Form

Polio AFP and AFM surveillance: laboratory sample submission

Laboratory sample submission form (E72) for the investigation of polio, acute flaccid paralysis (AFP) and acute flaccid myelitis (AFM) surveillance.

• From: UK Health Security Agency
• Published: 6 July 2023

Documents

Polio AFP and AFM surveillance: laboratory sample submission form (E72)

Ref: GOV-14954

PDF, 698 KB, 1 page

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Details

Healthcare practitioners should complete this form and send it with clinical samples to the Polio Reference Service for investigation of polio infection, particularly in suspected paediatric AFP or AFM and for polio surveillance.

Faeces is the preferred sample type (see National polio guidelines) although other sample types may be considered. Ideally, a discussion with the laboratory is encouraged prior to the submission of alternatives.

Send the completed form with clinical samples to:

Virus Reference Department (VRD)

UK Health Security Agency
61 Colindale Avenue
London
NW9 5HT

Email vrdqueries@ukhsa.gov.uk

Telephone 020 8327 6017

DX address UKHSA Colindale VRD, DX 6530006

For serology testing please see Poliomyelitis: indications for serological testing.

For submission of epidemiological information please refer to the Polio surveillance form.

Published 6 July 2023