>It's sounds like good advice to me.
>
>(But I'm really bugged by the notion that I'm meant to record it as CPD or
>it doesn't count)
>
>Regards
>
>Jeff
Jeff,
Many thanks for all this info.
No-one doubts that VAPP occurs, or that the virus can be transmitted. The
fact that you report not a single confirmed case of methotrexate associated
paralytic polio does though lead me to question the conclusion.
Most people on methotrexate for arthropathy or psoriasis are not in
isolation, they are exposed to countless infections all the time. Of
course their immune system is modified - that is the point of the
treatment, but to what degree?
This is (no criticism of you at all) partial knowledge and inference,
something I've come to distrust over the years.
It sounds to me like someone thought it was a good idea and so it's got
copied - but perhaps I'm entirely wrong because .... I don't trust my own
partial knowledge and inference either ;-)
Many thanks again,
Best wishes,
Julian
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