title: Poliomyelitis: 20 years--the Pondicherry experience.
abstract: During a 20-year period, 12,830 cases of acute poliomyelitis in children (aged 1 month-12 years) were seen in a South Indian teaching hospital (Pondicherry). Almost three-quarters (72.4%) of children were below the age of 2 years. The median age at onset of poliomyelitis shifted from 19.5 months (in the period 1968-1977) to 11 months (in the years 1978-1987). After 1981, epidemic peaks were noted every third year. 66.3% of cases had not received even a single dose of oral polio vaccine and 14.7% cases were vaccine failures (in the years 1983-1987). Provocation of poliomyelitis occurred in 66% of children and usually followed intragluteal injections associated with treatment of non-specific fevers. The overall mortality was 2.13%, the major cause of death being respiratory failure (60%). Polio virus type 1 was the major isolate among selected cases studied during 1983-1987. The risk factors identified in our study are lack of immunization and administration of intramuscular injections during the pre-paralytic phase. Ensuring early administration of multiple doses of oral polio vaccine to infants and avoiding intramuscular injections in young febrile children are important measures for the control of poliomyelitis--a continuing problem in Southern India.
authors.affiliation: Department of Pediatrics, Fawaharlal Institute of Post-Graduate Medical Education and Research, Pondicherry, India.
authors.forename: S
authors.initials: S
authors.lastname: Mahadevan
authors.forename: S
authors.initials: S
authors.lastname: Ananthakrishnan
authors.forename: S
authors.initials: S
authors.lastname: Srinivasan
authors.forename: P
authors.initials: P
authors.lastname: Nalini
authors.forename: R K
authors.initials: RK
authors.lastname: Puri
authors.forename: S
authors.initials: S
authors.lastname: Badrinath
authors.forename: R S
authors.initials: RS
authors.lastname: Rao
mesh_terms: D000367:Age Factors; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007114:Immunization; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D011051:Poliomyelitis / Q000453:epidemiology* / Q000401:mortality; D017955:Poliovirus / Q000302:isolation & purification; D011055:Poliovirus Vaccine, Oral / Q000008:administration & dosage*; D012307:Risk Factors; D012621:Seasons; D012737:Sex Factors
chemical_list: D011055:Poliovirus Vaccine, Oral