A 6-month-old infant develops acute flaccid paralysis of the left leg 30 days after receiving the first dose of oral polio vaccine. There is no sensory loss and deep tendon reflexes are absent. Which of the following is the most likely cause?

• A Non-polio enterovirus infection
• B Guillain-Barré syndrome
• C Transverse myelitis
• D Vaccine-associated paralytic poliomyelitis ✓

Explanation

Vaccine-associated paralytic poliomyelitis is a rare adverse event following oral polio vaccine, caused by reversion of the attenuated vaccine virus to a neurovirulent form. It typically occurs within 30 days of vaccination. Guillain-Barré syndrome presents with ascending paralysis and elevated CSF protein. Transverse myelitis has a sensory level. Non-polio enteroviruses can cause AFP but the temporal link to OPV points to VAPP.

Reference: Park's Textbook of Preventive and Social Medicine, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.