Pulse Polio & AFP Surveillance MCQ Quiz | Foundations & Public Health

Welcome to the specialized MCQ quiz on Pulse Polio and Acute Flaccid Paralysis (AFP) Surveillance, a critical topic within Foundations & Public Health for MBBS students. This assessment is designed to test your understanding of India’s journey to becoming polio-free, the strategies of the Pulse Polio program, and the vital importance of a sensitive AFP surveillance system. Covering key concepts from vaccine types and cold chain management to surveillance indicators and the global endgame strategy, these 25 questions will challenge and reinforce your knowledge. After completing the quiz, you can review your performance, see the correct answers, and download a complete question-and-answer key in PDF format for your future revision. Good luck!

1. What is the primary objective of the Pulse Polio Immunization (PPI) program?

To simultaneously immunize a large number of children in a short period to break the chain of poliovirus transmission.

To provide routine immunization services to all children.

To treat children already infected with polio.

To eradicate measles and mumps.

2. For AFP surveillance, what is the case definition of an Acute Flaccid Paralysis (AFP) case?

Any child with fever and rapid onset of weakness.

Any child under 15 years of age with acute (rapid onset) of floppy paralysis, or paralysis in a person of any age in whom polio is suspected.

Only children under 5 years of age with paralysis lasting more than 3 days.

Any patient with Guillain-Barré syndrome.

3. The non-polio AFP rate is a critical indicator of surveillance sensitivity. What is the WHO-recommended target for this rate per 100,000 children under 15 years of age?

At least 0.5

At least 1

At least 2

At least 5

4. As per WHO guidelines for AFP surveillance, an “adequate” stool specimen consists of:

One specimen collected within 7 days of paralysis onset.

Two specimens collected at least 48 hours apart, within 21 days of paralysis onset.

Two specimens collected 24-48 hours apart, within 14 days of paralysis onset.

One specimen of at least 20 grams collected anytime after paralysis.

5. What does the term “VDPV” stand for in the context of polio eradication?

Viral Derived Polio Vaccine

Vaccine-Derived Poliovirus

Viable D-antigen Poliovirus

Vaccine-Deficient Poliomyelitis Virus

6. The “cold chain” is crucial for maintaining OPV potency. At what temperature should OPV be stored at the PHC/district level?

0°C to 4°C

-15°C to -25°C

+2°C to +8°C

Below 0°C but not frozen

7. In the Polio Endgame Strategy, why was trivalent OPV (tOPV) switched to bivalent OPV (bOPV)?

bOPV is cheaper to produce.

To remove the type 2 component, which was the main cause of circulating VDPV after wild type 2 was eradicated.

tOPV was causing too many allergic reactions.

bOPV provides better protection against wild poliovirus type 1 and 3.

8. India was declared “polio-free” by the WHO. In which year did this official certification take place?

2011

2012

2014

2015

9. What is the role of a Vaccine Vial Monitor (VVM) on an OPV vial?

To indicate the expiry date of the vaccine.

To show if the vaccine has been exposed to excessive heat.

To count the number of doses administered from the vial.

To confirm the vaccine is not counterfeit.

10. “Mop-up” immunization rounds are conducted in response to:

The beginning of the polio transmission season.

Low coverage in a particular area during a routine Pulse Polio round.

The detection of a wild or vaccine-derived poliovirus case.

A request from the local community leaders.

11. Which of the following is an advantage of Inactivated Polio Vaccine (IPV) over Oral Polio Vaccine (OPV)?

It is cheaper and easier to administer.

It provides superior intestinal immunity.

It carries no risk of Vaccine-Associated Paralytic Poliomyelitis (VAPP) or VDPV.

It provides herd immunity through secondary spread.

12. What is meant by “silent” circulation of poliovirus?

Poliovirus that only infects adults.

Poliovirus spreading in a population without causing paralytic cases, often due to high immunity levels.

A strain of poliovirus that cannot be detected by standard lab tests.

The period before the onset of paralysis in an infected individual.

13. Besides stool samples from AFP cases, what other method is used for poliovirus surveillance, especially in high-risk areas?

Blood serology surveys.

Environmental surveillance (testing sewage water).

Household contact tracing and interviewing.

Testing of farm animals for zoonotic transmission.

14. What percentage of AFP cases should be investigated (visited by a health worker) within 48 hours of notification to meet surveillance quality standards?

At least 50%

At least 70%

At least 80%

At least 95%

15. The “P” form used in AFP surveillance is for:

Initial case reporting and investigation.

60-day follow-up examination to check for residual paralysis.

Laboratory reporting of stool sample results.

The final classification of the AFP case by the expert committee.

16. The Global Polio Eradication Initiative (GPEI) is a partnership led by national governments and five core partners. Which of the following is NOT one of the five core partners?

World Health Organization (WHO)

Rotary International

UNICEF

World Bank

17. Which serotype of Wild Poliovirus (WPV) is the only one that remains endemic in the world today?

WPV1

WPV2

WPV3

All three are still endemic in some regions.

18. What is the minimum recommended size for a stool sample collected from an AFP case?

2 grams (thumbnail size)

5 grams

8 grams (thumb size)

15 grams

19. If an AFP case has inadequate stool samples, the case is classified based on:

Clinical judgment of the treating physician alone.

The presence or absence of residual paralysis at 60-day follow-up.

The vaccination status of the child.

It is automatically classified as non-polio AFP.

20. What is the target age group for children in the Pulse Polio Immunization program in India?

0-1 year

0-5 years

0-10 years

0-15 years

21. In the context of AFP surveillance, what is a “hot case”?

An AFP case with a high fever.

An AFP case in a child with zero OPV doses or an AFP case in a community with low immunization coverage.

The first AFP case reported in a district in a calendar year.

An AFP case that tests positive for a non-polio enterovirus.

22. What is the primary reason for administering multiple doses of OPV to a child during PPI rounds?

To treat any existing subclinical polio infections.

Each dose boosts immunity against a different serotype.

To ensure that children who may not have seroconverted after previous doses develop immunity.

The vaccine’s effect wears off after a few months.

23. An AFP case is classified as “polio-compatible” when:

The clinical picture strongly resembles polio, but lab tests are negative.

The case has inadequate specimens and dies, is lost to follow-up, or has residual paralysis at 60 days.

The child’s family has a history of polio.

The case occurs in a polio-endemic country.

24. The ‘reverse cold chain’ refers to:

The process of warming vaccines before administration.

The system of transporting stool specimens from the field to the laboratory under refrigerated conditions.

The disposal of used vaccine vials.

Returning unused vaccines to the district storage facility.

25. Which strategy was key to India’s success in reaching migrant and mobile populations during PPI rounds?

Only offering vaccination on weekends.

Using newspaper advertisements.

Establishing transit vaccination booths at bus stands, railway stations, and construction sites.

Providing financial incentives for vaccination.

G S Sachin

I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.

Mail- Sachin@pharmacyfreak.com

Pulse Polio & AFP Surveillance MCQ Quiz | Foundations & Public Health

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