).
- General measures: safe drinking water, sanitation, hand hygiene (reducing faecal-oral transmission).
- Surveillance: acute flaccid paralysis (AFP) surveillance in children under 15 for early detection of residual poliovirus circulation.