India’s
National Expert Review Committee (ERC) for polio eradication
was established in 2000 in preparation for the transition
in January 2000 from clinical classification to virologic
classification of acute flaccid paralysis (AFP) cases. The
role of the ERC is to provide expert advice on the final classification
of AFP cases from which adequate stool specimens could not
be obtained, resulting in a lack of virologic evidence to
classify a case as polio or non-polio AFP.
The
ERC meets monthly at NPSU to review case records for all cases
with inadequate stool specimens, to classify these cases as
compatible with polio
or discarded as non-polio
AFP.
WHO
Virologic Classification Scheme
Aspects
that are taken into account by the ERC in classification of
these cases include detailed clinical information (the patient’s
medical record, age of the patient, the number of oral polio
vaccine (OPV) doses, presence and characteristics of residual
paralysis or weakness, results of nerve conduction and other
specialized ancillary laboratory tests, clinical photographs)
as well as epidemiologic aspects of the case (area of origin,
clustering of this case with others, travel history and possible
exposure to wild poliovirus). The mandate of the ERC is to
discard cases as non-polio AFP only if they can be absolutely
confident that the case is not compatible with polio; if any
doubt exists, then the case is classified as compatible
with polio. Polio-compatible cases may
be viewed as evidence of a failure of surveillance, and serve
as a reminder that all efforts must be undertaken to ensure
that adequate stool specimens are collected from every
AFP case.
Expert
Review Committee Members
Dr
R.N. Srivastava, MBBS,MD, Former Professor of Pediatrics,
All India Institute of Medical Sciences, New Delhi. Past President
of Indian Academy of Pediatrics. Presently Consultant Pediatrician,
Indraprastha Apollo Hospital, New Delhi
Dr
Lalit Kant, MBBS, MD, M Sc (Comm Dis Epid), FLSHTM, FIPHA;
Sr Deputy Director General, Division of Epidemiology &
Communicable Diseases, Indian Council of Medical Research,
New Delhi
Dr G Kumaresan, MBBS,MD (Pediatrics), DM (Neurology), Professor
of Pediatric Neurology, Madras Medical College, Institute
of Child Health and Hospital for Children, Chennai
Dr
P Biswal, Ass’t Commissioner (Immunization), Ministry
of Health & Family Welfare, New Delhi (Member Secretary)
Dr Bina Ahuja, MBBS,MD (Pediatrics), former Head PMR Dept,
Kalawatisaran Children’s Hospital, New Delhi
Dr Jagadish M. Deshpande, Director, Enterovirus Research Centre,
Mumbai
Dr. Veena Kalra, Professor and Head, Dept of Pediatric, Pediatric Neurologist – AIIMS, New Delhi, Dept. of Pediatric, AIIMS, Ansari Nagar, New Delhi – 29
