With the protocol and methodology described under the «Integrated Program for the Certification of Poliomyelitis Eradication» – Protocol 1 – the results of the retrospective record review for acute flaccid paralysis (AFP), conducted between November 1997 and February 1998 in both major hospitals in Macau, are as follows.

The first retrospective record search was conducted at the Centro Hospitalar Conde de S. Januário (CHCSJ); the period covered was 1 January 1993 to 31 December 1997.

Out of 2,731 cases listed (children less than 15 years old), a total of 56 cases were further reviewed by pediatricians and submitted for final evaluation and classification to the expert committee. No case of poliomyelitis was found.

Six cases of AFP were identified:

1. Guillain-Barre Syndrome (ICD.9: 357.0) with onset in 1993;

2. Spinal cord anaplastic astrocytoma (ICD.9: 191.9) with onset in 1993;

3. Lymphangioma (ICD.9: 357.0) with onset in 1994;

4. Guillain-Barre Syndrome (ICD.9: 357.0) with onset in 1995;

5. Epidural hematoma (ICD.9: 432.0) with onset in 1997; and

6. Herpes encephalitis (ICD.9: 054.3) with onset in 1997.

The second retrospective record search was conducted at the Kiang Wu Hospital (KW), with a methodology similar to that used in CHCSJ; the period covered was also 1 January 1993 to 31 December 1997.

After screening all the admission diagnoses in KW, a total of 447 suspected cases in children less than 15 years of age were listed. Out of these 447, a total of 85 cases were further reviewed by pediatricians and submitted to the expert committee.

Four cases of AFP were identified:

1. Preliminary diagnosis of poliomyelitis with onset in 1993, referred to CHCSJ for further evaluation, where it was finally diagnosed as "spinal cord anaplastic astrocytoma" (ICD.9: 191.9). This case was also identified during the first record search under no.2. The patient died in 1995;

2. Peripheral neuritis (ICD.9: 352.9) with onset in 1996;

3. Preliminary diagnosis of acute meningomyelitis with onset in 1997, referred to CHCSJ for further evaluation where it was diagnosed as "epidural haematoma" (ICD.9: 432.0). This AFP case was also identified during the first record search under no.5. It was first reported by KW and investigated under the active surveillance system; and

4. Preliminary diagnosis of virus encephalitis with onset in 1997, referred to CHCSJ for further evaluation where it was finally diagnosed as "herpes encephalitis" (ICD.9: 054.3). This AFP case was also identified during the first record search under no.6. It was first reported by KW Hospital and investigated under the active surveillance system.

Summary of AFP cases

© Fernando Costa Silva, 1999

© Tong Ka Io, 1999