A 7-year-old boy in a remote village develops acute flaccid paralysis of the left lower limb without fever, 5 days after receiving the oral poliovirus vaccine during a pulse immunization campaign. The limb shows hyporeflexia and asymmetric weakness. Which VAPP-specific criterion makes vaccine-associated paralytic poliomyelitis most likely?
- A Onset more than 60 days after OPV dose
- B Onset within 6–30 days of OPV dose (recipient VAPP) ✓
- C Bilateral and symmetric flaccid paralysis
- D Presence of meningeal signs and high CSF protein
Correct answer: B. Onset within 6–30 days of OPV dose (recipient VAPP)
Explanation
Vaccine-Associated Paralytic Poliomyelitis (VAPP) in the OPV recipient is defined by onset of AFP 4–30 days after OPV administration (most commonly 7–21 days). Contact VAPP occurs in unvaccinated close contacts within 60 days of vaccine administration to a child. Key features: asymmetric flaccid paralysis, residual deficit at 60 days, positive culture of vaccine-related poliovirus. VAPP risk is 1 per 750,000 first doses. Symmetric paralysis, meningism, or late onset would not support VAPP.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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