I Chung, BHY Chung, SHS Chan

Abstract

Poliovirus spread has been described as a "Public Health Emergency of International Concern" despite effective immunisation programmes. With the rare but serious adverse effect of vaccine-associated paralytic poliomyelitis after oral polio vaccination, the target for global eradication has evolved to include both endemic and vaccine-related poliomyelitis. Until oral vaccines are completely withdrawn, the risks of vaccine-associated paralysis continue to exist, requiring a high index of suspicion and timely investigations to evaluate the etiology of acute flaccid paralysis. Here we present a four year old boy with acute paralysis one month after oral polio booster dose. This case illustrates how vaccine-associated paralytic poliomyelitis should be queried as a possible differential during the work-up for acute flaccid paralysis, especially after excluding all other causes and in the context of a positive immunisation history.