January 25, 2011
Wilson on Haiti's polio outbreak
Via Dr. Jim Wilson's blog Haiti: Operational Biosurveillance: Acute Flaccid Paralysis: Port de Paix and Port au Prince, Haiti and Charlotte, North Carolina. Excerpt (but you'd better read the whole post):
On January 9th, an astute HEAS community member discovered a YouTube video of a patient being transported by ground and fixed wing aircraft by GlobalDIRT from Beraca Hospital in Port de Paix to a hospital in Port au Prince. In the video, they referred to ascending paralysis suspected to be caused by an infectious agent, where 2 other patients with similar symptoms had died.This prompted immediate engagement of the HEAS to:1. Verify the report with Medical Teams International (MTI);2. Confirm that MTI reported the event to local Haitian public health authorities (MSPP);3. Verify the Point(s) of Contact at the receiving hospital for the patient transferred from Port de Paix to Port au Prince4. Notify PAHO/WHO and the US Centers for Disease Control and Prevention given the suspicion of possible poliovirus activityThe HEAS then issued an advisory to the nearly 1,100-member HEAS community on Jan 11th to sensitize them to be vigilant for additional cases. Haitian Ministry of Health (MSPP)-approved reporting criteria for Acute Flaccid Paralysis case reported were shared.In the advisory, it was noted the last case of wild viral infection in Haiti was reported in 1989, and natural disease was declared eradicated as of 1991. However, Acute Flaccid Paralysis (AFP) had been reported every year in Haiti since at least 1998.This HEAS advisory resulted, minutes later, in a report from an HEAS community member of a 12 year old girl that was recently medivac'd to Charlotte, North Carolina and admitted to the PICU with respiratory failure secondary to ascending paralysis.HEAS team members then verified this report with the involved Charlotte hospital and updated CDC and PAHO with the point of contact there. Medical staff of the involved hospital were unaware of the context of concern until the HEAS contacted them.All told, Wilson describes seven cases, with an eighth probable case being the 12-year-old flown to Charlotte, North Caroline. Of the seven, four cases ended in death. Wilson also quotes an HEAS member who described a similar case in Fermate, just after the earthquake, when a teenage boy died of AFP.
This really, really needs attention.
