·- Government of West Bengal Department of Health and Family Welfare State Family Welfare Bureau Wing- A, 3rd Floor, Swasthya Bhavan GN 29, Sector- V, Salt Lake, Kolkata- 700091 Memo No. HFW-35099/15/2019-SFWB/43 ':f-- ~ ~ To, The MSVP, all Medical College and Hospitals West Bengal Dated. j ig /06/2020 Sub: Strengthening of Acute Flaccid Paralysis (AFP) and Case Based Measles Rubella (MR) Surveillance You are aware that following World Health Assembly decision in 1988 to eradicate poliomyelitis, India along with other signatory member countries has resolved to eradicate the disease from the worl d. It is indeed an accomplishment for all of us that India has remained Polio-fr ee for more than seven years. But our challenges are not yet over. There is an ongoing wild virus transmission in Pakistan & Af ghanistan. We must not forget that as long as virus is there in circulation, anywhere in the world, there is always a possibility of reintroduction into our country. Under this circumstance the role of tert iary care hospitals in leading this programme assumes utmost import ance to maintain the highest standards of Acute Flaccid Paralysis (AFP) Surveillance. Again Measles is a leading cause of Vaccine preventable death in India. In 20 15, India accounted for 37% of global measles death (49,200 of 134,200). In 66th SEAR Committee meeting of WHO in September 2013, it was resolved to adopt the goal of "Measles Elimination and Rubella / CRS Control by 2020". As a part of global Measles Elimination strategy, all suspected measles and rubella cases are to be notifi ed to District Maternal and Child Health Offi cer (DMCHO) /Surveillance Medical Offi cer(SMO) of WHO In order to reach the target, we must continue to strengt hen Measles-Rubella Surveillance in the State. Role and Responsibilities of Tertiary care hospitals in AFP and Case Based MR Surveillance- l , Nodal and back up nodal person are to be identifi ed in all health facilities to ensure prompt case reporting. 2. Write Acute Flaccid Paralysis (AFP) / Suspected Measles or Rubella cases along with Provisional Diagnosis in BHT, ER, OPD and Admission Register. Record in details name, address and phone number for future tracking. I. Active Case search through all Hospital Registers has to be undert aken with immediate eff ect in the hospitals at weekly interval by RMO of concerned departments for AFP (Paediatrics, Medicine, Neur ology, Orthopedics, Physical Medicine and ENT) and for Measles and Rubella (Paediatrics, Medicine, G&O, Dermatology) 3. Immediate notifi cation of all suspected AFP and MR cases to DMCHO I SMO of WHO followed by Case Invesigation in prescribed format to be carried out (CIF/MR -CIF)). 2. Advice for "Stool for Virology" has to be given in BHT and ensure timely collection of two stool samples from each AFP case by maintaining cold chain. 3. Advice for Blood sample for LgM study/ Throat sample for virology and genetic sequencing. Serum/throat swab to be collected and sent to DMCHO of the notifi ed district by report ing hospital for confir mation of disease. Involve laboratory personnel for blood collection and serum.separation. The Collection kits, VTM are to be supplied fr om NPSP-WHO. 4. DMCHO and SMO has to be given any time access to review and retrieve any hospital Records(BHT Admission Register, Discharge Register, Casuality Register, OPD Register etc) for AFP and MR Surveillance. DMCHO/SMO should also sign in the Registers aft er Active Case Search (ACS). 5. Compilation and upward transmission of Weekly report (VPD H002) on next Monday regularly. 6. Proper record keeping (Updated line list, Updated CIF, YPD HOOi/ H002/ H003/ H003a) and feedback register in Report ing Sites is essential for Surveillance Audit. 7. Help to procure Hospital records (BHT and Investigation Reports) for Expert Review Committ ee documentation of inadequate AFP Cases/Vaccine Virus/wild Virus cases) Page 1 of 2