Epidemiological and clinical features of acute poliomyelitis children admitted in an urban hospital.

Six hundred and fourteen acute poliomyelitis children (57% boys) admitted to the Institute of Child Health, Madras, during January 1988 to September 1989 were studied. Diagnosis was based on clinical grounds. The age ranged from 2 months to 75 months. Residents of Madras city area were 31%, the rest being from neighbouring district (55%) and states (14%). Only 24% got protected water supply and 26% had access to safe disposal of excreta. Only a quarter (26.4%) had been immunized with 3 or more doses of oral polio vaccine. Intramuscular injection was given in 70% within one month of onset of paralysis. The commonest presentation was spinal form (80%) followed by spinobulbar (18%) and bulbar form (2%). Paralysis was severe in 72%, moderate in 6% and mild in 22%. Case fatality was 3.3%. The age at paralysis and clinical features in India have not changed over years. We conclude that the immunization programme should be effectively implemented to the maximum efficiency especially for the poor/illiterate community. Clinicians must be educated to avoid unwarranted intramuscular injections for any febrile illness.