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Epidemic Control Toolkit
for community volunteers
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Last update: 2022-06-07

Key facts


  • Touching the mouth with hands or objects (for example, toys) that are contaminated by the stools of a person infected with polio
  • Drinking water or food contaminated by the stools of a person infected with polio


  • Starts with fever, tiredness, headache, vomiting, stiffness of the neck or back, or pain or stiffness in the arms or legs.
  • Symptoms of “acute flaccid paralysis” or AFP are: sudden loss of reflexes (movement), severe muscle aches or weakness, and loose and floppy arms and legs.
  • About one in 200 people with polio is permanently paralysed (unable to move).
  • Among those paralysed, up to a tenth (10 per cent) die because the virus affects the muscles that help them breathe.


  • Routine vaccination
  • Handwashing with soap (especially after using the toilet or cleaning a child)
  • Use of appropriate sanitation facilities (sound, clean latrines with proper faecal sludge management)
  • Social mobilization and behaviour change communication

Vulnerable people

  • Children who are not vaccinated are most at risk
  • Children living in areas with poor hygiene, sanitation and water infrastructure and services

If an epidemic occurs

  • Promote mass vaccination campaigns
  • Initiate community-based surveillance
  • Rapidly detect and refer suspected cases to health facilities
  • Increase social mobilization and behaviour change communication
  • Promote handwashing with soap (especially after using the toilet, defecating, or cleaning a child)
  • Promote use of appropriate sanitation facilities (sound, clean latrines that are well maintained and have proper faecal sludge management)
  • Promote safe, clean drinking water (including a clean, covered water container in the household)

Community-based assessment - questions

Make a map of the community and mark the information you gather on the map. Record other details.

  • When did the person first experience acute flaccid paralysis (AFP)?
  • How many people have experienced acute flaccid paralysis?
  • How many people have fallen sick with other polio symptoms? Where?
  • Was that person fully vaccinated against polio?
  • How many people live in the affected community?
  • How many children under 15 years old live in the affected community?
  • Are children in the affected community vaccinated for polio (orally or by injectable vaccine)? How many are not?
  • Do strong cultural beliefs or perceptions about vaccination prevent children from being vaccinated?
  • Who and where are the vulnerable people?
  • Are there any health services? Where?
  • Have the health services been alerted to a potential polio case?
  • Is a vaccination campaign planned?
  • Is a social mobilization or health promotion programme in place?
  • Which sources of information do people use most?
  • Are rumours or is misinformation about the disease spreading in the community?

 A child with acute flaccid paralysis (AFP)