Surveillance of acute flaccid paralysis in Australia, 1995-97

Objective: Acute flaccid paralysis (AFP) surveillance in Australia as part of the World Health Organization (WHO) certification process for polio erad ication in the Western Pacific region. Methods: Active monthly AFP surveillance through the Australian Paediatric Surveillance Unit, from March 1995 to December 1997. Results: Based on 80 cases, the reported overall rate of AFP was 0.73 per 1 0(5) children < 15 years (below the expected I per 105). Th, major causes o f AFP were Guillain-Barre syndrome (51%) and transverse myelitis (19%). Acc ording to the WHO virological classification, there was no case of poliomye litis, 37.5% were 'non-polio' and 62.5% cases were 'polio compatible' due t o inadequate stool testing and follow-up. However, case review by an expert panel enabled 95% to be classified as 'non-polio'. Conclusion: Australia must improve AFP surveillance to confirm absence of w ild poliovirus. Paediatricians can help Australia meet its certification re quirements and contribute to the global eradication effort by reporting and investigating all cases of AFP.